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Kaiser Daily Global Health Policy Report

In The News

Devex Examines PEPFAR Funding To Date

Devex: PEPFAR funding: Taking stock of the latest changes
“As the largest and most impactful global health initiative ever undertaken, the U.S. President’s Emergency Plan for AIDS Relief is credited with saving millions of lives and changing the trajectory of the global HIV epidemic. Since its creation in 2003, PEPFAR has set aside more than $80 billion for HIV bilateral programs across the globe…” (De Vos, 5/13).

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DRC Ebola Treatment Center Attacked Again, As Cases Rise Over 1,700, Experts Debate Benefits, Risks Of Declaring Outbreak An International Emergency

Associated Press: Ebola treatment center attacked again in eastern Congo
“Authorities say an Ebola treatment has come under attack again in eastern Congo. Butembo Mayor Sylvain Kanyamanda said Monday that one of the attackers was killed in the overnight assault in Katwa. Two patients also died after all the nursing staff fled the health facility. The mayor pleaded with residents to support the Ebola response teams…” (5/13).

CIDRAP News: Ebola cases top 1,700 in DRC as 4 health workers infected
“Once again, violent clashes in the Ebola outbreak region of the Democratic Republic of the Congo (DRC) have resulted in a spike of cases. Over the weekend and through [Monday], the DRC’s ministry of health recorded 56 new Ebola cases, including 4 in health care workers, and 19 new deaths. The new cases bring the outbreak total to 1,705, including 1,124 deaths. A total of 251 suspected cases are still under investigation. The total number of health workers infected during the outbreak is now 101…” (Soucheray, 5/13).

Reuters: Political games hinder efforts to end Ebola outbreak in Congo: WHO
“Attempts to end the second worst Ebola outbreak on record are being hampered by ‘political games’ and distrust of outsiders in two towns in Democratic Republic of Congo, a senior World Health Organization official said on Monday. … A rapid international response with an effective vaccine has managed to stop the spread in a string of towns, including Beni, Kyondo, Komanda, Tchomia, Mabalako, Mandima, and Kayna, WHO emergencies chief Mike Ryan said. But in two towns, Butembo and Katwa, there has been persistent infection and reinfection, Ryan told an audience at Geneva’s Graduate Institute…” (Miles, 5/13).

STAT: Could an emergency declaration over Ebola make a bad situation worse?
“…Despite the gravity of the situation, the North Kivu outbreak hasn’t been declared a public health emergency of international concern — a PHEIC in global health parlance. That fact has frustrated some health security experts, who insist it’s long past time to proclaim an international emergency. Other experts argue, however, that labeling this outbreak a global health crisis would not help to halt spread of Ebola in the region. They worry that it could even make an already perilous situation worse…” (Branswell, 5/14).

Additional coverage of the DRC Ebola outbreak is available from Agence France-Presse, AFP/The Observers, and Becker’s Hospital Review.

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News Outlets Examine Challenges, Successes In Pakistan's Efforts To Eliminate Polio

Al Jazeera: Anti-vaxxers stand in way of Pakistan’s final fight against polio
“…Today, Pakistan is one of the last countries with the wild poliovirus, reporting at least 15 cases this year. … In recent years, … Pakistan has been able to celebrate a precipitous drop, after recording more than 300 cases in 2014. Much of this success has been driven by more than 250,000 polio workers who have ventured into remote and inaccessible patches of the country to administer vaccinations to children under the age of five. However, recent eradication efforts have been stymied by suspicion from parents and the public at large that the vaccine is unsafe, driven by misinformation spread on social media…” (Toppa, 5/14).

The Guardian: The women defying menace and mistrust to rid Pakistan of polio
“…[A]rmed with essential vaccine drops and children’s vitamins — not to mention facts, smartphone videos, and the endorsements from doctors, clerics, and celebrities that have become an essential part of attempts to eradicate the centuries-old disease in Pakistan — [polio workers] remain resolute. Nationwide, a quarter of a million frontline workers are involved in efforts to vaccinate the 40 million children in the country under the age of five…” (Lamble, 5/14).

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Red Cross Officials Discuss Aid Efforts In Venezuela In New Humanitarian Interview

New Humanitarian: Q&A | Venezuela aid deal sees Red Cross prioritize health needs and hospitals
“After denying the existence of a humanitarian crisis for years and blocking foreign aid, Venezuelan President Nicolás Maduro struck an unexpected deal in March to allow the International Federation of Red Cross and Red Crescent Societies to assist his increasingly hungry and sick population. One month after the first shipment of medical supplies and generators arrived in Venezuela, the New Humanitarian spoke to Yves Daccord, director general of the International Committee of the Red Cross, and IFRC Secretary General Elhadj As Sy to find out how the mission was going…” (Dupraz-Dobias, 5/14).

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Some Palestinians Shun Foreign Assistance As Need For Food Aid Grows In Gaza

New Humanitarian: Why some Palestinians are shunning foreign aid
“Grassroots platforms to fund aid and development projects have been sprouting up in recent years throughout the West Bank and Gaza, with more groups purposefully steering clear of E.U. or U.S. money, and sometimes going it alone altogether. This trend towards so-called community philanthropy is a major shift for a part of the world consistently ranked among the top recipients of aid per capita — one driven by fears that external assistance can be a vessel for foreign countries to implement their vision of what a Palestinian state should look like, instead of a Palestinian vision for that future…” (Hatuqa, 5/13).

U.N. News: Gaza blockade causes ‘near ten-fold increase’ in food dependency, says U.N. agency
“At a time when Muslims globally are observing the holy month of Ramadan, more than half the population in Gaza depends on the international community for food aid, the director of the United Nations Relief and Works Agency for Palestine refugees in the Near East (UNRWA) said on Monday, citing a ‘near ten-fold increase’ in need. According to UNRWA, it must secure an additional $60 million by June to continue providing food to more than one million Palestine refugees in Gaza…” (5/13).

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Devex Examines Availability Of Fraudulent Vaccination Cards In Nigeria

Devex: Here’s how people in Nigeria are avoiding vaccination
“…[A]lthough 1 in 5 people who contract yellow fever in Nigeria die from it, not everyone gets immunized — and some are finding ways to bypass the travel requirements, increasing the risk of the epidemic-prone disease spreading to other countries. One way to do it is to buy a falsified vaccination card, readily available at the airport for those who either don’t want to be immunized or don’t have enough time before they travel. The Nigerian government told Devex the cards are fake, while evidence at the airport suggests they are authentic but fraudulently obtained. Airport staff and travelers said the cards had been bought at the port health authority’s store, duly stamped and signed as a way of generating underhand revenue for staff. Devex was able to buy one for 3,000 Nigerian naira ($8.50) and no evidence of immunization…” (Adepoju, 5/14).

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Prophylactic Antibiotic Dose Helps Prevent Maternal Infections Following Assisted Births, Study Shows

Reuters: Antibiotics after assisted births could stop thousands of infections
“Giving a single dose of antibiotics to mothers who have a medically assisted birth using forceps or vacuum could prevent almost half of maternal infections, researchers said on Monday, and global health authorities should change their advice. In a study published in The Lancet medical journal, the researchers said prescribing antibiotics as a preventative measure could save more than 7,000 infections in new mothers in the U.K. each year, and around 5,000 in the United States. They called on the World Health Organization (WHO) and other national health agencies to alter their advice in the light of the results…” (Kelland, 5/13).

Additional coverage of the study is available from The BMJ, The Guardian, New York Times, and The Telegraph.

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Plastics, Mismanaged Waste Kill Up To 1M People Annually, Report, Sir David Attenborough Warn

The Telegraph: Plastics killing up to a million people a year, warns Sir David Attenborough
“Sir David Attenborough has warned that the growing tide of plastic pollution is killing up to a million people a year as well as having devastating consequences on the environment. A report on the impact of plastic pollution, one of the first to document the impact of discarded plastic on the health of the poorest people in the world, estimates that between 400,000 and one million people die every year because of diseases and accidents linked to poorly managed waste in developing countries…” (Gulland, 5/14).

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More News In Global Health

Al Jazeera: Inadequate health facilities failing Mozambique’s mothers (Marima, 5/14).

Al Jazeera: Angola drought: Millions at risk of starvation (Mutasa, 5/14).

Al Jazeera: ‘No other option’: Climate change driving many to flee Guatemala (Abbott, 5/13).

Associated Press: U.N. humanitarian chief says 4.3 million in Cameroon need aid (Lederer, 5/13).

The Guardian: China ‘failing trans people’ as young attempt surgery on themselves — study (McVeigh, 5/10).

Homeland Preparedness News: TB Alliance awarded grant for development of two clinical stage TB drugs (Galford, 5/13).

NPR: Why It’s So Hard To Stop Women From Sleeping In A Menstrual Shed (Preiss, 5/13).

NPR: A Very Happy Viral Video With A Sad Backstory (Kumar/Noori, 5/10).

Reuters Health: With cancer rates rising worldwide, oncologist shortage predicted (Carroll, 5/13).

SciDev.Net: Venezuela struggles to halt measles epidemic (Núñez, 5/13).

Wall Street Journal: How a Chinese Scientist Broke the Rules to Create the First Gene-Edited Babies (Rana, 5/10).

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Editorials and Opinions

Global Health Community Should Help Improve Access To Vaccines, Primary Health Care In Middle-Income Countries

Nature: Vaccination lags behind in middle-income countries
Seth Berkley, chief executive of Gavi, the Vaccine Alliance

“…[H]ow do we increase access to vaccines, primary health care, and other essential health interventions in countries that can — at least according to their gross national incomes — afford them? … Despite success in the poorest countries, an analysis [Gavi, the Vaccine Alliance] carried out this year found that since 2010, routine immunization levels have either stagnated or dropped in 54 of 85 [middle-income countries (MICs)] too prosperous to qualify for Gavi support. … [B]y 2030, almost 70% of the world’s under-immunized children will be living in countries ineligible for Gavi’s vaccination programs … MICs need support to strengthen their health systems and to improve how they procure vaccines and regulate them. They need access to information technologies to monitor who is getting vaccines, to target at-risk communities, and to evaluate strategies. And mechanisms are needed that set prices according to what countries can reasonably pay. Prosperous countries should pay more for vaccines. But according to World Health Organization data, the pneumococcal vaccine, for example, costs, on average, eight times more in never-supported MICs than in countries receiving Gavi support, even though the MICs’ gross national incomes and ability to pay might not be commensurately larger. … It is time for the global health community to adapt: we must not leave behind vulnerable populations in middle-income countries” (5/14).

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Urgent Global Response Critical To Reducing Effect Of Plastic Waste On Health

The Telegraph: We need an urgent global response to the plague of plastic
David Attenborough, vice president of Fauna & Flora International

“…[A] report published jointly by … Fauna & Flora International and others highlights for the first time the effect of plastic waste on the health of the world’s poorest people. … A lack of waste collection in developing countries creates dumps of rubbish that provide ideal breeding grounds for rats, flies, and disease-carrying mosquitoes. … Better management of water and waste could lead to an estimated 95 percent reduction in the incidence of dengue. Many communities resort to burning waste releasing toxic chemicals and increasing air pollution. … [These toxic chemicals] increase the risk of diseases such as heart disease and cancer, respiratory ailments such as asthma and emphysema, skin and eye diseases, nausea and headaches, and damage to the reproductive and nervous systems. … This global problem can only be solved if there is an urgent global response. First and foremost, we need leadership from the companies and governments that are responsible for introducing plastic into countries where it cannot be properly managed. Multinational corporations … should be required to disclose the number of single-use plastic items they sell in developing countries and to reduce this by half by the year 2025. … Wealthy countries must also take more responsibilities for the waste they produce. … It is now time for governments, companies, and citizens to work together to find solutions to a crisis that is entirely of our own making, a crisis that now threatens the collective well-being of all the inhabitants, animal and human, that live on this planet” (5/14).

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From the Global Health Policy Community

New HIV Infections Among Children Falling, As Percentage Of Pregnant Women Living With HIV Who Receive Treatment Increases

UNAIDS: HIV infections among children falling
“The continuing fall in the number of children becoming infected with HIV is a major public health triumph. Globally, 1.6 million new child infections were averted between 2008 and 2017, an achievement that stems from a steep increase in the percentage of pregnant women living with HIV who receive antiretroviral medicines to prevent mother-to-child transmission of HIV or as lifelong therapy, from 25% in 2008 to 80% in 2017. However, much remains to be done. Efforts to prevent mother-to-child transmission have been slowed…” (5/13).

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May 2019 Issue Of U.N. Special Magazine Available Online

U.N. Special: May 2019 Issue
The May issue of U.N. Special magazine focuses on the World Health Organization and includes articles on various topics, including an interview with WHO Director-General Tedros Adhanom Ghebreyesus about major achievements of and remaining challenges for the agency; an interview with Tedros about the role of digital health in reaching the targets set out by the WHO’s 13th General Programme of Work; and an article on efforts needed to end TB (May 2019).

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From the Kaiser Family Foundation

KFF Analyzes Global Health Aspects Of U.S. House FY20 SFOPs, HHS Appropriations Bills

Kaiser Family Foundation: House Appropriations Subcommittee Approves FY 2020 State & Foreign Operations (SFOPs) Appropriations Bill; Full Committee Approves Health & Human Services (HHS) Appropriations Bill
The House Appropriations Subcommittee approved the FY 2020 State & Foreign Operations (SFOPs) appropriations bill on May 10, while the full committee approved the FY 2020 Labor, Health and Human Services, and Education (LHHS) appropriations bill on May 8. This budget summary highlights global health-related funding approved in both bills. Funding provided to the State Department and USAID through the Global Health Programs (GHP) account totaled $9.3 billion, an increase of $459 million above the FY 2019 enacted level and almost $3 billion above the President’s FY 2020 request. Funding provided to CDC for global health totaled $514 million, an increase of $25 million above the FY 2019 enacted level and $57 million above the President’s FY 2020 request (5/13).

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