KFF Daily Global Health Policy Report

In The News

Trump Administration Announces Expanded Mexico City Policy; Plan Will Impact Most U.S. Global Health Assistance

ABC News: Abortion restrictions expanded for foreign nonprofits receiving U.S. health funds
“The Trump administration is expanding a policy that requires foreign non-governmental organizations to neither perform nor promote abortion as a method of family planning, if they receive U.S. global health assistance funding…” (Finnegan, 5/15).

Associated Press: Trump details anti-abortion ban over U.S. global health aid
“…Senior administration officials said Monday a plan to expand the so-called ‘Mexico City policy’ had gone into effect. The policy would apply broadly to organizations receiving U.S. global health assistance, compared with past versions of the ban which specifically targeted international family planning groups. … Jen Kates, director of global health and HIV policy at the non-partisan Kaiser Family Foundation, said the policy was a significant expansion compared with past Republican administrations. ‘Right now there’s a lot of unknowns,’ she said. ‘This is a much bigger expansion. And the U.S. role in global health has increased over time. The U.S. footprint right now is quite big in global health’…” (Lucey, 5/16).

CQ Roll Call: Expanded ‘Mexico City Policy’ Unveiled by Trump Administration
“Senior congressional Democrats reacted with dismay Monday to the Trump administration’s announcement it will begin expanding the so-called Mexico City policy from just family planning programs to all U.S. global health assistance, with unknown impacts on billions of dollars in U.S. foreign aid aimed at preventing HIV/AIDS and other diseases…” (Mejdrich/Oswald, 5/15).

Devex: Trump expands ‘global gag rule,’ targeting $8.8B in global health aid
“President Donald Trump’s administration will significantly expand the ‘global gag rule’ to include much of the United States’ global health assistance, placing more than $8.8 billion of funding on the line. The U.S. is rebranding the Reagan-era regulation — which is also called the Mexico City policy — as the ‘Protecting Life in Global Health Assistance’ policy. It previously impacted about $600 million in family planning aid…” (Lieberman, 5/15).

NBC News: Trump Administration Expands Anti-Abortion Foreign Aid Policy
“…The broadened policy referred to as the global gag rule will now affect $8.8 billion in funding for international health programs including those for HIV/AIDS, maternal and child health, malaria, global health security, family planning, and reproductive health. … Governments and multilateral organizations remain outside of the scope of the expanded policy, which also will not apply to humanitarian aid provided through refugee or migration programs or to disaster relief…” (Williams, 5/15).

New York Times: Trump to Expand Funding Ban Tied to Abortion Overseas
“…The rules, issued by the State Department, mean that any foreign nongovernmental group that wants American money for any of its health activities — from AIDS treatment to malaria prevention to safe childbirth practices — must promise not to ‘promote abortion as a method of family planning.’ Already, American taxpayer dollars cannot be used for abortion services abroad…” (Harris/Sengupta, 5/15).

Reuters: Trump administration vastly expands global anti-abortion policy
“…U.S. Secretary of State Rex Tillerson has approved a plan to expand the policy’s provisions to funding for HIV/AIDS, maternal and child health, malaria, and other health programs, the State Department said on Monday. That includes about $6 billion in funding for the President’s Emergency Plan for AIDS Relief, or PEPFAR … Other programs affected by the expanded policy … include the President’s Malaria Initiative…” (Torbati, 5/16).

STAT: Expanded Mexico City Policy could imperil $8.8 billion in global health funding
“…Administration officials stressed that the amount of global health money distributed by the U.S. would not change … A number of global health advocacy groups immediately decried the expanded restriction, saying it would jeopardize preventive health and treatment efforts that depend on American money to operate…” (Swetlitz/Facher, 5/16).

VICE News: Trump administration to slash $8.8 billion in aid to groups that promote abortion access abroad
“…The largest non-governmental provider of contraception worldwide, the International Planned Parenthood Federation, stands to lose about $100 million in funding. The group announced in January that despite these cuts, it would not abide by Trump’s Mexico City policy…” (Sherman, 5/15).

Wall Street Journal: Trump Dramatically Boosts U.S. Anti-Abortion Policy Abroad
“…The administration officials briefed lawmakers and reporters on the policy directive and said the new approach will begin to take effect gradually in coming months as relevant agencies move to implement the necessary steps and grants come up for renewal. ‘The policy…implements what the president has made very clear: U.S. taxpayer money should not be used to support foreign organizations that perform or actively promote abortions as a method of family planning in other nations,’ a senior administration official said…” (Schwartz, 5/15).

Washington Post: Trump expansion of abortion ‘gag rule’ will restrict $8.8 billion in U.S. aid
“…On Monday, both supporters and critics of the policy came out in full force. Marjorie Dannenfelser, president of the Susan B. Anthony List, which supports politicians who oppose abortion, characterized the policy’s expansion as a way of modernizing it. ‘This executive order does not cut a single penny from U.S. aid, rather it simply ensures our hard-earned tax dollars are used by other health care entities that act consistently to save lives, rather than promoting and performing abortion. Abortion is not health care,’ she said in a statement. Democratic Reps. Nita M. Lowey, Eliot L. Engel, and Louise M. Slaughter of New York, and Barbara Lee of California marked the rule’s start by calling it ‘a cruel and unprecedented attack on the world’s most vulnerable women.’ They argued that it undermines U.S. ‘moral leadership abroad’ and could end access to critical health care programs” (Cha/Morello, 5/15).

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U.S. Global Health Spending Supports Nation's Security, National Academies Report Says

ScienceInsider: Global health spending good for U.S. security and economy, National Academies say
“If a serious infectious disease blossomed across the globe today, the U.S. death toll could be double that of all the casualties suffered in wars since the American Revolution. Those two million potential American lives lost to a global pandemic is just one sobering statistic cited in a new report released [Monday] by the U.S. National Academies of Sciences, Engineering, and Medicine that urges sustained U.S. spending on global health initiatives. … The report’s authors make 14 recommendations for intervening in global health across four broad areas: prepping for global disease outbreaks; sustaining funds for responding to AIDS, tuberculosis, and malaria; improving women’s and children’s health; and reducing incidence of cardiovascular disease and cancers in low- and middle-income countries. It also calls for ‘the creation of an International Response Framework to guide the U.S. response to an international health emergency’…” (Cross, 5/15).

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More Than 1.2M Adolescents Die Annually, Many From Preventable Causes, WHO Report Shows

The Guardian: Pregnancy problems are leading global killer of ​​females aged 15 to 19
“Pregnancy complications are the leading cause of death globally among females aged 15-19, with self-harm in second place, a global study has found. More than 1.2 million female and male adolescents die annually, the World Health Organization (WHO) report said — the majority from preventable causes including mental health issues, poor nutrition, reproductive health problems, and violence. The authors said that failing to tackle the health of 10- to 19-year-olds could undermine the improvements achieved in maternal and child health worldwide, pointing out that too often adolescent health was overlooked…” (Davis, 5/16).

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IBTimes U.K. Speaks With WHO DG Candidate David Nabarro, Discusses Organization's Upcoming Election

International Business Times U.K.: Who is David Nabarro, the U.K. candidate to lead the World Health Organization?
“David Nabarro is the U.K. candidate to become the next director general of the World Health Organization. After four decades working as a community-based practitioner, public servant, and diplomat on the international scene, he is ready to address the most pressing global health challenges of our time…” The newspaper features an interview with Nabarro (Surugue, 5/16).

International Business Times U.K.: ‘Bureaucratic, weak and ineffective’: How we can reform the World Health Organization
“… ‘Ebola uncovered all of WHO’s previous weaknesses — an inability to get the necessary resources, poor coordination and communication with WHO regional offices, the lack of an open society approach embracing NGOs and addressing the cultural impact of disease. Despite the loss of life, no single person at WHO accepted responsibility. That would not happen in a well-functioning organization,’ Lawrence Gostin, global health law specialist at Georgetown University, tells IBTimes U.K. The election of the director general may thus be the perfect time to initiate powerful reforms in key areas of the organization which are particularly in need of a shake-up…” (Surugue, 5/16).

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Death Toll In Yemen's Cholera Outbreak Reaches 180 People, ICRC Reports

NPR: Why A Man Is On An IV In His Car Outside A Hospital In Yemen
“On Monday, authorities in Yemen declared a state of emergency due to a sharp rise in cholera deaths. … From Aden, Yemen, Dominik Stillhart, director of global operations at the International Committee for the Red Cross, talked with NPR’s Ari Shapiro about the cholera outbreak and the dire state of health care in Yemen…” (5/15).

Reuters: Cholera outbreak death toll in Yemen rises to 180: ICRC
“A cholera outbreak in Yemen has killed 180 people since April 27, the International Committee of the Red Cross (ICRC) said on Monday, hours after the Houthi-controlled health ministry said 115 had died from the disease in the capital Sanaa…” (Mukhashaf/El Yaakoubi, 5/15).

Wall Street Journal: Amid Yemen’s War, Another Scourge Strikes: Cholera
“…In declaring the health emergency and issuing a plea for international aid on Sunday, the Houthis’ health minister said the cholera outbreak had exceeded the capacity of any country’s health system to handle, let alone one operating in the midst of war, now in its third year…” (al-Kibsi/Fitch, 5/15).

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Indian Court To Decide Whether 10-Year-Old Girl Raped By Stepfather Eligible For Abortion Under Country's Restrictive Law

New York Times: Indian Girl, 10, Was Raped Repeatedly. Now She May Have to Give Birth.
“A 10-year-old girl who was repeatedly raped by her stepfather, and who is now at least 20 weeks pregnant, may be forced to give birth because of India’s restrictive abortion law. In a case that has become a glaring example of both impunity for rapists and a lack of women’s reproductive rights in India, a court must decide whether the pregnant girl is entitled to an abortion…” (Kumar/Barry, 5/15).

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Global Iodine Price Increases Following Japan Earthquake, Tsunami Affect Access To Essential Micronutrient In Cambodia

New York Times: How a Tsunami in Japan Endangered Children in Cambodia
“The tsunami and nuclear disaster in Fukushima, Japan, now threatens the developing brains of children in Cambodia — but not for reasons that were ever expected. Cambodia has long struggled with iodine deficiency. … Cambodia was making great progress against iodine deficiency until 2011, according to a report published in 2015 by the Iodine Global Network, a public-private partnership combating the deficiency. … Then in 2011, after the earthquake and tsunami in Japan, the global price of iodine tripled…” (McNeil, 5/15).

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News Outlets Examine Histories Of Smallpox, Polio Eradication Efforts, Human Testing Of Contraceptives

New York Times: Retro Report: Politics and Plagues
“In bold documentary style, Retro Report looks back at the major stories that shaped the world using fresh interviews, analysis, and compelling archival footage.” This short documentary examines the eradication of smallpox and efforts to eliminate polio worldwide, with a focus on the interplay between global politics and disease control (5/15).

Washington Post: Guinea pigs or pioneers? How Puerto Rican women were used to test the birth control pill.
“…[B]efore the circular dials and rectangular packs [of contraceptives] gained a regular spot on bathroom sinks and at the bottom of purses, the people behind them first had to prove they were effective — and to do that, they needed to test them on humans. Where they chose to conduct those tests marks one the most controversial — and rarely discussed — chapters in the history of a drug that symbolizes women’s liberation. In the mid-1950s, the first large-scale human trial of the pill was launched in a public housing project in Puerto Rico — and the distrust was immediate…” (Vargas, 5/9).

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Editorials and Opinions

Foreign Assistance, Diplomacy 'Keys To American Global Leadership'

The Hill: Diplomacy and foreign aid are pillars of American global leadership
Dan Glickman, executive director of the congressional program at the Aspen Institute and senior fellow at the Bipartisan Policy Center

“…I hope President Trump will consider and appreciate the immense strategic and security value of foreign assistance. … [D]evelopment assistance and diplomacy are … strategic pillars of American global leadership. Like three legs of a stool, our national strength rests upon our military might, our diplomatic ingenuity, and our commitment to the economic development, health, and stability of the world. Effective foreign assistance and diplomacy are keys to American global leadership. … USAID deserves to stand on its own, not be subsumed into the State Department where it will be minimized. The impact it makes relative to the percent of the federal budget is transformational. … Foreign assistance limits the spread or eradicates dangerous diseases, stabilizes regions vulnerable to famine and political instability thus preventing humanitarian and refugee crisis, spurs innovation, and creates consumers eager to purchase American products around the world. … [W]ith effective oversight, the system works well. Swallowing USAID into the State Department will minimize its role and jeopardize future American-led successes on the global stage” (5/15).

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Ethiopia's Tedros Adhanom Ghebreyesus Remains Qualified Candidate For Next WHO Director General

New York Times: Letter to the Editor: A Qualified Candidate for Head of the WHO
Thomas R. Frieden, physician and director of the CDC from 2009-2017

“Although not optimal, many countries report cholera to the World Health Organization as acute watery diarrhea, as Ethiopia has. This allows reporting and response without laboratory confirmation, but in no way indicates that Tedros Adhanom Ghebreyesus, a former health minister of Ethiopia, is any less qualified to become director general of the WHO. Multiple independent evaluations have confirmed that under Dr. Tedros’s leadership, Ethiopia is one of the few countries in Africa to have rapidly reduced infant mortality and achieved the Millennium Development Goal in this area. … Dr. Tedros created a network of nearly 40,000 female community health workers who were trained, supported, and supervised to implement programs, including oral rehydration therapy, that prevent death from diarrhea and other causes. As director of the Centers for Disease Control and Prevention, I traveled to Ethiopia several times and saw impressive progress strengthening community health, improving hospital care, and establishing disease-tracking systems. The world would be safer and healthier if WHO facilitates this type of progress in more countries” (5/15).

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Improved Preventive Approaches, Risk Assessments Vital To Containing Threat Of Yellow Fever

New York Times: The Looming Threat of Yellow Fever
Seth Berkley, chief executive of Gavi, the Vaccine Alliance

“…[In Brazil, there] is serious concern … that if the [yellow fever] virus starts spreading in a major city, health authorities will be ill equipped to contain it. Rio de Janeiro, for one, is aggressively vaccinating its citizens in hopes of inoculating 12 million by the end of the year. … With a global emergency stockpile of six million doses and about 12 million people living in and around Rio, it is easy to see why public health experts are worried. If Rio and one other major city experience an outbreak, it is doubtful whether stocks could be replenished fast enough to keep up with demand. The proportion of people living in urban areas, where diseases can spread far more rapidly than in rural areas with scattered populations, is forecast to rise from one-third of the planet’s population in 1950 to two-thirds by 2050. Clearly, we need to revise our risk assessments for infectious diseases to reflect this trend. … And while these emergency stockpiles are essential, if we have to call upon them we have in some way already failed. They should be our last line of defense. … History has shown that preventive approaches can be highly effective at controlling yellow fever, but if they are to work we first need to recognize there is a problem…” (5/15).

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New Treatment Guidelines, Developments In Technology Can Help Sub-Saharan African Countries Address Cancer

Scientific American: Helping Cancer’s Forgotten Victims
Sally Cowal, senior vice president of global cancer control at the American Cancer Society, and Jennifer Ryan Crozier, IBM’s vice president of corporate citizenship and president of the IBM International Foundation

“…[During a meeting that took place in Nairobi last month, for] the first time, cancer treatment guidelines were created specifically for patients in lower-resourced countries in sub-Saharan Africa — the forgotten cancer sufferers. At the same time, technology is now helping poorer countries predict their unique chemotherapy needs and place larger, more discounted medicine orders with pharmaceutical manufacturers. The potential result? An assault on cancer in the developing world in much the same way that malaria and HIV, once thought intractable, were successfully addressed. … Without the reshaping of pharmaceutical markets, the new treatment guidelines are impotent. To that end, IBM worked with the American Cancer Society and the National Comprehensive Cancer Network to produce ‘ChemoQuant,’ free software to help ministries of health more accurately forecast their chemotherapy needs. … Uganda and Ethiopia’s ministries of health will begin using the software next month, with several other African countries to follow this year. Armed with better data and bigger medicine orders, the Clinton Health Access Initiative hopes to negotiate more affordable medicine deals with trusted pharmaceutical manufacturers…” (5/12).

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From the Global Health Policy Community

FAQ Addresses Key Questions Regarding Global Fund, U.S. Support

Friends of the Global Fight Blog: FAQ: U.S. Support for the Global Fund to Fight AIDS, Tuberculosis and Malaria
“This FAQ addresses key questions many congressional offices and their constituents have about the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), including: U.S. support for the Global Fund, how the Fund works with and complements U.S. global health programs, as well as the high levels of performance and transparency that the Global Fund achieves…” (5/15).

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U.N. Dispatch Discusses Race For Next WHO Director General

U.N. Dispatch: WHO’s the Boss? Inside the Race to Elect a New Head of the World Health Organization
Blogger and international development professional Alanna Shaikh discusses the race for next WHO director general, describing each of the three candidates and their qualifications, and citing challenges the next leader will face (5/15).

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Wilson Center Event Addresses 'Over-Intervention' In Maternal Health Care

Woodrow Wilson Center’s Environmental Change and Security Program’s “New Security Beat”: Too Much, Too Soon: Addressing Over-Intervention in Maternity Care
Schuyler Null, editor in chief of New Security Beat and a writer/editor for the Wilson Center’s Environmental Change and Security Program and Maternal Health Initiative, discusses an event at the Wilson Center on over-intervention in maternity care. Null highlights a panel discussion on a 2016 Lancet series on maternal health that warns of the increase in over-medicalization and over-intervention in health systems (5/16).

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CGD Blog Posts Examine Arguments For, Against Raising Tobacco Taxes

Center for Global Development’s “Global Health Policy Blog/Views from the Center”: Tobacco Taxes Need to Be a Much Bigger Part of the Fiscal Policy Discussion
Masood Ahmed, president of CGD, discusses the effectiveness of tobacco taxes, describing how “the cost is very low relative to the revenues and fully justified by the health gains.” Ahmed goes on to describe “three common objections to tobacco taxes and why they don’t hold up: 1. Tobacco taxes will not raise sufficient revenue? Experience suggests otherwise. … 2. Tobacco taxes are regressive and hurt the poor? To the contrary, evidence shows that the poor benefit more than the rich. … 3. Tobacco taxes will lead to illicit trade? That’s possible but the evidence shows that many countries have successfully tackled this…” (5/12).

Center for Global Development’s “Global Health Policy Blog/Views from the Center”: The World’s Most Profitable Slow-Motion Disaster: Tobacco
William Savedoff, senior fellow at CGD, discusses the challenges of addressing tobacco taxation globally, examining tobacco companies’ arguments against raising tobacco taxes and offering counterarguments. Savedoff writes, “The bottom line: raising tobacco taxes will save lives. … But raising tobacco taxes won’t necessarily reduce tobacco company profits” (5/15).

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From the U.S. Government

State Department Fact Sheet Describes 'Protecting Life In Global Health Assistance' Plan To Implement Mexico City Policy

U.S. Department of State: Protecting Life in Global Health Assistance
This fact sheet states, “…Secretary Tillerson has approved a plan, called ‘Protecting Life in Global Health Assistance,’ to implement the manner in which U.S. Government Departments and Agencies will apply the provisions of the Mexico City policy to foreign non-governmental organizations (NGOs) that receive U.S. funding for global health assistance. Under this expanded policy, ‘global health assistance’ includes funding for international health programs, such as those for HIV/AIDS, maternal and child health, malaria, global health security, and family planning and reproductive health…” (5/15).

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U.S. Continues To Support Efforts To Invest In Global Health Security, Reduce Biological Risks

U.S. Department of State’s “DipNote”: Preventing Outbreaks: U.S. Investment in Global Health Security Training
Kathryn Insley, acting director of the Office of Cooperative Threat Reduction in the Bureau of International Security and Nonproliferation, discusses the State Department’s investments in programs to reduce biological security risks (5/15).

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