KFF Daily Global Health Policy Report

In The News

Kaiser Family Foundation Panel Discussion Examines Defense Department's Role In Global Health

Speaking at an event at the Kaiser Family Foundation on Thursday, Kathleen Hicks, principal deputy undersecretary of defense for policy, discussed the U.S. Department of Defense’s (DOD) role in global health, the American Forces Press Service reports (Pellerin, 5/16). “Ours is a supporting role,” Hicks said, according to the Center for Global Health Policy’s “Science Speaks” blog, which adds Hicks “pointed to the military agency’s need to build ‘templates’ to better coordinate its global health activities with those of other agencies, foster closer ties to foreign governments, and develop the capacities of countries where disease responses are most critical” (Barton, 5/16). The DOD “supports U.S. global health activities because such efforts as preventing and containing lethal outbreaks align with DOD’s mission to help ensure geopolitical stability and security,” according to Hicks, the AFPS adds (5/16).

“[T]he agency’s global health role remains little recognized, little understood, and for those reasons, in danger of not being supported or replaced in the event that it is scaled back, panelists at the Thursday discussion said,” “Science Speaks” states (5/16). At the briefing, Kaiser Family Foundation Associate Director for Global Health Policy Joshua Michaud gave an overview of the foundation’s report on the DOD and global health, released in September 2012, according to the event webpage. The panel, moderated by Jen Kates, vice president and director of global health and HIV policy at the Kaiser Family Foundation, included a discussion with Kate Almquist, a visiting fellow at the Center for Global Development; Deputy Assistant Secretary of Defense for Force Health Protection & Readiness David Smith; Rabih Torbay, vice president of international operations at International Medical Corps; and Colonel Peter Weina, deputy commander at Walter Reed Army Institute of Research, the webpage notes. A podcast and video of the event is available online (5/17).

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Members Of Faith Community, U.S. Legislators, PEPFAR Leadership Meet To Discuss U.S. Foreign Aid, Global AIDS Response

“The U.S. government program that helps treat and prevent AIDS in foreign countries is threatened by budget cuts, Sen. Lindsey Graham (R-S.C.) warned Tuesday … at a Washington, D.C., event co-hosted by a number of organizations that have worked together to fight AIDS around the world, including World Relief, World Vision, Pan African Christian AIDS Network, UNICEF, and the United Methodist Church,” the Christian Post reports, noting, “He urged faith-based organizations [FBOs] to increase their efforts at rallying support for the program.” The news service writes, “Politicians find foreign aid an easy target for budget cuts, Graham explained, because most Americans believe foreign aid comprises a significant part, as much as 25 percent, of the budget,” adding, “In reality, though, foreign aid is only about one percent of the budget and not the cause of the nation’s budget woes” (Nazworth, 5/15).

Graham joined Ambassador Eric Goosby, U.S. global AIDS coordinator and head of the Office of Global Health Diplomacy, and Craig McClure, chief of HIV/AIDS program division at UNICEF, as guest speakers at the event, Johanna Harvey, a senior communications officer for the Elizabeth Glaser Pediatric AIDS Foundation, writes in the foundation’s blog. “Their remarks were followed by a panel discussion … moderated by Anita Smith, executive director of the Children’s AIDS Fund,” she notes, adding, “The group discussed the global health community’s commitment to the Global Plan towards the Elimination of New HIV Infections among Children by 2015 and Keeping Their Mothers Alive (.pdf)” (5/16).

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Lancet Special Issue Addresses Women's Health Issues Ahead Of Women Deliver Conference

This week The Lancet published a special theme issue “ahead of the 2013 Women Deliver conference, to be held May 28-30 in Kuala Lumpur, Malaysia,” a Lancet press release reports. “Women Deliver brings together voices from around the world to call for action to improve the health and well-being of girls and women, and the latest issue of The Lancet highlights some of the latest research and views on maternal health,” the press release states (5/17). According to the special issue’s homepage summary, “The studies published in The Lancet’s themed issue use different methods to show the multidimensional nature of reproductive health and the influence of social determinants and health systems” (5/17).

A Lancet editorial summarizes some of the papers, and states, “The question for Women Deliver is how to best harness passion and hard work to accelerate progress efficiently. That the fifth Millennium Development Goal to reduce the maternal mortality ratio by three quarters before 2015 will be missed should not dull aspirations, but rather, sharpen resolve” (5/18). In a comment published in the special issue, U.S. Health and Human Services Secretary Kathleen Sebelius writes, “As the global community continues this crucially important work at Women Deliver and beyond, we encourage all parties to assess the state of women’s health in their home countries, with a special focus on disadvantaged populations. Every day, 800 women die worldwide from preventable causes during pregnancy or childbirth. We all have a part to play in lowering that number. We can all do better” (5/18).

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GBCHealth Conference Begins In New York, Addresses Reproductive Health

The annual GBCHealth Conference began in New York on Thursday, and “the conference is specifically addressing the need to work harder to reach the difficult health-related goals concerning reducing child mortality, improving maternal health and combating the spread of HIV/AIDS, malaria and tuberculosis,” Thomson Reuters Foundation reports. “[F]or the first time, reproductive health issues are included this year in the agenda,” the news service notes, adding the conference “devoted its first session to family planning, calling it ‘a best buy for global health.'” The news service continues, “According to the Population Reference Bureau, every $1 invested in family planning can save up to $9 in other development costs,” and “the current unmet need for modern contraceptives in developing nations could be satisfied by investing $4.1 billion, which would save $5.7 billion annually in maternal and newborn health care costs, according to the Guttmacher Institute.” Thomson Reuters Foundation notes the “GBCHealth Frontline Hero Award was presented Thursday to Christine Kaseba-Sata, the first lady of Zambia and for 30 years an obstetrician and gynecologist who has made women’s reproductive health one of her signature campaigns” (Anderson, 5/17).

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Chronic Malnutrition Among Children Costs Sub-Saharan Africa $25B Annually, UNICEF Conference Says

High rates of chronic malnutrition among children in sub-Saharan Africa cost the region $25 billion a year, according to “a UNICEF conference on child malnutrition that wrapped up Wednesday in Paris,” VOA News reports. The conference brought together “humanitarian agencies and representatives from 35 African countries, … just weeks before G8 leaders discuss ways to combat malnutrition at a summit in Northern Ireland,” the news agency notes (Bryant, 5/15). “The meeting agreed it was urgent that governments in countries affected by child malnutrition accelerate the implementation of proactive, multi-sectoral and decentralized public policies with the clear objective of reducing the prevalence of malnutrition among children,” a UNICEF press release states, adding, “Ministers and parliamentarians from sub-Saharan Africa made concrete public commitments at the meeting to take national action.”

According to the press release, “the French Ministry of Foreign Affairs granted €30 million [$38.5 million] — the proceeds of its new tax on financial transactions — to promote the health of children in the Sahel, with a special emphasis on nutrition.” The press release notes, “The total of €3 billion [$3.85 billion] needed each year for Africa to combat child malnutrition fully would in the first year alone allow 22 million young African children to escape chronic malnutrition” (5/15). The conference was “[o]rganized in partnership with the French Ministry of Foreign Affairs, the French Development Agency, the Bill & Melinda Gates Foundation, Action Against Hunger, Doctors Without Borders, and the NGO Alliance for International Medical Action,” according to a UNICEF media advisory (5/8).

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International Donors Pledge More Than $4B To Fund Mali Development Plan

“An E.U.-led donor conference agreed on Wednesday to provide €3.25 billion [$4.18 billion] to fund a sweeping development plan for Mali, but European donors made clear that the interim government must live up to its promises to implement democratic and social reforms in exchange for the international lifeline,” The Guardian reports. “Four months after an E.U.-backed French force halted an advance by militants in the country’s north, the E.U. hosted the donor conference to help finance the Malian government’s plan to improve health, education, the economy and food security,” the newspaper adds (Spence/Simon, 5/16). “The sum exceeds the goals of Mali which had asked donors for nearly two billion euros for this year and next,” Reuters notes, adding, “France and the E.U. led the drive for funding to rebuild Mali and halt a resurgence of al Qaeda-linked Islamists who were driven out of the major northern towns by a French-led offensive” (Bilby, 5/15). In addition, “[t]he Global Fund to Fight AIDS, Tuberculosis and Malaria announced [at the donor conference] on Wednesday  that it has finalized two new grant agreements with Mali for malaria and TB, worth a total of €50 million [$64.3 million], which will significantly improve access to health services and deliver treatment to tens of thousands of people,” according to a Global Fund press release (5/15).

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Reproductive Health Bill Stalled In Philippines Supreme Court

“Health workers are awaiting the outcome of a Supreme Court hearing, which will decide if the Philippines can finally implement comprehensive reproductive health services,” The Lancet reports. The Responsible Parenthood and Reproductive Health Act of 2012 (RHA) was signed by President Bebigno Aquino last December, the journal notes. “[T]he passage of the RHA, which orders local government units to implement standardized reproductive health care services, drew several petitions from Filipino Catholic groups,” the Lancet continues, adding, “Their opposition has led to the Supreme Court’s issue of a status quo ante order that temporarily halts the government from implementing the act. The Court will hear arguments on June 18.” The journal writes, “The delay in implementation of the RHA worries medical professionals who argue that the three pillars of maternal health (access to contraception, provision of skilled attendance at birth, and high quality emergency obstetric care) needed to support a drop of pregnancy-related deaths cannot be established without it,” adding, “Regarding the Philippine Supreme Court’s decision to temporarily halt the implementation, pro-RHA campaigners believe that the court will eventually vote for full implementation” (Chiu, 5/18).

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USAID, Philippines Health Department Launch Bilateral Health Program

U.S. Ambassador to the Philippines Harry Thomas Jr. this week in Manila launched a bilateral health program between USAID and the country’s Department of Health (DOH), including “13 projects, several of which will be interventions to save mothers’ lives,” GMA News reports. “According to DOH Secretary Enrique Ona, maternal mortality is at 221 deaths per 100,000 deliveries as of 2011,” the news service writes, adding, “Apart from maternal and child health, the projects will also focus on family planning, tuberculosis, and HIV/AIDS.” GMA News notes, “USAID/Philippines Mission Director Gloria Steele stressed that health plays an important role in the nation’s growth.” She said, “Children who are healthy do better in school and when they do better in school, although there are no guarantees, the chances are high that they will do better in life,” the news service reports (Lapeña, 5/17).

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Editorials and Opinions

Congress Must Prioritize Funding For International Assistance Programs

“For many people around the world, sequestration is literally a life-or-death issue. Its impact may be most deeply felt by those living in developing nations,” Rev. Derrick Boykin, associate for African-American leadership outreach at Bread for the World, writes in the Huffington Post’s “Black Voices” blog. “Millions of people around the world depend on vital assistance provided through U.S. poverty-focused development assistance programs like [PEPFAR],” he continues, adding, “During my own recent trip to Africa, I too saw programs that provide vital medical assistance to mothers and children.” He continues, “Seeing that reality on the ground in Africa and knowing that the funding that supports these programs — comprising less than one percent of the federal budget — is under threat, I see sequestration as no mere inconvenience. Lives hang in the balance.”

“Fortunately, organizations like Bread for the World have lobbied relentlessly to protect vital programs,” Boykin writes, noting, “In February, Bread for the World joined a coalition of faith-based organizations in urging Congress to maintain funding for international humanitarian and poverty-focused development assistance.” He continues, “From our united effort, we can claim a small victory: funding for poverty-focused development assistance is relatively unchanged from the previous year — with a slight increase to cover development assistance, humanitarian assistance, and steady funding for global health initiatives,” although “these increases were offset by reductions in a number of other accounts.” He states, “Moving forward, with more tough budget choices ahead, Congress needs to prioritize funding for international assistance programs that have proven effective in saving and improving lives” (5/16).

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With HPV Vaccine Price Lowered, Challenge Now Is Strengthening Health Systems For Rollout

“Since their approval, health experts and campaigners, including The Lancet, have called for the vaccines against the human papillomaviruses (HPV) that cause cervical cancer to become available at a much cheaper price,” a Lancet editorial states. High prices “meant the vaccines were prohibitively expensive for low-income countries where most HPV infections and deaths from cervical cancer occur,” the editorial notes, adding, “Now, thanks to negotiations between the GAVI Alliance and the manufacturers, new record low prices have been secured. Merck has agreed to supply its vaccine at $4.50 per dose and GSK at $4.60 per dose. The previous lowest public sector price was $13.” The editorial continues, “Of course, the vaccines could and should be even cheaper,” adding, “However, as GAVI scales up the use of the vaccine, the price is expected to come down further” and “Merck has already agreed to lower the price of its vaccine further if total volumes increase in the future.” The journal states, “The challenge now is to make sure that countries have strong enough health systems for national rollout” (5/18).

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In Order To Meet Population Demands For Food, Farmers Must Find Ways To Double Productivity

“How and where we will we feed everyone has become one of the most pressing conservation issues of the 21st century,” Jason Clay, senior vice president of market transformation for the World Wildlife Fund, writes in the Huffington Post’s “Impact” blog as part of a series marking the occasion of the Chicago Council on Global Affairs’ annual Global Food Security Symposium in Washington, D.C. “Farmers will need to produce twice as much food as they do now to meet population demands,” he states and asks, “Where will this food come from?” He continues, “We need to freeze the footprint of food — find ways to double the productivity of farming, so that we can produce twice as much food and fiber on the same amount of land.” Clay continues, “At WWF, we have identified eight steps, when taken together, could produce enough food for all and still maintain a living planet,” and he notes the steps include eliminating waste in the food chain, harnessing technology to advance plant breeding, sharing better practices more quickly, using less to produce more, rehabilitating degraded land, establishing greater property rights, balancing the disparity between under and over consumption, and restoring soil carbon. He expands on each point (5/16).

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From the Global Health Policy Community

Statements Respond To Introduction Of Bipartisan 'Food Aid Reform Act'

The Modernizing Foreign Assistance Network’s (MFAN) “Modernize Aid” blog on Thursday published two statements regarding the bipartisan “Food Aid Reform Act” (H.R. 1983), introduced on Wednesday by House Foreign Affairs Chair Ed Royce (R-Calif.) and Africa Subcommittee Ranking Member Karen Bass (D-Calif.). The first is a statement “delivered on behalf of [MFAN] by co-chairs David Beckmann, George Ingram and Jim Kolbe,” which states, “We strongly commend [Royce and Bass] for introducing the Food Aid Reform Act (H.R. 1983)” that “includes common sense reforms that would improve the effectiveness and efficiency of U.S. food aid. … The bill is timely, coming shortly after the president’s FY 2014 budget request’s bold proposal to improve the Food for Peace program that distributes emergency food assistance” (5/16). The second is a statement delivered on behalf of the Jewish World Service, Bread for the World, CARE, Church World Service, the Modernizing Foreign Assistance Network, Oxfam America, and Partners in Health, which states, “These evidence-based reforms will significantly enhance the effectiveness and efficiency of our food aid program. Chairman Royce and Representative Bass’s plan is a balanced approach to delivering food assistance and maximizing efficiencies. We urge the House Foreign Affairs Committee to swiftly approve the proposal” (5/16).

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Recognizing International Day Against Homophobia and Transphobia

“Since [May 17] is International Day against Homophobia and Transphobia, it is worth recognizing the importance of efforts to stop inequality and stigma faced by lesbian, gay, bisexual and transgender people all over the world,” Mark Dybul, executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, writes in the Global Fund’s blog. “Among many other challenges, they face disproportionate rates of HIV infection,” he continues, adding, “Homophobia and discrimination by health providers can make it difficult for [men who have sex with men (MSM)] and transgender people to use traditional and mainstream health services. … The Global Fund is committed to implementing policies and strategies to address these challenges” (5/17).

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CGD Maps Global Health Funding Agencies

“Through our Value for Money working group, we’ve spent much of the past year immersed in the world of global health funding agencies,” Victoria Fan, a research fellow at the Center for Global Development (CGD), and Rachel Silverman, a research assistant for the global health team at CGD, write in the center’s blog. “With so many new agencies, particularly in the last quarter century, understanding the intricacies of the global health family can be daunting, even for the most devoted observers,” they continue, adding, “For our own reference (and yours), we thought it would be useful to compile a ‘cheat sheet’ on global health funding agencies.” The background brief (.pdf) “compile[s] key ‘stats’ for large global health players,” they note and summarize the brief’s tables. “We hope that this resource provides a useful overview for novices and veterans alike who are trying to make sense of the complicated global health landscape and architecture,” they conclude (5/16).

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Global Network For NTDs Policy Brief Address Maternal, Child Health

The Global Network for Neglected Tropical Diseases’ (NTD) “End the Neglect” blog notes the release of “the Global Network’s new policy brief, Better Health for Mothers and Children [.pdf], which urges policymakers to integrate NTD treatment into programs designed for improving maternal, newborn and child health.” The blog continues, “Integrating NTD treatment into existing maternal and child health efforts can help mitigate anemia, improve nutrition, and better equip a mother and her child’s immune system to fight off additional health threats, improving their overall health status and quality of life. As policymakers, non-profit organizations, and global leaders work to prepare the post-2015 development agenda, it is important for them to see the link between NTDs and women’s health and ensure that the programs include treatment for NTDs.” The blog notes, “For only 50 cents per person per year, pregnant mothers around the world can be protected from the effects of NTDs” (Corona-Parra, 5/16).

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London Summit Galvanized Global Community On Family Planning

“The most visible event last year for the family planning team here at the [Bill & Melinda Gates Foundation], and for all of our family health team was the London Summit on Family Planning,” Gary Darmstadt, head of the family health division of the foundation; Shannon Harris, a research analyst at the foundation; and Monica Kerrigan, an expert in family planning, reproductive and maternal health in Africa and Asia, write in the foundation’s “Impatient Optimists” blog. “The summit galvanized the global community to support the rights of women and girls to access family planning information, supplies and services, and included bold commitments by more than 20 countries to address the policy, financing, and delivery barriers to meet the family planning needs of women and families and improve maternal, newborn and child health in the poorest countries in the world,” they write, adding, “These partnerships will also move FP2020 forward — to sustain the momentum from London and ensure all partners are working together to achieve and support the goals and commitments announced at the summit” (5/16).

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