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Kaiser Daily Global Health Policy Report

In The News

Reuters Examines White House Proposal To Reform Food Aid Program

“A White House plan to modernize the major U.S. food aid program … is in trouble after fierce lobbying by farm groups, food processors, shippers and others who set out to sink the idea months before it was unveiled in President Barack Obama’s fiscal 2014 budget [request],” Reuters reports in an article outlining opposition and support for the administration’s effort to reform the Food for Peace program. One of the proposals set forth — “that at least 55 percent of aid spending, or nearly $800 million of the $1.4 billion requested, would be earmarked to buy and transport U.S.-grown food,” with the other 45 percent available as cash donations used to purchase local food or in the form of vouchers — “would still be the biggest change since the Food for Peace program was created in a mixture of Cold War ‘soft’ diplomacy, compassion for suffering overseas and a practical use of farm surpluses,” the news agency notes.

“In pressing the case to shift more aid to a cash system, the White House and the [USAID] have highlighted the potential ability to feed up to four million more needy people each year at a lower cost,” Reuters writes, adding, “But the proposed savings — $500 million over a decade — are too small to pique the interest of congressional budget hawks, especially when stacked against the vocal complaints about the potential loss of jobs and markets for U.S.-grown food.” According to the news agency, “[g]overnment spending of $1 billion or so a year to buy food for donation — typically rice, vegetable oil, flour, lentils, dry beans, a corn-soy blend, bulgur and dried peas — pales next to U.S. farm exports worth some $145 billion this year,” and the White House estimates “[c]ommodities shipped under the Food for Peace program ‘currently account for less than two tenths of one percent of U.S. agricultural production and about one half of one percent of U.S. agricultural exports.'” Reuters notes, “Congress could resolve the issue as soon as May or June, when it writes the annual funding bills for food aid and other agricultural programs. The long-term farm policy bill, another avenue for food aid reform, is scheduled for drafting in May” (Abbott et al., 5/1). Reuters also provides a factbox on U.S. food aid programs (5/1).

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20 Fragile, Conflict-Affected States Make Progress Toward MDGs, World Bank Says

“Twenty of the world’s most troubled countries have made progress in efforts that range from reducing poverty to improving the education of girls and cutting down on the deaths of women in childbirth, the World Bank said on Wednesday” in a new report (.pdf), Reuters reports. Each country has met the requirements for at least one Millennium Development Goal (MDG), while “[a]nother six are on track to meet the goals by the deadline in 2015, with the progress visible in part due to better data collection and monitoring,” the news agency notes, adding, “Data gathered in 2010 and earlier had found none of these states had met any of the MDGs” (Yukhananov, 5/1). “The 20 fragile and conflict affected countries which have met one or more targets are Afghanistan, Angola, Bosnia and Herzegovina, Comoros, Guinea, Guinea-Bissau, Iraq, Kiribati, Liberia, Libya, Marshall Islands, Federated States of Micronesia, Myanmar, Nepal, Sudan, Syria, Timor-Leste, Togo, Tuvalu, and West Bank and Gaza,” according to a World Bank press release, which notes Nepal is the only country among the list to have met the MDG for maternal mortality. The analysis is based on the Global Monitoring Report’s data, the press release states (5/1).

World Bank President Jim Yong Kim said, “This should be a wake-up call to the global community not to dismiss these countries as lost causes. … Development can and is being achieved, even amid fragility and violence,” according to Reuters. Countries “caught in repeated cycles of violence are still lagging behind the rest of the world in development metrics and are struggling to meet more than one target,” and some states “are also vulnerable to relapse,” the news agency notes. “One of the challenges in helping fragile nations is trying to bridge the gap between long-term development and humanitarian assistance, which tends to pour in once a country emerges from conflict but just as quickly dries up after international attention fades or there are no immediate signs of progress, Caroline Anstey, managing director at the World Bank, said,” Reuters writes. “Humanitarian aid isn’t going to enable you to build institutions, to have those long-term investments in training or even education and health. … We think that by working more closely with the U.N., we can bridge that development gap,” Anstey said, according to the news agency (5/1).

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Scientists Warn Of H7N9 Risks As Number Of Cases, Deaths Continue To Rise

“A new strain of bird flu that is causing a deadly outbreak among people in China is a threat to world health and should be taken seriously, scientists said on Wednesday,” Reuters reports (Kelland, 5/1). “The new H7N9 avian flu virus has been detected in one more patient in China, a finding that edges the number of cases in the outbreak to 128,” CIDRAP writes, adding, “The patient is a 69-year-old man from Hunan province” (Schnirring, 5/1). In addition, “[a] 55-year-old man in central China has died …, bringing to 27 the number of deaths,” Reuters notes in a separate article (Wee, 5/2). “The patient, a man surnamed Jiao, died after medical treatment failed to save him, according to an official from the provincial health and family planning department,” Xinhua notes (5/2).

“The first comprehensive genetic analysis of the virus is published in The Lancet medical journal on Wednesday,” The Guardian notes, adding, “It suggests the virus might have originated from the mixing of viruses from as many as four different origins, including ducks” (Boseley, 5/1). “Genetic analysis shows that H7N9 has two of the five mutations believed to be required for a flu virus to spread easily through the air between people, said Wendy Barclay, professor of influenza virology at Imperial College London,” according to the Financial Times (Cookson/Jack, 5/1). “The H7N9 virus has not, however, yet proved able to spread between people — which limits its global threat,” BBC News notes (Gallagher, 5/1). Science Magazine’s “Science Live” blog reports it is hosting a live chat about the virus on Thursday (Cohen, 5/1).

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Five More Die Of SARS-Like Disease In Saudi Arabia

“Saudi Arabia said five more people have died of a deadly new virus from the same family as SARS, and two other people were in intensive care,” Reuters reports. “The seven cases were discovered in al-Ahsa governorate in the Eastern Province, the Saudi news agency SPA quoted the Saudi Health Ministry as saying in a statement late on Wednesday,” the news service writes, adding, “The novel coronavirus (NCoV) is from the same family of viruses as those that cause common colds and the one that caused the deadly outbreak of severe acute respiratory syndrome (SARS) that first emerged in Asia in 2003” (5/2). “Sixteen people have now died from 23 cases detected in Saudi Arabia, Jordan, Germany and Britain. Riyadh has accounted for most of the deaths, with 11 people, including the five new fatalities,” Al Jazeera notes (5/2).

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U.K. To End Bilateral Assistance To South Africa By 2015

“The U.K. Department for International Development [DfID] has decided to end its bilateral assistance to South Africa by 2015, raising concerns among several non-governmental organizations,” Devex’s “The Development Newswire” reports. “DfID has pledged to finish active projects in the country. But by 2015, the United Kingdom’s role will solely focus on technical assistance as well as skills and knowledge sharing,” the news service notes (Ravelo, 5/1). “Charities have criticized the U.K. after the government announced it would stop direct aid to South Africa in 2015,” according to BBC News, which notes, “U.K. aid to South Africa is focused on reducing the mortality rate among women giving birth and supporting businesses.” The news service writes, “U.K. ministers said their relationship with South Africa should now be based on trade and not development,” adding, “South Africa’s government warned that ending the aid program, currently worth £19 million [$29.6 million] a year, would have ‘far-reaching implications'” (5/1).

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IPS Reports On Taliban Attacks On Health Care Facilities In Pakistan's FATA

Inter Press Service reports on Taliban-sponsored attacks on health care facilities in Pakistan’s Federally Administered Tribal Areas (FATA). The news service highlights a recent attack, adding, “With 26 hospitals, 10 rural health centers and 419 community health centers, FATA is well equipped to deal with all of its residents’ medical needs,” but “if the attacks do not stop immediately, Shaukat Ali [of the FATA Health Directorate] warned, the entire health system here will be rendered ineffective.”

“The entire medical community, along with a large majority of the general public, has slammed th[e] latest attack, which killed four people, as a plot to deprive FATA’s population of six million people of adequate health care,” IPS writes. “So far the Taliban have destroyed about 400 health facilities in FATA and the Khyber Pakhtunkwa (KP) province,” the news service notes, adding, “In the past three months the Taliban have claimed responsibility for the deaths of 17 policemen, female vaccinators and volunteers in polio-related violence.” IPS writes, “Meanwhile, medical facilities in Peshawar are struggling to keep pace with the influx of patients from tribal areas on the Afghanistan border, who say they are ‘too afraid’ to visit hospitals that might be targeted by militants” (Yusufzai, 5/1).

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Editorials and Opinions

Stakeholders Must Work Together On U.S. Food Aid Reform

“Congress should put aside partisanship and turf protection as it considers bold changes to a decades-old and increasingly inefficient international food aid program,” former Sen. Richard Lugar (R-Ind.), who chaired the Agriculture and Foreign Relations committees, and former Sen. Thomas Daschle (D-S.D.), who served as Senate majority leader, write in a Washington Times opinion piece. Noting “[t]he Obama administration’s 2014 budget proposed overhauling the Food for Peace program, building on a similar reform proposal from the George W. Bush administration to reduce high administrative costs and thereby reach more hungry people,” they state, “U.S. global food assistance provides vital humanitarian and emergency assistance to people facing famine, natural disasters or conflict. It is a central to U.S. leadership toward peace and security.”

“Amid economic and budgetary realities, it is inevitable that some will question the role of the United States in global affairs at any level, extending even to U.S. humanitarian programs,” Lugar and Daschle continue. “U.S. food aid is a key component of the U.S. national security strategy,” and “[b]eyond the national security imperative, we strongly believe that no global superpower that claims to possess the moral high ground can afford to relinquish its leadership in addressing global hunger,” they write. “Even in the worst of times, the United States remains a wealthy nation with interests in every corner of the globe,” the authors state, concluding, “Stakeholders and vested interests on all sides — inside and outside government — should work together cooperatively toward reforms now. To do so would be participating in a victory of cost savings, stability in aid programs, greater flexibility and efficiency, enhancement of self-sufficiency in some of the most desperate regions of the world, and an appreciation of U.S. leadership in the world” (5/1).

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End Of Poverty May Be Within Reach, But 'Bar Is Set Very Low'

“The end of extreme poverty might very well be within reach,” economics reporter Annie Lowrey writes in a New York Times Magazine opinion piece. “In part, this is because the bar is set very low,” she states, noting, “The World Bank aims to raise just about everyone on Earth above the $1.25-a-day income threshold.” She writes, “Of course, making it above the $1.25-a-day mark doesn’t guarantee a white picket fence and a Caddy in the driveway — indeed it doesn’t even guarantee a proper meal,” adding, “For that reason, some economists have criticized the bank for setting its targets too low.” She notes, “The 1.2 billion people living in such extreme poverty, according to researchers at the Massachusetts Institute of Technology, might own land, but they are not very likely to own durable goods or productive assets — things like bicycles — that might help them raise themselves out of poverty. In such families, about half or three-quarters of income goes toward food.”

“Fortunately, this deadly and cyclical form of poverty is already on its way toward obsolescence, and much faster than many development economists expected,” Lowrey continues. “Since 1980, the proportion of the developing world living in urban areas has grown to about 50 percent, from 30 percent, and according to the World Bank, that migration of hundreds of millions has been instrumental in pulling down poverty rates — and will be for a broader set of countries going forward,” she writes. “Urban poverty is hardly attractive — slums are cramped, unplanned, unhygienic places — but it is, in many cases, less deadly,” she states, noting, “Cities bolster access to health services and public resources; infant-mortality rates, for instance, are 40 percent lower in urban Cambodia than in rural Cambodia.” Lowrey adds, “More slums — as horrible as they are — could be a good thing” (4/30).

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From the Global Health Policy Community

Blogs Highlight Congressional Testimony Of USAID, CDC, MCC Heads

The Center for Global Health Policy’s “Science Speaks” blog highlights USAID Administrator Rajiv Shah’s recent testimony discussing U.S. foreign assistance priorities in the FY 2014 federal budget before the House Committee on Foreign Affairs and the Senate Committee on Foreign Relations. The blog focuses on discussions between Shah and members of Congress surrounding funding for tuberculosis (TB) programs, PEPFAR, and the Global Fund to Fight AIDS, Tuberculosis and Malaria. “Science Speaks” also highlights testimony by CDC Director Thomas Frieden, who testified last week “in front of the House Subcommittee on Africa, Global Health, Human Rights, and International Organizations at a hearing on meeting the challenges of drug-resistant diseases in developing countries” (Aziz, 5/1). The U.S. Global Leadership Coalition’s blog also describes Shah’s testimony on the Hill, as well as testimony from Millennium Challenge Corporation (MCC) CEO Daniel Yohannes (Rubin, 5/1).

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PEPFAR Committed To Programs Aimed At Children To Reach AIDS-Free Generation

Citing data on how HIV/AIDS has affected children worldwide, whether directly or through the death of one or both parents, U.S. Global AIDS Coordinator Ambassador Eric Goosby, who also heads the State Department’s Office of Global Health Diplomacy, writes in the agency’s “DipNote” blog that children are vulnerable “to the social, emotional, economic, and environmental effects that HIV and AIDS has on families, communities, and countries.” He continues, “This is why [PEPFAR] has set aside 10 percent of its funding to address the diverse, complex, and often critical needs of orphans and vulnerable children (OVC). Thus far, nearly five million children worldwide have benefited from PEPFAR’s efforts.” Noting that “in July 2012, PEPFAR issued new guidance for OVC programming, and on World AIDS Day last year, we released a blueprint that outlines a global path toward achieving an AIDS-free generation,” Goosby writes, “The interventions outlined in these documents also support the coordinated objectives in the recently released U.S. Government Action Plan for Children in Adversity, a government-wide plan for vulnerable children, while maintaining PEPFAR’s important mandate to serve children in the epidemic and their unique needs.” He concludes, “OVC programs are vital to achieving an AIDS-free generation and preventing child deaths and lost opportunities. They are truly a smart investment in our future” (5/1).

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USAID Blog To Highlight Agency's Work In Global Health

“During the month of May, USAID’s “IMPACTblog” “will be highlighting USAID’s work (.pdf) in Global Health,” the blog notes, adding, “From May 1-10, we will be featuring the role that science, technology and innovation plays in global health.” In the first post of the series, USAID Assistant Administrator for Global Health Ariel Pablos-Méndez writes, “Millions around the globe still do not have adequate access to reproductive, maternal and child health services.” He states, “USAID and the broader global health community invest in innovation, science and technology to find game-changing solutions,” highlighting the Grand Challenges for Development, the Development Innovation Ventures, the Higher Education Solutions Network, the Center for Accelerating Innovation and Impact in Global Health, and Saving Lives at Birth. He concludes, “At USAID, we are committed to finding innovative solutions to global health problems and if the global health community can harness science, technology and innovation for the poorest communities in the world, we can leave an unparalleled legacy in global health in this next decade” (5/1).

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With GPEI Plan, Polio Eradication May Finally Be Within Reach

“After 25 years of remarkable achievements and sometimes harrowing setbacks, a successful conclusion to global polio eradication could finally be within reach,” Nellie Bristol, a fellow with the Global Health Policy Center at the Center for Strategic and International Studies (CSIS) in Washington, D.C., and J. Stephen Morrison, senior vice president and director of the Global Health Policy Center at CSIS, write in a CSIS commentary. “In late April, the Global Vaccine Summit in Abu Dhabi released the Global Polio Eradication Initiative (GPEI) [plan], a promising new six-year strategy to win the polio ‘endgame,'” they note and describe the plan in detail. “This unprecedented mobilization may spark the momentum to stamp out the disease once and for all. But, as with most things associated with this long campaign, the outcome is still uncertain and much hard work remains,” they continue, highlighting a number of obstacles, such as funding and security concerns. “The challenge remains difficult, but armed with the new strategy and adequate funding, the GPEI has many of the tools it needs to be successful,” they state (5/1).

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Public-Private Partnerships Can Help Advance Global Health Goals

“Three people die every minute from tuberculosis [TB] — a treatable and largely preventable disease. Resistant forms continue to thrive, and increased travel makes the global threat very real. We face a public health emergency,” Vince Forlenza, chair, CEO, and president of the medical technology firm Becton, Dickinson and Company (BD), writes in the Harvard Business Review Blog Network. “Without adequate financing, ministries of health and even private hospitals in developing countries often don’t have the resources needed to purchase diagnostic equipment, train workers, and ensure access to appropriate treatment,” he notes, and asks, “What can the health care industry do to help fight disease, while still maintaining its commitments to shareholders?” Forlenza discusses some of the public-private partnerships of BD and outlines several lessons learned from the programs, which he says he “hope[s] will serve us and others as we continue to try to transform health care systems in Africa, India, and beyond.” He concludes, “Today’s health care marketplace calls for global problem solvers, not just products, and that is something we should all strive for — together” (5/1).

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GlobalPost Announces New Initiative Supporting Reporting On Global Health, Other Development Issues

On Wednesday, GlobalPost announced an initiative, dubbed “The GroundTruth Project,” which is supported by multiple foundations and includes fellowships for young reporters in “under-reported corners of the world.” According to GlobalPost, the “fellowships will focus on the issues of emerging democracies, human rights, global health, religion and other social justice issues and will seek to foster new forms of storytelling in the digital age.” The news service notes the Kaiser Family Foundation will “provid[e] a third year of support for a partnership in fellowships, training and reporting on global health issues and this year GlobalPost ‘Special Reports’ is exploring the challenges of reducing child mortality in a series titled ‘The Seven Million,’ referring to the number of children under the age of five who die every year largely from preventable diseases” (Sennott, 5/1).

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