Kaiser Daily Global Health Policy Report

In The News

U.S. FDA Approves Sanofi Pasteur's Dengue Vaccine With Major Restrictions On Use

Reuters: Sanofi wins U.S. approval to sell dengue vaccine but with major restrictions
“The U.S. Food and Drug Administration on Wednesday gave Sanofi SA’s dengue vaccine Dengvaxia a very narrow approval as the company continues to suffer from evidence that its vaccine, which took 20 years to develop, can cause severe infections in some people…” (Steenhuysen, 5/1).

STAT: FDA approves the first vaccine for dengue fever, but with major restrictions
“…The agency ruled that Dengvaxia, manufactured by Sanofi Pasteur, can only be used in individuals aged 9 to 16 living in parts of the United States where the dengue virus is endemic — in other words, where it circulates on an ongoing basis. Dengue is found only in Puerto Rico and a few other U.S. offshore territories and protectorates. Furthermore, the vaccine can only be given to children and teens who have had one previous laboratory-confirmed case of dengue…” (Branswell, 5/1).

Wall Street Journal: Sanofi’s Dengue Vaccine Gets FDA Approval
“…Dengvaxia was first approved in Mexico in 2015 and remains the world’s only approved vaccine against dengue. But safety fears have complicated efforts to contain the growing global threat. World Health Organization estimates put about half the world’s population at risk. … The Philippines, which was the first country to widely distribute the vaccine, revoked its product-license approval this year after a number of deaths were reported…” (Armental, 5/1).

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NPR Examines Controversy Over Dengue Vaccine In Philippines

NPR: Dengue Vaccine Controversy In The Philippines
“A dengue vaccine put thousands of kids at risk for a deadly disorder. Some scientists says the manufacturer did too little to warn parents in the Philippines” (Doucleff, 5/2).

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Rory Stewart Replaces Penny Mordaunt As U.K. Secretary Of State For International Development; Mordaunt Appointed U.K.'s First Female Defense Secretary

Devex: Rory Stewart: New DFID chief with a colorful career
“The new U.K. secretary of state for international development, Rory Stewart, has been hailed by the aid community as one of the most qualified ministers yet, having previously served as a junior minister in the department, as well as in the military and foreign service. … Announced as the new head of the Department for International Development Wednesday evening, he replaces former leader Penny Mordaunt, who now heads up the Ministry of Defence. The reshuffle marks a promotion for the 46-year-old who was previously prisons minister in the Ministry of Justice…” (Edwards, 5/2).

Devex: Aid community reacts as Rory Stewart replaces Penny Mordaunt as DFID chief
“…Stewart becomes the department’s fourth leader in three years. … Stewart wasted no time in using his new role to defend the U.K. aid budget, which is the third-largest globally after the United States and Germany. Speaking to the BBC’s Robert Peston on Wednesday evening, he reiterated his earlier support for the U.K.’s commitment to spend 0.7% of gross national income on aid — something that a number of Conservative members of Parliament have been challenging in recent months — and spoke specifically about the importance of addressing climate change…” (Abrahams, 5/1).

The Guardian: Penny Mordaunt becomes first ever female defense secretary
“Penny Mordaunt becomes the U.K.’s first female defense secretary after being tipped for the job two years ago after the sacking of Michael Fallon. It is a post that seems more suited to her background than her previous job as international development secretary. Mordaunt is a Royal Navy reservist, a former minister for the armed forces, and the MP for Portsmouth, home of HMNB Portsmouth…” (Elgot, 5/1).

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Number Of Ebola Cases In DRC Outbreak Nears 1,500; WHO Calls Situation 'One Of The Most Challenging Ever Confronted'

CIDRAP News: DRC Ebola cases near 1,500 after deadliest month
“The surge of Ebola cases continued [Wednesday], with the ministry of health in the Democratic Republic of the Congo (DRC) recording 15 new cases and 14 deaths in an outbreak in North Kivu and Ituri provinces. April was the deadliest month of the 9-month-long outbreak, which has been studded with acts of violence against response workers and discord between community members and health officials. … [Wednesday’s] cases raise the outbreak total to 1,495, of which 1,429 are confirmed and 66 are probable. There have been 984 deaths, and 306 suspected cases are still under investigation…” (Soucheray, 5/1).

CNN: Ebola outbreak in Congo hits record for confirmed cases in single day
“… ‘The increase in the number of new [Ebola] cases in the Democratic Republic of the Congo remains deeply concerning,’ WHO said in its latest situation report. … WHO said that sporadic violence by armed militias, limited health care resources and difficult-to-access locations meant this ‘outbreak is taking place in one of the most challenging circumstances ever confronted by WHO’…” (Hunt, 5/1).

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'Cash Plus' Malnutrition Program Shows Soft Conditionality Positively Impacts Diet, Nutrition Indicators In Conflict Situation, Evaluation Shows

Devex: Impromptu study reveals impact of cash transfers in conflict setting
“An impact evaluation of a ‘cash plus’ malnutrition program in Yemen found that soft conditionality used in a conflict situation has had significant positive impacts on diet and nutrition indicators — results that were obtained by chance. Previous data that measured results of such interventions during conflict was scarce, due to the ethical hesitations of conducting a randomized controlled trial during a crisis situation…” (Welsh, 5/1).

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Experts Discuss Ways To Incentivize New Antibiotic Development At Milken Institute Global Conference Panel

STAT: Fixing a ‘market failure’: To develop new antibiotics, upend the incentive structure, experts urge
“…[W]hat if U.S. policymakers upended the incentive structure for developing new therapies? What if, for instance, drug makers were granted additional exclusivity in certain situations? Increasingly, the idea of rethinking models for antibiotic development is animating industry leaders and policy wonks eager to find new tools to combat superbugs. … Finding new ways to spark enthusiasm — and investment — in tackling these ever-evolving pathogens is still very nascent. But experts [who participated in a panel discussion on the issue earlier this week at the Milken Institute Global Conference] agree that it’ll involve a public-private partnership: Government entities, investors, and the industry will have to work together to find better treatments…” (Keshavan, 5/2).

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More News In Global Health

ABC News: A reflection on living through Africa’s HIV/AIDS epidemic (Masuku, 5/2).

Associated Press: U.N. says 1.7 million Somalis will face major food insecurity (5/1).

Borgen Magazine: U.S. Foreign Assistance to Honduras (Lagattuta, 5/1).

Devex: The limits of Africa’s malaria vaccine pilots (Adepoju, 5/2).

The Guardian: Risk of obesity can be accurately predicted in babies, study finds (Boseley, 5/1).
The Telegraph: 12 signs to predict if your baby will be overweight by age 10 (Donnelly, 5/2).

The Lancet HIV: Legal reforms signal a change in India’s HIV response (Cousins, May 2019).

Reuters: Honduras Congress stalls reforms after violent protests (Palencia/Shrank, 4/30).

Smithsonian.com: Drug-Resistant Infections Could Kill 10 Million People Annually by 2050 (Solly, 5/1).

Xinhua News: South Sudan steps up fight against measles, polio (5/2).

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Editorials and Opinions

U.K. Should Continue Leadership Role In Advancing Global Development

The Guardian: Will the U.K. commitment to development become another casualty of Brexit?
Preet Kaur Gill, shadow minister for international development and MP for Birmingham Edgbaston

“…The U.K.’s commitment to development is recognized worldwide and Britain is respected for setting the agenda on humanitarian and development issues within the U.N. We must ensure that this does not become another casualty of the government’s … Brexit deal. [The Department for International Development (DFID)] must think about how it wants to work with others, how it wants to influence the course of international development, and where its engagement and expertise can have maximum impact. The Labour party has set out the new direction in which we’d like to take international development to reach a world that works for the many, not the few. We need a global development agenda that challenges a system that degrades the environment and perpetuates the causes of poverty and inequality. The U.K. should be at the forefront of these efforts as a progressive, outward-looking, global leader on international development” (5/1).

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Global Health Law Critical To Advancing Health Equity

Health Affairs: The Lancet Commission on Global Health Law: How Law Can Advance The Right To Health
Lawrence O. Gostin, O’Neill professor of global health law and director of the WHO Collaborating Center on National and Global Health Law at Georgetown University, and Eric A. Friedman, project leader for the Platform for a Framework Convention on Global Health at the Georgetown University Law Center’s O’Neill Institute for National and Global Health Law

“…Government’s fidelity to human rights obligations, including the right to health, is a core element of developing effective law to safeguard public health. The right to health — embedded in numerous treaties and constitutions, and a founding principle of WHO — demands universal access to quality health services, along with underlying determinants of health such as a clean environment, potable water, and nutritious food. … One basic step to maximize law’s impact … is to strengthen legal capacities in all countries … This September’s U.N. [high-level meeting (HLM)] on [universal health coverage (UHC)] offers a perfect opportunity for every country to enact, or to commit to soon enact, UHC legislation, giving everyone affordable access to high-quality health services. … [M]oving one step further to advance health with justice, the time has come for moving forward on the [Framework Convention on Global Health (FCGH)], the proposed international treaty that would bring far greater accountability to all aspects of the right to health, empowering populations and greatly advancing national and global health equity. WHO should take the lead, forming a multi-stakeholder working group of states, civil society, and community members to examine and report back on the potential benefits, principles, and architecture of the FCGH…” (5/1).

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International Community Must Support Community Health Workers, Prioritize Solutions That Address Global Malnutrition

Newsweek: Mia Farrow: What I Saw In South Sudan Shows Our System For Fighting Malnutrition Is Broken | Opinion
Mia Farrow, humanitarian and advocate with the International Rescue Committee

“…[W]hile the efforts of humanitarian actors are alleviating the suffering [in South Sudan], nearly 7 million people, more than half of the entire population, face acute food insecurity. … The International Rescue Committee … has been looking at acute malnutrition with fresh eyes. … [T]he IRC has shown that community health workers can successfully treat severe acute malnutrition. In a new model, the treatment — a peanut-based nutritional supplement, easily administered — is brought to the child rather than the reverse. Of course South Sudan is not alone. There are 50 million children around the globe who are, on this very day, suffering from acute malnutrition. Roughly 80 percent of them have no access to treatment at all. A better solution is in front of us and political will amongst aid organizations, U.N. agencies, governments, and international donors is the first step. They should prioritize solutions that address acute malnutrition. This means supporting efforts for community health workers to treat it…” (5/1).

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Opinion Piece Highlights 10 Signs Of Global Progress Against Pneumonia

Devex: Opinion: 10 signs we’re winning the fight against pneumococcal disease
Maria Deloria Knoll, senior scientist at Johns Hopkins Bloomberg School of Public Health and associate director of science for the International Vaccine Access Center

“…While pneumonia remains the leading cause of death in children under 5, mortality is dropping every year as more children get access to [pneumococcal conjugate vaccines (PCV)]. We’ve achieved global access on a scale no one predicted. Here’s 10 signs of that progress: 1. Over 140 countries have introduced PCV, including 60 low-income countries. … 2. India, which suffered the world’s highest toll of pneumococcal disease, began a phased introduction in 2017. … 3. Policymakers are better informed on the economic burden of pneumonia. … 4. An innovative financing mechanism will provide nearly 1.5 billion doses of PCV to infants in [Gavi, the Vaccine Alliance] countries by 2024. … 5. The price of vaccines continues to fall. … 6. Newest formulations of PCV are better suited for low-resource settings. … 7. Middle-income countries are funding their own PCV programs. … 8. Evidence of strong impact mounts across Africa. … 9. Levels of disease have dropped even for people who weren’t vaccinated. … 10. PCV will prevent over half a million child deaths in low-income countries by 2020…” (5/1).

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From the Global Health Policy Community

Friends Of The Global Fight Highlights President Chris Collins' Participation In KFF/CSIS Event On Future Of Global Health Financing

Friends of the Global Fight Against AIDS, Tuberculosis and Malaria: Friends’ President Joins Panel on the Future of Global Health Financing
“On Thursday, April 25, the Kaiser Family Foundation (KFF) and the CSIS Global Health Policy Center held an event entitled, ‘The Future of Global Health Financing: Hope vs. Reality in the Push for Universal Health Coverage.’ Friends’ President, Chris Collins, spoke on a panel that was moderated by Jen Kates, vice president and director of global health & HIV policy at KFF, and also included Stephen Morrison, senior vice president and director of the CSIS Global Health Policy Center; Christopher J.L. Murray, professor and director at the Institute for Health Metrics and Evaluation; and Loyce Pace, president and CEO of the Global Health Council. … A video of Chris’ opening remarks is available below and a video of the full event is available from KFF” (5/1).

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Aidspan Publishes New Issue Of 'Global Fund Observer'

Aidspan: Global Fund Observer
Aidspan, an independent watchdog of the Global Fund to Fight AIDS, Tuberculosis and Malaria, published Issue 355 of the ‘Global Fund Observer.’ The newsletter includes a preview of the decision items planned for the upcoming Global Fund Board meeting; a news article on the Global Fund’s approval of 11 new country grants in four countries; and an announcement regarding the Global Fund’s creation of a new data service that consolidates information on grants, donor contributions, allocations, and other benchmarks (5/2).

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Lancet Commission Report Discusses Role Of Law In Achieving Global Health Equity, Sustainable Development

The Lancet: The legal determinants of health: harnessing the power of law for global health and sustainable development
Lawrence O. Gostin, O’Neill professor of Global Health Law and director of the World Health Organization Collaborating Center on National and Global Health Law at Georgetown University, and colleagues discuss the Lancet-O’Neill Institute Commission on Global Health and Law, with the mission to “articulat[e] the crucial role of law in achieving global health with justice, through legal instruments, legal capacities, and institutional reforms, as well as a firm commitment to the rule of law. The Commission’s aim is to enhance the global health community’s understanding of law, regulation, and the rule of law as effective tools to advance population health and equity.” In addition to the Lancet Commission’s report, The Lancet also published two commentaries discussing the report, one by Carmel Williams, executive editor of the Health and Human Rights Journal, and Paul Hunt, chief human rights commissioner for New Zealand, and another by Lancet editors Selina Lo and Richard Horton (4/30).

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May 2019 Issue Of WHO Bulletin Available Online

WHO: Bulletin of the World Health Organization
The May 2019 WHO Bulletin features articles on various topics, including an editorial on ensuring access to medicines as countries shift from Global Fund support; a news article on improving emergency care in Uganda; and a research article on the prevalence of chronic respiratory disease in urban and rural Uganda (May 2019).

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Bill Gates Discusses Role, Efforts Of 'Virus Hunters'

Gates Notes: Meet the virus hunters
Bill Gates, co-chair of the Bill & Melinda Gates Foundation, discusses the role of “virus hunters,” scientists and researchers who “find out where a mystery pathogen came from, how it’s transmitted, and how to stop it.” In particular, Gates discusses the work of Peter Piot, director and professor at the London School of Hygiene and Tropical Medicine, who helped discover Ebola, and the work of the U.K. Public Health Rapid Support Team (RST), which “deploy[s] to outbreak zones to help local governments stop infectious diseases” (4/29).

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From the U.S. Government

HHS Secretary Azar Visits Peruvian Hospital Treating Migrants, Refugees, Meets With Venezuelan Health Care Professionals

HHS: Secretary Azar Visits Peruvian Hospital and Meets with Venezuelan Health Care Professionals
“Wednesday, May 1, Health and Human Services Secretary Alex Azar visited Hospital Maria Auxiliadora in Lima, Peru, with Minister of Health Zulema Tomás to learn about the hospital and the unique challenges they face treating migrants and refugees from Venezuela. … After the hospital visit, Secretary Azar, [U.S. Ambassador to Peru Krishna R. Urs, CDC Director Robert Redfield], and other U.S. officials met with Venezuelan medical health care professionals to get a better understanding of the health care needs and challenges Venezuelan migrants and refugees face, particularly those serving in health professions…” (5/1).

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U.S. FDA Announces Approval Of Dengue Vaccine For Previously Infected Youth In Endemic Areas

U.S. Food and Drug Administration: First FDA-approved vaccine for the prevention of dengue disease in endemic regions
“The U.S. Food and Drug Administration announced [Wednesday] the approval of Dengvaxia, the first vaccine approved for the prevention of dengue disease caused by all dengue virus serotypes (1, 2, 3 and 4) in people ages 9 through 16 who have laboratory-confirmed previous dengue infection and who live in endemic areas. Dengue is endemic in the U.S. territories of American Samoa, Guam, Puerto Rico, and the U.S. Virgin Islands…” (5/1).

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USAID, Indonesian Government Engage With Civil Society To Address TB In Communities

USAID/Medium: Partnering with Communities for Tuberculosis Control
Jennifer Jackson, senior communications adviser for the Office of Health Systems in USAID’s Bureau for Global Health, discusses Indonesia’s approach to tuberculosis control, which includes engagement of civil society and faith-based organizations. Jackson notes, “Through partnerships, USAID is advancing Indonesia’s self-reliance in engaging local communities in the fight against TB and other diseases. … As diagnosis and successful treatment rates rise  –  and as the government, health system, and communities strengthen their united front  –  fewer people contract and suffer from TB and other similar diseases. These partnerships show that when every life truly matters, partnering with people is critical” (4/30).

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