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Kaiser Daily Global Health Policy Report

In The News

World Health Assembly Begins With Focus On Health Systems Strengthening, UHC, Outbreak Preparedness

Devex: World Health Assembly kicks off with focus on health workers, universal coverage
“The 71st World Health Assembly kicked off Monday with the Ebola outbreak in DRC and support for universal health coverage in the spotlight…” (Chadwick/Ravelo, 5/21).

The Hill: HHS secretary to head U.S. delegation at World Health Assembly
“Health and Human Services Secretary Alex Azar will attend the 71st World Health Assembly (WHA) in Geneva, Switzerland, as the head of U.S. delegation on Tuesday. Azar will deliver remarks on the the U.S. commitment to global health security, attend official events focused on key public health challenges, and participate in multiple bilateral meetings with health ministers and officials from other nations, according to HHS…” (Hellmann, 5/21).

Intellectual Property Watch: WHO Director Dr. Tedros Opens First Annual World Health Assembly With ‘Keys For Success’
“World Health Organization Director-General Tedros Adhanom Ghebreyesus (‘Dr. Tedros’) in his first speech in his function as head of the World Health Assembly described three keys to reach the ambitious goals of the organization. He envisioned a transformed WHO helped by a strong leadership team, called for political commitment for which he said most country leaders are ready, and advocated partnerships with a number of international health actors, including the private sector…” (Saez, 5/21).

VOA News: WHO Chief Unveils an Ambitious Agenda to Promote Health for All
“…Tedros said [the Ebola outbreak in the Democratic Republic of Congo] was only the latest of 50 emergencies in 47 countries and territories to which WHO has responded in the past year. He noted the best way to prevent future disease outbreaks and emergencies was to strengthen health systems everywhere…” (Schlein, 5/21).

Additional coverage of the World Health Assembly is available from Global Health NOW, U.N. News, VOA News, and Xinhua News.

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Reuters Examines Impacts Of Reinstated Mexico City Policy On Family Planning Services Provision In Africa

Reuters: From Burkina to Zimbabwe, U.S. aid cuts squeeze family planning services
“…[USAID] cut all money for Marie Stopes International when it refused to comply with a rule reinstated by Republican President Donald Trump in January 2017. It bans [U.S. global health] funding to any foreign NGO carrying out or offering advice on abortions anywhere. The goal is to please Christian conservatives who strongly oppose abortion and are a major part of Trump’s political base. MSI and the International Planned Parenthood Federation are among only four [prime recipients] to reject the conditions of the order. They offer abortion services, in accordance with local rules, and say it is a last resort in preventing unwanted or unsafe births. USAID says … other NGOS still receive funding. But in Africa, MSI and IPPF are the two largest NGO providers of free contraception and family planning advice…” (Cocks et al., 5/22).

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USAID Administrator Green Calls On Myanmar To Guarantee Rohingya Rights

Reuters: U.S. aid chief to Myanmar: take ‘concrete steps’ on Rohingya rights
“The U.S. government’s aid chief urged Myanmar on Sunday to take ‘concrete steps’ to guarantee the rights of Rohingya Muslims and to show sincerity in that endeavor in order to encourage hundreds of thousands who have fled the country to return. Mark Green, administrator of the United States Agency for International Development (USAID), ended his three-day visit to Myanmar touring Rohingya and Rakhine communities in western Rakhine State, including a camp for displaced Rohingya people…” (Slodkowski, 5/20).

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Former USAID Acting Administrator Wade Warren Discusses Agency's Role In Devex Interview

Devex: Q&A: Former acting USAID Administrator Warren shares his insights on the agency’s evolving role
“After nearly three decades at the United States Agency for International Development, serving in a variety of positions including acting administrator, Wade Warren left with much fanfare and recently started a new job at Deloitte Consulting. … Warren sat down with Devex just before his departure to share his insights and some of the lessons he learned along the way…” (Saldinger, 5/21).

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Experts Express Hope Experimental Ebola Vaccinations Could Mark Turning Point In Efforts To Stop Disease's Spread In DRC

Associated Press: Congo announces 6 new confirmed cases of Ebola virus
“Congo’s health ministry has announced six new confirmed cases of the Ebola virus and two new suspected cases while a vaccination effort enters its second day. … The health ministry says there are now 28 confirmed Ebola cases, 21 probable ones and two suspected. The death toll stands at 27…” (5/22).

NPR: Experimental Ebola Vaccinations, Considered ‘Paradigm Shift,’ Begin In Congo
“Health workers have unsheathed their experimental new weapon against the Ebola virus in the northwest reaches of the Democratic Republic of the Congo. On Monday, the World Health Organization, together with local and international partners, began administering Ebola vaccinations in the region…” (Dwyer, 5/21).

Reuters: First Ebola vaccines given as WHO seeks to beat Congo outbreak
“…Use of the VSV-EBOV shot — an experimental vaccine developed by Merck — marks a ‘paradigm shift’ in how to fight Ebola, said the World Health Organization’s head of emergency response, and means regions with Ebola outbreaks can in future expect more than just containment of an outbreak with basic public health measures such as isolation and hygiene…” (Kelland, 5/21).

Wall Street Journal: Ebola Vaccination Begins in Democratic Republic of Congo
“…The vaccine is being administered for the first time since it showed promising results two years ago in Guinea, in the final stages of an Ebola epidemic that killed more than 11,300 people across West Africa. If it proves effective in Congo, the vaccine could permanently alter how the world responds to the virus, which is passed on through bodily fluids such as saliva or blood…” (Bariyo, 5/21).

Additional coverage of the Ebola vaccination campaign and other aspects of the Congo outbreak are available from The AtlanticBloomberg, CIDRAP News, The Hill, Mother JonesPBS NewsHour, Reuters, STAT, and Wired.

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More Focus On, Funding For Cervical Cancer Needed To Prevent, Treat Disease, Advocates Say

Devex: The women’s health advocates pitching the end of cervical cancer
“…After three years of work in India, [Kathy Vizas, a Maverick Collective member,] found that the larger donors she approached were not interested in supporting and expanding the work [to prevent, detect, and treat cervical cancer]. This follows a trend of cervical cancer programs ramping up then scaling back, leading her and other advocates to conclude that what stands in the way of eliminating this preventable and treatable disease is a lack of knowledge, urgency, and — above all — funding. … Vizas is the co-founder of TogetHER, a new initiative founded in February that focuses on advocacy and communications to end cervical cancer…” (Cheney, 5/22).

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New WHO Report Focuses On Efficiencies Gained Through Investments In NCDs

Global Health NOW: WHO’s Different Calculus on NCDs: Saving Lives…and Money
“…40 million NCD deaths each year is a massive tragedy, but repeatedly citing mortality data doesn’t seem to resonate with government leaders. A new WHO report on NCDs released [in Geneva on Sunday] tries a different calculus. The title isn’t subtle: ‘Saving lives, spending less: a strategic response to noncommunicable diseases.’ The report, produced with support from Bloomberg Philanthropies, argues that strategies requiring the 78 low- and middle-income countries spend just an additional $1.27 per year per person would save 8.2 million lives by 2030. And if that data point doesn’t capture finance ministers’ attention, the report goes one step further: … each $1 invested in WHO ‘Best Buys’ for reducing NCDs would yield a return of $7 by 2030…” (Simpson, 5/21).

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Gates Foundation, U.K. Government Pledge $52M To CARB-X To Accelerate Research Into New Antibiotics

STAT: Gates Foundation and U.K. put $52 million toward project fighting drug-resistant bacteria
“A transatlantic initiative devoted to underwriting new antibiotics and other treatments to tackle drug-resistant infections in developing countries received a big boost today when the Bill & Melinda Gates Foundation and the U.K. government agreed to fund the effort. The CARB-X project, which was created two years ago and later secured $455 million in funding from the U.S. government and a public-private partnership in the U.K., is now slated to receive an additional $52 million that will also be invested in getting new treatments into humans in clinical trials…” (Silverman, 5/22).

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Number Of Malaria Cases Climb In Venezuela, With Health Care System Collapsing

The Guardian: Malaria rates soar in Venezuela — a nation that had nearly wiped it out
“…Once the Americas’ most malaria-infected country, the disease was almost wiped out between the 1960s and the 1980s. Now, however, while infection rates have been in decline across the rest of the Americas, malaria is exploding in Venezuela and cases are being exported across its borders as people flee conditions in the country. … Venezuela’s rising malaria rates are one of the most visible aspects of growing problems within the country’s health care system, with maternal mortality and cases of HIV and tuberculosis increasing as access to treatment has collapsed…” (Beaumont, 5/21).

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More News In Global Health

BBC News: Malaria genetics: study shows how disease became deadly (Gill, 5/22).

Bloomberg: China Considers Ending Birth Limits as Soon as This Year (5/21).

Forbes: ‘Fatal Disconnect’ — Millions Of Children Are Victims Of Road Traffic, Yet World Is Silent (Mohn, 5/21).

The Guardian: HIV drug shortage puts hundreds of thousands of lives at risk in Uganda (Okiror, 5/22).

New York Times: For First Time, WHO Names Some Lab Tests ‘Essential’ (McNeil, 5/21).

Open Mind: The Real Drug Crisis (Heffner, 5/19).

Reuters: Ten die in India outbreak of brain-damaging virus, spurring rush to hospitals (Vengattil et al., 5/22).

Scientific American: A Warming Climate May Produce More Drug-Resistant Infections (Brouillette, 5/21).

Thomson Reuters Foundation: Third of girls in South Asia miss school during periods — study (Banerji, 5/22).

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Editorials and Opinions

Trump Administration's Withdrawal From Global Health Efforts Could Lessen U.S.'s Leadership Role, Threaten Americans' Health

Foreign Policy: Trump Is in a Coma on Public Health
Laurie Garrett, former senior fellow for global health at the Council on Foreign Relations

“…[T]he U.S. government is increasingly withdrawing from global health efforts writ large. And the world has noticed. The governance of international health is already being organized in a manner less dependent on Americans — and less influenced by Washington. … Some Trump supporters may applaud saving a few million taxpayer dollars by cutting support of global health efforts and believe that other nations can, and should, handle outbreak threats. But America is a safer place precisely because of the depth of experience and wisdom its scientists and public servants have acquired from decades of engagement in health crises overseas. Stepping away from such engagements only signals to the world that the United States no longer cares about the health and survival of non-Americans. Americans should not be surprised if, because of their government’s actions, the leaders of global public health organizations start to care less about them” (5/21).

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Strengthening Global Defenses Against Pandemic Threats Critical For World's Health

Washington Post: Think ‘globalists’ are villains? Look at the Ebola outbreak.
Michael Gerson, syndicated columnist

“…When it comes to health, the world has become a single, massive body. A serious infection arriving at the weakest part of the immune system — say, the health systems of West Africa — could easily spread to the whole. This argues for strengthening our health defenses — the ability to detect and respond to pandemic threats — in remote places. And it will require vaccines that can ring a disease and make a global immune response more effective. At the NIH, [Director Francis] Collins has been pushing hard for the development of a universal flu vaccine, which would be broadly protective against pandemic strains. Funding that effort could end up the most important spending in the entire federal budget. The globalization of threats — from terrorism to pandemic disease — is a bare, unavoidable fact. And it will only be met and mastered by determined, heroic globalists” (5/21).

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REPLACE Action Package Aims To Help Nations Eliminate Trans Fats From Food Supplies

The Lancet: REPLACE: a roadmap to make the world trans fat free by 2023
Tedros Adhanom Ghebreyesus, director general of the WHO, and Thomas R. Frieden, president and CEO of Resolve to Save Lives

“…WHO has identified the elimination of industrially produced trans fat (an artificial product contained in partially hydrogenated oils) from the food supply as an effective and cost-effective intervention to prevent cardiovascular disease. Industrially produced trans fat causes an estimated 540,000 deaths each year worldwide. … On May 14, 2018, WHO and Resolve to Save Lives announced the REPLACE initiative to make the world trans fat free by 2023. The REPLACE action package provides countries with tools they can implement now to eliminate industrially produced trans fats from their national food supplies. REPLACE is the first global initiative to eliminate a risk factor for cardiovascular disease. … This is a fundamental issue of health equity — there is no reason that people in lower-income countries should continue to be exposed to a toxic chemical from which people in many wealthier countries have adequate protection. Every individual deserves to have the greatest possible level of protection for their health…” (5/14).

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World Leaders Must Commit More Resources, Take Stronger Actions To End TB Epidemic By 2030

Bloomberg: Who Dies From Tuberculosis?
Editorial Board

“Tuberculosis, a disease fueled by poverty, overcrowding, and undernutrition, is a global barometer of deprivation. Of the more than 4,000 men, women, and children TB kills every day, most are poor. … Because healthy people are relatively safe from tuberculosis, improved living standards during the early 20th century helped lower the incidence. … But in recent decades, the emergence of HIV and mutant antibiotic-resistant bacteria have hampered control efforts, slowing the pace of decline in global TB incidence. From 2000 to 2015, TB claimed 33 million lives and cost the world economy an estimated $616 billion, with India, Indonesia, China, and Russia carrying half that burden, according to a recent KPMG report. Unless governments, civil society organizations, and individual citizens take more effective action, by 2030, a further $1 trillion and 28 million lives may be lost” (5/21).

Bloomberg: What It Will Take to Finally Defeat Tuberculosis
Editorial Board

“…[W]hen world leaders say they want to end the [TB] epidemic by 2030, they are setting a tight deadline. … [M]edical science needs to come up with quicker, safer, and cheaper ways to diagnose TB, and a pipeline of new drugs to kill the bacteria and its resistant forms. Economic incentives for drug makers are essential … A shortage of global funding for medical research … explains why decades have gone by with no new TB treatments or vaccines. The good news is that a dozen vaccine candidates are now in clinical trials. … But history is clear about the consequences of inaction: Infections will multiply, millions more lives will be lost, and increasing antibiotic resistance will make it even costlier to stop this ancient foe” (5/21).

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WHO Now Better Prepared To Address Current Ebola Outbreak

The Telegraph: The WHO may not be perfect but it’s far better prepared to fight Ebola this time
Jeremy Farrar, director of the Wellcome Trust

“…The WHO has traditionally been happier as a bureaucratic assembly than a leader. But it was terribly clear, in the aftermath of the last Ebola epidemic, that things needed to change. And they have. In the past few days the WHO’s response could not be more different. … A coordinated response took less than an hour to galvanize and 18 hours to launch. … Now the organization needs to set itself ambitious, measurable targets, to push itself even more. The sign of a confident organization is that it gives itself goals to achieve, goes about achieving them, and then resets for new challenges. … We should have high expectations of the WHO and challenge it when it gets things wrong. But national governments need to acknowledge when the WHO gets things right, trust it, and back that trust with financial support. If they do not, we may face a world without the WHO where the 2014-16 [Ebola] scenario — and worse — becomes far more likely…” (5/21).

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Global Community Must Strengthen Governance Against AMR

The Lancet: Global governance of antimicrobial resistance
Connor Rochford of the Blavatnik School of Government at the University of Oxford and colleagues

“…The danger of [antimicrobial resistance (AMR)] moving across borders demands the strengthening of global governance arrangements; no country can avoid the consequences if antimicrobials become ineffective. Effective action is only possible if all countries, agencies, and other actors organize ourselves across national boundaries. The focused set of priorities for AMR governance, the international legal process needed to deliver on these, and the supporting High-Level AMR Commission and Global Steering Board that we propose are only part of the solution. A truly global response to reduce the threat of AMR requires everyone to play their part. We welcome discussion on what the functions of the Global Steering Board could be” (5/19).

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Improving Pharmaceutical Systems Vital To Achieving UHC

Devex: Opinion: Strong pharmaceutical systems are crucial to attaining UHC
Kwesi Eghan, principal technical adviser at Management Sciences for Health

“…[U]nless country commitments [to universal health coverage (UHC)] include efforts to strengthen pharmaceutical systems, communities will continue to struggle with inadequate health services and rising health costs that put their health and economic well-being in peril. … Laws, policies, and financing arrangements should promote access to health services and quality-assured medicines at a cost that does not put people at risk of financial catastrophe. … Good pharmaceutical management improves cost-efficiencies, too. … [A]ll countries must explicitly recognize that strengthening pharmaceutical systems and management practices to improve access to and affordability of medicines is imperative for achieving UHC. … When the health leaders of every country gather [for the World Health Assembly] in Geneva this May and announce their commitments to making UHC a reality, I hope they will make pharmaceuticals a priority” (5/21).

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From the Global Health Policy Community

BMJ Blog Posts Discuss Aspects Of Universal Health Coverage

BMJ Blog: Paying and investing in last-mile community health workers accelerates universal health coverage
Wilhelmina Jallah, minister of health of the Republic of Liberia; Francis Kateh, chief medical officer/deputy minister of health of the Republic of Liberia; and Raj Panjabi, chief executive of Last Mile Health and assistant professor at Harvard Medical School, discuss the role of community health workers (CHWs) in expanding health coverage, highlighting Liberia’s experience. The authors write, “Paying and investing in CHWs isn’t just the right thing to do; it’s the smart thing to do to accelerate universal health coverage” (5/22).

BMJ Blog: Sania Nishtar: Non-communicable diseases must be part of Universal Health Coverage
Sania Nishtar, co-chair of the WHO Independent High-level Commission on NCDs, discusses the importance of integrating efforts to address non-communicable disease (NCD) into universal health coverage initiatives, writing, “There should be no escaping a strong global push to tackle NCDs. A strong institutional base, a clear strategy, and adequate funding are critically needed” (5/22).

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New Report, Campaign Call For World Leaders To Take Global Action On Road Traffic-Related Health Issues

FIA Foundation: Call for urgent action as ‘fatal disconnect’ in global health policies fails child victims of road traffic
“The international community is failing to take action on a global health crisis caused by road traffic, which kills 350,000 children and adolescents each year and causes serious harm and injury to millions more, says a new report and campaign launched [Monday] at the World Health Assembly in Geneva. The report, ‘Unfinished Journey: The Global Health Response to Children & Road Traffic,’ … identifies road traffic as one of the most neglected issues affecting the health and well-being of young people. … The report … spearheads a new campaign calling for a first-ever summit of world leaders on child and adolescent health to urgently re-focus global policy to address this road traffic-related health crisis…” (5/21).

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Safeguarding Health In Conflict Coalition Releases Global Report Highlighting 2017 Attacks On Health Care

Safeguarding Health in Conflict: Violence on the Front Line: Attacks on Health Care in 2017
This report examines attacks on health care in countries affected by conflict in 2017, discussing the scope of the problem and offering recommendations on action to be taken (May 2018).

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