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Kaiser Daily Global Health Policy Report

In The News

U.S. Releases First Water And Development Strategy; U.N. Recognizes World Water Day

“U.S. officials Tuesday formally unveiled the government’s first comprehensive strategy [.pdf] aimed at integrating water into all U.S. development funding and programs, a step long urged by advocates and development experts,” Inter Press Service reports (Biron, 5/22). USAID Administrator Rajiv Shah joined Sens. Richard Durbin (D-Ill.) and Chris Coons (D-Del.), and Reps. Earl Blumenauer (D-Ore.) and Ted Poe (R-Texas) to release the government’s five-year Water and Development Strategy, which “recognizes the vital role water plays in ensuring the health and economic well-being of people around the world” and “sets out to represent a fundamental shift at [USAID] toward a new model of development — defined by public and private partnerships, use of new technology, and emphasis [on] long-term results,” according to a USAID press release. The strategy includes two strategic objectives, including “Water for Health,” aimed at improving “health outcomes through the provision of sustainable Water, Sanitation and Hygiene (WASH),” and “Water for Food,” which aims to “[m]anage water for agriculture sustainably and more productively to enhance food security,” the press release states (5/21). “Notably, the plan puts into action new USAID guidance to emphasize local ownership and sustainability of U.S.-funded aid projects, while offering greatly expanded flexibility on how that funding is to be used,” IPS writes.

“Civil society groups are expressing excitement over the scope and strength of the new strategy, dubbing it a ‘major advance,'” IPS writes, adding, “But many are also calling on lawmakers to ensure that, during the coming implementation phase, U.S. aid is targeted primarily at the poorest communities in developing and middle-income countries.” The news service notes the U.S. Water for the Poor Act, passed in 2005, “requir[es] that water and sanitation be a central priority for U.S. foreign funding” and “requires that water and sanitation-related aid be centered on countries that have the least access to those services, with the aim of having the greatest possible impact on other development goals.” According to IPS, “while the new USAID strategy is not [an] implementation plan, observers are now planning to push lawmakers to ensure that the new strategy is closely aligned with the objectives of the 2005 legislation” (5/22). In related news, U.N. Secretary-General Ban Ki-moon on Wednesday recognized World Water Day in a statement, noting the day “is dedicated to highlighting the joint efforts necessary to ensuring a fair share for people and planet.” He highlighted the roles of climate change, agriculture, and sanitation in water access, saying, “Water holds the key to sustainable development,” according to the statement (5/22).

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Devex Examines U.S. Government's Action Plan On Children In Adversity

“Six months after its launch, the U.S. government’s Action Plan for Children in Adversity lacks ‘teeth,’ child development and health experts told a Senate appropriations subcommittee on Tuesday,” Devex’s “Development Newswire” blog reports. The blog post discusses the hearing, some of the challenges facing the action plan, including funding, as well as its future prospects. According to the blog, Neil Boothby, one of the action plan’s creators, and other advocates have suggested creating a PEPFAR-style program “to address children’s needs — including needs related to HIV and AIDS — in countries PEPFAR currently doesn’t prioritize.” However, “whether or not the U.S. government heeds the calls by some advocates to kickstart a PEPFAR-style movement in countries that aren’t prioritized by the flagship HIV and AIDS program, the action plan is likely to impact aid procurement, particularly application requests for child health and safety programs, as [USAID] has committed to align its priorities with the plan’s strategy, beginning in a list of ‘focus countries’ that will be announced in June, according to an agency official,” the blog writes. “It is important for agencies to start looking at how they can align and reorient what they’re doing, and it’s very, very important that we all work together to figure out how we’re actually going to measure achievement of results. … We’ve got to get much more attention and serious about the measurement piece,” Boothby said, Devex writes (5/22).

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At WHA, BRICS Countries Pledge Cooperation In Public Health, NCD Drafting Group Continues Work On Resolution

“The BRICS countries — Brazil, Russia, India, China and South Africa — pledged in a joint communiqué on the sidelines of the 66th World Health Assembly [WHA] in Geneva, Switzerland, to strengthen intra-BRICS cooperation in promoting [the] health of their peoples,” Xinhua reports. “[T]he BRICS decided to continue cooperation in the sphere of health through the Technical Working Groups on five thematic issues, such as strengthening health surveillance system[s]” and “reducing non-communicable disease [NCD] risk factors,” the news agency notes, adding that the countries also “reiterated their commitment to support WHO as a coordinating authority in global health and expressed support for the leadership role and broad directions of WHO’s action plan and further emphasized the importance of providing access to quality primary health care services for all” (5/23). Also at the WHA, WHO members “this week have made non-communicable diseases a top priority, and work on a draft resolution and action plan is being carried out by a drafting group that will report back later in the week,” Intellectual Property Watch reports. “The draft resolution endorses a WHO global action plan (GAP) framework for NCDs, which includes a set of 25 indicators to monitor trends and assess progress in strategies across regional and country settings, and nine voluntary global targets,” the news service notes (Ngo/New, 5/22).

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Polio Cases Detected In Kenya, Somalia, WHO Says

The WHO “says the Horn of Africa is experiencing an outbreak of polio with cases confirmed in Kenya and Somalia,” the Associated Press/Washington Post reports. The “WHO said Wednesday that a four-year-old girl near the Dadaab refugee camp in Kenya and two of her contacts tested positive for polio, the first confirmed cases in Kenya since July 2011,” and “[a] case in Somalia was confirmed earlier this month,” the AP writes (5/22). “Many parts of Somalia have not held polio vaccination campaigns since 2009, [the] Global Polio Eradication Initiative said, and the country, in general, has one of the lowest immunization rates in the world,” NPR’s “Shots” blog reports. “Genetic analysis suggests that the poliovirus in Somalia came from Nigeria, which is more than 3,000 miles away,” the blog writes, adding that while “[i]t’s still unknown if the Somalia case is connected with the ones in Kenya … the international health community has responded quickly to contain both outbreaks” (Doucleff, 5/22). “In response, a vaccination campaign reaching 440,000 children began May 14 in Somalia,” and “[a] second round of vaccinations is planned and will include parts of Kenya,” the AP reports (5/22). In related news, development blogger Tom Paulson interviews Apoorva Mallya, a program officer for the Bill & Melinda Gates Foundation’s Vaccine Delivery team, in Humanosphere. They discuss the challenges to eradicating polio, particularly in the three remaining endemic countries of Afghanistan, Pakistan and Nigeria (5/22).

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IPS Interviews UNAIDS Executive Director About Ending Stigma, Discrimination

While “[t]he global fight against HIV/AIDS has seen recent hard-won breakthroughs,” including a significant increase in the number of people with access to antiretroviral therapy, “ending stigma and discrimination against people living with HIV has proved more resistant, particularly so for those who are part of the lesbian, gay, bisexual, transgender or queer (LGBTQ) community,” Inter Press Service reports. “With May 17 marking the International Day Against Homophobia and Transphobia, IPS spoke with Michel Sidibé, executive director of UNAIDS, about how discrimination affects efforts to stem the spread of HIV/AIDS, how that fight is moving forward, and the post-2015 development agenda,” the news service writes. In the interview, Sidibé discusses the negative impacts on HIV prevention and care of criminalizing homosexuality and UNAIDS’ programs and activities surrounding its vision of “Zero new HIV infections, Zero discrimination and Zero AIDS-related deaths” and the post-2015 development agenda, according to IPS (Vaas, 5/22).

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Editorials and Opinions

Ending Child Marriage Should Be 'Strategic Imperative' For U.S.

“Child marriage is a global epidemic that occurs across regions, cultures, and religions,” and the practice “is undoubtedly a violation of human rights,” Rachel Vogelstein, a fellow at the Council on Foreign Relations and an adjunct professor of women’s human rights at Georgetown University, writes in an Atlantic opinion piece. “What happens to an individual girl affects the stability of her family, community, economy, and nation, which in turn has broad implications for U.S. foreign policy,” she continues, adding, “As I demonstrate in a new report from the Council on Foreign Relations, a body of evidence shows that child marriage undermines U.S. interests in development, prosperity, and stability.”

“Research suggests that child marriage often curtails education for young girls, which not only undercuts their potential but also stifles economic progress,” Vogelstein writes, adding, “Child marriage also undermines global health, a priority on which the United States spends billions of dollars in foreign aid every year.” In addition, “U.S. security interests are … weakened by child marriage,” she writes, providing examples. Noting the U.S. Congress in March reauthorized the Violence Against Women Act with “a provision that requires the Secretary of State to develop a U.S. strategy to combat the international scourge of child marriage,” Vogelstein states, “As the Obama administration develops this strategy in a time of fiscal austerity, policymakers would do well to remember that combating child marriage is not only a moral imperative — it is a strategic imperative.” She concludes, “The success of U.S. efforts to foster economic growth, improve global health, and promote stability and security will grow if this persistent practice comes to an end” (5/22).

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Gender Equality Essential For Reaching Health-Related MDGs

“In over 15 years of working in the field of global health, I have time and time again witnessed first-hand what research tells us: gender inequity and women’s low social status have a significant impact on women’s and children’s health, as well as the overall demand for maternal, newborn and child health services,” Patricia Mechael, executive director of the mHealth Alliance, writes in a Forbes opinion piece, published as part of a series on mobile health by the Skoll World Forum on Social Entrepreneurship, Johnson & Johnson, the mHealth Alliance, “Impatient Optimists,” and Forbes.com. “Many health problems in low-income countries, such as maternal mortality and unintended pregnancies, are directly linked to gender inequity … but increasingly we see mobile technologies being leveraged to improve access to vital family planning information and commodities,” she continues.

“Although more than one billion women have access to a mobile phone in developing countries, a woman living there is still 21 percent less likely to own a cell phone than a man,” Mechael writes, adding, “When I read these statistics, I can’t help but wonder how much closer we would be to achieving Millennium Development Goal 3 (MDG 3) — to promote gender equality and empower women — if we focused on consistently putting the power of mobile technology into their hands.” She continues, “If we are to effectively leverage mobile technologies to achieve MDGs 4, 5, and 6” — which aim to lower child mortality, reduce maternal mortality, and combat HIV, malaria and other diseases — “we must do a better job of addressing MDG 3.” Machael concludes, “This means engaging women and their husbands more consistently in the design and implementation of the very solutions that are meant to help them and their families” (5/22).

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From the Global Health Policy Community

WHO Working With Industry To Reduce NCD Risk Factors

The WHO “is in active dialogue with the food, beverage, alcohol, and even sporting goods industries to encourage marketing changes and product formulations to help curb the growing worldwide prevalence of non-communicable diseases (NCDs),” Nellie Bristol, a research fellow with the Center for Strategic & International Studies’ (CSIS) Global Health Policy Center, writes in the center’s “Smart Global Health” blog. “While the organization has long had a ‘zero tolerance’ policy in communicating with the tobacco industry, it is using newly strengthened conflict of interest guidelines to work with the food, beverage, and alcohol industries ‘to find acceptable public health solutions,'” WHO Director-General Margaret Chan said May 20 in a speech before the World Health Assembly, according to Bristol, who discusses actions industry could take to address NCD risk factors, as well as steps countries have taken to do so. She writes, “With obesity and high blood pressure rising worldwide along with increasingly globalized food markets, industry has to be part of the solution” (5/22).

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Seeking 'Predictable' Funding Sources For Global Health

In the second part of her blog series on the future of global health, Laurie Garrett, senior fellow for global health at the Council on Foreign Relations, discusses possibilities for upcoming global health funding outcomes, writing in her blog, “[T]he architecture of global health has been completely remade since 1990, though not through any process of collective wisdom. Money — what donors were willing to support, in large part due to sophisticated advocacy and activism — has reshaped all health priorities.” She continues, “For ministries of health and country-based health programs, this shift ushers [a] need to look to domestic sources for support.” Garrett discusses possible sources for this funding, including financial transaction taxes, and she states, “Transformation of entire social contracts between governments and their people to achieve such targets as universal health coverage, guaranteed 24/7 health services for all, 100 percent safe deliveries for all babies and moms, and wellness programming requires planning. And planning requires predictable funding.” She writes, “This week, as members of the World Health Assembly study the sober budget proposal for the WHO, it is wise to ask where will funds come from next year, and the next, and the next?” (5/22).

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Blog Calls For Increasing Awareness Of Obstetric Fistula

“This year marks the 10th anniversary of the launching of the United Nations Campaign to End Fistula,” and May 23 marks the first International Day to Obstetric Fistula, Glendora Meikle, project director for OperationOF, writes in the Bill & Melinda Gates Foundation’s “Impatient Optimists” blog. “Obstetric fistula is a horrific birthing injury” that “affects around two million women in Africa and Asia,” she notes, adding, “Exact numbers are hazy because the communities most affected are poor and rural, and because the stigma attached to it prevents sufferers from coming forward.” Meikle discusses the condition and its causes, and writes, “[B]y far the biggest obstacle to the eradication of fistula is lack of awareness.” She encourages readers to discuss the condition and spread knowledge, concluding, “It’s a shame fistula is such a difficult subject around which to hold a conversation. But look at it this way: if it makes us uncomfortable just talking about it, imagine how it feels to live with it” (5/22).

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