Kaiser Daily Global Health Policy Report

In The News

Bipartisan Congressional Report Calls On WHO To Change Opioid Guidance, Accuses Purdue Pharma Of Influencing Guidelines

Associated Press: U.S. lawmakers demand U.N. health agency change opioid guidance
“Two U.S. lawmakers are calling on the World Health Organization to withdraw pain care guidelines that include what they say are false claims about the safety of prescription opioids. They say the guidelines could lead other countries toward the same kind of addiction and overdose crisis that has plagued the U.S. in recent years…” (Mulvihill/Keaten, 5/22).

The Guardian: Purdue Pharma accused of ‘corrupting’ WHO to boost global opioid sales
“…An investigation by Katherine Clark and Hal Rogers, who represent districts in Massachusetts and Kentucky hard hit by the U.S. opioid epidemic, accuses Purdue of replicating its false marketing claims about the safety and effectiveness of opioids to change WHO prescribing guidelines in an attempt to expand foreign markets for its drugs…” (McGreal, 5/22).

NBC News: U.N. agency is accused of helping Purdue Pharma spread opioid epidemic around the world
“…In a 38-page report titled ‘Corrupting Influence, Purdue & the WHO,’ Rep. Katherine Clark, D-Mass., and Rep. Hal Rogers, R-Ky., charged that the WHO has published guidelines for opioid use that parrot Purdue’s claims ‘that dependence occurs in less than 1 percent of patients, despite no scientific evidence supporting this claim’…” (Siemaszkol, 5/22).

STAT: Lawmakers contend WHO pain treatment guidelines are really Purdue ‘marketing materials’
“…In a new report, the lawmakers contend that the WHO guidelines, which were released in 2011 and 2012, are ‘serving as marketing materials for Purdue.’ And they pointed to efforts by the company to create and fund front groups that participated in research that shaped WHO decision making — and dovetailed with corporate goals to boost use of opioids, such as its own OxyContin pill…” (Silverman, 5/22).

Washington Post: Congressional report: Purdue Pharma influenced World Health Organization’s opioid guidelines
“…Purdue said the company ‘strongly denies the claims’ in the report, arguing that it ‘seeks to vilify the company through baseless allegations.’ It said the company is based in the United States and has no international operations. The World Health Organization did not respond to a request for comment Wednesday…” (Zezima, 5/22).

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U.S. House Unanimously Passes Resolution Denouncing Female Genital Mutilation, Calling For Worldwide Efforts To Eliminate Practice

Newsweek: U.S. House passes resolution officially recognizing female genital mutilation as a ‘human rights violation’
“The House of Representatives has passed a bipartisan resolution denouncing the practice of female genital mutilation (FGM) and recognizing it as a human rights violation against women and girls. … In their resolution, which passed unanimously with a 393 to 0 vote, which was co-sponsored by 28 congress members, lawmakers call on the U.S. government, as well as the international community to undertake coordinated efforts ‘to eliminate the harmful practice’…” (Da Silva, 5/22).

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U.S. HHS Secretary Azar Endorses Vaccines At World Health Assembly Panel

Global Health NOW: Booster Shot for Vaccines
“It wasn’t so much the message as the messenger. ‘Vaccines are some of the most thoroughly tested medical products we have. Vaccines are safe, effective, and lifesaving.’ No one in Salle XXIII at the World Health Assembly on Tuesday afternoon was expecting anything different, nor would they doubt the statement’s veracity, but relief permeated the room as Alex Azar, U.S. secretary of health and human services, delivered the full-throated endorsement of vaccines. The U.S., under President Trump, unequivocally was backing vaccines on the world stage…” (Simpson, 5/22).

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Security Most Important Factor In DRC Ebola Outbreak, Health Minister Says, Calls For Regulatory Approval Of Merck Vaccine; WHO Appoints Emergency Ebola Response Coordinator

Al Jazeera: Fears of Ebola pandemic if violent attacks continue in DR Congo
“Health officials have warned that the second-deadliest outbreak of Ebola may spiral out of control unless attacks by armed groups on medical facilities and workers in the Democratic Republic of the Congo (DRC) stop…” (Bibbo, 5/22).

Reuters: U.N. creates new Ebola chief role to tackle security, political issues in Congo
“The United Nations named an Emergency Ebola Response Coordinator on Thursday, creating a new position to boost efforts to contain a 10-month epidemic in the Democratic Republic of Congo that has killed more than 1,200 people. … David Gressly, currently deputy chief of the U.N.’s MONUSCO peacekeeping mission in Congo, has been appointed to the new post, the statement said…” (Nebehay, 5/23).

Reuters: Congo wants more use of Merck vaccine rather than J&J newcomer: minister
“Democratic Republic of Congo called on Wednesday for Merck’s experimental Ebola vaccine to be fully licensed to facilitate its use in the Ebola-hit country, while saying Johnson & Johnson’s rival [experimental vaccine] would complicate matters. … ‘It would perturb the population to be faced with several different types of vaccines and that would muddle the message, and, as you know in a complex outbreak response, the message needs to be simple and clear,’ [Congolese Health Minister Oly Ilunga Kalenga] said…” (Miles, 5/22).

Additional coverage of the DRC Ebola outbreak and response is available from CBS News and CIDRAP News.

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WHO Publishes First-Ever Prevention, Control Strategy For Snakebite Envenoming

Associated Press: U.N. health agency issues 1st strategy to address snake bites
“The World Health Organization is publishing its first-ever global strategy to tackle the problem of snake bites, aiming to halve the number of people killed and disabled by snakes by 2030. … WHO’s strategy includes plans to increase global access to treatment and antivenom” (5/23).

Devex: The race to tackle snakebite
“…David Williams, WHO’s snakebite expert, told Devex at the World Health Assembly in Geneva, Switzerland, this week that the strategy is a holistic attempt to create and spread affordable, high-quality antivenoms, and change community habits. But Williams acknowledged that ‘to some extent, I still think that even our strategy is too cautious,’ adding that ‘we are only limited by our imagination’…” (Chadwick, 5/23).

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Investors, Health Groups Urge Changes In Corporate Policies Impacting Antibiotics Use In Meat Supply, Tobacco Marketing On Social Media

CIDRAP News: Investors push restaurant chains to cut antibiotics in meat supply
“A new report from a global coalition of investors suggests the world’s largest fast food and casual dining companies are getting the message about their role in addressing antibiotic resistance. … The [Farm Animal Investment Risk & Return (FAIRR)] coalition, which includes 74 institutional investors that manage nearly $5 trillion in combined assets, first began engaging with companies in 2016, when it sent letters to 10 of the largest publicly listed companies in the fast food and casual dining sectors following a review that found the companies were not acknowledging their role in addressing antibiotic resistance. Ten more publicly listed companies were targeted in 2017. By 2018, all targeted companies had recognized the need to limit antibiotic use in their supply chains…” (Dall, 5/21).

Reuters: Citing Reuters report, health groups push tech firms to police tobacco marketing
“More than 100 public health and anti-tobacco organizations are calling on Facebook Inc., Instagram, Twitter, and Snap Inc. to take ‘swift action’ to curb advertising of tobacco products on their platforms. … No law specifically prevents online tobacco or e-cigarette marketing, but social media firms have policies limiting it. The health groups said in their letter that the use of online personalities creates a ‘loophole’ in those policies and allows ‘rampant marketing’ of tobacco and other nicotine products to youth…” (Kirkham, 5/22).

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WHO Certifies Algeria, Argentina As Malaria-Free

Thomson Reuters Foundation: U.N. declares Algeria and Argentina free of deadly malaria
“Algeria — the nation where malaria was discovered — is officially free of malaria, the World Health Organization (WHO) said on Wednesday, making it the third African country to eliminate one of the world’s leading killer diseases. With no recorded cases of malaria in three consecutive years, Argentina was also declared malaria-free — the second country in the Americas after Paraguay in 45 years to wipe out the disease, which kills more than 400,000 people a year…” (Moloney, 5/22).

Additional coverage of the countries’ malaria elimination efforts is available from CNN, Quartz Africa, The Telegraph, and Xinhua News.

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More News In Global Health

Al Jazeera: Survivors: Inside Sierra Leone’s Ebola epidemic (Pratt, 5/22).

BBC News: How the malaria vaccine could change world health (Vince, 5/23).

Devex: Aid community caught off guard by Somalia drought (Root, 5/23).

Forbes: Immune To Drugs: Antimicrobial Resistance Could Kill 10 Million A Year (Fisher, 5/22).

The Guardian: ‘Hygiene is the first priority’: Nepal looks to clean up its act on sepsis (Lamble, 5/23).

Reuters: Venezuela turns to Russia, Cuba, China in health crisis (Nebehay, 5/22).

Reuters Health: Kissing is a risk factor for throat gonorrhea (Crist, 5/22).

Thomson Reuters Foundation: Charities fear for children separated from parents in cyclone-hit Mozambique (Bhalla, 5/22).

Xinhua News: U.N. chief calls for addressing root causes of displacement in Africa (5/22).

Xinhua News: World’s current food system is increasingly broken: U.N. chief (5/23).

Xinhua News: Study explores aspects of food system to end global hunger (5/22).

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Editorials and Opinions

Oslo Conference Could Serve As Opportunity To Strengthen Response To Sexual, Gender-Based Violence In Conflict

The Guardian: The world over, people in crisis suffer sexual violence — this scourge must end
Natalia Kanem, executive director of UNFPA, and Mark Lowcock, U.N. under-secretary general for humanitarian affairs and emergency relief coordinator

“…The U.N., governments, the International Committee of the Red Cross, and civil society organizations are coming together in Norway this week for a first-of-its-kind conference on ending sexual and gender-based violence in humanitarian crises. The aim is to strengthen collective responsibility, promote best practices, and increase funding and political commitment to prevention and effective response. … For survivors and their communities, the devastating consequences of sexual and gender-based violence include injuries, unwanted pregnancies, fistula, sexually transmitted infections including HIV, trauma, and death. … Yet our interventions during humanitarian crises remain chronically underfunded … Our strategy to address these shortcomings requires three steps. First, we must put survivors … at the center of our crisis response. … Second, we need to focus on prevention and address gender inequality, the root cause of gender-based violence, which is magnified during humanitarian crises. … Third, more needs to be done to hold perpetrators to account…” (5/23).

Washington Post: How do you reduce sexual and gender violence in conflict? Consider these five key issues.
Chen Reis, clinical associate professor and director of the Humanitarian Assistance Program at the Josef Korbel School of International Studies at the University of Denver, and Marie E. Berry, assistant professor at the Josef Korbel School of International Studies at the University of Denver and director of the Inclusive Global Leadership Initiative

“…The conference in Oslo could help the conversation on sexual violence in conflict return to focusing on survivors and grass-roots activists. Here are five key issues to keep in mind. 1. The Trump administration is backing away from advocating for women’s rights … 2. Language in high-level forums doesn’t always translate to impact on the ground … 3. Shifting language from ‘women and girls’ to include ‘men and boys’ sounds good but can backfire … 4. A narrow focus on perpetrators rather than survivors. … 5. Making room for grass-roots and feminist approaches … The Oslo conference could contribute by resisting efforts to erase women’s needs and rights. It can encourage governments, U.N. agencies, and other organizations to focus on supporting survivors and grass-roots activists, ensuring that services are available and establishing accountability mechanisms for those efforts” (5/22).

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Community Engagement Critical To Response, Research Activities During Global Health Emergencies

The Guardian: The importance of community involvement in tackling Ebola
Katharine Wright, assistant director of the Nuffield Council on Bioethics, and 18 colleagues in global health

“…When such crises [like the Ebola outbreak in the Democratic Republic of the Congo (DRC)] emerge, a trusting relationship between responders and affected community members makes a vital difference to whether the response is effective. As shown in DRC, trust is not a given, which is one of the reasons why community engagement — involving local people in the development of the response from the very start — is so important. In conflict zones this is more difficult than in other emergencies, and yet even more important. This also holds true when conducting research during an outbreak … A recent international meeting of survivors’ leaders, community engagement specialists, and medical and social science researchers … has identified key features of community engagement relating to both response and research, including: Effective engagement is a two-way process … Approaches must be founded on empathy, human connections, and a recognition of the history and experiences of those affected by the outbreak … Community engagement must be embedded from the beginning as a core part of response and research activities, with appropriate funding and support. … We call on national governments, research funders, research ethics committees, the media, and others to unite in promoting and supporting community engagement for response and research during global health emergencies” (5/22).

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Pilot Malaria Vaccination Campaign Marks Milestone In Global Effort To Eliminate Malaria

The Lancet Infectious Diseases: Malaria vaccination: a major milestone
Editorial Board

“…The launch of the pilot RTS,S vaccination program in April marks a major milestone that could make a substantial difference in the push for malaria elimination in sub-Saharan Africa. … The integration of the RTS,S vaccine into the national immunization programs of Malawi, Ghana, and Kenya over the next 5 years is … an exciting moment for public health. … However, the partial protection RTS,S offers means that vaccination will be supplementary and not superior to existing malaria control campaigns such as the use of bednets and indoor residual spraying. Therefore, the RTS,S project should support ongoing malaria interventions in the target countries by integrating bednet distribution and malaria education. Malawi, Ghana, and Kenya are now cemented in the history of malaria control and the data these countries produce over the next 5 years will be invaluable to securing elimination” (6/1).

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Genome Editing Needs To Be Regulated

Washington Post: We have the technology to customize our babies. It needs regulation.
Editorial Board

“When Chinese scientist He Jiankui announced last November his experiments making heritable genetic changes in human embryos followed by live births of twins, alarms went off. What shocked many scientists and others was how Mr. He used new technology for gene editing without serious oversight or transparency, amid grave questions about the medical rationale and potential future damage. One good thing came out of this: Mr. He spurred a more deliberate, international effort to answer the hard questions. Now that effort must lead to stricter regulation. … Fortunately, the right organizations are now in motion. The U.S. National Academies and the British Royal Society have launched an international commission. The World Health Organization has created an advisory committee, too. We hope these efforts will find a consensus that can be accepted and enforced by the widest circle possible. The goal must be a framework that will enable genuine scientific advancement but avoid reckless fiddling with the source code of life. It is a tall order — and an urgent need” (5/21).

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From the Global Health Policy Community

Experts Examine Current State Of U.S. Foreign Assistance Data 3 Years After Passage Of Foreign Aid Transparency And Accountability Act

Modernizing Foreign Assistance Network: Three years after FATAA: What’s the current state of U.S. foreign assistance data?
Sally Paxton, U.S. representative at Publish What You Fund, and George Ingram, MFAN co-chair and senior fellow at the Brookings Institution, discuss the state of U.S. foreign assistance data after the passage of the Foreign Aid Transparency and Accountability Act (FATAA) in July 2016, writing, “The effort to publish quality U.S. data has been hampered by old systems that leadership has yet to solve. … FATAA was passed to improve the effectiveness and accountability of U.S. foreign assistance. … Years later, the consolidation process and the quality issues are clearly not an [Office of Management and Budget (OMB)] priority” (5/22).

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WHA Side Event Focuses On Addressing AMR Challenges

IDSA’s “Science Speaks”: World Health Assembly 2019: As antibiotic pipeline diminishes, time runs out for patients
Amanda Jezek, senior vice president at the Infectious Diseases Society of America, highlights discussion from a World Health Assembly side event held by the Global Antibiotic Research & Development Partnership (GARDP) on addressing global antimicrobial resistance (AMR). Panelists at the event included Ravina Kullar, an infectious diseases specialist; Jeremy Knox, policy and advocacy lead on antimicrobial resistance at Wellcome; Ramanan Laxminarayan, board chair at GARDP; Hanan Balkhy, assistant director general for antimicrobial resistance at the WHO; and Manica Balasegaram, executive director at GARDP (5/22).

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Organizations Recognize International Day To End Obstetric Fistula

International Federation of Gynecology and Obstetrics: In Yemen, Ending Fistula under Armed Conflict (Al-Jailani, 5/22).

IntraHealth International’s “Vital”: Obstetric Fistula and Mental Health: From Tanzania to Mali (Watt, 5/22).

IntraHealth International’s “Vital”: How Local Fistula Training Helped Prevent an Ebola Outbreak in Mali (5/23).

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