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Kaiser Daily Global Health Policy Report

In The News

U.K. To 'Stand Strongly Against Rollback Of Women's Rights' Worldwide, International Development Minister To Announce At Oslo Conference

The Telegraph: Britain will fight the global ‘rollback’ of women’s rights, says U.K. development minister
“The new international development minister will use a speech in Norway today to make it clear that Britain will not follow America and ‘rollback’ access to abortions and other reproductive health services. Baroness Sugg, a 42-year-old former operations chief to David Cameron, will tell delegates at a conference on gender in Oslo that the U.K. must ‘stand strongly against the rollback of women’s rights’…” (Newey, 5/24).

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'Social Stigma' Surrounding Obstetric Fistula Must End, UNFPA Executive Director Says On International Day

U.N. News: End ‘shame, isolation and segregation’ of fistula sufferers, urges U.N. reproductive health chief
“…Marking the International Day on 23 May to end the almost entirely preventable condition [of fistula], the head of the U.N.’s sexual and reproductive health agency, UNFPA, said that sufferers continue to ‘face devastating social stigma.’ ‘Shame, isolation, and segregation are among the indignities faced by the hundreds of thousands of women and girls worldwide who suffer from obstetric fistula,’ said Dr. Natalia Kanem, UNFPA’s executive director, in a statement issued on Thursday…” (5/23).

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WHO Appoints Emergency Ebola Response Coordinator For DRC Outbreak; Risk Of Spread To Larger Cities, Other Countries High, Officials Warn

ABC News: U.N. names Ebola chief to tackle world’s 2nd largest outbreak: ‘We have no time to lose’
“United Nations officials on Thursday named an emergency Ebola response coordinator to help bolster efforts to contain the growing outbreak in the eastern Democratic Republic of the Congo that has killed more than 1,200 people in 10 months. David Gressly, the U.N. deputy special representative for the Democratic Republic of the Congo, has been appointed to the new position, in which he ‘will oversee the coordination of international support for the Ebola response and work to ensure that an enabling environment — particularly security and political — is in place to allow the Ebola response to be even more effective,’ according to a statement from the World Health Organization, the global health arm of the U.N…” (Winsor, 5/23).

The Lancet: NGOs push for decentralized Ebola treatment in DR Congo
“The initiative, led by MSF and ALIMA, would provide community-based Ebola virus disease care. But pushback from DR Congo Ministry of Health could prove difficult…” (Shuchman, 5/25).

New Humanitarian: As Ebola cases rise, so do worries of a cross-border epidemic
“The second-largest Ebola outbreak ever continues to spread, and health officials now say it’s likely to reach the populous city of Goma. Once there, the risk of it spreading beyond the Democratic Republic of Congo to Rwanda, South Sudan, or Uganda increases. … ‘I wouldn’t say (the spread to Goma) is inevitable, but it’s highly probable,’ said Ray Arthur, director of the Global Disease Detection Operations Center at the U.S. Centers for Disease Control and Prevention…” (Dodds/Elliot, 5/23).

U.N. News: DR Congo: ‘No time to lose’ says newly appointed U.N. Ebola response coordinator
“…Up to the middle of this month, the number of cases, according to U.N. figures, stood at 1,847 (1,759 confirmed and 88 probable). In total, there have been 1,223 deaths (1,135 confirmed and 88 probable) and 487 people have survived the deadly virus…” (5/23).

Additional coverage of the DRC Ebola outbreak and response is available from Agence France-Presse, CIDRAP News, National Geographic, NPR, Science Speaks, VOA News, and Xinhua News (2).

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WHO Outlines First-Ever Snakebite Strategy, Aims To Invest $136M Through 2030

UPI: WHO to invest $136M to combat snakebites
“Because snakebites kill and disable hundreds of thousands of people every year, the World Health Organization unveiled a new strategy Thursday to mitigate the dangers. Calling snakebites the world’s greatest hidden health crisis, the WHO announced a goal of investing $136 million to educate communities and prevent snakebites, make more effective treatments, and find safer, cheaper anti-venom…” (Sakelaris, 5/23).

Additional coverage of the snakebite strategy and research into treatments is available from CNN, Deutsche Welle, and The Guardian.

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Governments Working On Drug Pricing Transparency Deal At WHA; Some Advocates Fear Parts Of Agreement Will Remain Secret

Reuters: WHO drug pricing talks may fail to end secrecy, activists fear
“Governments are working on a drug pricing transparency deal at the World Health Organization’s (WHO) annual assembly, but activists said on Thursday they fear crucial costs may be left out, enabling pharmaceutical firms to keep prices high. … A six-page draft published by the WHO on Thursday urges states to publish prices and costs of medicines, vaccines, cell and gene-based therapies, and other health technologies, and improve the transparency of medical patents. … On Monday, U.S. Health and Human Services Secretary Alex Azar said the United States was very supportive of greater drug pricing transparency, hoping to bring down published ‘list prices’ for drugs and ‘out of pocket expenses’ for consumers. But there were some areas where lifting the veil of corporate secrecy may not be worthwhile, such as in R&D spending, Azar told reporters…” (Miles, 5/23).

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Pakistan Committed To Eliminating Polio; New Vaccination Campaign To Begin In June

Global Health NOW: Polio: Waiting for the Final Blow
“Dozens of member states pledged continued support for the global effort to eradicate polio during a #WHA72 committee meeting on Thursday morning. But one mattered more than most: Pakistan. … Pakistan’s representative assured fellow delegates that his government is fully committed to its polio elimination program — despite the recent suspension of a massive campaign to immunize more than 40 million children under 5 following the murders of 2 police officers protecting polio immunization teams…” (Simpson, 5/23).

New York Times: To Calm Nervous Families, Pakistan Changes Polio Vaccination Tactics
“After serious setbacks in April led to a cluster of new polio cases, Pakistan is revamping its vaccination strategy in a renewed effort to wipe out the virus. … Now, vaccination teams will take a friendlier approach, ask fewer questions, make fewer follow-up visits, and stop recording extensive details about the families they visit, Pakistan’s polio eradication program announced. … A new vaccination drive is scheduled for the second week of June; thousands of teams will spread out around the country trying to reach almost 40 million children under age 10…” (McNeil, 5/24).

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More News In Global Health

Devex: In Yemen, growing caseloads overwhelm international aid groups (Lieberman, 5/24).

Global Health NOW: A New Plan for Mental Illness, the Silent Killer (Simpson, 5/23).

The Lancet: Millions of health-care facilities lack WASH services (Burki, June 2019).

New York Times: 4 Women With Lives Scarred by Genital Cutting: Could a Surgeon Heal Them? (Belluck, 5/24).

NPR: The Philippines Is Fighting One Of The World’s Worst Measles Outbreaks (Beaubien, 5/23).

PRI: For centuries, migrants have been said to pose public health risks. They don’t (5/23).

Quartz Africa: As measles spreads, should African countries issue health travel restrictions for Westerners? (Kimeria, 5/23).

VOA News: Angola’s Record Drought Puts Millions at Food Security Risk (Coroado, 5/24).

Xinhua News: Tibet sees progress in health sector (5/23).

Xinhua News: Roundup: Nigerian gov’t mulls indirect subsidies for toilet construction to end open defecation (5/23).

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Editorials and Opinions

Protecting Access To Safe Abortions, Supporting Women Must Be High Priority, Opinion Piece Says

The Lancet: We must all support women in the fight for abortion
Editorial Board

“…The Guttmacher-Lancet Commission on Sexual and Reproductive Health and Rights (SRHR) explained why protecting safe abortions should be a high priority. … Importantly, the Commission concluded: ‘to move the SRHR policy agenda forward, advocates and policy makers should bring scientific evidence to legislative and other policy debate.’ As our 2019 Commission on the legal determinants of health stated, ‘laws that are poorly designed, implemented, or enforced can harm marginalized populations and entrench stigma and discrimination.’ The laws passed [recently restricting abortion in several U.S. states] are demonstrably poorly designed, implemented, and enforced, and will have these described effects. … [W]e must all stand up for women. Abortion is a settled, inviolable right that is central to achieving not only reproductive health goals but women’s freedom over their own bodies. It is of the utmost importance that medical organizations, journals, NGOs, and advocates come together to condemn the rolling back of abortion laws and campaign for rights to be respected” (5/25).

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Editorial, Opinion Pieces Discuss Challenge Of Mistrust, Importance Of Community Involvement In DRC Ebola Response

The Lancet: Acknowledging the limits of public health solutions
Editorial Board

“…WHO has not declared the [Ebola] outbreak [in the Democratic Republic of the Congo (DRC)] a Public Health Emergency of International Concern (PHEIC). Although calls to declare a PHEIC are understandable in the face of a worsening and precarious situation, such a declaration, and the increased technical response that it entails, will do little to address what is principally a political problem. … [Response] efforts are being compromised by a complex and dangerous security situation compounded by misinformation and mistrust. … Nonetheless, a very real risk remains that the outbreak will cross into Rwanda or Uganda, in which case a declaration of a PHEIC would probably be needed to increase technical capacity and international coordination. For now, the focus remains on DR Congo’s government and opposition groups. Sources at WHO told The Lancet that the organization is working with the governments of the USA, the U.K., and France to influence leadership within the country to address the security situation. There are limits to what the medical community alone can achieve — if the Ebola virus disease outbreak is to be ended, DR Congo’s leaders on all sides of politics must step up and take responsibility for the response” (5/25).

The Conversation: Radical ideas are needed to break the DRC’s Ebola outbreak. Here are some.
Mosoka Fallah, deputy director general at the National Public Health Institute of Liberia and visiting scientist at Harvard Medical School

“…[T]he current Ebola outbreak is expanding, largely unabated. And there is a growing risk that it will spill over to neighboring countries with the potential of spreading internationally. … What can leaders of the response do? … First, they can incentivize community leaders (chiefs, healers, women, priests) on a fixed stipend to head the response in their respective towns or villages. … Second, food can be used to incentivize community response and volunteer self-quarantine. … Third, find all means necessary to incentivize the rebels and make them a part of the response. … If we are to win the current war on Ebola, we must employ unconventional approaches, even ones that might be considered controversial. The fact is, people who are poor and neglected are more susceptible to infectious diseases and distrustful of authority. Distrust of authority, civil war, and Ebola are a recipe for disaster even with the most costly response and medical counter measures. Time is ticking” (5/22).

Thomson Reuters Foundation: OPINION: How to tackle Ebola in DRC? Focus on the community
Agoustou Gomis, Ebola virus disease project coordinator at World Vision DRC

“…[Families] must be at the heart of a locally-led [Ebola] response, working with trusted individuals in the community … Faith leaders, local radio, youth groups, and women’s associations are all crucial structures to help drive home messages about identifying symptoms, staying safe when caring for sick people, and where to get help. … Engaging the community, working with faith leaders and other peer groups, reinforcing health systems, and getting everybody to work together on a common cause — these are powerful incentives to keep focused on seeing an end to Ebola in the DRC” (5/23).

New York Times: Letters to the editor: Attacks on Ebola Health Workers in the Democratic Republic of Congo
David Miliband, president and chief executive of the International Rescue Committee, and Joe Amon, director of global health at Drexel University’s Dornsife School of Public Health

“…You are right to highlight the gulf of political mistrust at the heart of the Ebola crisis, which is far more worrying and dangerous than realized. … The International Rescue Committee runs more than 50 health centers in eastern Congo, and the recipe for trust is to work from the ground up. That means local hires — doctors, nurses, security — drawn from the community and galvanized to defend it. There must be a new partnership where every part of the response is assigned to those with real expertise. This is already the second worst Ebola outbreak in history. Too many lives are at stake for it to become the biggest” (Miliband, 5/23).

“…It is unfortunate that deep distrust in the affected communities has led to violence and attacks on health facilities and workers. … Trust needs to be restored with communities and governments, and we must expand efforts to protect health workers. Where attacks occur, immediate investigations must hold those responsible to account” (Amon, 5/23).

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Global Community Must Take Action Against Snakebite Envenoming

The Lancet Global Health: WHO’s Snakebite Envenoming Strategy for prevention and control
Ren Minghui, assistant director general for communicable diseases at WHO, and colleagues from Tanzania and WHO

“…A key aspect of this [new snakebite] strategy will be to engage and empower communities in preventing venomous snakebites and increasing training to provide better treatment. … Success [against snakebites] will … depend on accelerating the development of antivenoms and, crucially, building a sustainable market for safe, effective treatments. … [I]ntegrating an approach to prevention, treatment, and management of snakebite envenoming, in which the community is fully engaged, into national health policy and health systems will be crucial. Tackling the underlying social, cultural, and economic barriers to health care that many victims of snakebite experience will lead to earlier treatment and more effective outcomes. … Reducing the number of snakebite-related deaths and disabilities by 50% by 2030 is achievable, as they are mostly preventable. But WHO cannot do this alone. When we launch the [global strategy], we will call on governments, health professionals, researchers, international health agencies, antivenom manufacturers, philanthropists, and other stakeholders for their support in its implementation” (5/22).

STAT: Snakebites are on the rise as snakes migrate with climate change
Walter Ochieng, medical officer, health economist, and Aspen New Voices fellow

“…To stem [the] rising tide of death and disability [from snakebites], health systems must begin preparing now. … A few things should be done — and urgently. Countries need to update their maps of snake habitats and educate communities about new threats they may face from venomous snakes. Because different antivenoms are needed for different snakebites, this mapping will also help determine what antivenoms are needed where. Governments should consider providing manufacturers with incentives like tax breaks to resume production of antivenoms and to lower their prices for these drugs. … It is also important to begin funding research on promising universal antivenom candidates to treat bites from different snake species and on lifesaving antidotes like the antiparalytic drug neostigmine. … To be sure, these actions should not distract from the root cause of the problem. Global efforts to mitigate and reverse climate change must accelerate. The implementation of public health actions now will save millions of lives over the next decade, and avoid crippling disabilities…” (5/24).

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WASH Critical To Preventing Antimicrobial Resistance

Devex: Opinion: Our frontline defense against ‘superbugs’ is fatally weakened
Tim Wainwright, chief executive of WaterAid U.K.

“In Geneva this week, perhaps no other agenda item at the World Health Assembly seems so pressing, so frightening, so potentially global in reach, as antimicrobial resistance. … Yet what worries me deeply is the lack of attention being paid to the most obvious, most basic preventive frontline defenses against superbugs: water, soap, and decent toilets. … [This problem] cannot be ignored or neglected any longer if the ambition of ‘health for all’ is to become reality. … WaterAid was pleased to contribute our experience to WHO and UNICEF’s ‘practical steps’ report, published as a companion to the new data on WASH in health care facilities and summarizing very clearly eight tangible, specific actions countries can take to improve services. At this year’s [World Health Assembly], health ministers have the opportunity to address this issue head-on and to adopt an ambitious resolution, which could provide the cornerstone for a step-change in action…” (5/23).

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From the Global Health Policy Community

Global Fund Posts Highlight Importance Of Investment In Its Efforts To End HIV, TB, Malaria Epidemics

Global Fund to Fight AIDS, Tuberculosis and Malaria’s “VOICES”: Health Ministers: It’s Time for the World to Step Up the Fight
This post highlights remarks from health ministers about the importance of Global Fund investments to end the HIV, TB, and malaria epidemics (5/23).

Global Fund to Fight AIDS, Tuberculosis and Malaria: Step Up the Fight
In this video, Global Fund Executive Director Peter Sands explains why now is the time the global community must step up the fight to end the HIV, TB, and malaria epidemics (5/16).

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Friends Of The Global Fight Highlights Key Takeaways From Global Fund's 41st Board Meeting

Friends of the Global Fight Against AIDS, Tuberculosis and Malaria: Key Takeaways: The Global Fund’s 41st Board Meeting
This post highlights key takeaways from the Global Fund’s 41st board meeting, which took place last week in Geneva. The group outlines discussion around achieving a strong sixth replenishment, the approval of the allocation and catalytic funding methodology, and the selection of a new Board chair and vice chair (5/23).

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CARE International Challenges Global Leaders To Commit To Protecting Women From Gender-Based Violence During Conflict

CARE International: Less than 1 % of humanitarian aid spent on protecting women from violence in crisis, CARE warns Oslo conference
“[On May 23,] CARE International [challenged] global leaders to commit long-term, predictable funding mechanisms for the protection of women from gender-based violence abuse during crises and conflicts…” (5/22).

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Article, Blog Posts, Press Release Discuss Achieving Universal Health Coverage

The BMJ: Next steps towards universal health coverage call for global leadership (Bloom et al., 5/24).

Center for Global Development: Are Courts Promoting or Hindering Fair Priority-Setting in Health? (Wang/Chalkidou/Teerawattananon, 5/23).

U.N. Dispatch: Here is How Close the World’s Poorest Countries Are to Achieving Universal Health Coverage (Lu, 5/24).

World Health Organization: There is no stopping our progress to advance health for all (5/24).

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From the U.S. Government

USAID Recognizes International Day To End Obstetric Fistula, Highlights Story Of Survivor, Advocate

USAID: Justine’s Fresh Start
In recognition of the International Day to End Obstetric Fistula, which takes place annually on May 23, USAID highlights the story of a woman who underwent fistula repair surgery and now raises awareness in her community about fistula, the importance of giving birth in a facility, and healthy timing and spacing of pregnancies (May 2019).

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CDC's MMWR Provides Update On Global Progress Toward Polio Eradication

CDC’s “Morbidity and Mortality Weekly Report”: Progress Toward Polio Eradication — Worldwide, January 2017-March 2019
Sharon A. Greene of the Epidemic Intelligence Service and the Global Immunization Division at the Center for Global Health at CDC, and colleagues discuss global progress toward polio eradication, including updates on polio vaccination, surveillance, cases, and isolations of circulating vaccine-derived poliovirus (5/24).

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