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Kaiser Daily Global Health Policy Report

In The News

Devex Highlights PEPFAR's Successes On 15th Anniversary, Discusses Potential Impacts If Political Support Falters

Devex: 15 years later, PEPFAR is still at war with a global epidemic
“…Descriptions of what the President’s Emergency Plan For AIDS Relief has achieved in the last 15 years often include words ‘miracle,’ and ‘unprecedented.’ The initiative has provided antiretroviral medications to more than 14 million people, saved millions of lives, and helped stave off an epidemic that threatened to consume entire countries and cripple their economies. As PEPFAR celebrates its 15th anniversary this month, perhaps even more striking is the widespread agreement among the initiative’s biggest backers that if PEPFAR does not go even further — or if political support falters — the basic mathematics of disease will bring about a new emergency, wiping out a victory that was never fully achieved…” (Saldinger/Igoe, 5/25).

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The Intercept Examines Impact Of Mexico City Policy On Family Planning Services In Uganda

The Intercept: In Uganda, Groups Offering Contraception and Family Planning Have Lost Millions in U.S. Aid Thanks to Trump’s Global Gag Rule
“…President Donald Trump’s iteration of the GGR [global gag rule, also called the ‘Mexico City policy’], announced in the early days of his presidency, goes farther than those of his Republican predecessors, because it applies to all global health assistance, not just funds pegged specifically to reproductive health and family planning. … In much of sub-Saharan Africa, the best health services are provided by charity organizations or the United Nations, which makes their populations extremely susceptible to massive funding cuts that can come when a foreign government changes its priorities. The GGR is a prime example. Asasira [program manager of research documentation and advocacy at CEHURD] felt that the Ugandan government’s reliance on nonprofit organizations to fill its massive gaps in public services needed to be remedied. ‘The global gag rule happened, fine, it happened. But is the Ugandan government doing enough to provide health care for its citizens, in particular family planning?’ she asked. ‘Our government can’t say President Trump ruined everything — “Look, see the global gag rule happened and we can’t provide contraceptives.” We are trying to shake up our government and say there is social contract’…” (Kasinof, 5/26).

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U.S. Senators Introduce Legislation To Increase Taiwan's Participation In International Organizations, Including WHO

Taiwan News: U.S. Senators introduce ‘Taiwan International Participation Act’ of 2018
“Republican Senator Cory Gardner of Colorado, and Democrat Senator Edward J. Markey [of Massachusetts] announced a new legislative act on Friday May 25 entitled the ‘Taiwan International Participation Act of 2018’ (TIPA) that will be heading to the U.S. Senate. … The act aims to see Taiwan gain access to, and be able to participate in organizations such as the Civil Aviation Organization (ICAO), the International Criminal Police Organization (Interpol), and the World Health Organization (WHO), which recently excluded Taiwan from the annual World Health Assembly at the behest of China…” (DeAeth, 5/26).

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Former U.S. Official Speaks About Evolution Of Global Health, U.S. Policy At AAAS Lecture

Science: Global health shifts to local experts with global partners
“…Jimmy Kolker, now a visiting scholar at the American Association for the Advancement of Science’s Center for Science Diplomacy … was the assistant secretary for global affairs at the U.S. Health and Human Services Department, a position to which he brought experience as the former ambassador to Burkina Faso from 1999 to 2002 and later to Uganda from 2002 to 2005. Kolker traced the evolution of global health on 4 May as part of the AAAS-Hitachi Lecture on Science and Society, at AAAS’s Washington, D.C., headquarters. … U.S. funding for international health security is being squeezed, Kolker added, including programs designed to assist emerging economies to meet World Health Organization standards to prevent and respond to global health emergencies…” (Hoy, 5/25).

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Ebola Vaccinations Begin In Congo Outbreak; Health Workers Stress Need For Holistic Prevention Strategies

Associated Press: 1 new Ebola death confirmed in Congo, bringing total to 12
“Another person has died in Congo of a confirmed case of Ebola, bringing the number of fatalities from the latest outbreak to 12, the country’s health ministry said Sunday. … Congo now has 35 confirmed Ebola cases…” (Mwanamilongo, 5/28).

Associated Press: Ebola vaccinations begin in Congo’s northwest town of Bikoro
“Officials began vaccinating health workers and others on Monday in Bikoro, where Congo’s current Ebola outbreak was first declared at the beginning of May. Congo’s Health Minister Oly Ilunga traveled to oversee the Ebola vaccinations of at least 10 people in Bikoro, where at least five of 12 Ebola deaths have happened…” (Mwanamilongo, 5/28).

The Atlantic: Vaccines Alone Won’t Beat Ebola
“A deep understanding of the Congo’s culture and time-honored public health tactics are the keys to controlling the outbreak…” (Yong, 5/24).

CIDRAP News: DRC Ebola response faces community resistance as report analyzes U.S. policy
“Ebola responders in the Democratic Republic of Congo (DRC) are revealing more about local practices and community mistrust, which in some instances are hampering the actions needed to curb the spread of the disease in the country’s outbreak hot spots. In another development, Kaiser Family Foundation (KFF) [Friday] said the United States is playing a less prominent role in the response, a sign that suggests the international response is more prepared to tackle such outbreaks but also raises questions about the nation’s mixed signals regarding global health security…” (Schnirring, 5/25).

Devex: DRC Ebola response focuses on awareness campaigns, border controls
“As humanitarian workers gain steam in the fight against the Ebola outbreak in western part of the Democratic Republic of the Congo — which has left 27 dead — a multi-pronged containment effort and new rounds of funding hope to prevent the highly contagious virus from spreading to the capital, Kinshasa, or to other neighboring countries…” (Roby, 5/25).

IRIN: Congo Ebola outbreak offers first test for emergency fund to prevent pandemics
“A new financial mechanism that frees up emergency funding to ward off a pandemic has been activated for the first time, in response to an outbreak of Ebola virus in the Democratic Republic of Congo. Efforts to halt the outbreak received an injection of $12 million from the new World Bank fund and, if Ebola spreads to other countries and infects more people, hundreds of millions more could be released from a sister insurance scheme…” (Parker, 5/28).

Reuters: WHO’s Congo Ebola plan assumes 100-300 cases over three months
“The World Health Organization assumes 100-300 cases of Ebola in Democratic Republic of Congo between May and July, under a revised response plan to the outbreak that it published on Tuesday…” (Miles, 5/29).

Washington Times: CDC officials take precautions as Ebola outbreak spreads
“With Ebola once again flaring up in an African country, U.S. health officials have briefed border officers about potential danger from travelers, and U.S. airports are beginning to issue warnings about the deadly disease. Authorities say there’s no immediate danger and they’re better prepared should the outbreak begin to spread beyond the Democratic Republic of Congo. But the briefings and precautions are part of an effort to get out in front of the risks…” (Howell, 5/28).

Additional coverage of the Ebola outbreak, including prevention and vaccination efforts, is available from Agence France-Presse, Al Jazeera, BBC News, Christian Science Monitor, CNN, The Economist, Financial Times, The Lancet, New York Times, Reuters, Science, STAT, VOA News (2), and Vox.

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WHO, World Bank Launch Global Preparedness Monitoring Board To Improve Global Health Security Across Sectors

U.N. News: New health board aims to break ‘cycle of panic and neglect’ on pandemics
“…The Global Preparedness Monitoring Board (GPMB) brings together political leaders, heads of United Nations agencies, and health experts to strengthen global health security through stringent independent monitoring and regular reporting. It was launched on Thursday in Geneva by the World Health Organization (WHO) and the World Bank Group. … The board will monitor emergency preparedness across national governments, U.N. agencies, civil society, and the private sector…” (5/24).

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71st World Health Assembly Ends With 5-Year Strategic Plan, Including WHO Reform

Devex: What you need to know about the 71st WHA
“At a plenary session of the 71st World Health Assembly, during a statement in honor of the 100th birthday of former South African President Nelson Mandela, the World Health Organization Director-General Tedros Adhanom Ghebreyesus quoted the late leader: ‘It always seems impossible until it is done.’ That sentiment, he said, could also energize member states to realize health care for all. It is a fair assessment of the enormous tasks that lie ahead for global health leaders — as well, perhaps, of what the community accomplished last week at the WHA in Geneva…” (Ravelo/Chadwich, 5/29).

VOA News: WHO Chief Looks Forward to Ambitious Reform Program
“The World Health Organization’s annual conference ended on a high note Saturday, with the organization’s director general praising delegates for giving him a strong mandate to implement an ambitious program of reforms and initiatives that will improve global health. WHO chief Tedros Adhanom Ghebreyesus paid homage to his predecessor, Margaret Chan, saying the reforms begun under her leadership to make the World Health Organization more responsive and better able to tackle emergencies were now paying off…” (Schlein, 5/26).

Xinhua News: World Health Assembly closes with new course for WHO
“…At his closing speech on the final day of the WHA, Dr. Tedros recaptured the ‘triple billion’ targets which were approved this week in WHO’s new five-year strategic plan. By 2023 the targets aim to achieve: one billion more people benefitting from universal health coverage; one billion more people better protected from health emergencies; and one billion more people enjoying better health and wellbeing…” (5/27).

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Global Health NOW Wraps Up Reporting From 71st WHA

Global Health NOW: Alex Azar’s Excellent UHC Adventure
“…U.S. Health and Human Services Secretary Alex Azar brought a crystal clear Trump administration message of improving health care and access by relying more on the private sector, while global health experts who spoke after him emphasized more collaborative, public efforts…” (Simpson, 5/25).

Global Health NOW: Kwanele Asante: “It’s Our Lives That Are At Stake” (Simpson, 5/25).

Global Health NOW: Back To The Circus: Loyce Pace On The Value Of The World Health Assembly (Simpson, 5/24).

Global Health NOW: 5 Trans Fat Takeaways from #WHA71 (Simpson, 5/24).

Global Health NOW: Ready For The Next Outbreak? Let’s See Your Number (Simpson, 5/24).

Global Health NOW: Global Health NOW at #WHA71 (Simpson, 5/17).

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New ILO, UNAIDS Report Examines Continuing Impact Of HIV/AIDS On Workers, Workplaces

U.N. News: HIV/AIDS still impacting work and costing billions in lost earnings — new U.N. agency report
“Outlining the economic and social toll HIV and AIDS continues to take on workers around the world, the International Labour Organization (ILO) called on Thursday for an ‘urgent effort’ to improve treatment, step up testing, and ensure healthier and more productive workplaces. Prepared in collaboration with the U.N. agency dedicated to tackling the virus, UNAIDS, The impact of HIV and AIDS on the world of work: Global estimate, examines the past and future effects of HIV epidemic, and development of antiretroviral therapy (ART), while assessing the economic and social impact on workers and their households…” (5/24).

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13 Dead In India's Nipah Outbreak; CEPI Announces $25M Over 5 Years For Vaccine Development

CIDRAP News: Nipah death toll in India hits 12 as CEPI funds vaccine efforts
“…[Thursday] the Coalition for Epidemic Preparedness Innovations (CEPI) announced a $25 million collaboration with two pharmaceutical companies to develop a vaccine against the disease, one of the group’s priority diseases…” (Schnirring, 5/24).

Quartz: The latest outbreak of a deadly virus has scientists racing to create a vaccine
“…CEPI said it would grant up to $25 million over the next five years to U.S. pharma firms Profectus BioSciences and Emergent BioSolutions to advance the development of a vaccine against the viral infection, which has proved to be fatal in 70 percent of cases…” (Thomas, 5/25).

Reuters: India steps up hunt for origin of mysterious brain-damaging virus
“India began a fresh round of tests to trace the origin of a rare brain-damaging virus that has killed 13 people, a health official said on Monday, as initial tests on animals suspected of carrying the Nipah virus showed no sign of the disease…” (Patnaik/Jose, 5/28).

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Ireland Votes To Repeal 8th Amendment Banning Abortion

The Hill: Ireland overturns abortion ban in landslide vote
“Ireland has voted overwhelmingly to repeal a restrictive abortion ban from its constitution, the country’s prime minister said on Saturday. The eighth amendment of the Irish constitution imposed one of the world’s most restrictive bans on the procedure. But in a landslide, Irish voters rejected the amendment…” (Greenwood, 5/26).

POLITICO: Two-thirds of Irish vote to repeal abortion ban
“Irish voters backed amending the constitution to repeal a ban on abortion, with 66.4 percent voting in favor and 33.6 against, according to the official count completed [May 26]…” (Wheaton, 5/26).

Additional coverage of this story is available from BBC News, The Guardian, Wall Street Journal and Washington Post.

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Washington Post Analysis Examines Abortion Laws Worldwide

Washington Post: The many countries where abortion is basically banned
“…Only four countries regulate the procedure more strictly [than Ireland did before it repealed its ban on May 25], banning the procedure in all cases. … The countries with total bans house six percent of the world’s 1.64 billion women of reproductive age, according to the Guttmacher Institute. … It’s relatively rare for a country to ban abortion entirely. But that doesn’t mean women have easy access to the procedure in most places. The vast majority of countries put at least some restrictions on abortion access…” (Erickson, 5/24).

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U.N., World Bank Provide Emergency Funding To Avert Famine In War-Torn Yemen

Associated Press: U.N., World Bank give cash to Yemen’s neediest to avert famine
“The U.N. agency for children said Monday it has distributed cash to nearly 1.5 million families in war-battered Yemen to help avert the risk of famine. The emergency payout, part of a $200 million World Bank-funded program, comes in the fourth year of a civil war that has killed more than 10,000 people, displaced more than three million and crippled the country’s infrastructure…” (5/28).

U.N. News: Yemen: Human suffering at risk of further deterioration, warns U.N. aid chief
“An escalation in fighting, increasing obstacles to aid delivery and lack of food and fuel, is compounding Yemen’s dire humanitarian crisis, the United Nations top relief official warned on Thursday, calling on all parties to the conflict to end the violence. Across Yemen, more than 22 million people are dependent on humanitarian assistance or protection, of whom around 8.4 million are severely food insecure and at risk of starvation…” (5/24).

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More News In Global Health

Deutsche Welle: Guinea worm: inching towards eradication (Winter, 5/23).

Devex: Tuberculosis and NCDs jostle for space in global health agenda (Chadwick, 5/25).

Intellectual Property Watch: Fake Medicines To Be Discussed On Side Of WTO TRIPS Council Next Week (5/29).

Intellectual Property Watch: South Africa Approves New IP Policy, With Guidance From U.N. Agencies (Daniels, 5/27).

The Lancet Infectious Diseases: AIDS, Africa, and high ambition (Burki, June 2018).

The Lancet Infectious Diseases: Rohingya threatened by infectious diseases (Cousins, June 2018).

NPR: Why It’s Difficult For Viruses To Turn In To Deadly Pandemics (Doucleff, 5/29).

NPR: Why It’s So Hard To Wipe Out Polio In Pakistan (Hadid, 5/26).

Reuters: Pakistan diluted proposed tobacco health warnings after Philip Morris, BAT lobbying (Kalra et al., 5/29).

Reuters: Think of investment return, UNICEF chief tells Europe (Macdonald, 5/25).

Taiwan News: Taiwan to donate US$1 million to WHO’s Ebola fund despite being denied entry to WHA (Tzu-ti, 5/26).

Thomson Reuters Foundation: Rebooting food: Finding new ways to feed the future (Win, 5/24).

Thomson Reuters Foundation: Are the global goals doomed to fail without better open data? (Gerretsen, 5/24).

Thomson Reuters Foundation: Millions could avoid deadly fever if world limits warming (Taylor, 5/28).

STAT: Polio eradication initiative meets resistance to appeals to destroy samples (Branswell, 5/25).

Xinhua News: Zambia, Global Fund pledge to continue strengthening health systems (5/24).

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Editorials and Opinions

U.S. Administration Should 'Step Up' Efforts As Global Health Landscape Changes

The Hill: If we want to make America great, let’s focus on global health
Farhan Majid, L.E. and Virginia Simmons fellow in Health and Technology Policy, and Aastha Sharma, former senior consultant at National Health Systems Resource Center

“…Global health trends have not only become unpredictable, but also less localized. … The changing disease patterns call for changes in strategies and revision of targets every few years, demonstrating that health problems are global problems requiring cross disciplinary solutions and international participation for complete containment. In light of these rapid changes in global health landscape, it is essential that developed countries such as the U.S. pool in resources and support global health efforts with unprecedented zeal and commitment. … [B]y investing in global health, the U.S. would not only be saving lives and promoting human rights globally, it can also further its economic interests strategically. The current administration needs to step up its game or risk losing its stature as a global health leader, in addition to putting at risk the security of millions of American lives and potentially damaging American business interests locally and globally” (5/24).

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PEPFAR Continues To Have Positive Impact As Jamaica Works Toward Ending HIV/AIDS Epidemic

Jamaica Observer: Impressive life-saving achievements President’s Emergency Plan for AIDS Relief celebrates 15th anniversary
Eric Khant, chargé d’affaires at the U.S. Embassy in Kingston

“…PEPFAR assistance truly has a positive impact across the Jamaican society. … For the first time in modern history we have the opportunity to control a pandemic without a vaccine or a cure while laying the groundwork for eventually eliminating or eradicating HIV. … U.S. Embassy Kingston applauds the Government of Jamaica’s leadership in adopting the ‘Treat All’ policy, the global standard for HIV/AIDS response which says that all individuals who test positive should rapidly initiate treatment. … Together we can end the HIV/AIDS epidemic in Jamaica. Let’s … ensure that all 30,000 people living with HIV on the island have access to life-saving treatment, paving the way for an HIV-free Jamaica…” (5/27).

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U.S. 'Should Use Its Leverage' To Ensure Yemenis Able To Receive Humanitarian Aid

Washington Post: The world’s worst humanitarian crisis could get even worse
Editorial Board

“The world’s worst humanitarian crisis may be about to get much worse. In Yemen, where some eight million people are on the brink of famine and the worst cholera epidemic in history is raging, the country’s most important port has become the target of a new offensive in the three-year-old civil war. Yemeni forces backed by the United Arab Emirates and Saudi Arabia are seeking to cut off and eventually capture Hodeida, a city of 700,000 that is the entry point of 70 percent of the aid shipments keeping millions of civilians alive. The United States, which supplies the Saudi-UAE alliance with arms and intelligence, should use its leverage to stop this reckless venture…” (5/28).

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To Continue Improving Global Health, WHO Should 'Rededicate Itself To Its Core Mission'

The Hill: We need reform at the WHO if we actually care about global health issues
Kenneth E. Thorpe, professor of health policy at Emory University and chair of the Partnership to Fight Chronic Disease

“…For decades, the WHO has partnered with universities, nonprofits, and businesses to advance global health initiatives, leveraging their resources and expertise. … But recently, the WHO has moved away from that approach, expanding its mandate while shrinking the number of partners it is willing to engage. … [T]he WHO must rededicate itself to its core mission and focus on activities where it has the expertise and ability to make an impact. Rather than shutting out critical players, it must return to the tried-and-true approach of building bridges and platforms to engage with all public and private-sector stakeholders. … The WHO has been essential in improving public health and welfare around the world. With reform, the WHO can continue improving global public health. To do so going forward, it must start reforming now” (5/24).

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Opinion Pieces Discuss Pandemic Preparedness, Ebola, 'Disease X'

Financial Times: We can only tackle epidemics by preparing for the unexpected
Anjana Ahuja, science commentator (5/28).

The Conversation: Stopping Ebola before the virus goes viral
Michael J. Armstrong, associate professor of operations research at the Goodman School of Business at Brock University (5/28).

Globe and Mail: Will we be prepared for ‘Disease X’ — the next pandemic?
Tom Koch, professor of medical geography at the University of British Columbia and author (5/28).

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From the Global Health Policy Community

U.S. Joins G20 Countries At Launch Of Global Antimicrobial Resistance Research, Development Hub

IDSA’s “Science Speaks”: U.S. joins other G20 countries in antimicrobial resistance research initiative
Rabita Aziz, writer at “Science Speaks” and senior global health policy specialist at IDSA, discusses the launch of a new global antimicrobial resistance research and development hub, writing, “The U.S. is one of 18 countries and organizations in the new international research initiative to combat antimicrobial resistance, which aims to facilitate collaboration on antimicrobial resistance research and development at an international level, identify and prioritize research and development gaps, and promote and facilitate increased investments” (5/25).

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U.S. Senate Approves Legislation With Potential To Help Alleviate Humanitarian Crisis In Yemen

Oxfam America: Senate bill helps push peace in Yemen
“[Last] Tuesday, the Senate approved legislation to shift the U.S. government away from unconditional and unlimited support to Saudi Arabia’s military intervention in Yemen. This measure has the potential to be vital in helping alleviate the humanitarian crisis in Yemen. The bill holds the State Department accountable to monitor and certify that Saudi Arabia is making real efforts to reach a peaceful resolution in Yemen and to limit its role in the humanitarian crisis by letting more vital goods like food, fuel, and medicine into the country, and avoiding civilian targets in its strikes…” (5/25).

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Friends Of The Global Fight Presents Q&A With Global Fund Board Member Representing Communities

Friends of the Global Fight: Q&A with Maurine Murenga, the Global Fund Board Member Representing Communities Affected by the Three Diseases
In this Friends of the Global Fight Q&A, Maurine Murenga, founder of the Lean on Me Foundation, discusses her experience serving as the Global Fund Board member representing the Communities delegation (5/25).

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CFR Expert Provides Scorecard For WHO Director General's Achievements Thus Far

Council on Foreign Relations: A Scorecard for Dr. Tedros as the WHO’s Director-General
Yanzhong Huang, adjunct senior fellow for global health at the Council on Foreign Relations, discusses WHO Director-General Tedros Adhanom Ghebreyesus’s achievements thus far in his first year leading the WHO, and writes, “Tedros’s first year as director general of the WHO demonstrated his vision, leadership, and ability to seize an opportunity for action. However, concerns remain regarding his willingness to balance public health with governance and human rights challenges” (5/24).

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FT Health Discusses Topics Addressed At WHA, Features Interview With Takeda Pharmaceutical CEO

FT Health: U.S. support for global health comes at a price
The latest issue of the Financial Times’ weekly global health newsletter highlights topics discussed at the 71st World Health Assembly, including the WHO director general’s call for “fresh funding and partnerships” and the U.S. stance on global health security. The newsletter also features an interview with Christophe Weber, CEO of Takeda Pharmaceutical, on acquiring Shire, which specializes in rare diseases, and provides a round-up of global health-related news stories (Jack et al., 5/25).

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From the U.S. Government

PEPFAR Celebrates 15th Anniversary With New Year-Long Campaign

U.S. Department of State’s “DipNote”: PEPFAR Marks 15 Years of Saving Lives
This blog post recognizes the 15th anniversary of PEPFAR and notes, “To mark our 15th anniversary, we are celebrating #PEPFAR15, a year-long campaign highlighting ’15 Years of Saving Lives through American Generosity and Partnerships.’ The campaign highlights the tremendous impact, efficiency, and accountability of the U.S. government’s longstanding HIV/AIDS leadership across three U.S. presidential administrations and eight U.S. Congresses…” (5/27).

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From the Kaiser Family Foundation

KFF Issue Brief Examines Key Differences In International, U.S. Response To Ebola Since 2014 Outbreak

Kaiser Family Foundation: The latest Ebola outbreak: what has changed in the international and U.S. response since 2014?
The United States played a leading role in the international response to the 2014 Ebola outbreak in West Africa, providing the most financial support, mobilizing U.S. staff across the federal government, and jumpstarting international efforts to strengthen global health security. As this month’s new outbreak unfolds in the Democratic Republic of Congo (DRC), the U.S. so far is playing a more limited role. In this new Kaiser Family Foundation brief, Josh Michaud, associate director for global health policy, and Jen Kates, vice president and director of global health & HIV policy, examine key differences and changes since 2014 that are shaping how the U.S. and international community are responding in the DRC (5/25).

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