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Kaiser Daily Global Health Policy Report

In The News

Global Leaders Discuss Progress, Announce New Commitments At Women Deliver Conference

“On the second day of Women Deliver 2013, the largest conference on girls and women of the decade, global leaders announced progress and new commitments toward expanding contraceptive access for women in developing countries,” a Global Health Strategies press release/AllAfrica.com reports. “The day’s events built on commitments and energy generated at the landmark July 2012 London Summit on Family Planning, where global leaders pledged more than $2.6 billion to provide 120 million more women and girls in the world’s poorest countries with voluntary access to contraceptive services, information and supplies by 2020,” the press release states (5/29). “Melinda Gates, co-founder of Bill & Melinda Gates Foundation, spoke at the panel … on Wednesday and said that a year after the transformational London Family Planning Summit, she had seen so much progress in many countries, including in Senegal, Zambia, Indonesia, Bangladesh and the Philippines in terms of scaling up health care and education access for women and girls,” the Jakarta Post notes (Widiadana, 5/30).

However, “[d]espite tremendous momentum for health and empowerment [of] women worldwide, many countries, particularly developing countries, are yet to show their commitment and implement policies and programs,” the newspaper writes in a separate article (Widiadana, 5/29). “Women and girls who have been displaced by conflict or disaster need to be offered the same sexual and reproductive health care available in other settings, [Lakshmi Puri,] the acting head of U.N. Women, said on Wednesday,” adding that “women’s right to access health care needed to be upheld ‘in all circumstances, in all settings, including for refugee[s],'” according to The Guardian (Ford, 5/30). In an interview with the Thomson Reuters Foundation, “Babatunde Osotimehin — a trained doctor, former health minister of Nigeria and now head of the U.N. Population Fund (UNFPA) — describes the importance of reproductive rights and how UNFPA convinces governments and communities that family planning is the right thing to do” (Win, 5/29). Digital News Asia examines the use of live-streaming and social media to join “tens of thousands from all over the world” for the conference (Asohan, 5/19).

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Annual State Of World's Children Report Calls For End To Discrimination Against Children With Disabilities

“In its annual State of the World’s Children report, UNICEF says ending discrimination against children with disabilities and nurturing their abilities will benefit both the children and society as a whole,” VOA News reports, adding, “The report presents a grim assessment of the discrimination and stigma suffered by tens of millions of children with disabilities in all regions of the world” (Schlein, 5/29). “Disabled children are at greater risk of being poor, are least likely to receive an education and health care, and in many countries face abandonment or institutionalization, according to the report,” Agence France-Presse/The Telegraph writes (5/30). “The marginalization of children with disabilities can begin at birth; many are not officially registered in their first days of life,” The Guardian writes, noting, “UNICEF has urged countries to start the process of inclusion early by pinning down the number of disabled people in their population” (Tran, 5/29).

“This year, UNICEF’s flagship publication highlights not just the challenges of the estimated tens of millions of children who live with disabilities, but also the contributions they can make, if allowed to achieve their ambitions,” a Save the Children press release states (Niles, 5/29). “The report says that while the situation facing disabled youngsters varies widely from country to country, the solution generally lies in a change of focus from what such children cannot to what they can do,” Deutsche Welle notes (5/30). “The report’s executive summary lays out nine key recommendations for building inclusive societies that help children with disabilities reach their potential,” according to The Star, which notes, “The report also urges an end to placing disabled children in institutions, where they are more likely to suffer abuse or neglect” (Yang, 5/30). The Guardian’s “Data Blog” discusses some of the findings of the report (Chalabi, 5/30). Also this week, “[t]he international coalition Countdown to 2015 released a report tracking progress toward the U.N. Millennium Development Goals (MDGs) related to child and maternal health, and the non-profit Save the Children published a separate report addressing child malnutrition,” GlobalPost notes (Miley, 5/29).

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Wall Street Journal Investigates Shipments Of Fake Malaria Medicines From China To Africa

The Wall Street Journal investigates the shipping of counterfeit antimalarial medicines from China to Africa, writing a “blizzard of fakes threatens the progress” made against the mosquito-borne illness in recent years. The article looks specifically at Chinese copies of Coartem available for purchase in markets in Luanda, Angola, where last year the largest seizure of fake medicines ever recorded occurred when 1.4 million packets of counterfeit Coartem were discovered in a shipping container of stereo speakers. “Coartem isn’t the only malaria drug available in Angola,” the newspaper writes, adding, “But it is the most widely used because it is a relatively new form of treatment that global health authorities consider more effective than previous generations of medicine.” Novartis, the manufacturer of Coartem, “said it is ‘collaborating with partners in government, industry and law enforcement’ to fight counterfeits,” according to the Wall Street Journal, which adds the company “has also added new security features on its packaging to make copies more difficult to produce” (Facon/Murphy/Whalen, 5/29). The newspaper also provides a video interview with the authors, discussing the shipping route and the growing trade relationship between China and African countries (5/28).

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WHA Concludes With Several Resolutions, Including Pledge To Tackle NCDs

“After seven days of intense discussions, the 66th World Health Assembly (WHA) concluded with agreement on a range of new public health measures and recommendations aimed at securing greater health benefits for all people, everywhere,” a WHO press release reports, noting “24 resolutions and five decisions were adopted by the nearly 2,000 delegates representing the [WHO] Member States” (5/27). Devex summarizes “five takeaways” from the meeting, including the WHO 2014-2015 budget, neglected tropical diseases (NTDs), non-communicable diseases (NCDs), mental health, and leadership priorities (Ravelo, 5/28). BMJ reports on the NCD resolution, writing, “The WHA resolution highlighted the importance of tackling non-communicable diseases by stating that of the 57 million deaths that occurred globally in 2008, an estimated 63 percent were caused by non-communicable diseases.” BMJ adds, “The assembly also agreed that by the end of 2013, WHO would set up a mechanism to coordinate activities and promote engagement on non-communicable diseases on a global scale” (Gulland, 5/29).

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Supreme Court In El Salvador Rules Against Woman Seeking Abortion, New York Times Reports

“El Salvador’s highest court on Wednesday denied an appeal from a woman with a high-risk pregnancy to be allowed to undergo an abortion, upholding the country’s strict law banning abortion under any circumstances,” the New York Times reports. “Beatriz, a 22-year-old woman who asked that her last name be withheld to protect her identity, has lupus and related complications that doctors say will get worse as the pregnancy, which is in its 26th week, continues, possibly leading to serious illness or even death,” the newspaper notes, adding, “Her fetus, which has anencephaly, a severe birth defect in which parts of the brain and skull are missing, has almost no chance of surviving after birth, leading her doctors to urge an abortion to protect Beatriz’s health before it deteriorates further.”

“But in a 4-to-1 ruling, the court cited the country’s legal ‘absolute impediment to authorize the practice of abortion,’ and ruled that ‘the rights of the mother cannot be privileged over those’ of the fetus,” the newspaper continues (Zabludovsky/Palumbo, 5/29). In a separate article, the newspaper examines how the case “has quickly become a focal point in a broad battle over abortion in Latin America, a largely conservative region where the Roman Catholic Church holds considerable sway.” While “[s]everal Latin American nations have softened their stances against abortion in recent years” — including Uruguay, Colombia, Brazil and Argentina — “a total ban on the procedure remains in El Salvador, Chile and Nicaragua,” the New York Times writes (Zabludovsky/Palumbo, 5/28).

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Editorials and Opinions

Support Of PEPFAR As Important Now As It Was 10 Years Ago

“Ten years ago this May, when the AIDS pandemic was at its worst, ravaging many African countries and a sure death sentence for millions, our country responded in an unprecedented way,” Rep. Barbara Lee (D-Calif.) and former Senate Majority Leader Bill Frist (R-Tenn.) write in an opinion piece in The Hill. “[I]n 2003, then-President George W. Bush instated PEPFAR, … pledging $15 billion over five years to combat the spread of HIV, prevent further infections and improve access to care for millions of people across the globe,” they continue. “Each year since then, Congress, with bipartisan support, has stood behind the program, providing critical funding to enable PEPFAR to truly help change the trajectory of the AIDS epidemic,” they note, adding, “Now, a decade later, PEPFAR’s success isn’t just measured in dollars spent, but in lives saved and communities improved.”

“PEPFAR has directly supported life-saving antiretroviral treatment for nearly 5.1 million men, women and children around the world, and is helping prevent hundreds of thousands of mother-to-child transmissions, an essential step toward achieving an AIDS-free generation,” Lee and Frist write. However, “we are at a tipping point to truly realize this vision,” they continue, adding, “If we back away now, the gains we’ve made will evaporate; the success we’ve had will disappear. Support of PEPFAR now is as important as it was 10 years ago.” They conclude, “Democrats and Republicans should be proud of PEPFAR’s legacy and continue to support it moving forward, providing the program with the robust funding it still needs to help achieve an AIDS-free generation” (5/28).

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Partnership Becoming Central Aspect Of Health-Related Foreign Assistance

In an opinion piece in The Atlantic, Lindsay Abrams, an editorial fellow with the Atlantic Health channel, examines how a “new culture of questioning, commonly attributed to the signing of the Paris Declaration on Aid Effectiveness in 2005, … is now driving the [WHO] to change the way international aid is delivered.” She continues, “The reform, which now includes close to 60 signatories, is driven by coordination,” noting, “Donors, be they contributing governments or non-state actors, don’t just go into developing countries and start implementing their own programs. Instead, they’re asked to contribute to a single health plan, which is managed and implemented by the government receiving the aid.” She adds, “The initiative, called International Health Partnership, sounds idealistic, but made a certain kind of sense when discussed last week at the World Health Assembly, an annual gathering of the WHO’s 194 member states that just wrapped up in Geneva.”

“One of the most surreal aspects of the two weeks of policy talk and resolution making that took place there was the equal footing given, at least theoretically, to each country represented,” Abrams continues, adding, “This diplomatic equality made it possible for the ministers of health from countries most often on the receiving end of aid — Rwanda, Ethiopia, Myanmar, and Senegal — to stand up, at a side meeting attended by about 200 people, and accuse those countries with the money and power to direct international development of undermining their own investments, by failing to allow the countries they claim to be helping to have any say in where the money goes.” She writes, “International aid has always been driven by good intentions; unfortunately, good intentions don’t always guarantee results.” She concludes, “As we begin to allow developing nations to ‘dare to innovate,’ as [Kampeta Sayinzoga, representing Rwanda’s Ministry of Finance and Economic Planning,] put it, and as aid becomes more about collaboration than competition for prestige, it’s something we’re coming closer to figuring out” (5/29).

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Opinion Pieces Address Issues Discussed At Women Deliver Conference

Women Deliver 2013, an international conference held this week in Kuala Lumpur, Malaysia, is focusing on the health and empowerment of girls and women. The following opinion pieces address issues being discussed at the conference.

  • Caitlin Callahan, Sonya Soni, and Hannah Smalley, Huffington Post’s “Global Motherhood” blog: Describing the “equitable involvement” of young men and women at the Women Deliver conference, the authors, all Global Health Corps fellows, write, “Ultimately, women and youth are not products of their environment, as we are often mistakenly told, but are outcomes of the expectations that we place on them. If we expect them to be stewards, rather than beneficiaries, of the social change movement, equitable partnerships among youth will not only be subscribed to by a few [non-governmental organizations (NGOs)] like Global Health Corps or Women Deliver, but will be the norm in all international institutions” (5/29).
  • Denise Dunning, Huffington Post’s “Global Motherhood” blog: “Following a gradual evolution of development priorities, the global community now recognizes that investing in girls is one of the most successful strategies to alleviate poverty, reduce infant and maternal mortality, and improve health and educational outcomes,” Dunning, program director at the Adolescent Girls’ Advocacy & Leadership Initiative (AGALI), writes. She describes a girl-centered advocacy model developed by AGALI and the United Nations Foundation, and concludes, “Only by investing in girl-centered advocacy for laws and policies that advance girls’ rights will we move beyond the important first step of providing services to thousands of girls, and instead begin transforming the lives of millions of girls” (5/29).
  • Sarah Edwards, Huffington Post U.K.: Edwards, head of policy and campaigns at Health Poverty Action, describes a Women Deliver side event on equity, titled “Ensuring Every Mother and Newborn Counts,” that was organized by Health Poverty Action, Save the Children and WaterAid. She discusses the “lively debate” that occurred over a suggestion to disaggregate data by ethnicity, and she writes, “While it may be appropriate to use proxies such as region in some highly sensitive contexts, in most countries disaggregating data by ethnicity is a prerequisite for exposing the realities of ethnic inequities in health and addressing the health rights of the most vulnerable in a targeted, culturally appropriate way” (5/29).
  • Melinda Gates, CNN: “Empowered women and girls will save lives, make families more prosperous and help the poorest countries in the world build stronger economies,” Gates, co-chair of the Bill & Melinda Gates Foundation, writes in the opinion piece, part of CNN’s “Girl Rising” series. “One key to empowerment — and an issue that’s a personal priority for me — is letting women decide when to have children,” she writes, adding, “Family planning is just the start. Women who have the power to decide when to get pregnant also must have the power to vaccinate their children, feed them healthy food and pay their school fees. Each of these things is a link in a chain of good health and prosperity.” Gates concludes, “Once these basics are in place, the only limit is women’s ambition for the future” (5/29).
  • Paul Brandeis Raushenbush, Huffington Post’s “Religion” blog: “It is crucial to talk about the role religion can play in the effort to empower girls and women in the area of family planning,” but “the role of religion in the reproductive lives of women is also fraught and touches on many of the flash points that religious communities are grappling with today,” Raushenbush, senior religion editor at the Huffington Post, writes. He describes the “Faith and Family Planning” panel he moderated at the Women Deliver conference, and writes, “[E]ven small advances in how religious communities view reproductive health issues can have huge positive effects on the lives of women and girls on the ground” (5/29).

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From the Global Health Policy Community

GAO Report Examines Stability Of PEPFAR ARV Drug Supply Chains

Following the release of two reports earlier this month, the U.S. Government Accountability Office (GAO) recently published a third report on PEPFAR. The report examines how PEPFAR “has worked with U.S. implementing agencies, international donors, and partner countries to increase the efficiency and reliability of antiretroviral (ARV) drug supply chains,” but it notes that “[e]valuations of partner-country supply chains reflect weaknesses in inventory controls and record keeping, which may increase the risk of drug shortages, waste, and loss,” the report summary states. GAO recommends “[t]he Secretary of State should direct OGAC to require country teams to (1) develop and implement plans to help partner countries improve inventory controls and record keeping; and (2) track the progress partner countries are making in measuring ARV drug consumption, waste, and loss,” according to the summary (5/28). The Center for Global Health Policy’s “Science Speaks” blog examines the report (Barton, 5/29).

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CSIS Report Examines Relationship Between MDGs, U.S. Development Aid Policies

A new report (.pdf) from the Center for Strategic & International Studies (CSIS), titled “Do U.N. Global Development Goals Matter to the United States?” and written by CSIS Global Health Policy Center Fellow Nellie Bristol, examines how “[t]he goals sometimes played a behind-the-scenes role in U.S. funding decisions, but U.S. programs have retained their own identities — most recently, for example, Feed the Future, AIDS-Free Generation, and the Child Survival Call to Action — rather than joining in campaigns around specific MDGs,” according to the summary page. “Nonetheless, U.S. development assistance feeds into progress on the MDGs,” and “[a]s the process gets under way to develop successor goals to the MDGs, U.S. involvement is critical to ensure U.N. goals continue to reflect U.S. strategies, to generate U.S. input into the future development agenda, and to foster political buy-in into growing development needs that are likely to go beyond traditional U.S. priorities,” the summary states (5/29).

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Blogs Examine Addition Of Treasury, Defense Data To Foreign Assistance Dashboard

Last week, the U.S. Departments of Treasury and Defense added data to the Foreign Assistance Dashboard. In a post on the Center for Global Development (CGD) blog, Modernizing Foreign Assistance Network (MFAN) Principal Sarah Jane Staats and Will McKitterick, a research assistant at CGD, examine the new data, writing, “There is still a long way to go before the Foreign Assistance Dashboard has the complete picture of where and how the United States invests its aid dollars, but new Treasury and Defense data are good steps in the right direction” (5/23). And in a post on the Oxfam America blog, Gregory Adams, director of aid effectiveness at Oxfam, writes, “This is not a lot of new data. … But politically, this is an important signal of progress.” But, he continues, “Without project-level data that helps people understand how aid is being invested and how we are measuring success, the dashboard fails to actually help U.S. aid dollars work better” (5/28).

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Kaiser Family Foundation Fact Sheet Examines Global Polio Eradication Efforts, U.S. Role In Addressing Polio

The Kaiser Family Foundation on Tuesday published a fact sheet that provides a snapshot of global polio eradication efforts and examines the U.S. government’s role in addressing polio worldwide, including current programs, funding, and key issues (5/28).

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Blogs Address Issues Discussed At Women Deliver Conference

The following is a summary of blog posts addressing the Women Deliver 2013 conference taking place in Kuala Lumpur, Malaysia, this week.

  • Jaime-Alexis Fowler, Bill & Melinda Gates Foundation’s “Impatient Optimists” blog: “We are facing huge, often seemingly intractable challenges to improving the lives of women around the world: from maternal mortality and access to family planning to girls’ education and gender inequity. We cannot let perfect be the enemy of improvement,” Fowler, the associate director of public relations and online communications at Pathfinder International, writes. “Gains have been made for women and girls around the world because we haven’t waited for perfect. Yet we need to push for more, particularly in access to family planning,” she continues, adding, “We have to be imperfect, impatient optimists, with better solutions, to ensure we deliver for women and girls — particularly in improving access to family planning” (5/28).
  • Helene Gayle and Julia Newton-Howes, Development Policy Centre’s Development Policy Blog: “Conferences like these play a critical role in keeping global attention focused on the issues that are core to empowering women — which is the key to fighting poverty,” Newton-Howes, CEO of CARE Australia, and Gayle, president and CEO of CARE USA, write. “But women’s empowerment cannot be achieved unless women’s sexual and reproductive health rights are protected,” they continue, adding, “Real change requires addressing underlying and systemic factors, including the pervasive gender inequality and violence that undermines the health of women and girls throughout their lives” (5/29).
  • Karen Grepin, Karen Grepin’s Global Health Blog: “The main reason I am here … was to present the findings from a new report [.pdf] that I co-authored with Jeni Klugman, the director of gender and development at the World Bank,” Grepin, a researcher and blogger writes, noting, “In it, we attempted to summarize the evidence on what is known about the economics [of] maternal health in developing countries.” She continues, “Yesterday I attended a panel where every panelist presented an overview of their work where they were trying out nearly identical ‘new approaches.’ Sadly, this conference has also convinced me that there is too little research underway to test the many innovative approaches underway around the world” (5/28).
  • Emily Ross, United Nations Foundation Blog: “While not everyone could make it to Malaysia for the conference, they could add their voice to the conversation through ‘WomenDeliver+SocialGood,’ an in-person and online event that brought together media experts, social entrepreneurs, and policy leaders to discuss how digital media and technology can address challenges facing women and girls around the world,” Ross, deputy director of U.N. relations and special initiatives, writes. “The event highlighted how technology can help empower women and address urgent health challenges,” she adds (5/28).
  • Jane Silcock, USAID’s IMPACTblog: “Coinciding with the Women Deliver conference, USAID is highlighting our work in family planning this week on IMPACT as part of our Global Health blog series this month,” Silcock, a communications analyst with the Office of Population and Reproductive Health, writes. “Family planning plays a critical role in meeting our goals of ending preventable child and maternal deaths and creating an AIDS-Free Generation, and is crucial to improving people’s lives across the globe,” she continues, adding, “We know that family planning enables women and couples to choose the timing and spacing of their pregnancies, resulting in incredible health and economic benefits for families” (5/28).
  • Camaro West, Bill & Melinda Gates Foundation’s “Impatient Optimists” blog: “What a conference like Women Deliver does is offer the opportunity for actors at all levels to engage with one another and the issue at hand. It provides a platform for knowledge sharing and perhaps most importantly, the formation of linkages within and across sectors,” West, a blogger with Girls’ Globe, writes. “As a collective of individuals, organizations and governments gathering together at Women Deliver and mobilizing all of this non-traditional currency, we can work to ensure that when money is thrown at a problem, it is thrown in a direction that will best get at the root causes and lead to lasting changes,” she adds (5/28).
  • Edward Wilson, USAID’s IMPACTblog: “On the USAID | DELIVER PROJECT we work alongside USAID and other partners every day to strengthen health programs by improving the supply chains in-country,” Wilson, project director for USAID’s DELIVER Project with John Snow, Inc., writes. “In our work we often say ‘No Product. No Program,'” he notes, adding, “What we mean by that is ensuring an adequate supply of contraceptives is critical to the success of family planning programs.” He continues, “While meeting the family planning needs of women around the world happens one woman at a time, making contraceptives available to each of those women requires the concerted and coordinated efforts of individuals and organizations around the world” (5/29).

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