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Kaiser Daily Global Health Policy Report

In The News

U.S. Government Officials Engage In Pandemic Exercise

Washington Post: This mock pandemic killed 150 million people. Next time it might not be a drill.
“A novel virus, moderately contagious and moderately lethal, has surfaced and is spreading rapidly around the globe. Outbreaks first appear in Frankfurt, Germany, and Caracas, Venezuela. The virus is transmitted person-to-person, primarily by coughing. There are no effective antivirals or vaccines. U.S. troops stationed abroad are infected. Now the first case to reach the United States had been identified on a small college campus in Massachusetts. So began a recent day-long exercise hosted by the Johns Hopkins Center for Health Security. The simulation mixed details of past disasters with fictional elements to force government officials and experts to make the kinds of key decisions they could face in a real pandemic. … The exercise was inspired in part by the troubled response to the Ebola epidemic of 2014, and everyone involved was acutely aware of the very real and ongoing Ebola outbreak spreading in Congo. In the simulation, a bipartisan group of current and former high-ranking U.S. government officials played a team of presidential advisers faced with a host of real-world policy, political, and ethical dilemmas…” (Sun, 5/30).

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WHO Officials Express 'Cautious Optimism' On Experimental Vaccine Use In DRC Ebola Outbreak Response

Associated Press: Health officials ‘cautiously optimistic’ on Ebola response
“The World Health Organization said Tuesday it is ‘cautiously optimistic’ about efforts to curb the spread of Ebola in an urban area in Congo, although the lethal virus is still reported in at least two remote areas…” (5/29).

CIDRAP News: Ebola outbreak response shifts to remote DRC hot spots
“…At a briefing in Geneva [Tuesday] live-streamed on the WHO’s Twitter feed, health officials also said DRC’s health ministry is finalizing protocols for testing five therapeutic treatments and that a trial of a second experimental Ebola vaccine — a prime-boost regimen developed by Johnson & Johnson — may take place in the outbreak setting…” (Schnirring, 5/29).

Reuters: Almost all in Congo city at immediate risk of Ebola now vaccinated — WHO
“The World Health Organization said on Tuesday almost all the people it considers at immediate risk from an Ebola outbreak in the Democratic Republic of Congo city of Mbandaka have now been vaccinated against the disease…” (Miles, 5/29).

STAT: Ebola outbreak opens way to chaotic jockeying to test experimental drugs
“Companies and other players involved in the development of experimental Ebola drugs are jockeying to have their products tested in the outbreak in the Democratic Republic of the Congo, part of a chaotic and politically charged effort to use them in the midst of a crisis. With one vaccine already being used in the field, plans are underway to see if another might also be tested. And as many as five drugs, most of which are not supported by much human data, could be used in head-to-head trials…” (Branswell, 5/30).

Additional coverage of the Ebola outbreak and response is available from Bloomberg, CNN, Devex, NOVA Next, NPR, Reuters, Washington Times, and Wired.

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2M Syrians In 'Desperate' Need In Hard-To-Reach Areas, U.N. Emergency Relief Coordinator Tells Security Council

Associated Press: U.N. urges Syria to allow aid to 2 million in desperate need
“The U.N. humanitarian chief on Tuesday urged the Syrian government primarily but also some rebel groups to allow the delivery of aid to more than two million desperate people in hard-to-reach areas. Mark Lowcock told the U.N. Security Council that the situation in Idlib, one of the opposition’s last footholds in Syria, is ‘alarming’ with airstrikes, clashes between armed groups, overcrowding, and severely stretched basic services…” (5/29).

U.N. News: U.N. aid chief highlights 2 million Syrians in greatest need
“Less than 20 percent of the ‘desperate’ civilians living in Syria’s hard-to-reach areas have got the humanitarian aid they need so far this year, a senior United Nations official warned on Tuesday, calling for the Security Council to help ease their plight. … Only six inter-agency convoys have reached those areas since January, providing relief for 169,000 people…” (5/29).

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Flooding In Eastern Africa Could Lead To Food Shortages

Bloomberg: Fatal Floods in Eastern Africa May Mean Yet More Food Shortages
“Rainfall that’s been twice the seasonal average in parts of Eastern Africa has claimed almost 500 lives, forced thousands from their homes and damaged crops, raising the specter of a repeat of last year’s food shortages. … The flooding comes about a year after Eastern Africa faced the opposite problem: its worst drought in 60 years that left more than 11 million people in Kenya, Ethiopia, and Somalia needing food aid…” (Gebre, 5/29).

Devex: Horn of Africa burdened with crisis after crisis
“…People struggle to recover from one calamity, only to face another. This has left the humanitarian sector scrambling to respond to crisis after crisis, with no end in sight. And this could well be the region’s new normal. ‘The frequency and severity of floods, storms, droughts, as a result of climate change are expected to increase over the coming decades,’ said Dr. Nathanial Matthews, program director at the Global Resilience Partnership. ‘It’s also this general shift into uncertainty’…” (Jerving, 5/30).

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Food Shortages, Malnutrition, Civil War Plague South Sudan

New York Times: We Visited South Sudan, Where a Never-Ending Hunger Season Puts Millions in Danger
“…More than four years of civil war — most of this young country’s existence — have chased millions from their homes, leaving countless farms abandoned. The economy has been obliterated. Fighting has overcome some of the nation’s most productive land. Food prices are ruinously high. Even during harvest time in January, when food was most abundant, more than five million people — almost half the population — did not have enough to eat. Now, as food runs out over the next few months, international officials expect that number to grow considerably, with millions potentially facing acute malnutrition…” (Specia/Bracken, 5/30).

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IRIN 3-Part Series Examines Conflict, Humanitarian Crisis In Central African Republic

IRIN: Central African Republic: Little peace to keep, but 4.7 million lives to live
“[This] three-part series explores one of the world’s most overlooked and least understood conflicts. … Philip Kleinfeld spent five weeks in the Central African Republic meeting peacekeepers, warlords, aid workers, and civilians whose lives intersect in a country rich in resources but impoverished by coups, mutinies, and civil war…” (Kleinfeld, 5/24).

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More News In Global Health

ABC News: Meghan Markle effect on menstrual hygiene: A royal ‘champion’ for the cause (Kindelan, 5/28).

CNN: Fewer babies were born in Brazil amid Zika outbreak, study says (Scutti, 5/29).

Devex: How to combat NCDs? Take a sector-wide approach (Politzer, 5/29).

Intellectual Property Watch: Global Health Policymakers Take Action To Improve Access To Assistive Products (Saez, 5/26).

Inter Press Service: Food Waste Enough to Feed World’s Hungry Four Times Over (Deen, 5/28).

News Deeply: A New Test for Kenya’s Students: Learning to Eat Healthier (Aroko, 5/29).

Reuters: China overtakes U.S. for healthy lifespan: WHO data (Miles, 5/30).

Thomson Reuters Foundation: Labeled sorcerers, Cameroonian children with sickle-cell disease face death (Kouagheu, 5/27).

VOA News: Nigerian Health Workers Blame Cultural Practices for Fistula Epidemic (Oduah, 5/29).

Xinhua News: Experts call on more focus on youth to prevent HIV/AIDS infections in Africa (5/30).

Xinhua News: S. African gov’t working hard to fight HIV/AIDS: deputy president (5/30).

Xinhua News: South Sudan, U.N. vow to strengthen fight against HIV (5/30).

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Editorials and Opinions

Careful Language Needed To Communicate Possible Efficacy, Experimental Status Of Ebola Vaccine

Al Jazeera: Why we should be cautious about the ‘game-changer’ Ebola vaccine
Adia Benton, assistant professor at Northwestern University

“…Most media coverage about the [experimental Ebola] vaccine’s deployment to the [West Africa] region has been triumphalist, referring to the vaccine as a ‘game-changer’ and ‘a paradigm shift.’ But these reports should be viewed with caution. … The introduction of this experimental Ebola vaccine — whatever its efficacy and potential risks — will inevitably shape the landscape of care and communities’ trust of the health system, more generally. … Perhaps health officials have too narrowly focused on the ‘game changer’ potential of the vaccine to a vaguely defined audience in the West, with too little recognition that these triumphalist messages also travel and circulate in the very places where they work. They starkly contrast with the messages that need to be communicated to the communities facing an imminent threat from Ebola. That is: this vaccine is likely highly effective in the current formulation, but this element is still under investigation; only close contacts will receive the vaccination; and it is possible that some people will fall ill after they have been vaccinated…” (5/30).

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U.N. Must Continue To Condemn Attacks On Health Care Facilities, Workers In Conflict Situations

The Lancet: Health care in conflict: war still has rules
Editorial Board

“…[A] new report from the Safeguarding Health in Conflict Coalition, Violence on the front line: attacks on health care in 2017, shows a grim reality of continued attacks on health infrastructures coming from all sides, and which persist with impunity. … [T]he sheer number of attacks in 2017 demonstrates the international community’s catastrophic failure to uphold its commitment to the [U.N. Security Council’s] resolution [denouncing attacks on health care facilities and personnel in conflict situations]. The Coalition makes specific recommendations to the U.N. High Commission for Human Rights, Security Council, and secretary general to ensure that the lives and rights of health care workers and patients are protected in conflict areas. António Guterres, U.N. secretary general, must continue to condemn these attacks, work proactively to stop them, and hold the perpetrators accountable for their war crimes” (5/26).

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From the Global Health Policy Community

CSIS Video Explores Value Of U.S. Foreign Assistance For Global Food Security

Center for Strategic & International Studies: A Common Sense U.S. Budget for Global Food Security
“…In light of the Trump administration’s proposal to scale back Feed the Future funding, the CSIS Global Food Security Project explored the value of foreign assistance in the agricultural and nutrition sectors. As the video explains, a sustained U.S. commitment is just common sense to support the American and global economies, foster aid independence, and curb the toll of conflict” (5/29).

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Blog Post Discusses Mexico City Policy's Impact On Sexual, Reproductive Health Care For Women, Girls In Kenya

DSW: Lack of Information and Unsafe Abortions: How the Global Gag Rule Affects Girls and Women in Kenya
Evelyn Samba, DSW’s country office director for Kenya, discusses ways in which the expanded Mexico City policy, also known as the global gag rule, has affected sexual and reproductive health care for women and girls in Kenya (5/25).

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Blog Post Examines Impact Of Restrictive Abortion Laws On Women, Families

BMJ Opinion: Gilda Sedgh: Restrictive abortion laws hurt women worldwide
Gilda Sedgh, principal research scientist at the Guttmacher Institute, discusses findings from a recent Guttmacher Institute report on abortion and examines the impact of restrictive abortion laws on women and their families, writing, “[C]ountries should expand the circumstances under which abortion is legal, ensure safe abortion care is available and accessible, and undertake public awareness campaigns to reduce stigma. These steps will promote the well-being of women, families, and societies at large” (5/24).

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Podcast, Blog Post Discuss Response To DRC Ebola Outbreak

U.N. Dispatch’s “Global Dispatches Podcast”: A New Ebola Outbreak in the Democratic Republic of Congo
Mark Leon Goldberg, editor of U.N. Dispatch and host of the Global Dispatches Podcast, speaks with Laurie Garrett, former fellow at the Council on Foreign Relations, about the current Ebola outbreak in the Democratic Republic of Congo (DRC) and how the response to this outbreak differs from the 2014 Ebola response (5/29).

IDSA’s “Science Speaks”: Health information system strengthening supports DRC government Ebola response
Olivier Kakesa, senior technical specialist and DRC resident adviser for MEASURE Evaluation, discusses efforts to strengthen the DRC’s health information system, particularly in the context of the current Ebola outbreak (5/29).

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Health Ministers Express Optimism For Ending TB, Achieving Health-Related SDG

Global Fund to Fight AIDS, Tuberculosis and Malaria’s “VOICES”: U.N. High-Level Meeting on TB: High Expectations
“At the sidelines of the 71st World Health Assembly, the Global Fund spoke to health ministers from across the world, who expressed optimism that 2018 can be a turning point in the fight against TB as well as the effort to deliver Sustainable Development Goal 3, which seeks to ensure healthy lives and promote well-being for all.” This blog post highlights remarks made by the health ministers of South Africa, Kenya, India, Burkina Faso, Swaziland, Cameroon, and Paraguay (5/24).

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Medicines Patent Pool Releases New 5-Year Strategy To Improve HIV, HCV, TB Treatment Access In LMICs

Medicines Patent Pool: The Medicines Patent Pool Presents New Five-Year Strategy For Improving Access To Priority Treatments In Developing Countries
“The Medicines Patent Pool Foundation (MPP) released its five-year strategic plan during a side event at the 71st World Health Assembly … The strategy calls for renewed efforts to reach people living with HIV, hepatitis C, and tuberculosis in low- and middle-income countries (LMICs) with better-adapted, affordable medicines. Based on a feasibility study also presented at the MPP-partner event, … the plan supports the expansion of the MPP model to other patented medicines with high medical value, starting with small molecules on the World Health Organization Model List of Essential Medicines (EML)…” (5/24).

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Ending TB Must Include Efforts To Improve Conditions In Prisons, Advocate Says

Action: How prison conditions fuel the tuberculosis epidemic
David Bryden, TB advocacy officer at RESULTS, discusses prison overcrowding and the risk of TB in prisons. Bryden writes, “Unless the world tackles prison conditions, ending this disease will remain just a distant dream. … When heads of state gather for the U.N. High-Level Meeting on Tuberculosis this September, they must make strong commitments, including funding, to improve conditions and achieve rapid reductions in TB, HIV, and other diseases in prisons — and we must hold them to their promises” (5/24).

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Global Community Must 'Holistically' Address Issues Of Menstrual Health, Hygiene

U.N. Dispatch: Let’s Talk About Menstrual Hygiene
Thorsten Kiefer, founder and CEO of WASH United, and Gabrielle Fitzgerald, founder and CEO of Panorama, discuss the stigma associated with and lack of discussion surrounding menstrual health and hygiene, writing, “[I]t is imperative for the global community to approach the issue [of menstrual health and hygiene] holistically. … As a global community, it is our responsibility to invest in the research to understand the links between menstruation and social and physical health outcomes. In parallel, we must also advocate for unrepresented issues affecting the daily lives of women and girls. These approaches are not mutually exclusive, but should reinforce each other” (5/28).

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World Bank Releases 2018 SDG Atlas

World Bank’s “Data Blog”: The 2018 Atlas of Sustainable Development Goals: an all-new visual guide to data and development
The World Bank released its 2018 Atlas of Sustainable Development Goals, a publication that “shows the progress societies are making towards the 17 SDGs. It’s filled with annotated data visualizations, which can be reproducibly built from source code and data” (5/24).

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WHO Validates Nepal As 1st Country In SE Asia To Eliminate Trachoma As Public Health Problem

WHO: Nepal: first country in South-East Asia validated for eliminating trachoma
“The World Health Organization (WHO) has validated Nepal for having eliminated trachoma as a public health problem — a milestone, as the country becomes the first in WHO’s South-East Asia Region to defeat the world’s leading infectious cause of blindness…” (5/21).

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From the U.S. Government

Community-Based Survey Approach Informs Local Tobacco Cessation Campaign For Australia's Aboriginal Population

CDC’s “Our Global Voices”: Community-based Surveys are Informing Local Cessation Smoking Campaigns for Indigenous Australians
Alyson Wright, project leader at the National Centre for Epidemiology and Population Health at Australian National University, discusses the challenges that remote communities in Australia face in reducing tobacco use, highlighting a project “aimed to evaluate the effectiveness of a local tobacco campaign by undertaking a community-based survey in Australia’s Aboriginal population.” Wright notes, “Using a community-based survey approach has helped to build capacity and inform service delivery at the local level, while also providing advice to national decision makers related to community tobacco prevention programs” (5/28).

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