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Kaiser Daily Global Health Policy Report

In The News

Save The Children Releases Annual 'State Of The World's Mothers' Report

“The worst place in the world to give birth is the Democratic Republic of the Congo, where a woman has a one in 30 chance of dying as a result — while the best is Finland, where the risk of death is one in 12,200, according to” Save the Children’s “State of the World’s Mothers” (.pdf) report, released Tuesday, The Guardian reports (Boseley, 5/6). “The 10 bottom-ranked countries were all from sub-Saharan Africa, with one woman in 30 dying from pregnancy-related causes on average and one child in seven dying before his or her fifth birthday,” BBC News writes, noting, “The charity compared factors such as maternal health, child mortality, education and income in 176 countries” (5/7). “The charity’s report also charts the numbers of babies dying within 24 hours of being born,” BBC reports in a separate article (Sellgren, 5/7).

The annual report “says despite much progress being made in reducing maternal and child deaths, every year, three million babies die within the first month of life. Many just live a few hours,” according to VOA News, which adds, “Save the Children President and CEO Carolyn Miles said there’s a widespread and mistaken belief that little can be done to save newborn lives in developing countries” (DeCapua, 5/7). “Although the calls for some big changes in health care systems to prevent newborn deaths, it also says that some simple, inexpensive things could save many lives,” such as washing umbilical cords with an antiseptic, NPR’s “Shots” blog notes (Beaubien, 5/7). Save the Children provides a number of infographics related to the index on its webpage (5/7).

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China, Africa Explore Cooperation On Health Issues At Roundtable

“China has reiterated its commitment to help Africa improve its health sector amid various challenges faced by the African continent through deepening existing health cooperation,” Xinhua reports, noting the 4th International Roundtable on China-Africa Health Cooperation kicked off in Gaborone, Botswana on Monday (5/7). “During the two-day meeting, officials will engage in sessions aimed at determining how China and African countries can jointly tackle critical issues such as AIDS, malaria, schistosomiasis, reproductive health, access to lifesaving vaccines and non-communicable diseases,” according to AfriqueJet, which notes, “The roundtable comes as China and Africa mark the 50th anniversary of providing medical teams to Africa, with China also supporting African health personnel, infrastructure, malaria control and other programs such as scholarships for training health experts” (5/6).

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Questions Remain About H7N9 Bird Flu Strain As 4 More Die Of Virus In China

“Four more people in China have died from a new strain of bird flu, bringing to 31 the number of deaths from the mysterious H7N9 virus, with the number of infections rising by two to 129, according to Chinese health authorities,” Reuters reports. “Among the deaths, two occurred in the eastern province of Jiangsu; one was from eastern Zhejiang; while another was from central Anhui, based on a Reuters analysis of the data provided by Chinese health authorities on Monday,” the news service adds (Wee, 5/6). CDC Director Thomas Frieden “says the current strain of bird flu that is causing illness and deaths in China cannot spark a pandemic in its current form — but he added that there is no guarantee it will not mutate and cause a serious pandemic,” Reuters reports in a separate article (Steenhuysen, 5/6). And the WHO’s “ability to police the new strain of bird flu … in China is being jeopardized by budget cuts, according to” Frieden, Reuters notes in another article, adding, “Frieden said he planned to raise the issue with other countries at the World Health Assembly (WHA) meeting, which is being held in Geneva, where the U.N. agency has its headquarters, from May 20 to May 28.”

“Many scientific questions still have to be answered about the new flu strain,” the article continues (Hirschler/Nebehay, 5/6). “Poultry workers moving to and from wet markets and farms may be responsible for the spread of the deadly H7N9 virus in China, says a virologist who’s working with the WHO to investigate the outbreak,” CNN’s “On China” blog notes (Hunt, 5/6). “The WHO has said so far there is no evidence of human-to-human transmission but has warned H7N9 is ‘one of the most lethal’ influenza viruses ever seen, and urged travelers against contact with live poultry,” Agence France-Presse writes (5/6). “A map of avian influenza (H7N9) risk [was published] in Biomed Central’s open access journal Infectious Diseases of Poverty” last week, according to a BioMed Central press release (5/3). BBC News provides a Q&A on the virus (Gallagher, 5/3). Additionally, Reuters provides a factbox of “key facts about vaccines, drugs and avian influenza” (Hirschler/Steenhuysen, 5/6).

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New Coronavirus Kills 2 More People In Saudi Arabia

“Two more people in Saudi Arabia have died from a new strain of coronavirus that has emerged in the Middle East, bringing the toll in the kingdom’s latest outbreak to seven, the [WHO] said on Tuesday,” Reuters reports, noting, “Worldwide, there have been 30 laboratory-confirmed infections with the new virus, including 18 deaths, since it came to scientists’ attention last September” (Nebehay, 5/7).  According to the Wall Street Journal, “International public-health officials say they are as concerned about the coronavirus as they are about the new H7N9 avian flu virus that recently began sickening people in eastern China,” and that “Saudi Arabia’s announcements in the past five days of seven new deaths from a SARS-like virus have heightened fears that the Mideast outbreak is entering a more-aggressive phase” (Knickmeyer, 5/6). “In a move that may end more than seven months of confusion, an international group of scientists and public health officials will soon recommend that the new virus be called Middle East respiratory syndrome coronavirus (MERS-CoV)” ScienceInsider writes (Enserink, 5/6).

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Editorials and Opinions

U.S. Has Played 'Major Role' In Afghan Health, But Report On U.S.-Built Hospitals Shows More Could Have Been Done

“Last week, the federal Special Inspector General for Afghanistan Reconstruction (SIGAR), examined a pair of hospitals [USAID] is building in the eastern part of the country,” Pulitzer Prize-winner Mark Thompson reports in Time Magazine’s “Battlefield” blog, noting, “It found the hospitals too big for Afghanistan to handle.” Thompson continues, “IGAR John Sopko’s staff details a tragedy of errors, where USAID failed to determine the Afghan government’s ability to operate the two hospitals, and where construction began a full year before USAID coordinated the final design plans with the Afghan Ministry of Public Health (MOPH).”

“‘USAID’s $18.5 million investment in these new hospitals,’ the inspector general reports, ‘may not be the most economical and practical use of these funds,'” Thompson notes, and details the specific findings of the report. “USAID disputed the SIGAR report, saying it failed to take into account ‘the highly complex public health system in Afghanistan,'” he writes, adding, “It said it has helped provide health care for more than 11 million Afghans, and trained more than 21,000 healthcare providers.” He states, “There is no denying the U.S. has played a major role in improving Afghan health. The question is how much more could have been done if the Americans had been more willing to do things the Afghan way” (5/6).

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Opinion Pieces Address Proposed Food Aid Reform

The following is a summary of two opinion pieces addressing proposed reform to the U.S. food aid program contained in President Obama’s FY 2014 budget request.

  • Christopher Barrett, CNN’s “GPS” blog: Noting “the Obama administration’s 2014 budget sensibly proposes that the federal government, for the first time, begin handling most food aid the way all of us manage our charitable contributions: give the money directly to those agencies that help the needy,” Barrett, a professor at Cornell University and author, writes, “The key is the flexibility to move resources quickly and efficiently, saving more lives and giving recipients foods they typically prefer over unfamiliar commodities from a distant continent.” He continues, “Peer-reviewed research on pilot programs run in 2010-11 conclusively supports these claims. … Yet a powerful coalition of U.S. agribusinesses, shippers and a few international development organizations want to block this sensible proposal.” Barrett writes, “This ‘iron triangle’ of special interests benefits from the outdated arrangements, at the expense of taxpayers and hungry people around the world,” adding, “There really is no good economic or humanitarian reason to oppose the administration’s proposed reforms. The only reasons are political” (5/6).
  • Andrew Natsios, U.S. News & World Report’s “World Report”: “Millions of people suffering in famines have been saved by the Food for Peace program. So why has the Obama administration proposed these changes?” Natsios, a senior fellow at the Hudson Institute, asks. “The proposed reforms are not new, but came out of painful experiences in Afghanistan,” he writes, adding, “USAID was importing several hundred thousand tons of food aid in the form of wheat for Afghan refugees and displaced people.” He continues, “Had USAID purchased its food aid locally from this surplus instead of importing it from the U.S., we could have stabilized Afghan wheat prices and avoided the incentive for farmers to convert their wheat fields to poppy production,” concluding, “Congress should approve the reforms, but only if they provide permanent statutory protection to ensure that the humanitarian food aid budget is used for food for the poor, not for diplomatic purposes” (5/6).

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Opinion Piece, Editorial Address Outbreak Of H7N9 In China

The following is a summary of an opinion piece and an editorial addressing the outbreak of a new strain of bird flu — H7N9 — in China.

  • Tyler Cowen, New York Times: “The outbreak raises renewed questions about how to prepare for possible risks, should the strain become more easily communicable or should other deadly variations arise,” Cowen, a professor of economics at George Mason University, writes. “Our current health care policies are not optimal for dealing with pandemics,” he continues, adding, “The central problem is that these policies neglect what economists call ‘public goods’: items and services that benefit many people and can’t easily be withheld from those who don’t pay for them directly.” He states, “One obvious step forward would be to exempt biomedical research from cuts of the current federal budget sequestration,” adding, “The government could also take another, more unusual step: it could promise to pay lucrative prices for the patents on drugs and vaccines that prove useful in dealing with pandemics” (5/4).
  • Debora MacKenzie, New Scientist: “The worry now is that as H7N9 sporadically infects people, it might be acquiring the mutations it needs to go on the rampage,” MacKenzie, a correspondent for the magazine, writes. “That’s a good reason — alongside saving lives — to prevent human infections. But how?” she asks, noting “killing and vaccinating poultry and preventing human infections won’t stop a pandemic strain emerging. It will only slow it down.” She continues, “When that happens, we will need vaccine,” adding, “There are several promising new technologies able to churn out vast quantities of pandemic vaccine quickly. But [research and development (R&D)] funding has been limited.” She writes, “Maybe if we start now, and slow the virus down, we will have enough time. Chances are low, but if we don’t even try they are zero” (5/6).

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From the Global Health Policy Community

Examining The Need For New Technologies In Global Health

“In the past decade, U.S. investments in science, technology and innovation have led to critical breakthroughs in prevention, diagnosis and treatment of deadly global diseases,” Ellie Dehoney and Morgan McCloskey of Research!America, write in a post in USAID’s “IMPACTblog,” noting the development of vaccines, diagnostic technologies and new drugs for neglected diseases, as well as efforts “to expand access to treatment for millions through programs like PEPFAR and USAID’s Neglected Tropical Disease (NTD) program.” However, they continue, “there is still much work to be done. Global diseases like HIV/AIDS, malaria and tuberculosis take eight lives per minute.” They state, “Developing new tools to combat these diseases is critical not only for saving lives, but also for allowing individuals to achieve their earning potential and enabling impoverished nations to develop sustainable economies” (5/6).

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Examining Implications Of U.S. 'Anti-Prostitution Pledge'

“Recently, the Supreme Court heard arguments regarding what is widely known as the ‘anti-prostitution pledge,’ a requirement that organizations receiving government money for overseas disease-prevention work adopt policies opposing prostitution and sex trafficking,” Mie Lewis, a staff attorney with the ACLU Women’s Rights Project, writes in an analysis on RH Reality Check. “As the American Civil Liberties Union (ACLU) set out in a prior friend-of-the-court brief, the pledge has taken a concrete toll, visible in its impact on overseas health organizations which, unlike their U.S. counterparts, have been subject to the pledge requirement all along,” she notes, adding, “If the Supreme Court sides with the government, and United States-based health organizations are also subject to the pledge, the human cost will undoubtedly climb.” She continues, “The second way in which the pledge is unprecedented and dangerous is that, far from merely requiring organizations hired by the government to convey a governmental message (think ‘Just Say No to Drugs’), it would operate as a kind of ideological screening that would disqualify organizations that may not share the government’s view but are perfectly capable of carrying out the funded work” (5/6).

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U.N. Calls For Accelerated Action On Achieving MDGs, Recognizes International Day Of The Midwife

“The planet’s social and economic inequalities must be addressed if women and children are to ‘survive and thrive,’ [U.N.] Secretary-General Ban Ki-moon urged today, calling for accelerated action on achieving the Millennium Development Goals (MDGs) ahead of the 2015 deadline,” the U.N. News Centre reports. “In remarks delivered to a special event held by the United Nations’ Economic and Social Council (ECOSOC) and titled ‘Meeting the Challenges of the Health MDGs and Beyond,’ Ban told delegates that while much progress in achieving the goals has been made, a great deal still remained to be done,” the news service notes (5/6). In a separate article, the news service reports on a U.N. Population Fund (UNFPA) and the International Confederation of Midwives joint statement to mark the International Day of the Midwife, observed on May 5, writing, “Midwives can make the difference between life and death for hundreds of thousands of women every year, the United Nations population agency affirmed today, recognizing their crucial role in improving maternal health, family planning and assisting during humanitarian emergencies” (5/6).

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Blog Examines Implications Of 'Oregon Experiment' For Global Health Policy

In two separate posts, the Center for Global Development’s (CGD) “Global Health Policy” blog discusses the results from the “Oregon Experiment,” a study published in the New England Journal of Medicine that finds “no significant effect of Medicaid coverage on the prevalence or diagnosis of hypertension or high cholesterol levels or on the use of medication for these conditions,” according to the article’s abstract (5/2). “Limitations of the study aside, the Oregon Experiment is a good example of the importance of rigorously testing all U.S. health programs, rather than just assuming ‘more care = better health,'” Research Fellow Victoria Fan and Research Assistant Rachel Silverman write in the first post, adding, “The Innovation Center at the United States Centers for Medicaid and Medicare Services, created under the umbrella of the Affordable Care Act, represents a new and encouraging approach to address this problem, an approach that we think has important lessons for global health” (5/6). In the second post, Fan and Amanda Glassman, CDG’s director of global health policy and a senior fellow, ask “[W]hat are the lessons for global health?” and write, “In the drive to universal health coverage, as championed by the U.N. and others, we should remember the evidence base is still developing, and that key interventions delivered with quality as well as people’s own behavior and incentives are important factors that will drive health status improvements in the short-term” (5/6).

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