Kaiser Daily Global Health Policy Report

In The News

President Trump Supports South Korea's Humanitarian Food Aid For North Korea, President Moon's Office Says In Statement

New York Times: Trump Supports Food Aid for North Korea, South Says
“Despite North Korea’s recent weapons tests, including of a possible new short-range ballistic missile, President Trump said he supported South Korea’s humanitarian aid for the North to help alleviate its food shortages, the office of President Moon Jae-in of South Korea said on Tuesday. Mr. Trump expressed his support for humanitarian aid for North Korea when he and Mr. Moon talked on the phone on Tuesday night to discuss how to bring the North back to the negotiating table for nuclear disarmament, Mr. Moon’s office said in a statement. … ‘President Trump assessed that South Korea’s humanitarian food aid for North Korea would be a very timely and positive step, and supported it’…” (Sang-Hun, 5/7).

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USAID Taking Steps To Address Gender Pay Gaps In Agency's Contracts

Devex: USAID takes aim at gender pay gaps in contracting decisions
“The U.S. Agency for International Development is taking aim at a contracting process that many believe allows gender pay gaps to persist within the agency’s contracts. USAID is seeking regulatory changes that would allow contracting officers to deemphasize the use of salary history in determining pay rates for contractors. The agency’s administrator, Mark Green, announced the effort at an internal event on Monday…” (Igoe, 5/8).

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Devex Examines Internal Complaint Regarding Appointment Of Zsuzsanna Jakab As New WHO Deputy Director General

Devex: Exclusive: Questions arise over Tedros’ new deputy director-general
“An internal complaint at the World Health Organization’s ethics office has questioned the appointment of Dr. Zsuzsanna Jakab as WHO’s new deputy director general as part of the agency’s organizational restructuring in March. The complaint, filed after the appointment and seen by Devex, came from a ‘group of concerned staff members at WHO’ who ‘feel confused and outraged’ by Jakab’s elevation. The complaint alleges that Jakab, while serving as regional director of WHO’s European office from 2010 to early 2019, was a recipient of ‘many allegations of harassment.’ In addition, the complaint also alleges that by appointing 67-year-old Jakab to the position, WHO has violated the retirement age limit of 65…” (Ravelo, 5/8).

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WHO Experts Recommend New Ebola Vaccination Guidelines For DRC Outbreak As Violence Continues, Virus Spreads

Associated Press: City in Congo’s Ebola outbreak attacked by militia; 8 dead
“Militia fighters attacked a city at the epicenter of Congo’s Ebola outbreak on Wednesday after threatening health workers in the field, further damaging efforts to contain the deadly disease. At least eight people were killed…” (Maliro et al., 5/8).

CIDRAP News: With rising cases and dwindling stockpiles, WHO suggests alternative Ebola vaccination strategies
“[On Tuesday,] SAGE, the World Health Organization’s Strategic Advisory Group of Experts, released new guidelines to address several growing concerns about vaccination strategies currently being used in [the] Democratic Republic of the Congo (DRC) Ebola outbreak…” (Soucheray, 5/7).

Reuters: WHO experts recommend ramping up Ebola vaccine after Congo cases surge
“…A large share of new cases are now occurring in people who were not known contacts of earlier patients, and the disease is spreading to areas where it is impossible to trace contacts and swiftly vaccinate them. [SAGE] recommended a number of changes, including expanding vaccination to a third ring of people exposed to those in the second ring, and ‘geographic’ vaccinations that would target everyone at a location without trying to track their exposure…” (Miles/Kelland, 5/7).

Science: DRC expands Ebola vaccine campaign as cases mount rapidly
“…With SAGE’s approval, WHO now plans to use an even lower dose for the third ring, extending the vaccine even further. … A broader vaccine program for people at lower risk still may soon launch, too, with a different experimental product. The SAGE recommendations call for offering an Ebola vaccine made by Johnson & Johnson of New Brunswick, New Jersey, to everyone in a DRC ‘health zone’ that has a case of the disease, or even those in neighboring health zones. This will potentially protect even more people without affecting the stockpile of Merck vaccine, and also offers a real-world chance to test the Johnson & Johnson vaccine…” (Cohen, 5/7).

STAT: WHO broadens the pool of people who can get the Ebola vaccine
“…The changes must still be approved by ethics and scientific committees advising DRC’s health ministry. But professor Jean-Jacques Muyembe, director of the country’s national microbiology laboratory, welcomed the recommendations. … Merck and J&J are donating all the vaccine to the outbreak response…” (Branswell, 5/7).

Additional coverage of the SAGE recommendations is available from Agence France-Presse, New Humanitarian, and Science Speaks.

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Global Alcohol Consumption Expected To Increase, Lancet Study Shows

CNN: Binge drinking expected to rise as alcohol use increases around the world, study says
“…Between 1990 and 2017, per capita adult alcohol consumption increased by nearly 0.7 liters (about the same in quarts) to 6.5 liters (6.9 quarts) annually, new research indicates. The number is predicted to reach 7.6 liters (8 quarts) by 2030. By 2030, then, half of the world’s adults will drink (up from 45% in 1990), while 40% will abstain (down from 46% in 1990), according to the study published Tuesday in the journal The Lancet…” (Scutti, 5/7).

The Guardian: World alcohol consumption on the rise as China’s thirst grows
“The world is consuming significantly more alcohol than 30 years ago thanks in large part to heavier and more widespread drinking in China and India, researchers have claimed. … Globally, some 237 million men and 46 million women suffer from alcohol-related disorders, with the highest rates in Europe (15% and 3.5%, respectively, for men and women) and North America (11.5% and 5%)…” (5/7).

USA TODAY: Alcohol use soaring worldwide: The average adult now consumes about 1.7 gallons of pure alcohol per year
“…The study analyzed data from 189 countries around the world. … The estimates also suggest that by 2030, half of the world’s adults will drink alcohol, and almost a quarter (23%) will binge-drink at least once a month. That means the world is not on track to meet alcohol reduction efforts recently recommended by the World Health Organization (WHO)…” (Rice, 5/7).

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Mali Appoints UNAIDS Executive Director Sidibé As Health Minister

The Guardian: Mali gives top job to U.N. executive accused of ‘tolerating harassment’
“A senior U.N. official accused of ‘tolerating harassment and abuse of authority’ has been appointed health minister in Mali. Michel Sidibé faced pressure to stand down from his position as head of UNAIDS following criticism over his handling of a sexual assault allegation made against one of his deputies. … Sidibé was appointed Mali’s new health minister by president Ibrahim Boubacar Keita, who announced a new government on Sunday” (Ratcliffe, 5/8).

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Mexican Government Working To Resolve HIV Medication Issues As Health Advocates Warn Of Shortages

Thomson Reuters Foundation: Drug buying plan leaves hundreds without HIV treatment in Mexico — health advocates
“Hundreds of people living with HIV in Mexico may have gone without life-saving treatment for weeks, health advocates said on Tuesday, while welcoming announcements from the Mexican government that it was working to resolve the drug shortage. The announcements followed a months-long outcry from activists, health experts, and people with HIV that a drug shortage was imminent because of changes in the way the government bought medicines…” (Lopez, 5/8).

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Mosaic Examines Rwanda's Efforts To Eliminate Cervical Cancer Through HPV Vaccination

Mosaic: How Rwanda could be the first country to wipe out cervical cancer
“The East African country’s campaign to end cervical cancer through the HPV vaccine has had to overcome cultural taboos and rumors about infertility — but it’s saving lives…” (Cousins, 5/7).

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Aid Organizations Work To Prevent Widespread Cholera Outbreak In Cyclone-Hit Northern Mozambique

Thomson Reuters Foundation: Aid workers race to contain cholera outbreak in cyclone-hit Mozambique
“Aid workers were on Tuesday racing to contain a cholera outbreak in northern Mozambique after a powerful cyclone contaminated water sources and damaged health clinics. … Reported cases of cholera in the province have risen almost five-fold to 64 since the outbreak was officially declared on May 2, according to the United Nations…” (Bhalla, 5/7).

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Bubonic Plague Kills Couple In Mongolia, Forces 6-Day Quarantine Of Village

BBC News: Plague deaths: Quarantine lifted after couple die of bubonic plague
“A quarantine imposed in Mongolia after two people died from the bubonic plague has been lifted, allowing a number of tourists to leave the area. The Mongolian couple contracted the illness after eating the raw meat of a marmot, a type of rodent…” (5/7).

NPR: Bubonic Plague Strikes In Mongolia: Why Is It Still A Threat?
“…This is the same illness that killed an estimated 50 million people across three continents in the 1300s. Nowadays, the plague still crops up from time to time, although antibiotics will treat it if taken soon after exposure or the appearance of symptoms. Left untreated, the plague causes fever, vomiting, bleeding, and open, infected sores — and can kill a person within a few days…” (Schreiber/Bichell, 5/7).

Washington Post: A couple ate raw marmot believed to have health benefits. Then, they died of the plague.
“…The decision to impose the quarantine came after officials became worried that the husband and wife had developed pneumonic plague, which can be swiftly passed to other people through airborne droplets, [Ariuntuya Ochirpurev with the World Health Organization in Ulaanbaatar] said. Pneumonic plague is the ‘most serious form of the disease’ and the only type that can spread from person to person, according to the CDC. If left untreated, cases of the plague have a 30 to 100 percent fatality rate, the WHO said…” (Chiu, 5/8).

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More News In Global Health

Al Jazeera: Angola drought: Millions struggle for food (Jamjoon, 5/7).

Borgen Magazine: A Status Update on Tuberculosis in Thailand (Sherrington, 5/7).

HealthDay News: Slowing Climate Change Could Cut Health Costs, Save Money (Preidt, 5/7).

Devex: Rory Stewart: DFID should not play ‘international policeman’ on safeguarding (Edwards, 5/8).

Devex: In response to critical report, CDC lays out changes in its work (Saldinger, 5/8).

Thomson Reuters Foundation: Missing wombs: the health scandal enslaving families in rural India (Srivastava, 5/7).

Vox: Our antibiotics are becoming useless (Samuel, 5/7).

Xinhua News: Chinese hospital offers free cervical cancer treatment to Zimbabwean women (5/7).

Xinhua News: Research reverses drug-resistant tuberculosis (5/8).

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Editorials and Opinions

Drug-Resistant TB Continues To Pose Threat To Global Health; TB Community Must Adopt Human Rights-Based Approach To Ending Disease

Forbes: Drug-Resistant TB: A Clear And Present Danger
Madhukar Pai, Canada research chair in epidemiology & global health and director of global health programs and the McGill TB Centre at McGill University

“…Drug-resistant TB is [a] classic example of the dangers posed by antimicrobial resistance (AMR) … [On Tuesday,] The Economist Intelligence Unit (EIU) published a report entitled ‘It’s Time to End Drug-Resistant Tuberculosis.’ … The report makes … key observations. [Drug-resistant TB (DR-TB)] poses a significant threat to global health security, yet gets little funding. … DR-TB imposes a huge economic burden, on families and countries. … The case for investing in DR-TB is compelling and strong. … There is growing global commitment to fight DR-TB — but it is time for action. … [C]ountry leaders must be held accountable for meeting their SDG targets, and here, public engagement and advocacy is critical. The HIV field has greatly benefited from patient advocacy and a human-rights approach that is centered on helping people, not just disease control. It is time for the TB community to harness the power of patient advocacy and adopt a human rights-based approach for ending TB” (5/7).

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Global Community Must Take Action Against Counterfeit Medicine

STAT: It’s time to stop murder by counterfeit medicine
Joel G. Breman, senior scientist emeritus at the Fogarty International Center of the National Institutes of Health and president-elect of the American Society of Tropical Medicine and Hygiene

“…According to the WHO, 1 in 10 medical products in developing countries is falsified or substandard. … Poor-quality antimicrobials are most often found in low-income countries. In addition to failing to treat infection, they also contribute to the evolution of antimicrobial resistance … [I]t’s time for a multilateral international treaty targeting counterfeit drug crime and promoting detection, apprehension, extradition, and punishment of the criminals and cartels that make, sell, and distribute fake drugs — rather than letting them off easy, as now occurs for fake and substandard drug crime. Delays in providing technologies, protocols, and laws to guard against falsified and substandard drugs will contribute to preventable tragedies around the world as well as allowing antimicrobial resistance to increase and spread” (5/7).

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From the Global Health Policy Community

ODA Decreases For Second Year In Row, 'Governments Must Re-Prioritize,' ONE Campaign Policy Officer Says

ONE: Aid levels drop for second year in a row
Jorge Rivera, policy officer at the ONE Campaign, discusses findings from the Organisation for Economic Cooperation and Development’s (OECD) preliminary aid statistics for 2018, which show that official development assistance (ODA) decreased for the second year in a row. Rivera writes, “To reverse these concerning trends, people should demand that their governments do better — and governments must re-prioritize so that their aid budgets go to the countries and the people who need it the most” (5/7).

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Global Burden Of Disease Report Plays Vital Role In Health Surveillance, Gates Foundation Blog Post Says

Bill & Melinda Gates Foundation’s “The Optimist”: Worldwide in scope, but local in relevance, the Global Burden of Disease report is revolutionizing health surveillance
Journalist Ryan Bell discusses the role and importance of the Global Burden of Disease (GBD) report in health surveillance, writing, “[T]he GBD represents a quantum leap in how health data is calculated and reported. … By putting global health into a worldwide context, the Global Burden of Disease is revealing subnational health trends that show health ministers where to take action” (May 2019).

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IMF Managing Director Christine Lagarde Delivers Remarks On Financing International Development At Paris Forum

International Monetary Fund: How to Ensure the Effective and Sustainable Financing of International Development
During remarks at the Paris Forum, IMF Managing Director Christine Lagarde discussed the challenge of financing and attaining the Sustainable Development Goals (SDGs), the importance of international initiatives in global development efforts, and the role of borrowing countries, creditors, and the Paris Club in development efforts (5/7).

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Global Action Against Vaccine Hesitancy Critical To Improving Public Health, Pediatric Experts Say

BMJ Opinion: We need a global plan to tackle low vaccine uptake and vaccine hesitancy
Nuria Martinez-Alier, senior pediatric infectious diseases specialist and consultant at the Evelina London Children’s Hospital, and Claire Lemer, consultant general pediatrician at the Evelina London Children’s Hospital and deputy director of CYPHP, discuss the importance of vaccines in preventing the spread of infectious diseases and the threat of vaccine hesitancy, writing, “Concrete action by our leaders is necessary. … We need to discuss the role of schools in supporting the education of families on the importance of vaccines. A core approach of our efforts to improve public health should be a focus on the importance of vaccines, and this must be part of every relevant clinical interaction” (5/7).

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From the U.S. Government

PMI Releases 13th Annual Report To Congress

President’s Malaria Initiative: 2019 PMI Thirteenth Annual Report
“The U.S. President’s Malaria Initiative’s (PMI’s) Thirteenth Annual Report to Congress describes the U.S. Government’s leadership and technical and financial contributions to the fight against malaria in FY 2018…” (May 2019).

President’s Malaria Initiative: U.S. President’s Malaria Initiative By the Numbers
This fact sheet provides visualizations on PMI’s achievements, contributions, and results to date (April 2019).

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PMI-Supported Project Brings Malaria Education To Schools In Uganda

USAID/Medium: A “Malaria Smart School”
Caitlin Christman, technical adviser with the U.S. President’s Malaria Initiative in USAID’s Bureau for Global Health, discusses a PMI-supported initiative in Uganda to promote malaria education and prevention efforts in schools, writing, “Through these health clubs and the lessons learned at school, these children are encouraging seemingly small, yet powerful actions in the fight against malaria  —  both in their homes and communities  —  that will help pave the way towards a malaria-free world” (5/6).

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