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Kaiser Daily Global Health Policy Report

In The News

Bill Gates In Washington To Promote Polio Eradication Plan, Discuss Other Health-Related Agendas

Bill Gates, co-chair of the Bill & Melinda Gates Foundation, was in Washington this week “promoting his plan to combine a 1960s-era oral vaccine with new satellite photography and GPS trackers to eradicate polio finally from the globe,” Politico reports. “Gates appeared with former President Bill Clinton at a public forum Tuesday morning and then went behind closed doors to speak to the Senate Republican luncheon,” the news service writes, noting “there were face-to-face meetings [on Tuesday] with senior members of the Senate and House Appropriations committees important to Gates’s health and agriculture agendas.” According to the news service, Gates is “asking Washington to increase its annual commitment to an international polio fund from $100 million to $150 million. That’s a 50 percent increase — post the March sequester.”

“But the payoff could be huge if polio is wiped out, eliminating the need for costly vaccinations in the future,” Politico adds (Rogers, 5/8). “‘Polio is special,’ Gates tells NPR’s Robert Siegel on ‘All Things Considered,'” NPR’s “Shots” blog writes, adding, “Once you [eradicate polio], you save $2 billion a year that will be applied to those other [health] activities. There’s no better deal economically to getting to zero” cases. The blog continues, “Plus, he says, much of the $5.5 billion spent on polio will go toward building up health care systems in the affected countries” (Doucleff, 5/8). According to Politico, while in Washington, “Gates [also] talked up new farming methods and genetically modified seeds as an answer for hunger in Africa, whose staple crops were neglected in earlier research” (5/8).

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Victims Of Haiti Cholera Epidemic Threaten U.N. With Lawsuit Over Compensation

“Victims of Haiti’s cholera epidemic have given the United Nations a 60-day deadline to start talks about billions of dollars’ worth of compensation or face legal action,” BBC News reports, noting, “The U.N. is accused of negligently allowing peacekeeping soldiers to pollute Haiti’s water with cholera” (5/8). “Lawyers for the Institute for Justice and Democracy in Haiti said they hoped to be able to settle with the United Nations but are ready to go to court in New York if that fails,” the Associated Press/U.S. News & World Report writes, adding, “The announcement was the group’s response to a U.N. letter in February saying it is legally immune and was not responsible for the cholera outbreak that has sickened nearly 500,000 people and killed over 7,750 people since the outbreak began in October 2010” (Spielmann, 5/8). “Institute lawyers say they are seeking $100,000 for the family of each victim who died from cholera and $50,000 for each survivor,” Agence France-Presse notes, adding, “That could take the potential claim into several billion dollars” (5/8). “The U.N. has repeatedly denied any responsibility for the cholera outbreak,” Al Jazeera writes. The news service examines the issue in a video report (5/9).

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WHO Experts To Visit Saudi Hospital Where Coronavirus Has Spread

WHO “experts and local officials will visit a Saudi hospital where the SARS-like coronavirus has spread, killing seven people, the U.N. agency said on Wednesday,” Reuters reports. “The WHO-Saudi team of experts will focus on the Al-Moosa hospital in the town of Hofuf in Ahsa governate in Eastern Province, where the patients are being treated,” according to Reuters, which adds, “Health experts’ concerns are growing over clusters of cases, despite no evidence of sustained human-to-human transmission — the type of infection pathway that can lead to pandemics.” Reuters writes, “‘One focal point of the investigation at the moment is the hemodialysis unit in the hospital,’ said WHO spokesman Gregory Hartl in Geneva, referring to equipment used on kidney and diabetes patients.”

“A total of 23 cases have been reported since September in Saudi Arabia, including 13 since mid-April in al-Ahsa, where seven patients have died and four remain critically ill in intensive care, with two improving in hospital, the WHO said,” Reuters notes. The news service adds, “France reported its first case on Wednesday in a 65-year-old Frenchman who had recently returned from Dubai with the virus that has emerged from the Gulf and has also spread to Britain and Germany as well as Jordan, Qatar and United Arab Emirates” (Nebehay/Habboush, 5/8).

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Experts Say Too Soon To Tell If H7N9 Will Slow; Research Continues Into Origin, Vaccine

Some experts believe the number of new cases of H7N9 avian flu might be slowing, “perhaps due to control measures China has taken,” the Canadian Press/Vancouver Sun reports. “But experts warn it’s far too soon to gauge what H7N9 has in store for humankind,” the news agency continues (Branswell, 5/8). According to NPR’s “Shots” blog and “All Things Considered,” Daniel Jernigan, deputy director of CDC’s influenza division, said the virus is receiving a lot of attention in the research community because “people who get it usually get very sick,” it has killed one-quarter of the 130 human cases, and “the genetic makeup of this new virus is disturbingly different from an older bird flu virus [H5N1] that has sickened more than 600 people over the past 10 years and killed more than half of them.” NPR reviews research efforts into treatments and vaccines, as well as pandemic preparedness steps underway in the U.S. (Knox, 5/8). The Canadian Press includes comments from several experts regarding the potential of the virus to become better adapted to human-to-human transmission (5/8).

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IRIN Examines Effectiveness Of mHealth Technologies

In an analysis examining the effectiveness of mobile technologies in health care, IRIN asks, “[I]s the evidence there yet that mHealth is an effective health delivery intervention for the developing world?” The news service highlights a January 2013 systematic review published in PLOS Medicine that found mixed results on the “effectiveness of mHealth technology in improving health delivery” based on 42 studies; a 2012 study (.pdf) by the mHealth Alliance that found mHealth was being used more in sub-Saharan Africa compared with Asia and Latin America; and an mHealth Aliance recently released “review (.pdf) of standards in the use of mHealth among low- and middle-income countries.” According to IRIN, “experts say the use of mHealth and other humanitarian technology should be allowed to be driven by the communities who benefit from it” (5/8).

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Mobile Health Technology Could Help Poor Urban Residents Access Health Services, Reduce Spending, Study Says

“Using mobile health technology to monitor patients in poor urban areas could improve residents’ access to health care while also reducing health care spending, a study [.pdf] conducted in a Rio de Janeiro hillside ‘favela’ slum suggested Wednesday,” the Associated Press/Seattle Times reports. The New Cities Foundation’s “18-month Urban E-Health Project … provided [staff at a clinic in the slum] with a backpack with nine portable diagnostic tools to track blood pressure, glucose levels and other health measurements during weekly house calls on 100 elderly patients with chronic diseases and reduced mobility,” the news agency writes. The study found that “[s]uch quick, easy diagnoses were shown to help prevent more serious health problems down the line, cutting down on instances of heart failure, strokes and other ailments,” according to the AP, which adds, “The mobile treatment also led to hundreds of thousands of dollars’ worth of savings to Brazil’s public health system by helping prevent serious ailments requiring costly treatment” (5/8). New Cities Foundation Executive Director Mathieu Lefevre said, “We should not wait for this kind of innovation to slowly trickle down to the bottom of the pyramid. … This study shows that we can and should start where better access to health care is needed most, and we should do so using the best available technology,” Bloomberg Businessweek reports (Warner, 5/8).

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Editorials and Opinions

Chicago Tribune Publishes Opinion Piece, Editorial Discussing Food Aid Reform

The following is a summary of an editorial and an opinion piece published in the Chicago Tribune that address proposed reform to the U.S. food aid program contained in President Obama’s FY 2014 budget request.

  • John Kerry, Tom Vilsack, Rajiv Shah: “Through a program called Food for Peace, America’s agricultural bounty and heartland values have fed well over a billion people in more than 150 countries since 1954,” Secretary of State John Kerry, Department of Agriculture Secretary Tom Vilsack, and USAID Administrator Rajiv Shah write. “But while the world has changed significantly since President Dwight Eisenhower was in the White House, our hallmark food assistance program has not evolved with the times,” they continue, adding the “important” reforms proposed by President Barack Obama in his FY14 budget request would feed up to four million more people annually and save an estimated $500 million over 10 years. “At a time of urgent human need and budget constraint, this is the right choice,” they state. The authors summarize some of the proposed changes, which include more flexibility for local food procurement and distribution of cash vouchers, writing, “This more agile, flexible and modern approach pairs the continued purchase of the best of American agriculture with greater flexibility around interventions such as local procurement and electronic payments to save more lives.” They conclude, “By freely and flexibly harnessing the tools we’ve developed and the knowledge we’ve gained, we can save more lives without asking for more money — an opportunity we must not pass up” (5/9).
  • Editorial: “The food program is an agricultural subsidy in disguise,” the Chicago Tribune writes, continuing, “Requiring the purchase of U.S. goods, transported only on U.S. ships, creates profits for American farmers and the agribusiness giants that control shipping. But American taxpayers don’t get their money’s worth.” The newspaper writes, “This program desperately needs to change, but the farm lobby works furiously to protect its vested interests,” and it describes the proposed changes. “Food aid can help to lift developing nations out of poverty, promote political stability and economic growth. It must be structured efficiently to achieve its objective,” the editorial writes, concluding, “As is, the Food for Peace program doesn’t work well, except for the benefit of a privileged few. Reforming food aid would enable America to do justice to a large taxpayer outlay — and to save lives” (5/9).

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U.S. Government Should Develop Unified National Security Budget To Free Up Spending For 'Soft Power' Initiatives

Highlighting an opinion piece published in Politico on Monday in which Retired Gen. David Petraeus, former director of the CIA, and Michael O’Hanlon, senior fellow at the Brookings Institution, argue that further cutting U.S. foreign aid could hinder “America’s ability to protect itself and advance its global interests,” Lawrence Korb, a senior fellow at the Center for American Progress who served as an assistant secretary of defense in the Reagan administration, and Miriam Pemberton, a research fellow at the Institute for Policy Studies, write in a separate Politico opinion piece, “Retired Gen. David Petraeus and Michael O’Hanlon are correct that we should protect funding for the State Department and [USAID] … because doing so enhances our national security.” They note, “Their comments are in line with those of former Secretary of Defense Robert Gates, who made this point several times during his time in office.” However, “neither Gates nor Petraeus and O’Hanlon are willing to reduce defense spending in order to provide additional funds for the soft power supplied by [the State Department] and USAID,” they continue.

“Given that we now spend more on defense, in real terms, than we did during the Cold War and that bipartisan groups like Bowles-Simpson and Domenici-Rivlin have recommended cutting up to $1 trillion from defense over the next decade, it would seem logical that funds could be shifted from the DOD budget, which is 10 times larger than State and [USAID], so that we could not only not cut that budget but actually increase theirs,” Korb and Pemberton state. “For example, purchasing seven fewer F-35 Joint Strike Fighters, a troubled program that is 70 percent over budget, would … allow the administration to avert the cuts it made to the Global Fund to Fight AIDS, Tuberculosis and Malaria,” they write, concluding, “In order to make these trade-offs, the U.S. government needs to develop a unified national security budget that allows the president and the Congress to make trade-offs like these. Until we do, agencies like State and USAID, which as Petraeus and O’Hanlon acknowledge, generally lack a strong constituency, will continue to receive less than they need to project soft power and enhance our national security” (5/8).

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Continued Support For Child Immunization From U.S., Partners Critical To Sustaining Progress

“In the last 50 years, immunization has saved the lives of more children than any other medical intervention, reducing child mortality rates by 35 percent in the last two decades alone. Yet, every 20 seconds, a child still dies from a vaccine-preventable disease,” Sen. Jeanne Shaheen (D-N.H.) writes in the Huffington Post’s “Global Motherhood” blog. “We have an opportunity to make a real and lasting difference in the lives of children across the globe, and the services provided by Shot@Life are a proven tool in that fight,” she continues.

“Vaccines have saved the lives of over 20 million children globally, but continued support from the U.S. and other global players is critical to sustaining this progress,” Shaheen states, adding, “As our economy continues to recover, we must work harder and smarter to make sure that our children continue to have access to quality health care.” She writes, “We know how to save millions of children from completely preventable diseases, and the United Nations Foundation’s Shot@Life Campaign works with both public and private partners toward that goal by ensuring that children in developing countries receive the vaccines they need,” concluding, “We can’t stop now — continued support from the U.S. and other global players is critical to sustaining this progress” (5/9).

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China, Africa To See A Stronger Collaboration On Health Moving Forward

In a CNN opinion piece, Lucy Chen, executive deputy director of the Institute for Global Health at Peking University in Beijing, examines the underlying reasons for China and Africa collaboration on health. Noting the 4th annual International Roundtable on China-Africa Health Cooperation in Gaborone, Botswana, this week, which “tackled such topics as malaria, AIDS, reproductive health, and schistosomiasis — health issues that China has largely brought under control but remain major health challenges in Africa,” she writes, “To be sure, there is a long history of China and Africa collaboration on health.” She adds, “Going forward, we all foresee a stronger collaboration,” as “[m]any African countries could benefit from low-cost, high-quality Chinese-made health products.”

“The relationship between China and Africa has of course been long and complex, and not without misunderstandings,” Chen continues, noting “tensions that have on occasion emerged due to different styles of management and communication.” She writes, “This is why these face-to-face meetings are so valuable. They pave the way for our long walk together,” adding, “Of course, we still have far to walk before all people with AIDS, malaria and TB receive the treatments and dignity they deserve; before all children are immunized; before all women have access to safe and effective contraception; and before neglected tropical diseases are eradicated forever.” She concludes, “But, I am encouraged that we are walking together, and in the right direction” (5/9).

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From the Global Health Policy Community

Blog Examines Global Partnerships Act Of 2013 Introduced In Congress Last Week

“Last week, Reps. Gerry Connolly (D-Va.), Karen Bass (D-Calif.), and Earl Blumenauer (D-Ore.) introduced the Global Partnerships Act of 2013 [.pdf],” Ashley Bennett, a policy officer at the Global Health Technologies Coalition, writes in the coalition’s “Breakthroughs” blog. “The bill is a welcome step to reform the U.S. government’s foreign assistance programs, including strengthening important aspects of U.S. global health research and development (R&D) efforts,” she continues, noting, “Throughout the bill, research and innovation to improve health worldwide are highlighted as central components of U.S. foreign assistance programs.” Bennett provides details of the bill and adds, “Congress should unquestionably move this legislation forward and introduce a Senate companion bill. However, given that Congress hasn’t made much traction on most pieces of legislation in the past few years, the Partnership Act’s fate isn’t clear” (5/8).

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Open Agriculture Data Important To Improve Global Food Security

“The concept of open agriculture data fuses transparency and technology to improve food security worldwide; farmers, entrepreneurs, and researchers recognize the impact and potential of increasing access to information and are increasingly receiving high-level support,” Katherine Townsend, special assistant for engagement at USAID, writes in the agency’s “IMPACTblog.” She describes some of the programs that have improved smallholder farmers’ access to data to “enabl[e] better decision making on which crops to plant to yield the highest income,” with the aim of improving global food security. “In an increasingly networked and tech-savvy world, open data has the potential for more people to use information for social good, and USAID and global development goals directly benefit from increasing access to information,” Townsend writes, concluding, “Only through active and consistent participation can we ensure that information is timely, useful, and used. We can expect that these changes will come. Let’s get that information online and useable” (5/8).

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President's FY14 USAID Budget Request Created By Collaborative Effort

“With the completion of [USAID Administrator Rajiv] Shah’s final congressional hearing on the FY 2014 President’s Budget Request for USAID [.pdf], I want to highlight that this budget reflects the development priorities of this administration while making difficult tradeoffs due to the constrained budget realities,” Dennis Vega, chief of staff in the Office of Budget and Resource Management, writes in USAID’s “IMPACTblog.” “A prime example of our commitment to maximize the effectiveness of USAID programs is the President’s Food Aid Reform Proposal,” he states, noting the reforms would feed up to four million more people worldwide each year. Vega describes the collaborative process involved in creating a budget proposal “focused on maximizing results for every dollar spent,” and writes, “This inclusive approach led to a resource request that reflects administration and USAID priorities, modernizes our development activities, and provides the most cost-effective and sustainable development.” He concludes, “[W]e will continue to work closely with Congress to enact a budget that supports our national security, promotes our economic interests, and alleviates human suffering” (5/8).

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