Kaiser Daily Global Health Policy Report

In The News

Devex Examines Trump Administration's Treatment Of Security Assistance, Development, Humanitarian Aid

Devex: Trump’s Ukraine defense sparks questions about mixing aid with politics
“…While U.S. security assistance — arms and defensive equipment for foreign governments and militaries — and U.S. humanitarian and development assistance serve different functions and flow from different parts of the U.S. government, [Acting White House Chief of Staff Mick] Mulvaney’s argument described them both as part of the same basic philosophy. Aid experts who spoke to Devex differ about whether or not Trump’s suspension of security assistance to Ukraine constitutes a clear violation of the constitution. But they generally agree that the episode highlights a general breakdown in the administration’s understanding of how aid serves the U.S. national interest. In addition, Mulvaney’s remarks resurfaced questions about when it is, and is not appropriate to use assistance in pursuit of narrow interests, as opposed to the broader aim of attempting to help people in need or contribute to a more prosperous world…” (Igoe, 11/1).

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Nigerian Newspapers Examine PEPFAR Funding, Programs In Country Following U.S. Consulate Briefing, Visit

Guardian: Why U.S. does not give direct funding to agencies in Nigeria
“Officials of the United States (U.S.) Consulate in Nigeria have provided more explanation why their government does not give direct funding to agencies and governments in Nigeria. They said it is more efficient to channel the resources through non-governmental organizations (NGOs) for effective utilization and accountability…” (Muanya, 10/31).

Nation: U.S. to support HIV treatment for 60,000 Lagosians
“The United States President’s Emergency Plan for AIDS Relief (PEPFAR) has announced that it is implementing an antiretroviral treatment (ART) surge program in Lagos State to identify and provide treatment for about 60,000 people living with HIV (PLHIV) who have not previously received such treatment. The support program is being administered by U.S. Centers for Disease Control (CDC), Department of Defense, and U.S. Agency for International Development (USAID)…” (Yusuf, 11/1).

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Nigeria Government Lifts Ban On 2 Humanitarian Aid Groups, Allowing Food Assistance Delivery

Associated Press: Nigeria lifts ban on 2 prominent humanitarian groups
“Nigeria’s government has lifted a ban on the operations of two prominent international aid groups after accusing them of providing food and medicines to Boko Haram extremists, which the groups denied. The United Nations humanitarian office replied Wednesday that humanitarian groups are ‘relieved’ that Nigeria has suspended the ban on Mercy Corps and Action Against Hunger. More than 350,000 people now can receive food assistance that had been put on hold, the U.N. said…” (Adigun, 10/31).

Additional coverage of the ban’s lifting is available from Reuters.

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New Global Consortium Forms To Aid Ebola Response In DRC, Launch 2nd Experimental Vaccine; J&J Donating 500K Doses

Bloomberg: Johnson & Johnson Giving 500,000 Ebola Shots in Congo Test
“Johnson & Johnson will donate as many as half a million doses of its experimental Ebola vaccine for a trial in the Democratic Republic of the Congo, where more than 2,000 people have died in the latest outbreak. The vaccine will be studied in areas outside the ‘hot zone’ where cases are spreading most quickly, J&J research chief Paul Stoffels said…” (Lauerman, 10/31).

CIDRAP News: Consortium readies for launch of 2nd Ebola vaccine in DRC
“A global consortium that includes the Democratic Republic of the Congo (DRC) ministry of health, Doctors without Borders, the Wellcome Trust, and CEPI (the Coalition for Epidemic Preparedness Innovations), among other groups, is preparing for the introduction of a second Ebola vaccine to be used in the DRC in the coming days…” (Soucheray, 10/31).

Devex: Ebola in DRC: NGOs organize to coordinate community engagement work
“NGOs responding to the Ebola emergency in the Democratic Republic of the Congo have formed a consortium to help better involve communities…” (Jerving, 11/1).

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New Humanitarian Examines Leaked Confidential Draft Report On Sex Abuse Allegations Against U.N. Peacekeepers In CAR

New Humanitarian: EXCLUSIVE: Blunders in Central African Republic sex abuse probe detailed in internal U.N. review
“After nearly 100 women and girls in Central African Republic accused Burundian and Gabonese peacekeepers of rape, sexual abuse, and exploitation, the U.N. deployed investigators to the country in 2016. The number of allegations rose to more than 130, with more than half ultimately dismissed. Now, a 50-page internal U.N. report, marked ‘confidential draft’ and obtained by The New Humanitarian from a former U.N. staffer concerned over the review’s findings, details blunders in the investigations and lays out how women and girls — as well as U.N. investigators — were let down in the process…” (Kleinfeld/Dodds, 10/31).

Additional coverage of the leaked report also is available from the AP.

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Measles Infection Can Cause Damage To Immune System, Increasing Risk Of Contracting Other Diseases, 2 Studies Show

New York Times: Measles Can Cause ‘Immune Amnesia,’ Increasing Risk of Other Infections
“Measles is far more dangerous than most people realize, new research shows. The disease itself can cause a severe and sometimes deadly illness, but two new studies published on Thursday found that even when patients recover, the virus can inflict lasting harm on their immune systems…” (Grady, 10/31).

STAT: How measles infections can wipe away immunity to other diseases
“…The first paper, published in Science, showed that children infected with measles lost between 11% and 73% of their antibodies after infection. The authors, from Harvard University, noted the children studied had been healthy and well-nourished before contracting measles, and the impact on malnourished children in parts of the developing world is likely greater still. … The second paper, from researchers in Europe, was simultaneously published in the journal Science Immunology…” (Branswell, 10/31).

Washington Post: Measles makes your body forget how to fight other diseases
“…The discoveries have enormous and immediate public health implications, researchers and clinicians said, and underscore more than ever the importance of measles vaccination. In recent years, anti-vaccine misinformation has been one reason vaccination rates have plummeted and global measles cases have surged. … More than 7 million people are estimated to have been infected with measles in 2018, according to global health officials. Comprehensive coverage with the measles, mumps, and rubella vaccine would prevent more than 120,000 deaths directly attributed to measles this year, and it could also ‘avert potentially hundreds of thousands of additional deaths attributable to the last damage to the immune system,’ the authors [of the Science paper] wrote…” (Sun, 10/31).

Additional coverage of the study is available from Financial Times, The Guardian, Newsweek, Reuters, Science, Scientific American, and Wired.

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More News In Global Health

The Guardian: Death toll in Yemen war reaches 100,000 (Beaumont, 10/31).

Reuters: Record 45 million people in southern Africa facing food crisis: U.N. agencies (Roelf, 10/31).

Science: Gates and NIH join forces on HIV and sickle cell diseases (Cohen/Kaiser, 11/1).

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Editorials and Opinions

Innovation, New Ideas Help Shape Global Health, Peter Piot Writes In Opinion Piece

Scientific American: How Human Innovation Shapes Global Health
Peter Piot, director of the London School of Hygiene & Tropical Medicine and member of the judging panel for the Recognizing Excellence Around Champions of Health (REACH) Awards

“…In health, innovation is so much more than the discovery or launching of new therapies, vaccines, and/or apps. It is first and foremost about finding better ways of reaching people to improve the efficiency, quality, sustainability or affordability of health care and disease prevention. … I’m excited to see what innovative solutions this year’s [REACH] nominees have utilized to advance global health. … By delivering one device or one training session at a time, the problem [of ‘equipment graveyards’] is perpetuated. In response to this challenge, the London School of Hygiene & Tropical Medicine (LSHTM) recently announced that it is co-leading, together with Rice University’s Rice 360° Institute for Global Health in the U.S., and the Malawi College of Medicine, as well as leading institutions across Africa, a new £50 million partnership. … By applying groundbreaking ideas and tools that create new possibilities, we can better reach and inform those in need of care. Innovation constantly challenges the status quo and so must we” (11/1).

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Lancet Editorial Calls For More Robust International Collaboration To Better Control, Treat Chagas Disease In PAHO Region

The Lancet: Chagas disease: still a neglected emergency
Editorial Board

“A report from the Pan American Health Organization (PAHO), released on Oct. 19, describes progress in the spread and control of Chagas disease … [and] the troubling issues confronting regions dealing with this neglected infectious disease. … In an increasingly interconnected world, it is dangerous to view a disease historically restricted to one specific region as someone else’s problem. This report should be proof enough that international collaboration with a focus on improving control and treatment of Chagas disease is long overdue and that this infection requires a truly international response…” (11/2).

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From the Global Health Policy Community

UNICEF USA Highlights Status Of U.S. Legislation Addressing Children's Health, Related Issues Globally

UNICEF USA: Celebrating Legislation On Education, Protection And Nutrition
Fabienne Goldgaber, manager for advocacy and engagement at UNICEF USA, highlights recent U.S. legislation addressing children’s health and related issues globally. Goldgaber writes, “Over the past year, supporters and volunteers of UNICEF USA have been advocating for three significant pieces of legislation to bolster girls’ education, prevent and respond to violence against children around the world, and reaffirm the importance of global nutrition. We are thrilled to share that the Keeping Girls in School Act (H.R.2153/S.1071), Resolution to End Violence Against Children Globally (H.Res.230/S.Res.112) and Global Nutrition Resolution (H.Res.189/S.Res.260) have passed the House Foreign Affairs Committee (HFAC)” (10/30).

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WASH In Primary Care Settings Critical, More Action Needed At All Levels, Global Water 2020 Principal Says

GBCHealth: Water, Sanitation, and Hygiene — A fundamental necessity of primary health services
In this post for GBCHealth, Anthony Rock, principal at Global Water 2020, addresses inadequate WASH in primary health care facilities. Rock writes, “This challenge is solvable today, with the tools readily at our disposal. Leaders at national, regional, and local levels must therefore acknowledge both the moral and the economic imperative to make needed investments in adequate WASH in health facilities for healthy and vibrant societies. Those who are entrusted with delivering health care, as well as water and sanitation services, must, in turn, recognize the imperative to work together for progress. Progress requires training, monitoring, and evaluation to ensure sustainability…” (October 2019).

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Experts Examine Implications Of 'Deep' Statistical Uncertainty In TB Decision Making By Policymakers, Clinicians, Others

Center for Global Development: Managing “Deep” Uncertainty in Global Health: The Case of TB Testing
Rachel Cassidy, CGD non-resident fellow, and Charles Manski, board of trustees professor at Northwestern University, address the implications of statistical uncertainty for decision making in global health, examining the case of TB testing and treatment specifically. The authors write, “Policymakers and clinicians in global health often face considerable uncertainty when making decisions. Statistical uncertainty — arising from the fact that analysis and modeling typically use samples rather than whole populations — can be accounted for by placing confidence intervals on the estimated impacts of different policies and treatment regimes. However, ‘deep’ uncertainty — which may arise from issues including missing data or limited external validity from existing trials — poses a more fundamental challenge to decision-making. In a newly published article in The Proceedings of the National Academy of Sciences, we examine such ‘deep’ uncertainty in the context of a new diagnostic test for tuberculosis (TB), including discussions of diversification, and ask what a reasonable policy response might be for public health agencies combatting TB” (10/31).

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Health Groups Sign Open Letter Urging ILO To Reject Tobacco Industry Donations, Increase Regulation

World Heart Federation: Public health groups call on International Labour Organization to reject tobacco funding
This release discusses an open letter from public health groups to the International Labor Organization (ILO) regarding tobacco funding and industry regulation. The release states, “Global public health groups called on the ILO Governing Body to reject tobacco donations and tap tobacco taxes as [a] funding source; as well as to espouse strict regulations on labor standards in order to eliminate concerns such as hazardous working conditions and child labor. … The organizations signing the letter, led by STOP (Stopping Tobacco Organizations and Products), include Action for Smoking and Health, U.S., Campaign for Tobacco Free Kids, Corporate Accountability International Framework Convention Alliance, Johns Hopkins Institute for Global Tobacco Control, NCD Alliance, and World Heart Federation” (10/30).

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DRC Ministry Of Health, WHO, Partners Launch 2nd Phase Of Cholera Vaccination Campaign

WHO: 835,000 people to receive second dose of the cholera vaccine in North Kivu, Democratic Republic of the Congo
“The second phase of an oral vaccination campaign to protect more than 835,000 people from cholera in the North Kivu Province of the Democratic Republic of Congo (DRC) [began this week]. While North Kivu has been struggling with an outbreak of Ebola virus disease for more than a year, this north-eastern province is also endemic for cholera. The Ministry of Health is launching this major campaign, which is fully funded, including operational costs, by Gavi, the Vaccine Alliance and is being implemented with the support of the World Health Organization (WHO) and other partners in the Global Task Force on Cholera…” (10/30).

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November 2019 Issue Of WHO Bulletin Available Online

WHO: Bulletin of the World Health Organization
The November 2019 WHO Bulletin features articles on various topics, including an editorial on monitoring adverse drug reactions in community settings, a research article on international corporate tax avoidance and domestic government health expenditure, and a research paper on tuberculosis prevalence in the Russian Federation (November 2019).

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From the U.S. Government

CDC's MMWR Addresses Guinea Worm Disease, Challenges To Interrupting Transmission

CDC’s “Morbidity and Mortality Weekly Report”: Progress Toward Global Eradication of Dracunculiasis — January 2018-June 2019
Donald R. Hopkins and colleagues from the Carter Center, with colleagues from the World Health Organization Collaborating Center for Dracunculiasis Eradication at the CDC, discuss the status of global dracunculiasis (Guinea worm disease), including an overall decrease in human cases since 1986 but a recent increase in human cases in three countries, as well as cases among dogs. The piece’s summary states, “Existence of infected dogs, especially in Chad, and impeded access because of civil unrest and insecurity in Mali and South Sudan are now the greatest challenges to interrupting transmission” (11/1).

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