KFF Daily Global Health Policy Report

In The News

U.S. Senate Releases FY21 State, Foreign Operations Budget Bill; Emergency COVID-19 Funding Not Included

Devex: U.S. Senate foreign aid funding bill holds spending steady, leaves out COVID-19
“The Senate’s fiscal year 2021 state and foreign operations budget bill provides roughly the same amount of funding for aid as last year, though it has a couple of notable differences from the House of Representatives bill — including no emergency COVID-19 funding. The bill, released by the Senate Committee on Appropriations Tuesday, … [is] well above President Donald Trump’s request, which would have substantially cut the aid budget and about the same amount that the Senate proposed last year. The funding bill is good for the development community and perhaps even better than what some had expected given discussions earlier this year, one development advocate who asked for anonymity to speak freely, told Devex. Other development experts said that it demonstrates once again that Congress is willing to push back against proposed cuts, but also called for Congress to pass supplemental funding for global COVID-19 response…” (Saldinger, 11/11).

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At WHA, U.S. Criticizes WHO Efforts To Investigate Coronavirus Animal Origins, Germany Decries Agency's Longstanding Financing Woes; AP Examines Recordings Of Internal WHO Meetings Held Early In Pandemic

AP: U.S.: WHO not sharing enough info about China virus probe
“A senior U.S. government official complained Tuesday that the World Health Organization has not shared enough information about its planned mission to China to investigate the animal origins of the coronavirus. Garrett Grisby of the U.S. Department of Health and Human Services griped that the criteria for WHO’s China mission had not been shared with other nations. He spoke during a weeklong meeting of the U.N. health agency’s member countries…” (Keaten/Cheng, 11/11).

AP: Recordings reveal WHO’s analysis of pandemic in private
“…With its annual meeting underway this week, WHO has been sharply criticized for not taking a stronger and more vocal role in handling the pandemic. For example, in private internal meetings in the early days of the virus, top scientists described some countries’ approaches as ‘an unfortunate laboratory to study the virus’ and a ‘macabre’ opportunity to see what worked, recordings obtained by the Associated Press show. Yet in public, the U.N. health agency lauded governments for their responses…” (Cheng et al., 11/11).

Devex: Germany sick of ‘déjà vu’ in WHO financing battle
“Germany is hoping to draw on momentum around the global COVID-19 response in order to address the World Health Organization’s longstanding funding woes, and is pushing for an agenda on sustainable financing at the WHO executive board’s meeting in 2021. … Much of the organization’s funding also comes from a few donors, leaving it vulnerable to shocks should a donor withdraw funding…” (Chadwick/Ravelo, 11/11).

Reuters: U.S. denounces terms for WHO-led inquiry into COVID origins
“The United States, which has accused China of having hidden the extent of its coronavirus outbreak, called on Tuesday for a ‘transparent and inclusive’ WHO-led international investigation into the origin of the pandemic, criticizing its current terms. … Tedros revealed the team’s composition on Tuesday, telling the WHO annual ministerial meeting: ‘These are very respected individuals in their areas.’ Team members came from Russia, Australia, Sudan, Denmark, the Netherlands, Germany, Japan, Vietnam, the United Kingdom, and the United States, he said…” (Nebehay, 11/10).

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Pandemic Impacting Freedom, Democracy In Some Nations, New Report Examining 192 Countries Shows

NPR: Report: The Pandemic Is Not Good For Freedom And Democracy. But There Are Exceptions
“The pandemic has had a chilling effect on freedom around the globe, according to a new report from Freedom House, a nonpartisan group that advocates for democracy and whose founders include Eleanor Roosevelt and Wendell Willkie. … Certain countries show how a global health emergency can have far-ranging repercussions on the overall health and well-being of a country — but also how countries can rally and do the right thing. The report, Democracy Under Lockdown: The Impact of COVID-19 on the Global Struggle for Freedom, was published in October in partnership with the survey firm GQR. Researchers surveyed nearly 400 journalists, activists, and other experts in governance and democracy from March to September to find out how the pandemic is affecting freedom in 192 countries…” (Gharib, 11/10).

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E.U. Pre-Purchasing Pfizer-BioNTech COVID-19 Vaccine; Botswana Joins COVAX; Philippines Looking To Procure 50M Vaccine Doses; India's Serum Institute Aims To Supply Vaccines To Developing Nations

AP: E.U. to buy up to 300 million doses of Pfizer-BioNTech vaccine
“The European Commission will sign a deal to secure up to 300 million doses of the experimental coronavirus vaccine developed by BioNTech and Pfizer…” (11/10).

Reuters: Botswana signs agreement with global vaccine scheme for 20% of population
“Botswana has signed an agreement with the global vaccine distribution scheme co-led by the World Health Organization, giving it the option to buy coronavirus vaccines for 20% of its population, a senior health official told Reuters…” (Benza, 11/10).

Reuters: Philippines seeking 50 million doses of COVID-19 vaccines next year
“The Philippines plans to procure an initial 50 million doses of COVID-19 vaccines to ensure at least a quarter of its population gets inoculated next year, a top coronavirus task force official said on Monday…” (Lema, 11/9).

Washington Post: Who will make coronavirus vaccines for the developing world? India holds the key.
“…In the quest for effective coronavirus vaccines, India is poised to play a critical role in supplying the developing world, which is starting the race with a distinct disadvantage. … Rich nations are ‘all cutting in line and hoarding vaccine supply to immunize as many people as possible, even if this leaves other countries unable to immunize those at highest risk,’ said Nicholas Lusiani, a senior adviser at Oxfam America, a nonprofit group devoted to fighting poverty. Enter Indian vaccine makers, led by Serum Institute, the largest manufacturer in the world by volume…” (Slater, 10/11).

Additional coverage of COVID-19 vaccine research and supply is available from The Atlantic, Bloomberg, Financial Times, The Guardian, New York Times, Reuters, The Telegraph, and Wall Street Journal.

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Pfizer-BioNTech Vaccine's Cold Storage Needs Complicate Logistics Of Transportation, Delivery, Especially In Remote Asian, African Regions

The Guardian: Pfizer and BioNTech’s vaccine poses global logistics challenge
“Two vast football-pitch-sized facilities equipped with hundreds of large freezers in Kalamazoo, Michigan, and Puurs, Belgium, will be the centers of the huge effort to ship the coronavirus vaccine, developed by U.S. drug giant Pfizer and German biotech firm BioNTech, around the world. Governments are scrambling to prepare for the rollout of the vaccine, which must be stored at -70C (-94F), after the announcement from the two companies that it was more than 90% effective and had no serious side-effects. The news sparked hopes of a return to normal life and a stock market rally, but now minds are turning to the practicalities of getting the vaccine quickly to populations across the world, in particular to the vulnerable people who need it most…” (Kollewe, 11/10)

Reuters: Pfizer COVID-19 vaccine ‘very promising’ but cold chain issues: WHO
“…However, the necessity to keep the vaccine in extremely cold storage could complicate any inoculation program, above all in regions of Asia or Africa where the climate is warm, distances vast, and the required infrastructure may be lacking…” (Nebehay, 11/10).

Reuters: Swiss plan for centers to deliver deep-chilled COVID vaccine
“…Switzerland, whose neighbor Germany has already said it is planning centralized inoculation centers, on Tuesday reported nearly 6,000 new coronavirus infections and 107 new deaths. The Swiss have reserved nearly 10 million doses of vaccine candidates that both AstraZeneca and Moderna are developing, should they pass trials…” (Miller et al., 11/10).

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Limited Supply, Questions Surrounding Dosing Impact Eli Lilly's Newly Authorized COVID-19 Treatment

STAT: For Eli Lilly’s newly authorized Covid-19 treatment, a dosing discrepancy causes confusion
“Some clinicians are confused about the best dosing for Eli Lilly’s new Covid-19 treatment, which the Food and Drug Administration approved for emergency use on Monday. … Some clinicians wondered, though, if the decision to authorize doses of 700 milligrams — rather than a greater quantity — was made in part because the drug is in short supply. In data first released in September, researchers tried three different doses, but only the middle one — 2,800 milligrams — met the primary goal that the study had set, of reducing the amount of virus found inside patients. Given that that wasn’t the case for those patients who got either 700 milligrams or 7,000 milligrams, it seemed like this finding might just be a fluke. After all most patients, even those who’d gotten a placebo, had almost no virus in them at all after 11 days, anyway…” (Boodman, 11/10).

Washington Post: Trump officials promise fair distribution of new covid-19 antibody drug, but limited supply and logistical problems loom
“Trump administration officials Tuesday promised to fairly and swiftly distribute the first covid-19 treatment that helps to protect people with mild illness from developing severe symptoms. But the drug’s extremely limited supply and logistical difficulties in administering it could restrict how many people get access to it…” (Wan/Johnson, 11/10).

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Washington Post Examines Chinese Investigations Showing Coronavirus Can Survive, Infect Workers In Cold-Chain Food Systems

Washington Post: The U.S. has absolutely no control over the coronavirus. China is on top of the tiniest risks.
“The announcement by Chinese officials was as striking as it was alarming. After spending weeks investigating a mysterious coronavirus outbreak in the port city of Qingdao, officials from China’s Center of Disease Control declared confidently on Oct. 17 that they had found the culprit: packages of frozen food imported from abroad. … The new claims from China have presented a dilemma for international bodies such as the World Health Organization and deeply divided experts. Some say the Chinese data, which include genetic sequences of the virus from the packaging that matched viral strains in Europe, appear to be persuasive. Others dismiss the evidence as inconclusive. … In the end, the verdict seems to be that the route of transmission that China is highlighting is possible, but rare — whatever the merits of the cases that have been highlighted…” (Mooney et al., 11/10).

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Denmark Government Lacks Legal Basis For Mink Cull To Prevent Coronavirus Mutations, Puts Forth Legislation To Back Up Order To Kill All Minks

Reuters: Mink cull puts Denmark’s government in legal pinch
“The Danish government put forward hastily drawn up legislation on Tuesday to back up its order to cull all the country’s farmed mink, admitting it lacked the legal basis for the measure aimed at preventing human contagion of a mutated coronavirus strain. … The opposition says the cull of healthy mink should not have been initiated before compensation plans were in place for the owners and workers at some 1,100 mink farms…” (Gronholt-Pedersen/Skydsgaard, 11/10).

Additional coverage on Denmark’s mink dilemma and the detection of coronavirus among minks on U.S. farms is available from AP, Reuters, and Washington Post.

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President-Elect Biden Promises More Coordinated Federal COVID-19 Response But Efforts Hampered By Transition Delay

The Hill: Biden seeks to use the bully pulpit he has on COVID-19
“President-elect Joe Biden is wasting no time in using his bully pulpit to push public health measures, like mask wearing and physical distancing, that public health experts say will work best to combat the rapid spread of COVID-19. Biden has promised a much more forceful federal response to the COVID-19 pandemic than President Trump and has announced his own COVID advisory board of health experts…” (Weixel, 11/11).

POLITICO: Transition delay hampers Biden’s ramp-up of Covid-19 response
“The Trump administration’s refusal to authorize a presidential transition is interfering with President-elect Joe Biden’s plans for a rapid scale-up of the federal coronavirus response, leaving the incoming administration locked out of key health agencies amid the spiraling pandemic. … GSA Administrator Emily Murphy’s failure to approve a transition process — as President Donald Trump refuses to concede the election — has prevented the Biden forces from deploying dozens of health officials and blocked them from accessing information and resources critical to combating the crisis…” (Cancryn, 11/10).

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President-Elect Biden Expected To Rescind Mexico City Policy Upon Taking Office; Advocates Hope For Passage Of HER Act To Permanently Repeal Policy

The Guardian: Reproductive health NGOs pin hopes on Biden reversing ‘global gag rule’
“One of Joe Biden’s first acts as president is expected to be the rescinding of a rule on U.S. foreign aid … Trump reinstated the so-called ‘global gag rule,’ also known as the Mexico City policy, on his first Monday morning in office in January 2017. … Reinstating the rule was an expected move for a Republican administration, but in the months afterwards, it was expanded to make it unprecedentedly broad. … Rights advocates hope that a Biden administration would be able to pass a piece of legislation introduced to Congress last year, known as the Global Health, Empowerment and Rights (HER) Act, that would repeal the rule permanently. The vice president-elect, Kamala Harris, came out in support of the act last year…” (Walker, 11/10).

In a video, DW examines the impact of the Mexico City policy on women’s health care in Kenya.

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Science Examines Successes, Challenges Of Polio Vaccines; New Vaccine Could Be Available By Year's End

Science: The polio eradication campaign is faltering. Can a new vaccine help it get back on track?
“The Global Polio Eradication Initiative (GPEI) is about to roll out a brand-new vaccine — one that its leaders desperately hope will turn the flagging effort around. If it works as expected, the vaccine just might overcome one of the biggest obstacles to polio eradication: out-of-control outbreaks caused by the polio vaccine itself. If not, GPEI will be back to dousing each outbreak with a vaccine that risks starting another, as eradication slips further from sight. … The first drops could be delivered in several countries by the end of the year…” (Roberts, 11/10).

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More COVID-19 & Global Health News

AP: In Iran, a massive cemetery struggles to keep up with virus (Nasiri, 11/11).

AP: Frantic search after medicines vanish from Lebanon shelves (El Deeb, 11/11).

Devex: What we learned from the FCDO chief’s grilling by U.K. politicians (Worley, 11/11).

Devex: Léo Heller’s last call for water and sanitation as a human right (Root, 11/11).

Devex: Hurricane Eta destroys harvests, increases food insecurity concerns (Welsh, 11/11).

Forbes: UNICEF Warns Pandemic Could Cause Spike In Stillbirths (Buechner, 11/10).

Global Press Journal: Corruption Taints Anti-Malaria Program as Sickness Spreads (Mujuru, 11/10).

The Hill: Latin American children’s education suffering most from pandemic: UNICEF (Choi, 11/10).

Reuters: Nepal to provide free COVID-19 tests and treatment as cases surge (Sharma, 11/10).

SciDev.Net: ‘Forest foods’ drive risks of next global pandemic (Corso, 11/10).

U.N. News: U.N. agency for Palestine refugees runs out of money as COVID-19 spreads (11/10).

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Editorials and Opinions

Opinion Pieces Address Topics Related To COVID-19 Pandemic, Including Sustainable Development, Potential Vaccines, Impacts In Latin America

Devex: Opinion: Drive home a global green recovery in 2021 — no excuses
Patricia Scotland, secretary general of the Commonwealth, and Ibrahim Thiaw, undersecretary general and executive secretary of the United Nations Convention to Combat Desertification (11/11).

Foreign Policy: The Vaccine News Is Good. Here’s the Bad News
Laurie Garrett, former senior fellow for global health at the Council on Foreign Relations (11/10).

IPS: The Covid Pandemic: Broadening the Discourse
Asoka Bandarage, scholar, practitioner, and author (11/10).

Project Syndicate: The COVID Reset Latin America Needs
Mauricio Cárdenas, senior fellow at Columbia University’s Center on Global Energy Policy, and colleagues (11/9).

STAT: How to spot good Covid-19 vaccine trials results when you see them
Mark Siedner, clinical epidemiologist at Massachusetts General Hospital and associate professor of medicine at Harvard Medical School, and Paul E. Sax, clinical director of the Division of Infectious Diseases at Brigham and Women’s Hospital and professor of medicine at Harvard Medical School (11/10).

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Opinion Piece Outlines 3 Steps Biden Administration Can Take For Reproductive Rights

Rewire: 3 Things President Biden Can Do on Day One for Reproductive Rights
Caroline Reilly, legal fellow with Rewire News Group

“…It will take a progressive Congress and court reform to undo many of the harms of the last four years, including the erosion of reproductive health care access for millions who rely on abortion and contraceptive care. But here are three steps the Biden administration can take on Day One … Rescind the domestic ‘gag rule’ … Rescind the global ‘gag rule’ … Rescind Trump’s Affordable Care Act rollbacks…” (11/9).

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Global Fund Must Integrate Mental Health Into Its TB, HIV Strategies, Opinion Piece Says

Devex: Opinion: Why mental health integration in HIV and TB programs is a win-win
Ren Minghui, assistant director general for universal health coverage/communicable and noncommunicable diseases at the WHO and WHO representative on the boards of the Global Fund, UNAIDS, and UNITAID; and Shannon Hader, deputy executive director of programs at UNAIDS and assistant secretary general of the United Nations

“Lack of mental health and psychosocial support for people living with, or at risk of, HIV and tuberculosis poses huge barriers to their health and well-being, as well as ending these epidemics. This week, the board of the Global Fund to Fight AIDS, Tuberculosis and Malaria meets to discuss the fund’s strategy for the years to come. This is a unique opportunity to ensure that mental health — a missing piece in current strategies — becomes an integral part of the global responses to HIV and TB — from prevention, to testing, to treatment and care, and addressing stigma related to mental health, HIV, and TB. … HIV, TB, and mental health are interrelated. Two decades of evidence shows that poor mental health is a risk factor for HIV and TB infections. Additionally, having HIV and/or TB is associated with developing mental health conditions. … It is therefore crucial that the Global Fund explicitly defines in its new strategy the importance of addressing mental health, and recommends specific types of mental health services and activities that countries could request funding for in support of ending their AIDS and TB epidemics. The Global Fund has the opportunity to be a trailblazer by fully integrating mental health services throughout its programs. This will not only greatly strengthen systems for health, including community responses, but it will also, most importantly, bring better health and quality of life to countless people across the globe” (11/11).

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Boosting Psychological, Social Well-Being Could Play Role In Countering Conspiracy Theories, Misinformation About COVID-19, Opinion Piece Says

Nature: To counter conspiracy theories, boost well-being
Aleksandra Cichocka, political psychologist at the University of Kent and affiliate of the Nicolaus Copernicus University

“…[T]hose who believe conspiracy theories are less likely than those who don’t to comply with public health measures. The World Health Organization has called on countries to manage the spread of false information. But how? … [The Routledge Handbook of Conspiracy Theories] concludes that it is easier to spread them than to refute them. Correcting entrenched beliefs is very difficult. So it is better to prevent falsehoods taking root than to try to weed them out. That means looking beyond their content and the platforms and algorithms that fuel their spread. We need to examine what makes people susceptible. … The COVID-19 pandemic created a perfect storm for vulnerability to conspiracy narratives. Uncertainty and anxiety are high. Lockdown and social distancing bring isolation. People struggling to understand this unprecedented time might reach for extraordinary explanations. … Education counters conspiracy beliefs because it develops analytical thinking and because it empowers people. Other interventions could promote a sense of common identity, to boost feelings of belonging and meaning. What happened in New Zealand during the pandemic is encouraging. Prime Minister Jacinda Ardern stressed solidarity and transparent decision-making, and offered people a sense of purpose. Early data suggest that despite an increase in distress during lockdown, New Zealanders showed no increase in conspiracy thinking, and more trust in science. We should expand this approach globally” (11/10).

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From the Global Health Policy Community

Friends Of The Global Fight Applauds Senate Appropriations Committee For Maintaining $1.56B For Global Fund

Friends of the Global Fight Against AIDS, Tuberculosis, and Malaria: Friends applauds Senate Appropriations Committee for maintaining U.S. contribution to the Global Fund
“[On Tuesday] the Senate Appropriations Committee posted its fiscal year 2021 State, Foreign Operations, and Related Programs (SFOPS) funding bill, sustaining $1.56 billion for the Global Fund to Fight AIDS, Tuberculosis and Malaria (The Global Fund). … In 2019, the world pledged $14 billion for the Global Fund’s hugely successful sixth replenishment — an unprecedented 15 percent increase over the previous fundraising cycle. Maintaining a $1.56 billion appropriation for fiscal year 2021 would equal a $4.68 billion U.S. contribution over the three-year replenishment cycle, consistent with the expected U.S. share of the overall $14 billion replenishment goal…” (11/10).

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CGD Policy Experts Discuss COVID-19 Vaccine Trial Results, Implications For LMICs

Center for Global Development: Monday Morning Vaccine Breakthrough: Terrific News for the West, but in LMICs Terms and Conditions Apply
Rachel Silverman, policy fellow with CGD, discusses Pfizer’s and BioNTech’s announcement that “their SARS-CoV2 vaccine candidate showed 90 percent efficacy in preventing symptomatic COVID-19 in the interim analysis of their late stage clinical trial,” and highlights three challenges: distribution, cold-chain supply, and feasibility of future efficacy trials for other vaccine candidates (11/9).

Center for Global Development: Don’t Cheer Yet — There Is Too Much at Stake on COVID-19 Vaccines
Kalipso Chalkidou, director of global health policy and senior fellow at CGD, urges caution over the vaccine trial results, highlights lessons from remdesivir trials, and discusses implications for LMICs (11/10).

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Experts Urge Global Community To Prioritize Gender Equality, Health Of Women, Children Amid COVID-19

World Bank Blogs: Turning the tide: The fight to reclaim gains and accelerate progress for women and children
Inger Ashing, CEO of Save the Children, and colleagues, urge the international community to prioritize efforts on gender equality and protecting health care for women and children amid COVID-19. The authors conclude, “COVID-19 has changed the world forever. We each come to this with our own perspectives, but we all come to the same conclusion: By working together, we can ensure that the progress lost on gender equality in health can be clawed back. This is our commitment and we are calling on the international community to join us and contribute to getting progress back on track and accelerating our efforts to ensure women and children can access the health and nutrition services they need to survive and thrive” (11/10).

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From KFF

KFF Analyzes Global Health Aspects Of Senate SFOPs, LHHS FY21 Appropriations Bills

KFF: Senate Appropriations Committee Releases FY 2021 State and Foreign Operations (SFOPs) and Labor Health and Human Services (Labor HHS) Appropriations Bills
The Senate Appropriations Committee released its FY 2021 State, Foreign Operations, and Related Programs (SFOPs) (links to bill and report) and Labor, Health and Human Services, Education, and Related Agencies (Labor HHS) (links to bill and report) appropriations bills and accompanying reports on November 10, 2020. The SFOPs bill includes funding for U.S. global health programs at the State Department and the U.S. Agency for International Development (USAID), while the Labor HHS bill includes funding for global health programs at the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH). Funding provided to the State Department and USAID under the SFOPs bill and through the Global Health Programs (GHP) account, which represents the bulk of global health assistance, totals $9.3 billion in the bill, $161 million above the FY20 enacted level, $3.3 billion above the President’s FY21 request, and $96.5 million above the FY21 House level (11/11).

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KFF Provides Resources On Global, Domestic Aspects Of Pandemic

KFF: COVID-19 Coronavirus Tracker — Updated as of November 11, 2020
Data on country government actions in response to COVID-19 are included in the tracker (11/11).

Additional KFF COVID-19 resources on the global situation, as well as those focused on the response and impact within the U.S., are available here.

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