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Kaiser Daily Global Health Policy Report

In The News

Ebola Deaths Surpass 5,000, WHO Reports

News outlets report on the WHO’s announcement that more than 5,000 people have died from Ebola.

Associated Press: More than 5,000 Ebola deaths, says WHO
“More than 5,000 people have died in the Ebola outbreak, which was first identified in Guinea in March, the World Health Organization reported Wednesday, marking another grisly toll in the epidemic…” (Ahmed/DiLorenzo, 11/12).

BBC News: Ebola outbreak deaths pass 5,000
“The number of people killed by the worst outbreak of Ebola has risen to 5,160, the World Health Organization (WHO) says. The frequency of new cases no longer appears to be increasing in Guinea and Liberia but remains high in Sierra Leone, the health agency added…” (11/12).

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Senate Appropriations Committee Hears Testimony From Administration Officials Urging Approval Of $6.2B In Emergency Ebola Funding

News outlets report on a Senate Appropriations Committee hearing Wednesday that discussed President Obama’s emergency request for Ebola funding.

CQ News: Republicans Note Gaps in Ebola Emergency Funding Request
“Senate GOP appropriators were critical of the Obama administration’s response to the Ebola crisis and vowed to closely scrutinize a $6.2 billion White House request for emergency funding, but lawmakers stopped short of promising to oppose the plan or push for offsets…” (Hallerman, 11/12).

The Hill: GOP: Obama playing catch-up on Ebola
“…After grilling White House leaders on Ebola for nearly three hours, the Senate Appropriations Committee’s top Republican said he is still looking for answers about exactly where the money would go…” (Ferris, 11/12).

NBC News: Health and Human Services: We Have the Right Strategy in Place
“President Barack Obama’s request for $6.18 billion to fight Ebola will go to fill years of funding cuts at home and abroad that have put the U.S. at risk of new disease outbreaks, experts argued Wednesday…” (Fox, 11/12).

Politico: Ebola money fight an early lame-duck test
“…Wednesday’s hearing before the Senate Appropriations Committee amounted to a full court press to quickly attach the emergency funds to a year-end spending bill to keep the government funded through September 2015…” (Rogers, 11/12).

Reuters: U.S. calls its Ebola response the right strategy at home, abroad
“…U.S. Health and Human Services Secretary Sylvia Burwell told the Senate Appropriations Committee … a $1 billion-plus U.S. response in West Africa has already begun to show ‘fragile and fluid’ progress to contain infection and assured senators that ‘we are confident that we can limit the number of cases in the United States’…” (Morgan, 11/12).

Wall Street Journal: Obama Administration Asks Lawmakers for $6.2 Billion to Fight Ebola
“…The administration’s request encompasses a wide range of activity, from building treatment centers in Liberia and elsewhere, to enhanced screening at U.S. airports, to augmented research and medical treatments in this country…” (Burton, 11/12).

Washington Times: Obama administration makes case to Congress for Ebola funding
“…Committee Chairwoman Barbara A. Mikulski, Maryland Democrat, signaled her support for President Obama’s request for money, deeming the situation ‘urgent and temporary.’ But Republicans on the panel were not so sure…” (Howell, 11/12).

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DoD Announces Fewer Troops Will Be Sent To Ebola-Hit Liberia Than Originally Planned

News outlets report on the Department of Defense’s announcement that it will deploy fewer troops to West Africa than originally planned.

New York Times: Health Officials Reassess Strategy to Combat Ebola in Liberia
“As the rate of new Ebola infections in Liberia has slowed, American and Liberian officials are debating whether to build all 17 planned Ebola treatment centers in the country or to shift money from the Obama administration that was planned for the centers into other programs to combat future outbreaks…” (Cooper/Tavernise, 11/12).

Politico: DoD to deploy fewer troops in Ebola fight
“The Pentagon is sending about 1,000 fewer troops to fight Ebola in West Africa than it previously planned, officials said Wednesday…” (Ewing, 11/12).

Reuters: General says U.S. troops on Liberia Ebola mission to top out at 3,000
“…Army Major General Gary Volesky told a Pentagon telephone briefing fewer U.S. troops were needed than initially expected because the military had discovered greater local capacity for building treatment centers in Liberia than it initially expected…” (Alexander, 11/12).

Washington Post: Fewer U.S. troops than initially planned will be deployed against Ebola in West Africa
“…The decision to stop short of sending the full number of troops initially authorized comes as the rate of Ebola infections has fallen sharply in Liberia in recent weeks, leaving once-overwhelmed treatment centers half empty and some corners of the country with few new cases. At the same time, despite the recent positive turn in Liberia, infections are up in Sierra Leone and in parts of Guinea…” (Dennis/Ryan, 11/12).

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CDC Director Says U.S., Global Community Must Maintain Efforts Against Ebola

Devex: U.S. ‘not out of the woods’ on Ebola response — CDC
“As members of the U.S. Congress and Obama administration officials prepared Wednesday to discuss whether to allocate $6.18 billion to fight Ebola — the first of at least two public hearings focused on the outbreak on Capitol Hill — Centers for Disease Control and Prevention Director Tom Frieden stressed that to stop the epidemic, the international development community needs to work with a speed and scale never before seen in public health. ‘We are nowhere near out of the woods,’ Frieden told an audience at the Center for Strategic and International Studies in Washington, D.C…” (Tyson, 11/13).

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Washington Post Interviews USAID Administrator Rajiv Shah On Ebola In Liberia

Washington Post: Q&A with Rajiv ‘Raj’ Shah, USAID administrator dealing with Ebola in Liberia
“The Ebola crisis has incited a massive global response, and it’s not easy to figure out who is running the whole operation. But one key figure is Rajiv ‘Raj’ Shah, administrator of the U.S. Agency for International Development. … Shah is scheduled to testify Thursday before the House Foreign Affairs Committee in a hearing on the Ebola outbreak. … We talked to Shah over lunch on Veterans Day at a restaurant near his home in Northwest Washington. Here are excepts of the interview, edited for concision and clarity… ” (Achenbach, 11/12).

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Several U.N. Officials Comment On Ebola Response In West Africa

News outlets report on comments made by several U.N. officials about the Ebola epidemic in West Africa and the international response.

Agence France-Presse: U.N. encourages travel to ‘vibrant’ Ebola-hit West Africa
“The U.N.’s Ebola czar on Wednesday encouraged tourists to visit West Africa, saying Liberia, Sierra Leone, and Guinea were ‘vibrant and alive’ and that contact with infected people was largely avoidable…” (11/12).

Associated Press: U.N.’s Ban calls on Asia to step up Ebola fight
“U.N. Secretary-General Ban Ki-moon urged Asian countries on Wednesday to step up their efforts in the global fight against Ebola…” (11/12).

Reuters: U.N. says sees no signs security in Liberia is worsening due to Ebola
“Despite the devastating Ebola outbreak in Liberia, the United Nations is not seeing signs of deteriorating security in the country and some public authorities are even showing strength after years of post-civil war rebuilding, the U.N. peacekeeping chief said on Wednesday…” (Nichols, 11/12).

U.N. News Centre: Ebola: U.N. special envoy says combating stigma integral to overall crisis response
“The Secretary-General’s Special Envoy on Ebola, Dr. David Nabarro, today made a passionate appeal to combat stigmatization surrounding the disease by calling for a global social media campaign to ‘express solidarity and to show we are anti-discrimination.’…” (11/12).

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Liberia's President Will Not Extend Ebola State Of Emergency; Disease Hits Country's Food Supply

News outlets report on the Ebola situation in Liberia.

Reuters: Liberia won’t extend Ebola state of emergency, says president
“Liberia’s President Ellen Johnson Sirleaf said on Thursday she would not seek an extension to a state of emergency imposed in August over Ebola, which has hit the country harder than any other this year…” (Giahyue et al., 11/13).

Washington Post: As Ebola takes lives in Liberia, it leaves hunger in its wake
“The Ebola virus, which has killed more than 2,830 Liberians and collapsed the country’s health care system, is also attacking Liberia’s food supply, bringing intermittent hunger to a wide swath of this country even as its 4.1 million people try to survive the epidemic…” (Bernstein, 11/12).

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MSF To Begin Ebola Drug Trials In West Africa Next Month

News outlets report on issues surrounding Ebola drug trials and note Médecins Sans Frontières (MSF) will begin clinical trials for two Ebola drugs in West Africa beginning in December.

Nature: Ethical dilemma for Ebola drug trials (Hayden, 11/11).
New York Times: Researchers to Test New Treatments in Countries Hit Hardest by Ebola (Pollack, 11/12).
Reuters: MSF centers in Guinea and Liberia to test Ebola drugs next month (Kelland, 11/13).
Wall Street Journal: Trials of Two Antivirals to Treat Ebola Patients to Start Next Month (Loftus, 11/13).

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WHO Issues Guidance On Reducing Indoor Air Pollutants

Media sources report on the WHO’s recently released recommendations on reducing emissions from health-damaging household pollutants.

U.N. News Centre: New U.N. targets on indoor air pollution aim to save millions of lives each year
“The United Nations World Health Organization (WHO) [Wednesday] highlighted the dangers of burning fuels like unprocessed coal and kerosene in the home, and issued targets for reducing emissions of health-damaging pollutants from domestic cook stoves, space heaters, and fuel-based lamps…” (11/12).

VOA News: Indoor Air Pollution Kills Millions Annually
“…The World Health Organization reports nearly three billion people have no access to clean fuels and technologies for cooking, heating, and lighting. It says more than seven million people die from exposure to indoor or outdoor air pollution each year. Of that number, WHO reports some 4.3 million people, mainly in developing countries, die from household air pollution emitted by rudimentary biomass and coal cookstoves…” (Schlein, 11/12).

WHO: WHO sets benchmarks to reduce health damage from indoor air pollution
“…Millions of people die each year as a result of household air pollution; 34 percent are due to stroke, 26 percent to ischemic heart disease, 22 percent to chronic obstructive pulmonary disease, 12 percent to childhood pneumonia, and six percent to lung cancer…” (11/12).

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Doctor Involved With Indian Sterilization Campaign That Killed 13 Women Arrested

News outlets continue to report on the deaths of 13 women who took part in a mass sterilization campaign in India. A doctor involved in the campaign has been arrested, and investigations are ongoing into the cause of the women’s deaths and the hospitalizations of dozens of others.

The Guardian: India mass sterilization: ‘my wife died in tremendous pain’ (Burke, 11/12).
New York Times: Web of Incentives in Fatal Indian Sterilizations (Barry/Raj, 11/12).
Reuters: Women face hasty surgery, dirty clinics in Indian sterilization drive (Kalra, 11/12).
Reuters: Tainted drugs suspected in Indian sterilization surgery deaths (Kalra, 11/13).
Wall Street Journal: Indian Sterilization Deaths a Sign of Women’s Lack of Options (Anand, 11/12).
Washington Post: Deaths shine light on ‘horrible’ conditions in India’s mass sterilization camps (Gowen, 11/12).
Washington Post: Doctor arrested after botched sterilization at India camp kills 13 (Gowen, 11/13).

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U.S., India End WTO Stalemate Over India's Food Security Program

Financial Times: U.S. and India end WTO stand-off
“India and the U.S. have ended their stand-off at the World Trade Organization over New Delhi’s vast food security program, breaking an impasse that had been described as the biggest crisis to hit the global trade body in two decades…” (Kazmin/Donnan, 11/13).

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China Tests Malaria Drug On African Island Nation Of Comoros

CBS News: China tests malaria drug on an entire African nation
“Malaria kills more than half a million people every year, and in the Comoros, a tiny island nation off Africa’s east coast, it’s been a constant fear. In some villages here, 90 percent of people carried the disease. But a team of Chinese scientists, partnered with the Comoran government, say they’ve wiped malaria off the islands with a new, Chinese-made drug given to everyone in the country in a massive, controversial medical experiment…” (Van Sant, 11/11).

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Vaccine-Resistant Polio Strain Identified As Cause Of 2010 Outbreak In DRC

VOA News: Researchers Identify Vaccine-Resistant Polio Strain
“As the world enters the final phase of a global polio eradication effort, French researchers have identified a mutant strain of the virus that is resistant to the polio vaccine. Despite this, an American expert said the war on polio can be won with continued vaccination. … [A] mutant strain of the virus responsible for a deadly outbreak in the Republic of the Congo in 2010 has been discovered, rendering the polio vaccine less effective…” (Berman, 11/12).

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FGM Practiced In Rural Kenya Despite Laws Against It

Reuters: In rural Kenya, traditions run deeper than law on cutting girls
“…Kenyan law provides for life imprisonment when a girl dies from the procedure, which in addition to excruciating pain, can cause hemorrhage, shock, and complications in childbirth. [The country] set up a prosecution unit in March and is currently investigating 50 cases. Officials are optimistic they can force a change in attitude but still worry that the practice is too ingrained for legal threats to have an impact…” (Modola, 11/12).

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El Salvador's Abortion Ban Causing Teens Pregnant From Rape To Commit Suicide

Thomson Reuters Foundation: Rape, abortion ban drives pregnant teens to suicide in El Salvador
“El Salvador’s ban on abortion is driving hundreds of girls who become pregnant after being raped to commit suicide every year because they see no other option, a government official said. Teenage pregnancy is one of the leading causes of suicide in the Central American country of six million people…” (Moloney, 11/12).

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Editorials and Opinions

Opinion Pieces Discuss Various Aspects Of Ebola Epidemic

Huffington Post: What Would It Really Take to Halt Ebola and Prevent Future Epidemics?
Cheryl Healton, dean of global public health at New York University and director of the NYU Global Institute of Public Health, and Christopher Dickey, clinical associate professor at the institute

“…The Ebola crisis, and future epidemics, can only be addressed with dramatic changes in direction. This begins with strengthening public health and health delivery systems around the world, including in the U.S., and fully funding the Centers for Disease Control (CDC) and the World Health Organization (WHO). Both have been burdened by budget cuts that can only be seen from the current perspective as having been a tragic miscalculation” (11/11).

The Hill: For Ebola, don’t forget lessons from the AIDS epidemic
Claire Pomeroy, president of the Albert and Mary Lasker Foundation

“…So how much funding is enough?   It’s time for us to have that national conversation once again.  We do not know what the superbugs of tomorrow will look like.   But we do know that novel pathogens will emerge or existing ones will mutate, and that as global travel and migration inexorably increase, disease knows no border.   It is time for us to stop chasing at AIDS and Ebola from behind, and take stock of our capacity to commit…” (11/12).

New England Journal of Medicine: Out of Africa — Caring for Patients with Ebola
Eric Rubin, NEJM associate editor, and Lindsey Baden, NEJM deputy editor

“…The most important take-home message from these [Ebola] case reports is the importance of intensive fluid management and care. … Although this news is encouraging for patients with access to an intensive care unit, it is only more discouraging for those in areas where such infections are endemic and even basic care is often unavailable. It will be a tremendous challenge to bring to all patients the benefits of routine care, such as intravenous fluid and electrolyte support, as part of the response to this epidemic, but it must be done” (11/12).

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$4B In Mid-Term Election Spending Could Go Far In Global Health

Huffington Post: 3 Things We Could Do With the Money Spent on the 2014 Midterm Elections
Claire Standley, senior research scientist for the Global Health Security Program at Milken Institute School of Public Health at the George Washington University, and Sarah Kornblet, senior researcher in the program

“This year’s mid-term election in the United States has been this nation’s most expensive yet, costing an estimated $4 billion. Compared to national and state budgets, it’s a small amount, but that kind of money can still make a huge impact on issues that affect our health, well-being, and security. … So, imagine for a minute that all those corporate donations, Super PACs, individual contributions, and public money wasn’t spent on persuading us why one politician is better than another — what could $4 billion buy? Here are three ideas at the top of our wish list: 1) Controlling Ebola AND Eradicating Measles … 2) Honor the U.S. Commitment to the Global Fund … 3) Build Foundational Health Systems in Every Country…” (11/12).

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Malaria Eradication Requires Targeting Mosquitoes

Washington Times: Money alone, public or private, won’t eradicate malaria
Editorial Board

“…Earlier this month, [Bill Gates] wrote a check for $500 million to eradicate malaria. … His goal is to eradicate the mosquito-borne disease that kills an estimated 627,000 annually, mostly in Africa, by distributing mosquito nets and developing a ‘next-generation vaccine.’ It’s a commendable effort, but this isn’t a problem solved only with money. … Throwing money at a serious health problem isn’t always the best way to fight disease. Eliminating malaria requires killing bugs, not just writing checks” (11/12).

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Devex #HealthyMeans Opinion Pieces Address Global Health Challenges, Opportunities

Devex: Ensuring that no child dies for want of the right antibiotic
Richard Francis, global head of Sandoz

Devex: What Ebola has taught us about global health financing
Rene Karsenti, chair of the IFFIm Board of Directors and president of the International Capital Market Association

Devex: Every breath counts — help #FightPneumonia
Keith Klugman, director for pneumonia at the Bill & Melinda Gates Foundation

Devex: Health is a human right, not a commodity
Tim Roosen, coordinator of Action for Global Health (AfGH)

Devex: How can we strengthen health systems? Let’s learn from what works
Fiona Samuels, research fellow at the Overseas Development Institute

Devex: Moving beyond access to development — immunization reframed
Robert Steinglass, director of the Immunization Center at John Snow, Inc. and immunization team leader at USAID

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From the Global Health Policy Community

Fighting Pneumonia Requires Access To Prevention, Treatment Interventions

USAID’s “IMPACT”: You Can’t Save Lives if you Don’t Fight Pneumonia
Robert Steinglass, director of the Immunization Center at John Snow, Inc. and immunization team leader at USAID, and Katrin DeCamp, senior communications specialist for USAID’s Maternal and Child Survival Program, discuss the importance of improved access to pneumonia prevention and treatment interventions (11/12).

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Article Examines Global Health Funding Allocation Methodologies

Health Affairs: How A New Funding Model Will Shift Allocations From The Global Fund To Fight AIDS, Tuberculosis, And Malaria
Victoria Fan, Amanda Glassman, and Rachel Silverman of the Center for Global Development “present a typology of three [funding] allocation methodologies to align [global health program] allocations with priorities” and “apply our typology to the Global Fund to Fight AIDS, Tuberculosis and Malaria. … We conclude with recommendations for the Global Fund and other global health donors to further develop their allocation methodologies and processes to improve efficiency and transparency” (November 2014).

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Analysis Examines Subnational Health Spending, Implications For Donors

Center for Global Development’s “Global Health Policy Blog”: Most Money for Health Is Subnational, But What Will Donors Do About It?
Amanda Glassman, senior fellow and director of global health policy at CGD, and Yuna Sakuma, research assistant at CGD, examine subnational health spending and “whether allocations of public money to subnational jurisdictions are done according to need, whether they create incentives for better performance or more spending on health, and whether they generate accountability for spending and results. The results of our analysis inform the consultation draft of ‘Intergovernmental Fiscal Transfers for Health: Overview Framework and Lessons Learned’ (comments welcome by December 15), which intends to trigger a rethink on how governments and donors engage to achieve health goals…” (11/12).

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Investing In Local Leaders 'Most Promising Strategy' To Save Lives Of Mothers, Children

Bill & Melinda Gates Foundation’s “Impatient Optimists”: Why Are Women and Children Still Dying?
Denise Raquel Dunning, founder and executive director of Let Girls Lead and Champions For Change, writes, “…Saving the lives of women and children takes financial resources, political will, and savvy advocates who are undaunted by the enormity of the challenges they face. Investing in visionary local leaders and organizations is the most promising strategy to ensure that policies, systems, and services improve health outcomes…” (11/12).

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Blog Post Discusses Challenges In Defining, Achieving Malaria Eradication

Humanosphere: Visualizing zero malaria, whatever zero might be
In a guest post, Nancy Fullman, policy translation specialist at the University of Washington’s Institute for Health Metrics and Evaluation, discusses malaria eradication efforts and issues around defining and achieving zero malaria (11/12).

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New Issue Of 'Global Fund News Flash' Available Online

Global Fund to Fight AIDS, Tuberculosis and Malaria: Global Fund News Flash
The latest issue of the Global Fund News Flash discusses emergency funding to provide financing for HIV, TB, and malaria in emergency situations, challenges in addressing TB, and several concept notes (11/13).

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