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Kaiser Daily Global Health Policy Report

In The News

U.S. Treasury Official Signals Trump Administration's Intention To Withdraw Funding For Global Agriculture And Food Security Program

Foreign Policy: Treasury Takes Aim at Global Food Security Program
“The Treasury Department said this week it would withdraw U.S. funding from a program created by the Obama administration meant to boost food security in the world’s poorest countries. The Global Agriculture and Food Security Program, or GAFSP, was formed after the G20 summit in 2009. The Obama administration drove the program’s creation and saw it as important part of the ‘Feed the Future’ initiative meant to answer the global food price crisis in 2008…” (Allen-Ebrahimian, 11/10).

Newsweek: The Trump administration is choosing to starve poor people
“…The U.S. has been the program’s biggest donor, providing a third of its total expenditures to date. But not anymore. ‘[The] U.S. is not expecting to make any future contributions,’ Treasury Undersecretary for International Affairs David Malpass said in written testimony to the House Financial Services Committee on November 8. ‘[GAFSP] should be wound down, with donors exploring options to return future reflows to donors.’ Experts said the U.S. pullout is a recipe for disaster because food security programs stop famine, war, and instability…” (Ballesteros, 11/12).

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U.S. Likely To Nominate Former USAID Administrator Henrietta Holsman Fore As UNICEF Executive Director Candidate

Devex: Former USAID chief Henrietta Holsman Fore possible pick for top UNICEF job
“Henrietta Holsman Fore will likely be the next executive director of the United Nations Children’s Fund, with multiple sources telling Devex that she is set to be the candidate put forward for the role by the United States. Fore, an American businesswoman and former U.S. Agency for International Development administrator, has been unofficially floated as the U.S. choice for the job, according to sources close to the process. The top UNICEF job has historically gone to the American candidate, so her nomination would likely lead to her selection…” (Lieberman/Saldinger, 11/13).

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U.S. President Trump Nominates Former HHS Deputy Secretary Alex Azar As Agency's Next Secretary

The Hill: Trump nominating Azar as next HHS secretary
“President Trump on Monday tapped Alex Azar for secretary of Health and Human Services (HHS), a role vacated by Tom Price in late September amid revelations that Price took repeated trips on government and private jets that cost taxpayers more than $1 million…” (Roubein, 11/13).

New York Times: Trump Chooses Alex Azar for Health and Human Services Secretary
“…The nominee, Alex M. Azar II, served as a deputy at the department under former President George W. Bush. Until January, he was the head of the pharmaceutical company Eli Lilly’s United States division. Mr. Trump made his announcement in a Twitter post while traveling in Asia. Mr. Trump said Mr. Azar would be ‘a star and lower drug prices!’…” (Sullivan/Shear, 11/13).

Washington Post: Trump picks Alex Azar to lead the Health and Human Services Department
“…The decision to enlist the 50-year-old Azar — who served as president of Lilly USA, the biggest affiliate of Eli Lilly and Co., before stepping down in January to work as a health care consultant — represents a pragmatic pick. An establishment figure with a reputation as a conservative thinker and methodical lawyer, Azar would be expected to use his experience as HHS general counsel and deputy secretary to pursue Trump’s goals through executive action…” (Eilperin/Goldstein, 11/13).

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Devex Examines DFID's Likely Priorities Under New International Development Secretary Penny Mordaunt

Devex: What next for DFID?
“…Penny Mordaunt was officially named as DFID’s new head on Thursday afternoon. Having previously served in the Ministry of Defence and most recently as minister of state for disabled people, health, and work in the Department of Work and Pensions, Mordaunt is an outsider to DFID. Her appointment drew mostly blanks from the aid industry immediately after it was announced. But some clues are now emerging as to where the new DFID minister’s priorities could lie, and what her appointment might mean for the international development sector. Devex spoke to experts to get their insights on how current DFID policy might survive the transition, and what they want from the new secretary of state…” (Edwards, 11/10).

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Bill Gates Announces $100M In Personal Funding For Dementia, Alzheimer's Research

Financial Times: Gates joins Alzheimer’s fight with $50m dementia fund investment
“Bill Gates has made his first move to support Alzheimer’s disease research, with a $50m investment in the London-based Dementia Discovery Fund. The DDF provides venture finance for companies developing innovative treatments for Alzheimer’s and related neurodegenerative diseases…” (Cookson, 11/13).

Reuters: Bill Gates makes $100 million personal investment to fight Alzheimer’s
“…The investment — a personal one and not part of Gates’ philanthropic Bill & Melinda Gates Foundation — will be followed by another $50 million in start-up ventures working in Alzheimer’s research, Gates said. With rapidly rising numbers of people suffering from Alzheimer’s and other forms of dementia, the disease is taking a growing emotional and financial toll as people live longer, Gates told Reuters in an interview…” (Kelland, 11/13).

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U.N. Kicks Off World Antibiotic Awareness Week To Promote Responsible Use Of Medicines

Healio: Health agencies kick off World Antibiotic Awareness Week
“Today marks the start of World Antibiotic Awareness Week — an event led by WHO, the Food and Agriculture Organization of the United Nations, and the World Organization for Animal Health that promotes appropriate antibiotic use in humans and animals…” (Viguers, 11/13).

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Preemptively Treating Children For Malaria Works To Save Lives In West Africa, Researchers Report

Nature: Resurrected malaria strategy saves thousands of lives in Africa
“In a sea of high-tech malaria fixes — everything from drug-delivery by drone to gene-edited mosquitoes — an old-fashioned approach is saving thousands of children in West Africa, according to studies presented [last] week at the American Society of Tropical Medicine and Hygiene (ASTMH) meeting in Baltimore, Maryland. The measure, called seasonal malaria chemoprevention, involves giving children a dose of antimalarial drugs once each month in the rainy season to prevent the disease in hard-hit regions…” (Maxmen, 11/10).

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More Action Needed On Hunger, Malnutrition In Asia-Pacific Despite Food Security Progress, FAO Report Says

U.N. News Centre: Unhealthy diets could undo progress on food security in Asia-Pacific, warns U.N. report
“Urgent action is needed to tackle malnutrition and promote consumption of healthier foods in the Asia-Pacific region — home to most of the world’s undernourished people — the United Nations food security agency said Friday. … The FAO report, 2017 Regional Overview of Food Security and Nutrition, has revealed that while food security has improved for millions of people in Asia and the Pacific, hunger and malnutrition appear to be rising in some areas, leaving roughly half-a-billion people undernourished…” (11/10).

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Rohingya Children Suffer Malnutrition, Exploitation In Bangladesh's Refugee Camps, Reports Show

The Guardian: Rohingya children close to starvation amid ‘health crisis on an unimaginable scale’
“One in four Rohingya children who recently fled to Bangladesh from Myanmar is now suffering from life-threatening malnutrition, with aid workers warning that refugees are ‘essentially starving’ before they have even crossed the border. The preliminary findings of a joint nutrition assessment conducted in late October at Kutupalong refugee camp in Cox’s Bazar show that severe acute malnutrition rates among child refugees under five have doubled since May, while nearly half of young children are also underweight and suffering from anemia…” (Hodal, 11/10).

Reuters: Exclusive: $6 for 38 days work: Child exploitation rife in Rohingya camps
“Rohingya refugee children from Myanmar are working punishing hours for paltry pay in Bangladesh, with some suffering beatings and sexual assault, the International Organization for Migration (IOM) has found. … The results of a probe by the IOM into exploitation and trafficking in Bangladesh’s refugee camps, which Reuters reviewed on an exclusive basis, also documented accounts of Rohingya girls as young as 11 getting married, and parents saying the unions would provide protection and economic advancement…” (Allard/Wilkes, 11/12).

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Without Reopening Of Ports, Yemen Set To Run Out Of Fuel, Vaccines In 1 Month, UNICEF Says

The Guardian: ‘Only God can save us’: Yemeni children starve as aid is held at border
“…Seven million people are on the brink of famine in war-torn Yemen, which was already in the grip of the world’s worst cholera outbreak when coalition forces led by Saudi Arabia tightened its blockade on the country last week, stemming vital aid flows. … Less than 45 percent of the country’s medical facilities are still operating — most have closed due to fighting or a lack of funds, or have been bombed by coalition airstrikes…” (Craig, 10/12).

Reuters: Yemen set to run out of fuel and vaccine in a month: UNICEF
“Yemen’s stocks of fuel and vaccines will run out in a month unless a Saudi-led military coalition allows aid into the blockaded port of Hodeidah and Sanaa airport, UNICEF’s representative in the country said on Friday…” (Miles, 11/10).

Reuters: Saudi-led coalition opens Yemen border crossing; aid agencies warn of famine
“The Saudi-led military coalition fighting against Yemen’s Houthi movement reopened a land border crossing, partly easing a blockade imposed earlier this week, but aid agencies warned of famine and a health catastrophe if other ports stay shut…” (Mokhashaf/Miles, 11/10).

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South Sudan Using Food As Weapon Of War By Blocking Aid, Confidential U.N. Report Says

Reuters: S. Sudan’s government using food as weapon of war — U.N. report
“South Sudan President Salva Kiir’s government is using food as a weapon of war to target civilians by blocking life-saving aid in some areas, United Nations sanctions monitors told the Security Council in a confidential report seen by Reuters on Friday…” (Nichols, 10/11).

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Editorials and Opinions

U.S. State Department's 'Redesign' Must Maintain Robust Diplomatic Corps

Washington Post: Tillerson’s ‘redesign’ for State looks a lot like a retreat
Editorial Board

“What is going on at the State Department? … In a forthcoming issue of the Foreign Service Journal, the monthly magazine of the American Foreign Service Association (which is the professional association and union of the Foreign Service), the group’s president, former Ambassador Barbara Stephenson, raises a fresh alarm about the future of the U.S. diplomatic corps. … Ms. Stephenson reports that the department has decided ‘to slash promotion numbers by more than half.’ … ‘The rapid loss of so many senior officers has a serious, immediate, and tangible effect on the capacity of the United States to shape world events,’ she wrote. In response, a State Department spokeswoman said that ‘suggestions that drastic cuts to our Foreign Service ranks are taking place are simply not accurate,’ that freezes on hiring and promotions ‘are only temporary,’ and that Mr. Tillerson’s commitment will be ‘reinforced once the freezes on personnel movement, including hiring, are lifted at the appropriate time.’ When will that be? … The United States has sprawling interests around the globe, and the State Department is on the front lines. The world is not growing any less adversarial, nor the need for diplomacy any less urgent. The ‘redesign’ must not be a recipe for retreat” (11/12).

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Editorial, Opinion Piece Recognize World Antibiotic Awareness Week

The Lancet Global Health: Fighting antimicrobial resistance on all fronts
Editorial Board

“The theme of this year’s World Antibiotic Awareness Week (Nov 13-19) is ‘seek advice.’ But what if your health professional’s advice is not evidence-based? … The news media regularly resounds to hope stories of new antibiotics, but — as a WHO report released in September made clear — the current antibiotic development pipeline is still dominated by entities that are merely modifications of existing drug classes and is thus ‘insufficient to mitigate the threat of antimicrobial resistance.’ Raising awareness of the looming ‘antibiotic apocalypse’ should include framing the solution as a continuum, from surveillance to infection prevention to diagnosis to treatment. Everyone — patients, researchers, health care providers, farmers, veterinarians, journalists, and policymakers — must play their part in defeating these tiny but deadly foes” (December 2017).

HuffPost: Time is Running Out: Why Diagnostic Tests Are A Crucial Tool in Fight Against Antibiotic Resistance
Lance Price, director of the Antibiotic Resistance Action Center at the George Washington University’s Milken Institute School of Public Health

“…With Antibiotics Awareness Week (November 13-19) quickly approaching, we have to refocus and find ways to encourage the use of diagnostics in the fight against superbugs. … We have to bring together public health experts, diagnostic companies, insurance companies, health care professionals, and policymakers to find ways to incentivize the use of existing diagnostic tests and encourage the creation of new ones that can be used within the short span of an outpatient visit. If we’re going to avoid a world where untreatable bacterial infections are the new norm, we have to take the long view and use all the tools that we have at our disposal, including diagnostics” (11/10).

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Pneumonia Can Be Effectively Treated, Prevented With Investments In Health Care Systems, Global Development Goals

Devex: Opinion: 3 ways to end preventable child deaths from pneumonia
Marian Blondeel, senior communications specialist at the Malaria Consortium

“Pneumonia is the deadliest infectious disease among children under the age of five worldwide — more than HIV, tuberculosis, Zika, Ebola, and malaria combined. … Shockingly, these deaths can be largely prevented as the disease can be easily detected and treated. Despite recent mobilization of funding and targeted interventions by donors, nongovernmental organizations, and the private and public sectors between 2005 and 2015, much more needs to be done to end preventable child deaths by 2030. What do we need to do? 1. Protect … 2. Detect … 3. Treat … Investing in child health by preventing, detecting, and treating pneumonia will not only support the achievement of the global goal for good health and wellbeing. It will also have knock-on effects on other goals for clean air and water, economic stability, equality, clean energy, and eliminating poverty and hunger” (11/10).

HuffPost: Pneumonia — Africa’s silent killer
Toyin Ojora Saraki, founder of the Wellbeing Foundation Africa

“…The developing world urgently needs more, and better allocated resources, to avoid … unnecessary deaths from illnesses as curable and preventable as pneumonia. This will require revolutionizing health care systems, many of which are stuck in cycles of underfunding and understaffing, at the expense of human life. … Solid and effective systems of universal primary health care would not just positively impact pneumonia, but would have widespread implications for the spread of other infectious and non-communicable diseases across the continent. Pneumonia is a symptom of the wider health care deficit that sees the unnecessary deaths of millions of people each year. Through the implementation of universal primary health care, we have the power to ensure that no more children die unnecessarily at the hands of preventable and treatable diseases like pneumonia. We must act now…” (11/10).

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National, International Plans To Build Climate Change Resiliency Must Consider Vulnerabilities Of All Local Communities

Thomson Reuters Foundation: Embracing uncertainty while planning for resilience
Mozaharul Alam, Rohini Kohli, and Angus Mackay, climate change adaptation and learning experts at U.N. Environment, UNDP, and UNITAR, respectively, and coordinators of the joint UNDP-U.N. Environment National Adaptation Plans Global Support Programme (NAP-GAP)

“…[H]ow do we respond to a world of increasing uncertainty induced by climate change? We would suggest that the answer lies in effective medium- to long-term adaptation planning. Key to this will be the formulation and implementation of national adaptation plans, which will support countries in achieving their Nationally Determined Contributions to the Paris deal, and serve as a blueprint for future climate action. … National adaptation plans are fundamental to achieving the Paris deal and the Sustainable Development Goals. More importantly, they can help to secure a better future for the billions of people worldwide who face the rising threat of hunger, malnutrition, and uncertainty resulting from climate change. They provide a mechanism to empower those that are most vulnerable through a chain of improved knowledge, skills, and decision-making leading to more effective climate action” (11/13).

Thomson Reuters Foundation: Don’t wait for peace to fight climate change
Laurie Goering, climate editor at Thomson Reuters Foundation

“…Building resilience to climate change in areas beset by conflict and competition for land, water, grazing, and jobs is a challenge — and not just because extreme weather and other climate pressures are making life harder for everyone. The reality is that helping some communities cope more effectively with climate change can leave others worse off — and that can deepen conflict. … But other sorts of conflict are on the rise … In many cases, it is happening in places facing similar pressures: poverty, worsening weather disasters, growing competition for water, land and other resources, and governments that can’t cope. That suggests governments, aid agencies, and other groups trying to help those most vulnerable to climate change are going to need to work in some very tough places, where the right thing to do isn’t always clear. … [A] report released last month … noted that between 2004 and 2014, nearly 60 percent of deaths from disasters happened in countries that are among the top 30 most fragile states. Tackling disaster risk in such countries ‘should therefore be a priority for national governments and the international community alike’ — both on moral grounds and in an effort to achieve the Sustainable Development Goals, the report noted…” (11/12).

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Cholera In Yemen Is 'Man-Made Disaster'

New York Times: How War Created the Cholera Epidemic in Yemen
Alia Allana, writer for Fountain Ink magazine

“…The spread of cholera in Yemen glaringly illustrates how disease follows in the wake of bombs. … Cholera in Yemen is a manmade disaster, and its spread and casualties are tied to the politics of the war. Aerial bombing by the Saudi-led coalition in Houthi-held areas have damaged hospitals, public water systems, and sewage plants. More than half of health care facilities have fully or partly closed. Doctors, nurses, and ambulance drivers have gone without salaries for months. Sanitation has worsened. People live amid sewage. Acute watery diarrhea has been more fatal in areas controlled by the rebels than in areas controlled by the government. … The United Nations estimates that about seven million people are on the brink of famine in Yemen and nearly 900,000 are infected with cholera. An unrelenting blockade threatens a catastrophic increase in both disease and hunger” (11/12).

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Including Pregnant Women In Clinical Trials Could Be Key To Developing Effective Zika Vaccine

The Hill: To find an effective Zika vaccine, we must include pregnant women in the trials
Jae Jung, professor and chair of the Department of Molecular Microbiology and Immunology at the Keck School of Medicine at USC; and Suan-Sin Foo, postdoctoral scholar and research associate in the Department of Molecular Microbiology and Immunology at the Keck School of Medicine

“…The pursuit of a truly effective Zika virus vaccine … is handicapped by a long-standing clinical practice: the exclusion of pregnant women from drug development and vaccine trials. The main reason for this is ethical: Why expose a growing fetus, or a mother-to-be, to unknown risks in an experimental setting? … As commendable as this practice is, we argue it is more ethical to include pregnant women in certain clinical trials than to exclude them. … When contagions like Zika disproportionately affect pregnant women, excluding moms-to-be may end up harming them and their babies more than it helps. … To decide the most effective Zika virus vaccine based on tests among non-pregnant women with different body chemistry may produce a vaccine not potent enough for expectant mothers. … By contrast, the addition of expectant mothers as subjects in vaccine and drug-development trials holds out an intriguing and desirable possibility: a tailored therapy for different trimesters of pregnancy that caters specifically to the health and well-being of both mother and child” (11/12).

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From the Global Health Policy Community

WHO, U.N. Climate Change Announce Health-Related Outcomes From COP23

WHO: U.N. Climate Change and WHO Team Up to Protect Health from Climate Change at COP23
“WHO and the United Nations Climate Change Secretariat (UNFCCC) signed a new Memorandum of Understanding [Sunday] to renew the two institutions’ joint commitment to tackle public health challenges emerging from rising temperatures and to help countries boost the efficiency of their response to climate change. The agreement coincides with the U.N. Climate Change Conference (COP23) in Bonn, and the need to ensure that countries with weak or inadequate health infrastructure receive support to protect human health and build climate resilience to respond to such threats…” (11/12).

WHO: Launch of special initiative to address climate change impact on health in Small Island Developing States
“[Sunday], at the United Nations Climate Change Conference (COP23), WHO, in collaboration with the U.N. Climate Change secretariat and in partnership with the Fijian Presidency of the twenty-third Conference of the Parties (COP23), … launched a special initiative to protect people living in Small Island Developing States from the health impacts of climate change. The vision is that, by 2030, all Small Island Developing States will have health systems that are resilient to climate change and countries around the world will be reducing their carbon emissions both to protect the most vulnerable from climate risks and deliver large health benefits in carbon-emitting countries…” (11/12).

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FT Health Discusses Global Fund's Executive Director Search, Features Interview With IFPMA Executive Director

FT Health: Decision time at Global Fund
The latest issue of the Financial Times’ weekly global health newsletter discusses the Global Fund’s efforts to select a new executive director. The newsletter also includes an interview with Thomas Cueni, director general of the International Federation of Pharmaceutical Manufacturers and Associations, and features a roundup of other global health-related news stories and releases (Jack/Dodd, 11/10).

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