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Kaiser Daily Global Health Policy Report

In The News

Congo Ebola Outbreak Will Continue For At Least 6 Months, WHO Official Predicts; Merck Takes Next Step In Regulatory Review Process For Experimental Vaccine

Associated Press: WHO official predicts 6 more months battling Ebola in Congo
“The emergencies chief for the World Health Organization predicted Tuesday that Congo’s Ebola outbreak will last at least another six months, saying that informal health facilities have become ‘major drivers’ of the current, deadly transmission. … In some cases, people appeared to have contracted Ebola while visiting the centers for other health concerns, [Peter] Salama said. He described the ‘tradi-modern’ centers as popular but unregulated neighborhood facilities that vary from stand-alone structures to ‘just a room in someone’s house’…” (11/13).

CIDRAP News: As outbreak area expands, DRC Ebola total climbs to 339
“Over the past week, three health zones in the Democratic Republic of Congo (DRC) reported their first confirmed Ebola cases, a worrisome sign that the outbreak is spreading to new areas, the World Health Organization’s (WHO’s) African regional office said [Tuesday] in a weekly update…” (Schnirring, 11/13).

STAT: Merck takes key step toward approval of experimental Ebola vaccine
“Merck said Tuesday that it has begun the process of submitting the evidence it will use to seek approval for its experimental Ebola vaccine, a crucial step in the drug maker’s long effort to bring the vaccine to market. The company said it hopes to complete the filing process sometime next year…” (Branswell, 11/13).

Additional coverage of the DRC Ebola outbreak and response is available from BMJ, Reuters, and VOA News.

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Antibiotic Use Varies Widely Around World, WHO Report Shows

Becker’s Hospital Review: WHO releases antibiotic resistance report: 4 things to know
“The World Health Organization issued a 127-page surveillance report on antibiotic consumption, which highlights large discrepancies in how the medications are used worldwide. For the report, the WHO examined 2015 data from 65 countries and territories. Most of the data centered on Europe and countries with pre-existing, fully developed antibiotic surveillance systems…” (Bean, 11/13).

STAT Plus: WHO finds huge disparities in antibiotic usage around the world
“…[The] report finds wide differences in how these medicines are used in 65 countries and territories, underscoring concerns that some countries may be overusing antibiotics while that access may be insufficient elsewhere. Specifically, overall antibiotic use ranged widely, from 4.4 to 64.4 so-called defined daily doses per 1,000 residents per day in 2015, according to the World Health Organization, which released the first such review of global consumption of the medicines. The lowest usage was found in Burundi, while antibiotic use was highest in Mongolia…” (Silverman, 11/13).

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U.S., U.N. Express Concern Over Myanmar's Plan To Begin Resettlement Of Rohingya Refugees

CNN: U.S., U.N. warn against Rohingya repatriation plan
“The United States and United Nations’ top human rights official have expressed concern at a plan to repatriate thousands of Rohingya refugees from Bangladesh to Myanmar beginning this week, warning that such a move is premature. … The UNHCR — the U.N.’s refugee agency — has repeatedly warned of the risk of resettling the refugees. … The U.S. State Department affirmed its support for the UNHCR’s position that conditions are not conducive for the Rohingya to return…” (Hansler, 11/13).

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USAID, Corteva Agriscience Sign MoU To Help African Smallholder Farmers, Advance Feed The Future, Private Sector Goals

Devex: USAID, Corteva sign memorandum as part of private sector engagement strategy
“The United States Agency for International Development and Corteva Agriscience signed a memorandum of understanding to expand collaboration on scaling agricultural technology to smallholder farmers in Africa, as part of the agency’s focus on increasing private sector partnerships. USAID Administrator Mark Green said the five-year partnership will allow both Feed the Future — the U.S. government’s global hunger and food security initiative — and Corteva to make progress toward goals they wouldn’t be able to reach alone…” (Welsh, 11/14).

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U.K. Launches Women's Integrated Sexual Health Program With £200M Investment, Goal Of Improving Access To Contraceptives In Asia, Africa

The Guardian: U.K. gives ‘landmark’ £200m to improve contraceptive access in Africa and Asia
“The U.K. government has launched a £200m program to increase the availability of contraceptives in 27 countries across Africa and Asia, in what has been described as a ‘landmark’ investment. The Women’s Integrated Sexual Health (WISH) program from the Department for International Development will expand services to young and poorer women, and aims to support an estimated six million couples a year. The International Planned Parenthood Federation (IPPF) and Marie Stopes International are to implement the program…” (Ford, 11/13).

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New York Times Examines Deteriorating Health System, Declining Public Health In Papua New Guinea

New York Times: Papua New Guinea Is Rich in Resources but Poor in Health
“Polio was vanquished by the Pacific nation of Papua New Guinea 18 years ago. Now, as world leaders gather there for the Asia-Pacific Economic Cooperation summit meeting this week, polio has returned … All over the country, there are symptoms of a profound public health emergency; young and old are getting sick and dying unnecessarily, while facilities lack basic medicines and equipment. Doctors and experts say the unfolding crisis is the realization of their worst fears after years of deterioration and neglect. … Officials in Papua New Guinea hope that hosting the Asia-Pacific Economic Cooperation, or APEC, meeting in Port Moresby will elevate the country’s international profile, but the health crisis has become an embarrassment for a nation with an abundance of gold, copper, silver, oil, and gas…” (Chandler, 11/13).

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More News In Global Health

Al Jazeera: What makes family planning controversial in some African nations? (11/13).

Devex: Safeguarding adolescents when using HCD in family planning (Edwards, 11/14).

Devex: Using the ‘World Disasters Report’ for programming and advocacy (Cornish, 11/14).

The Guardian: Rights groups condemn ‘brutal and humiliating’ tests on gay men in Tunisia (Ratcliffe, 11/14).

Nature: North and South Korea team up to tackle TB and malaria (Zastrow, 11/13).

Pulitzer Center: The Last Pill: The Search for Post-Transplant Medication in Venezuela (Sandoval, 11/13).

SciDev.Net: Q&A: Nutrition solutions lie beyond health (Makri, 11/13).

Thomson Reuters Foundation: Fast-growing African cities at ‘extreme risk’ from climate change: analysts (Rowling, 11/13).

U.N. News: U.N. food agency appeals for access to key storage facility amid fight for Hudaydah (11/13).

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Editorials and Opinions

Lessons Learned From Global Response To HIV/AIDS Could Help Inform TB, NCD Control Efforts

Project Syndicate: TB, NCDs, and the Lessons of HIV
Elizabeth Radin, lecturer in epidemiology and technical director of the PHIA Project at ICAP at Columbia University; Miriam Rabkin, professor of medicine and epidemiology and director of Health Systems Strategies at ICAP; and Wafaa El-Sadr, professor of epidemiology and medicine and director of ICAP

“…Efforts to control TB and [noncommunicable diseases (NCDs)] — which, like HIV/AIDS, place a heavy burden on low- and middle-income countries — can leverage the lessons learned from the response to HIV. Three lessons in particular stand out. First, as the global AIDS response expanded, it faced the dual challenge of including hard-to-reach communities while continuing to support a growing number of patients receiving treatment. In response, HIV programs have evolved to offer services shaped by the preferences of patients. … A similar approach could be taken for TB and NCDs. … Second, HIV programs succeeded in part because they established goals for the entire ‘cascade of care’ — from diagnosis to treatment. … Targets along the cascade could be similarly beneficial for controlling TB and NCDs. … Finally, the AIDS effort was able to expand as a result of strong advocacy and collaborations that reshaped markets for diagnostic and treatment programs. … Likewise, controlling TB and NCDs will require making medications more convenient and affordable. … [W]ith the AIDS response blueprint already in hand, there is no need to reinvent the wheel” (11/13).

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Addressing Antibiotic Resistance Requires 'Multi-Prong, Global Approach'

The Hill: Antimicrobial resistance is an urgent, global crisis
Cynthia Sears, president of the Infectious Diseases Society of America and professor of medicine at the Johns Hopkins University School of Medicine

“…Americans are right to be concerned that the antibiotic treatments that ushered in the era of modern medicine are losing their power to stop infections. … [A]ntimicrobial resistance is not our problem alone, but a global problem with disastrous ramifications. If we do not begin to address antimicrobial resistance around the world … we will not win. Americans recognize and have voiced the need to confront antimicrobial resistance across the board. It is now time for government, industry, and innovators to show they have been heard. A multi-prong and global approach — with strong stewardship to protect the antibiotics we have and the ones to come, incentives to ensure that development of new antibiotics meets our patients’ needs, and investment in research and public health initiatives — is necessary to turn the tide against antibiotic resistance” (11/13).

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Environmental Engineering Could Offer Sustainable Approach To Malaria Elimination

Scientific American: Africa Doesn’t Need Genetically Modified Mosquitoes
Ify Aniebo, molecular geneticist, senior research scientist at the Health Strategy and Delivery Foundation, Takemi fellow at the Harvard T.H. Chan School of Public Health, and 2016 Aspen Institute New Voices fellow

“Some scientists have proposed genetically modified (GM) mosquitoes as a solution to controlling malaria, a scourge that has been around for centuries and is spread by mosquitoes. I am skeptical that this is the answer. … Supporters of the technology consider it a huge step forward in the war against mosquitoes and by extension, vector-borne diseases like malaria, dengue, yellow fever, and Zika. Critics of the idea, however, say it is dangerous to manipulate the DNA of any animal, and that experimentation could bring disastrous consequences that are yet unknown. … While innovations in science have been important in controlling malaria in Africa, they should never be the only focus. Sanitary engineering; getting rid of mosquito breeding sites; and swamp drainage are some of the interventions that have helped in the past and have proven to be sustainable solutions. Why spend billions of dollars on developing genetically modified insects when the money could be directed towards environmental engineering projects that hinder the ability of mosquitoes to breed in the first place? The latter is a long-term and sustainable approach and should not be ignored if we are very serious about malaria elimination” (11/13).

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India Must Take Action To Address Air Pollution

Project Syndicate: India’s Deadly Air
Shashi Tharoor, MP for the Indian National Congress and chair of the Parliamentary Standing Committee on External Affairs

“…The consequences [of air pollution in India] are alarming. Poor air quality is now costing India at least one percent of GDP every year in respiratory diseases, reduced productivity, and increased hospitalization, and may be reducing Indians’ lifespans by three years. … India needs to make improving air quality a national priority. It needs to create state and national action plans for clean air; set tough new targets for thermal power plant emissions, factory chimneys, and automobile exhausts; and establish a proper air pollution monitoring system. … In the face of this national catastrophe, the government’s complacency is appalling, but not surprising. Public discussion of India’s deteriorating air quality and its effects on human health — and thus awareness of the problem — is startlingly limited. India’s politicians need to design an action plan that generates a groundswell of public pressure on the government to confront the issue head-on. The Indian public … should be demanding … the ability to breathe…” (11/13).

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From the Global Health Policy Community

MSF Calls On Global Fund Board To Change Policies, Practices For Countries Transitioning From Donor Support

Médecins Sans Frontières: HIV and TB treatment at risk as countries gradually lose Global Fund support
“Médecins Sans Frontières (MSF) has called on the Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria to make urgent changes to their policies and practices for countries transitioning away from, or gradually losing, donor support, which increase the risk of critical drug stock-outs and alarming drug quality issues in many countries. … ‘Allowing countries to fall off a cliff without mitigating the risks for people who need treatment could reverse nearly two decades of progress against two of the world’s deadliest infectious diseases,’ [Els Torreele, executive director of MSF’s Access Campaign, said]…” (11/13).

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Friends President Chris Collins Discusses Finding Balance In Vertical, Broader Health System Approaches To HIV/AIDS

Friends of the Global Fight: Integrating the exceptional in an evolving response to AIDS
Chris Collins, president of Friends of the Global Fight Against AIDS, Tuberculosis and Malaria (Friends), discusses the challenge of balancing the “vertical approach to HIV while simultaneously broadening the health services delivered.” Collins writes, “Much can be gained by concentrating on a particular disease challenge and much can be achieved by being comprehensive in health delivery. Success is about finding the balance in different settings, but it is not about losing focus. Going forward we can ask what achieves the most benefit for people in each setting. … The bottom line is we need more investment in health, and that means thinking about the politics of health financing” (11/13).

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CGD Experts Discuss Collaborative, Responsible Financing For SDGs

Center for Global Development: Is the Donor Agenda for the SDGs Making Aid a Tool of Inequity?
Pamela Jakiela, senior fellow, and Charles Kenny, director of technology and development and senior fellow, both at CGD, discuss financing for the Sustainable Development Goals, with a focus on mobilizing domestic resources. The authors highlight the roles of lower-middle-income country (LMIC) governments, donor governments, and development finance institutions with regard to responsibly implementing tax laws, ensuring accountability, and focusing “on the greatest public policy or poverty-reducing priorities of poor countries” (11/13).

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Global Health Expert Discusses Importance Of 4th People's Health Assembly On Efforts To Achieve Global Health Equity

BMJ Opinion: Fran Baum: Why the 4th People’s Health Assembly is an important event for global health equity
Fran Baum, Matthew Flinders distinguished professor of public health and foundation director of the Southgate Institute for Health, Society, and Equity at Flinders University, and member of the Global Steering Council of the People’s Health Movement, discusses the importance of and issues to be discussed at the 4th People’s Health Assembly (PHA4) being held in Bangladesh this week. Baum notes this year’s assembly will address “the importance of community-based comprehensive primary health care”; “growing global and national economic inequities which pose a threat to health and whether the trend can be reversed”; and “the role of gender in shaping population health” (11/13).

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NASEM Document Summarizes Proceedings Of Workshop On Global Health Transitions, Role Of PPPs

National Academies of Sciences, Engineering, and Medicine: Global Health Transitions and Sustainable Solutions: The Role of Partnerships: Proceedings of a Workshop
“Economic and programmatic transitions are changing the global health landscape profoundly. … In this changing landscape, the global health community is exploring innovative, coordinated, and sustainable solutions to support countries and maintain health gains during and after transitions. To explore how public-private partnerships can ease transitions and offer sustainable solutions, the Forum on Public-Private Partnerships for Global Health and Safety held a workshop, planned by an ad hoc expert committee, on June 13-14, 2018 to examine these transitions and innovative models for sustainable solutions in the current global health context” (11/13).

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Guttmacher, Partners Release Study Providing Data On Unintended Pregnancy, Abortion In 6 Indian States

Guttmacher Institute: Extensive New Body of Evidence on Abortion in Six Indian States Released
“Abortion has been legal under broad criteria in India since 1971, yet representative information on abortion incidence and access to abortion services in the country has been scarce. The results of a large-scale study titled Unintended Pregnancy and Abortion in India have now been released, filling a critical evidence gap. The results of the study — which was conducted jointly by researchers at the International Institute for Population Sciences (IIPS), Mumbai, the Population Council, New Delhi, and the New York-based Guttmacher Institute — include a wide range of data on abortion in six Indian states: Assam, Bihar, Gujarat, Madhya Pradesh, Uttar Pradesh, and Tamil Nadu…” (11/12).

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From the U.S. Government

U.S. State Department Establishes Humanitarian Assistance Steering Council To Optimize U.S. Aid

U.S. Department of State: Launch of the Humanitarian Assistance Steering Council
In this press statement, U.S. Secretary of State Mike Pompeo notes, “In order to further optimize the State Department and USAID’s humanitarian assistance, I have established a new senior-level mechanism for coordinating and overseeing U.S. humanitarian assistance — the Humanitarian Assistance Steering Council. The purpose of the Council is to coordinate U.S. government efforts in order to achieve seamless, efficient, and effective delivery of humanitarian assistance overseas in support of U.S. foreign policy objectives, including promoting burden-sharing and U.N. humanitarian reform…” (11/13).

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USDA Outlines Agencies' Efforts To Address Antimicrobial Resistance

U.S. Department of Agriculture: USDA’s Role in Combatting Antimicrobial Resistance
Roxann Motron and Kim Cook of the USDA Agricultural Research Service, and Uday Dessai and Sheryl Shaw of the USDA Food Safety and Inspection Service discuss how “USDA agencies continue to work on numerous issues related to antibiotics and antimicrobial resistance (AMR),” outlining efforts in food safety, veterinary services, and agriculture (11/13).

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