KFF Daily Global Health Policy Report

In The News

Trump Administration's Expanded Mexico City Policy Impacting Health Facilities, Programs, Causing Confusion, Experts Say At Conference

Thomson Reuters Foundation: Millions at risk globally from U.S. abortion ‘gag rule’: experts
“A gag rule imposed by President Donald Trump that bans U.S.-funded [foreign] groups around the world from discussing abortion has sown confusion and fear in developing nations, risking the health of millions of women, experts said on Thursday. The policy has forced the closure of health clinics, outreach programs, and refugee services that rely heavily on U.S. [global health] aid, according to experts meeting at an international conference on family planning in Rwanda…” (Wulfhorst, 11/15).

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Devex Highlights Key Talking Points From International Conference On Family Planning

Devex: View from the ground: International Conference on Family Planning 2018
“…[The International Conference on Family Planning in Kigali, Rwanda,] now in its fifth year, appeared [this week] to show broad consensus around the need for fresh thinking. But some participants expressed concern that not enough was being done to address the growing threat of populism. Some advocates said they were surprised not to see more sessions on the United States’ Mexico City policy on abortion-related work, for example. Devex was on the ground in Kigali to round up the key talking points…” (Edwards, 11/16).

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Experts At International Conference Discuss Efforts To Involve Men In Family Planning

Thomson Reuters Foundation: Where are the men? Experts target missing link in contraception
“…Getting men on board [with family planning] has major benefits in developing nations that struggle with booming populations, a trend that puts pressure on limited resources and fuels fresh cycles of poverty, said experts, researchers, and policymakers gathered at an international family planning conference this week in Rwanda. Involving men increases contraceptive use, reducing infant and maternal mortality, as well as the number of unwanted children. All of this frees up women for school or jobs. … The experts said the key to success is to inform and involve men while preserving women’s autonomy. And while some of the more creative efforts have worked, most schemes are localized and remain small-scale in the face of deep-seated resistance…” (Wulfhorst, 11/14).

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8 Peacekeepers Killed In Military Operation Against Rebels In Congo Region Facing Ebola Outbreak

Associated Press: U.N. says 8 peacekeepers killed in fight against Congo rebels
“Eight U.N. peacekeepers and at least 12 Congolese soldiers were killed in a joint military operation against rebels in Congo’s northeast, which is facing a deadly Ebola outbreak, the U.N. Security Council said late Thursday…” (Lederer, 11/15).

Reuters: Seven peacekeepers killed in clashes near Ebola-hit part of east Congo
“…Eastern Congo has been plagued by banditry and armed insurrections for more than two decades since the fall of military ruler Mobutu Sese Seko, but the past year has seen a surge in violence around North Kivu. Beni and the surrounding villages are also suffering an Ebola epidemic that has infected over 300 people and killed two-thirds of them…” (Mahamba et al., 11/15).

The Telegraph: Outbreak: Ebola spreads to Congolese city of 1.2 million sparking containment fears
“…Unlike previous outbreaks, which have been restricted to fairly remote, rural areas, the present epidemic has swept through populated parts of northeastern Congo, a lawless area that is infested with rebel groups, freelance militias, and armed criminal gangs…” (Blomfield, 11/15).

VOA News: Ebola Outbreak in DRC Could Stretch Well into Next Year
“The Ebola outbreak in the Democratic Republic of Congo, which has already killed hundreds of people, could continue for several months. That’s the latest warning from a senior World Health Organization official. VOA Correspondent Mariama Diallo reports…” (Diallo, 11/16).

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Experts Express Concern North Korea Running Out Of TB Medicines After Global Fund Withdrawal; Situation Compounded By U.S. Sanctions, Nonprofit Says

Associated Press: North Korea running low on TB meds, experts fear epidemic
“The withdrawal of a major international aid organization threatens to leave tens of thousands of tuberculosis patients in North Korea without the medication they need and could spiral into a severe crisis if it is not addressed soon, according to health experts familiar with the situation in the North. The dwindling stockpile of crucial medications follows the abrupt departure of the Global Fund to Fight AIDS, Tuberculosis and Malaria, an international aid organization whose grants to North Korea supported the treatment of 120,000 TB patients last year. Its support officially ended in June despite an outcry among health officials in North Korea and in the international community that it could spark a major epidemic. … The U.S.-based nonprofit Eugene Bell Foundation, which works on the ground treating tuberculosis in North Korea, said Friday that the crisis is being compounded by U.S.-led sanctions over Pyongyang’s nuclear weapons and missile program…” (Talmadge/Tong-Hyung, 11/16).

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Some Scientists Worry Proposed Temporary Moratorium On Use Of Gene Drive Technology Could Stall Malaria Research

Nature: Ban on ‘gene drives’ is back on the U.N.’s agenda — worrying scientists
“Government representatives from nearly 170 countries will this month consider whether to temporarily ban the release of organisms carrying gene drives — a controversial technology that can quickly propagate a chosen gene throughout a population. The technique has the potential to eradicate disease, control pests, and alter entire ecosystems, but with unpredictable consequences — leading some groups to call for a global moratorium on its field applications. Chances are slim of a moratorium being approved at the upcoming meeting of the United Nations Convention on Biological Diversity (CBD), which begins on 17 November in Sharm El-Sheikh, Egypt…” (Callaway, 11/15).

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Fake, Counterfeit Medications Lead To Tens Of Thousands Of Deaths In Africa Annually, Report Says

Reuters: Tens of thousands die in Africa each year due to fake drugs
“Tens of thousands of people in Africa die each year because of fake and counterfeit medication, an E.U.-funded report released on Tuesday said. The drugs are mainly made in China but also in India, Paraguay, Pakistan, and the United Kingdom. Almost half the fake and low-quality medicines reported to the World Health Organization (WHO) between 2013 and 2017 were found to be in sub-Saharan Africa, said the report, also backed by Interpol and the Institute for Security Studies…” (Christensen et al., 11/15).

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More News In Global Health

The Atlantic: A Bold New Strategy for Stopping the Rise of Superbugs (Yong, 11/15).

The Lancet: Fighting a polio outbreak in Papua New Guinea (Chandler, 11/17).

The Lancet: Susan Buchbinder: driving HIV prevention efforts worldwide (Kirby, 11/17).

New York Times: ‘It’s Time to Try to Change the Men’: Papua New Guinea’s Epidemic of Abuse (Solomon, 11/15).

Thomson Reuters Foundation: Calls mount to stop orphanages exploiting poor children to lure money, tourists (Batha, 11/13).

U.N. News: ‘Let the children live’: U.N. prepares to ramp up food aid to Yemen as famine risk grows (11/15).

U.N. News: Senior U.N. adviser sees ‘rare’ victory for humanitarian diplomacy as aid convoy reaches desert camp in Syria (11/15).

U.N. News: Ukraine: Temperatures plunge amid rising humanitarian needs (11/15).

Washington Post: In El Salvador, where abortion is illegal, a rape survivor who gave birth faces trial for attempted abortion (Mellen, 11/15).

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Editorials and Opinions

Other Nations, Global Health Organizations Must Fill Gaps Left By Trump Administration Policies

The Lancet: The future of Trump’s global health agenda
Editorial Board

“…[U.S. President Donald Trump’s] ability to affect global health through non-legislative means remains vast. His record to date is not encouraging. … Just in the past year, Trump has begun pulling Ebola experts from the field, threatened to cut foreign aid to countries in Latin America over political disagreements, slashed funds to the U.N. Relief and Works Agency for Palestine Refugees and reduced other economic aid agency support, as well as [made] moves to curtail refugees and asylum seekers in the USA. … Trump has given ample evidence of his willingness to use global aid for political purposes … [L]ittle can constrain Trump’s moves within the Executive Branch, which makes it incumbent on other nations and global health organizations to resist the changes politically when they can — and step in to fill the gap left by America’s abandonment of global health and its ecological commitments” (11/17).

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Eliminating Malaria Requires Leadership, Engagement From Civil Society, Local Communities

Devex: Opinion: Civil society and community engagement key to achieve malaria elimination
Olivia Ngou, deputy director for Africa and Cameroon country director at Malaria No More, member of the Global Civil Society Network for the Malaria Elimination Secretariat, and member of the RBM Partnership to End Malaria

“…Now, more than ever, the global fight to end malaria needs new ideas. We need to get high-burden countries — especially in sub-Saharan Africa — back on track to continue driving down malaria cases and deaths. And we need countries on track to elimination to stay committed until they get to zero malaria cases. Sustaining funding for strong and stable health systems is one of the most critical aspects for making this happen. However, we have learned that top-down government investment is not enough. Experience shows that no matter how near or far countries are in achieving zero malaria, we are stronger working together from local communities upward. We are stronger pooling our resources and efforts. We also are stronger when civil society, through community-led action, engages in the fight against malaria. … If funded and empowered adequately, engaged communities can demand greater accountability from government decision-makers and the private sector. We can transform victims of malaria into champions for strong health systems and stable financing to sustain them. And working together, we can deliver the knockout punch to end this disease for good” (11/15).

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Vaccines Critical To Preventing Diseases, Staving Off AMR

Project Syndicate: Vaccinating Against Superbugs
Seth Berkley, CEO of Gavi, the Vaccine Alliance, and Jeremy Farrar, director of the Wellcome Trust

“…[D]espite vaccines’ effectiveness in the fight against [antimicrobial resistance (AMR)], we are not taking full advantage of them. … [T]here is an urgent need to increase uptake of vaccines that are already available … and to develop new ones. For existing vaccines, the top priority should be to ensure universal access, which will require a huge expansion in international coordination. … [V]accines are also needed to prevent … diseases in the first place. To accomplish that goal — and stave off AMR in the process — significantly more money must be spent on vaccine research and development. … Although more needs to be done to strengthen R&D pipelines for new diagnostic tools and antibiotics to treat drug-resistant infections, similar attention must be devoted to vaccine discovery, development, and uptake. … When health professionals have the right tools to tackle AMR, millions of lives around the world will be saved. And when effective vaccines are deployed widely, superbugs will cease being so menacing” (11/15).

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Eradicating Guinea Worm Requires New Approaches, Reform

Undark: Three Decades Later, We’re Still Grappling With the Guinea Worm
Jordan Schermerhorn, analyst, researcher, and consultant

“…[T]he final push to full eradication of the [Guinea worm] parasite requires new approaches — including the implementation of better surveillance in at-risk communities, and more rigorous and field-informed scientific research. … The Guinea worm eradication program is deeply in need of reform. So how do we get there? First, assumptions must be tested. … Secondly, case searches must be creatively broadened. … Thirdly, the World Health Organization must update procedures for certifying a country as being free of Guinea worm disease. … I must temper these recommendations with political reality. Pressures to report success, both for endemic countries and international institutions, run contrary to comprehensiveness. … But efforts in this critical period may determine whether humanity ultimately succeeds in once more banishing a disease from the earth. In the face of this potential achievement, it would be a shame to linger in the realm of ‘almost'” (11/15).

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From the Global Health Policy Community

CGD Europe Experts Examine Measures Of Aid Quality, Effectiveness

Center for Global Development: How Do You Measure Aid Quality and Who Ranks Highest?
Ian Mitchell, deputy director and senior policy fellow, and Caitlin McKee, research associate, both with CGD Europe, write, “Here we report on new results of one of the few measures of aid ‘quality’ — the Quality of Official Development Assistance (QuODA), which aims to bring aid effectiveness back into focus. Aid effectiveness still matters enormously to the world’s poor; donors should revisit effective aid principles and agree measures which take better account of today’s challenges and context. … [W]e look at how we can currently measure aid effectiveness, how countries and multilateral donors rank, and where the agenda should go next. Across the measures, New Zealand, Denmark, and Australia rank highest. The results also highlight what many countries can and should improve on: eliminating tied aid and enhancing the use of recipient country systems and priorities…” (11/15).

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CFR Expert Discusses Challenges Of Containing Ebola Outbreak In DRC's North Kivu Province

Council on Foreign Relations’ “Africa in Transition”: Population Density and Conflict Drive Ebola Outbreak in Eastern Congo
John Campbell, Ralph Bunche senior fellow for Africa Policy Studies at CFR, discusses the Ebola outbreak in the Democratic Republic of the Congo’s North Kivu province, highlighting conflict, disruption of health workers’ efforts, population density, and cross-border travel as challenges to containing the outbreak (11/15).

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World Bank Expert Examines Challenges Of Providing Health Care To Syrian Refugees

Brookings Institution’s “Future Development”: The challenges in providing health care to Syrian refugees
Omer Karasapan, regional knowledge and learning coordinator at the World Bank, discusses the challenges in providing health care to Syrian refugees. Karasapan writes, “In host countries, [refugees] often face poor housing and sanitary environments, difficult labor conditions, inadequate nutrition, and inaccessible medical care. … Negative coping mechanisms such as child labor, child marriages, etc. add to the burdens facing refugees, preparing the ground for intergenerational transmission of vulnerabilities. … In all three host countries [– Jordan, Lebanon, and Turkey –] economic headwinds signal further problems for the health of refugees” (11/15).

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Aidspan Publishes New Issue Of 'Global Fund Observer'

Aidspan: Global Fund Observer
Aidspan, an independent watchdog of the Global Fund to Fight AIDS, Tuberculosis and Malaria, published Issue 346 of the ‘Global Fund Observer.’ The newsletter includes updates discussing the various outcomes of and decisions made at the 40th Global Fund Board meeting, which took place in Geneva this week (11/16).

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From the U.S. Government

CDC's MMWR Publishes Updates On Global Routine Vaccination, Efforts To Eradicate Guinea Worm

CDC’s “Morbidity and Mortality Weekly Report”: Global Routine Vaccination Coverage — 2017
Kristin VanderEnde of the CDC’s Global Immunization Division and colleagues provide an updated report on the Global Vaccine Action Plan 2011-2020 and present global, regional, and national vaccination coverage estimates and trends as of 2017 (11/16).

CDC’s “Morbidity and Mortality Weekly Report”: Progress Toward Global Eradication of Dracunculiasis — January 2017-June 2018
Donald R. Hopkins of the Carter Center and colleagues provide an update on global efforts to eradicate dracunculiasis, or Guinea worm disease, including country reports from Chad, Ethiopia, Mali, and South Sudan (11/16).

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USAID Launches 5-Year, $200M Program To Control, Eliminate 5 NTDs In 11 West African Countries

U.S. Embassy in Ghana: USA Launches New Neglected Tropical Disease Control Program in West Africa
“The United States of America, through the U.S. Agency for International Development (USAID) and in collaboration with the ministries of health in 11 countries, is launching a new, five-year $200 million program to control and eliminate five neglected tropical diseases in sub-Saharan West Africa. This newly launched program deepens USAID’s efforts to eliminate trachoma, lymphatic filariasis, onchocerciasis, schistosomiasis, and soil-transmitted helminthiasis in 11 West African countries…” (11/15).

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