KFF Daily Global Health Policy Report

In The News

Senate Foreign Relations Committee Approves Foreign Aid Transparency, Accountability Act

“The U.S. Senate Foreign Relations Committee approved on Thursday the Foreign Aid Transparency and Accountability Act, which would make law Obama administration policies that strive to hold foreign aid agencies more accountable through systematic monitoring, evaluation and online disclosure of program data and results,” Devex reports. The news service examines the content of the bill and discusses next steps (Igoe, 11/15). Additional information on the bill is available from the Kaiser Family Foundation’s “Policy Tracker” (11/14).

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China To Relax One-Child Policy For Some Families

“China will ease family planning restrictions nationwide, the government said on Friday, allowing millions of families to have two children in the country’s most significant liberalization of its strict one-child policy in about three decades,” Reuters reports (Sui-Lee/Li, 11/15). “The new change says that if either parent is an only child, the couple may have a second child,” according to the Washington Post’s “WorldViews” blog, which lists current exceptions to the rule (Fisher, 11/16). “Previously, the one-child policy allowed couples where both parents were only children to have a second child,” Al Jazeera America notes (Hayoun, 11/15). The new policy was “announced Friday as part of a blueprint for economic and social reforms drawn up by the Communist Party leadership,” the Wall Street Journal reports (Burkitt, 11/17). “The plan … won’t trigger a surge in births in the short term as relatively few couples fulfill the criterion, Wang Peian, deputy director of the National Health and Family Planning Commission, said in a statement on the government website [Saturday],” Bloomberg News writes (11/16).

“The one-child policy, though applauded by many for slowing down China’s population growth, has been widely criticized for resulting in forced abortions and hefty fines that are sometimes used to enforce it,” CNN reports (Castillo, 11/16). According to the New York Times, “The Chinese government’s decision to relax a decades-old one-child limit on couples has already encountered two problems likely to test dozens of social and economic changes promised by President Xi Jinping — vagaries about implementation and magnified public expectations of even bigger changes ahead” (Buckley/Zuo, 11/17). However, “China is not considering a broad relaxation of its strict one-child policy despite an easing of existing rules since it would be too disruptive, the health ministry said on Saturday,” Reuters reports in a separate article (Blanchard, 11/15).

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Progress Made In Delivery Of Aid To Philippines, But Challenges Remain

“With substantial progress in opening up airports and clearing roads in typhoon-hit regions of the Philippines, United Nations agencies and partners are scaling up their support of government efforts to provide relief, but a major fuel shortage is hampering access to millions of affected people,” the U.N. News Centre reports (11/15). “Even as a major international aid effort has begun to take hold around the coastal city of Tacloban, the situation grimly differs just a few miles inland, where large numbers of injured or sick people in interior villages shattered by Typhoon Haiyan more than a week ago have received no assistance,” the New York Times writes (Bradsher, 11/17). “While aid packages have begun to reach more remote areas, much of it carried by helicopters brought by the USS George Washington aircraft carrier, the United Nations said people were still going hungry in some mountainous provinces,” according to Reuters (Belford, 11/17).

“The death toll from one of the world’s most powerful typhoons surged to about 4,000 on Friday, but the aid effort was still so patchy bodies lay uncollected as rescuers tried to evacuate stricken communities across the central Philippines,” Reuters states in a separate article (Grudgings/Belford, 11/15). “The death toll had reached 3,261, officials said, with the state news agency reporting that more than 12,000 were injured,” according to The Guardian, which adds, “The mayor of devastated Tacloban cited figures of 4,000 dead across the central Philippines, while the United Nations put the toll at 4,460, but later said it was reviewing that figure” (Branigan, 11/15). In a separate article, the newspaper notes “the number of displaced people increased to four million” (Branigan, 11/17).

Additional coverage is available from Agence France-Presse, American Forces Press Service, The Guardian, the Philippine Information Agency, Reuters, the U.N. News Centre, and a WHO press release.

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Addressing Health, Climate Changes Together Has Mutual Benefits, Experts Say

“Attacking health and climate change problems together makes sense, experts said Saturday at a climate and health summit on the sidelines of the U.N. climate negotiations in Warsaw,” Thomson Reuters Foundation reports. “But changing behavior that causes global warming can be just as difficult as changing behavior that leads to health problems, doctors at the summit admitted,” the news service notes, adding, “Instead, campaigners on both health and climate issues need to find ways of talking about the genuine benefits of taking action, experts said.” According to Reuters, “Moving toward action on climate and health issues is crucial, speakers at the summit said, because climate change threatens a range of worsening problems for health — from the geographical spread of diseases like malaria and dengue, to growing heat stress, food shortages and psychological pressures” (Goering, 11/17).

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Technology, Innovation, Partnerships Critical For Sustainable Development, Ban Says

During a visit to Estonia on Saturday, U.N. Secretary-General Ban Ki-moon “underscored the vital role of technology and innovation in finding solutions to some of today’s most pressing challenges such as advancing the global sustainable development agenda,” the U.N. News Centre reports. “Our sustainable development goals must be informed by the best science. They must be bold in ambition yet simple in design. They must be universal yet responsive to the complexities and needs of individual countries. They must be rights-based, with special emphasis on women, young people and marginalized groups. And they must protect the planet’s resources and support action to tackle climate change,” Ban said, according to the news service (11/16). In an interview with The Guardian’s “Media Network” blog, Ban spoke “about the post-2015 development agenda and the power of partnerships to address complex challenges at a global level,” according to the newspaper. According to the interview transcript, Ban highlights several initiatives, saying, “Such partnerships and alliances are the wave of the future in helping governments to pursue their development priorities and in eliciting the engagement of all those in a position to help make a difference” (Davidi, 11/15).

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U.S. Withdrawal From Afghanistan Bringing Closure Of 'Model' Hospital

“By next month, there will be no more doctors at the clinic once deemed a model for Afghanistan,” as “its [U.S.] funding [is] depleted and the Afghan government [is] unable to provide support,” the Washington Post reports. “As the United States’ longest war winds down, hundreds of aid projects are being handed over to Afghan ministries, which sometimes lack the capacity or interest to sustain what foreign donors started,” the newspaper writes, adding, “The Urgent and Primary Care Clinic in Kabul is a small but telling example: one of the few medical facilities in Afghanistan with state-of-the-art American equipment, a place that once saw nearly 5,000 patients per month and will soon see none.” The article examines the history of the hospital and its prospects for continuing operations (Sieff, 11/17).

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News Outlets Examine Global Fund's Suspension Of Contracts With 2 Bednet Suppliers

“The Global Fund to Fight AIDS, Tuberculosis and Malaria has suspended contracts with two international firms that supplied mosquito bednets over ‘serious financial wrongdoing’ in Cambodia,” The Guardian reports. “Contracts with Vestergaard Frandsen and Sumitomo Chemical Singapore were suspended on Thursday pending a full review after a two-and-a-half-year investigation,” the newspaper writes, adding, “A report published by the Global Fund’s Office of the Inspector General found that between 2006 and 2011, the suppliers paid commissions to two Cambodian officials from the National Centre for Parasitology, Entomology and Malaria Control (CNM), totaling $410,000 (£304,534), in return for awarding contracts for insecticide-treated bednets, which help prevent the spread of malaria” (Ford, 11/15). “The report, released Friday, implicates senior officials of [CNM] and the National Center for HIV/AIDS, Dermatology and STD Control (NCHADS), both arms of the Ministry of Health, as well as Medicam, an umbrella network of health [non-governmental organizations (NGOs)], of participating in a network of bribery, as well as double- and triple-charging donors for the same expenses,” according to the Cambodia Daily (Hruby, 11/16).

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Media Outlets Examine Dengue's Spread, Prevention Research

According to the WHO, dengue “infections [this year] are breaking records all over Asia and Latin America — from sweeping epidemics in Nicaragua to the worst outbreaks in six years in India, 20 years in Thailand and the first homegrown case in Western Australia in seven decades,” TIME reports. “The U.S. has not been spared either, with the first case in a major city in Houston and ‘serious levels’ in Florida,” the news magazine notes. “Mosquitoes have more places to breed now that chemical spraying is less effective, and population clusters give the disease areas to propagate,” TIME writes, adding, “This now includes the temperate climates of Europe and North America. Scientists say global warming may play a part — since associated higher rainfall creates more stagnant water that in turn allows more mosquito larvae to hatch” (Campbell, 11/18). “Right now, with no vaccine against the virus, the best defense available is reducing mosquito habitat in areas where dengue fever is common,” Scientific American reports in an article examining why some areas are affected by the disease while others are not (Maron, 11/15). The Florida Times-Union profiles the U.S. Navy’s entomology program, which is researching ways to fight mosquito-borne diseases such as dengue (Davis, 11/16).

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U.N.'s Ban Recognizes World Day Of Remembrance For Road Traffic Victims

In a message for the World Day of Remembrance for Road Traffic Victims, recognized on November 17, U.N. Secretary-General Ban Ki-moon “call[ed] for urgent action to make roads safer for all those who use them in an effort to save millions of lives worldwide,” the U.N. News Centre reports. “Ban applauded the fact that governments have agreed to a Decade of Action for Road Safety, 2011-2020, with the target of saving five million lives,” the news service writes. “Let us work to make more roads safe for all who use them. Together, we can save millions of lives,” Ban said, according to the news service (11/17).

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New York Times Examines Device Developed To Aid In Obstructed Labor

The New York Times examines an invention by Jorge Odón, an Argentine car mechanic, which can be employed in the event of obstructed labor “to save babies in poor countries, and perhaps to reduce caesarean section births in rich ones.” The newspaper notes, “With the Odón Device, an attendant slips a plastic bag inside a lubricated plastic sleeve around the head, inflates it to grip the head and pulls the bag until the baby emerges.” The newspaper writes, “Unlikely as it seems, the idea that took shape on [Odón’s] counter has won the enthusiastic endorsement of the [WHO] and major donors, and an American medical technology company has just licensed it for production.” The New York Times adds, “Although more testing is planned on the Odón Device, doctors said it appeared to be safe for midwives with minimal training to use” (McNeil, 11/13).

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Editorials and Opinions

Editorial, Opinion Piece Urge U.S. To Invest In Global Fund

The following editorial and opinion piece address U.S. funding for the Global Fund to Fight AIDS, Tuberculosis and Malaria, which is holding its replenishment meeting in Washington, D.C., in December and aiming to raise an additional $15 billion over the next three years.

  • Eugene Register-Guard: “The United States should set the tone by pledging $5 billion, an amount that would essentially require it to continue its current level of contributions,” the editorial states. “That’s a lot of money, and it’s not unreasonable to ask why the United States should make such a commitment at a time when the federal budget is squeezed on all sides,” the editorial continues, adding, “The answer is simple: Health officials say the fight against these diseases is at a critical crossroads, and any significant cut in funding could unravel hard-won gains.” In addition, advances against the diseases “will reduce the need for future U.S. foreign aid dollars to offset the ravages of these diseases, and will enhance political, economic and social stability in regions hard hit by such diseases, most notably sub-Saharan Africa,” the editorial states (11/16).
  • Heather Stein, Durham Herald-Sun: “The U.S. should demonstrate its commitment to ending these diseases by announcing a commitment to $5 billion over the next three years,” Stein, a volunteer with RESULTS, writes, noting, “For every dollar the U.S. puts into the pot, other donors have to put in two dollars.” She continues, “Infectious diseases don’t patiently hang around waiting for opportune moments for us to tackle them. They can and will return with a vengeance if we take the short-sighted approach of ignoring this historic chance to defeat them.” Stein adds, “With a relatively small investment from us, just think of the huge payback we will receive for the health of our global community and future generations” (11/16).

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'More Comprehensive, Integrated Approach' Needed For Future Global Health Targets

The “disease-specific and demographic-selective approach” taken under the global health-related Millennium Development Goals “has skewed funding, resources and the global health narrative to the exclusion of other important causes of global morbidity and mortality,” physician and development advocate Tim Crocker-Buque writes in a Devex opinion piece. “Although the decline in child mortality and reduction in new HIV infections are to be celebrated as an unprecedented success, there remains a missed opportunity to provide comprehensive health care to those most in need,” he states. Crocker-Buque discusses key areas of focus and calls for better data collection. “It is unlikely that all of the things required to seriously improve global health could be captured within a set of highly focused, internationally agreeable, time-limited development goals,” he writes, adding, “Yet, sticking to a rigid system of disease-specific and demographic-selective targets will leave millions without the health care they desperately need.” He concludes, “A much more comprehensive and integrated approach is required to tackle the synergistic relationship between poverty and ill health” (11/18).

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To Continue Progress, African Leaders Must Boost Domestic Health Funding

“In the last 10 years, Africa has transformed itself from the stereotype of a dark continent of death, disease and destruction to one of triumph and growth,” Mustapha Kaloko, commissioner for social affairs for the African Union Commission, writes in a Thomson Reuters Foundation opinion piece. “Today, according to IMF estimates, seven African countries appear on the list of the world’s 10 fastest-growing economies,” he notes, adding, “Across the continent, improved standards of living have been registered” and “indicators for health in Africa have registered tremendous improvements.” He states, “In the field of infectious diseases, the continent has been pulling all the stops on its way to defeating HIV, tuberculosis and malaria,” adding, “In achieving these results, partnerships with development partners” — such as the Global Fund to Fight AIDS, Tuberculosis and Malaria and PEPFAR — “have been fundamental.”

“To perform even better, Africa must invest vigorously in finding self-reliant ways to financing the fight against these diseases,” Kaloko continues, adding, “Domestic finances set aside to build African health will enhance country ownership and sustainability in the continent’s health programs.” The 2001 Abuja Declaration, renewed recently in 2013 at the Abuja+12 meeting, and the African Union Roadmap on Shared Responsibility and Global Solidarity (2012-2015) have helped “African countries take action to boost domestic funding for health,” he states, adding, “Africa must continue to seek more ways to stand on its feet and march forward towards controlling these diseases” (11/15).

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China's One-Child Policy Promotes Human Rights Abuses

Noting “China is relaxing its 34-year-old one-child policy, which prohibits most families from having more than one child,” to allow “[p]arents who themselves do not have siblings … to have two children,” blogger Max Fisher writes in a Washington Post opinion piece, “The policy is controversial for a number of reasons, but maybe the one that Americans hear about most is the practice of forcing abortions on mothers who become pregnant with an unapproved second child.” He states, “The awful persistence of forced abortions, sterilizations and infanticide in China reflect a contradiction in the Chinese system — and in the one-child policy itself,” noting, “The senior leadership in Beijing may set national policy, such as today’s relaxation of the one-child policy, but it’s local- and provincial-level officials who choose when, whether and how to actually enforce those policies.”

“Here’s the contradiction in the one-child policy: Chinese officials want to keep down the birthrate, which is why they enacted the policy in 1979 and have kept it ever since,” Fisher continues, adding, “But they also want to forbid state officials to enforce the policy with forced abortions and sterilizations, which are rightly loathed as horrific human rights abuses.” He asks, “If they conclude that they can’t keep down the birthrate without using forced abortions and sterilizations, which of their two orders do they disobey?” He concludes, “This contradiction is why human rights groups have been arguing for years that the only real way for China to end forced abortions and sterilizations is by ending the one-child policy. And they’re probably right” (11/15).

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From the Global Health Policy Community

Lawmakers Urge President Obama To Double PEPFAR Treatment Goal

Rep. Barbara Lee (D-Calif.) and Sen. Tom Coburn (R-Okla.), “along with 38 other lawmakers, sent a letter [.pdf] to President Obama calling on the administration to announce a doubling of the number of people on treatment through [PEPFAR] during the Fourth Replenishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria scheduled to take place in Washington, D.C., in December,” a press release from Lee states (11/14). Citing “evidence from HPTN 052, the study that proved antiretroviral treatment for HIV also prevents transmission of the virus,” the lawmakers urged the administration to “ensure that 12 million people living with HIV are receiving treatment by 2016,” the Center for Global Health Policy’s “Science Speaks” blog notes (Barton, 11/15). The letter also urges the administration “to work diligently toward the international goal of virtually ending the transmission of HIV to newborns of pregnant mothers by 2015” (11/13).

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U.S. Investment In Family Planning Provides 'Social, Economic, Political Benefits'

Noting the recently concluded third annual International Conference on Family Planning, Isobel Coleman, senior fellow for U.S. foreign policy and director of the Civil Society, Markets, and Democracy Initiative at the Council on Foreign Relations (CFR), writes in the CFR “Development Channel” blog, “This week’s meeting in Ethiopia underscores the importance of investing in family planning.” She highlights a 2011 CFR report she co-authored with Gayle Tzemach Lemmon, titled Family Planning and U.S. Foreign Policy, that “emphasizes how investing in family planning supports a myriad of U.S. foreign policy and international development objectives.” She concludes, “Not only does it save millions of lives, it also helps create healthy, resilient families in some of the most vulnerable parts of the world: a positive outcome for U.S. security interests. As international development funding becomes increasingly strained, the United States and governments around the world should remember the social, economic, and political benefits they stand to gain from investing in family planning” (11/15).

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Blog Examines U.S. Food Aid Program, Proposed Changes

In a post in the Center for Global Development’s (CGD) “Rethinking U.S. Foreign Assistance” blog, senior fellow Kimberly Ann Elliott and research assistant Will McKitterick examine the U.S. Food for Peace program and proposed changes to the food aid program in light of the humanitarian situation in the typhoon-stricken Philippines. Because the typhoon hit at the beginning of the U.S. government’s fiscal year, money was available in the program to help, they note. “Had the typhoon struck a few months earlier, however, cash for such crises would have been exhausted by relief operations in Syria,” they write, examining proposed changes to the program that they say “could allow food aid to reach as many as 10 million more needy people without increasing the budget.” They conclude, “The evidence on the value of food aid reform keeps growing, as does the momentum behind it. Something good could come of the tragedy in the Philippines if it gives reform that final push to the top of the hill” (11/15).

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USAID Working To Help Philippines After Typhoon

“While nothing can undo the damage wrought by [Typhoon Haiyan in the Philippines], the U.S. government has mounted a swift, large, and coordinated relief effort using all of the tools at our disposal, with USAID leading that humanitarian response,” Jeremy Konyndyk, director of the Office of U.S. Foreign Disaster Assistance, writes in USAID’s “IMPACTblog.” He continues, “As aid begins to reach tens of thousands of survivors, we are proud of our assistance to the Filipino people even as we are humbled by the breadth of the devastation.” Konyndyk summarizes the agency’s activities so far, and says “[m]uch more help will be needed.” He concludes, “As more and more aid from the U.S. and many others — from countries to charities to individual donors — begins to reach the Philippines, we are optimistic that the response effort is turning a corner” (11/16).

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Examining Key Lessons From 3rd Global Forum On Human Resources For Health

Noting “USAID staff from Washington and the field gathered in Recife, Brazil, this week for the 3rd Global Forum on Human Resources for Health (HRH), joining over 2,000 HRH policymakers, experts, advocates and frontline health workers from 57 countries,” Diana Frymus, health systems strengthening adviser for USAID’s Office of HIV/AIDS; Estelle Quain, senior human resources for health adviser for the Office of HIV/AIDS; and Lois Schaefer, senior human resources for health adviser for the Office of Population and Reproductive Health, examine in the agency’s “IMPACTblog” “several key lessons from [their] participation in the forum.” They write, “Foremost, there must be better integration of HRH into the broader dialogue about health systems strengthening and development goals and challenges.” In addition, “the economic transition occurring in many countries is impacting HRH and should inform human resources planning,” and “we must build a new generation of leaders to help carry the HRH agenda forward,” they write (11/16).

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Uganda Should Employ Several Types Of HIV Prevention Strategies

Gemma Ahaibwe, a research analyst at the Economic and Policy Research Centre (EPRC) in Uganda, examines in the Brookings Institution’s “Africa in Focus” blog an increase in Uganda’s HIV/AIDS prevalence in recent years. She notes Ugandan President Yoweri Museveni and his wife earlier this month “publically tested themselves for HIV/AIDS to encourage all Ugandans to take steps to curb the spread of disease, which currently affects 7.3 percent of the population.” “The increase in the HIV/AIDS prevalence has been blamed on the complacency of Ugandans — especially regarding sexual behavior — with the availability of antiretroviral therapies (ARTs),” “a slow uptake of proven prevention strategies like safe male circumcision (SMC),” and a failure thus far to “achiev[e] its target of universal coverage of HIV/AIDS testing by 2015,” she writes, adding, “Uganda should expand coverage and uptake of a mix of different HIV/AIDS prevention methods and interventions as we move towards achieving the HIV/AIDS-related [Millennium Development Goals (MDG)]” (11/15).

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