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Kaiser Daily Global Health Policy Report

In The News

U.S. Funding For Malaria Program Must Be Maintained To Prevent Resurgence; Researchers Warn Of Spread Of Drug-Resistant Strain

New York Times: As Malaria Resists Treatment, Experts Warn of Global Crisis
“…[A] new, drug-resistant strain of the disease, impervious to artemisinin and another popular drug with which it is frequently paired, piperaquine, threatens to upend years of worldwide eradication efforts — straining health care systems and raising the prospect that the death toll could increase again. In recent years, public health officials have tracked the spread of deadly falciparum malaria parasites from western Cambodia to Thailand and Laos, and most recently into Vietnam. … A much bigger worry is that resistance could spread to sub-Saharan Africa, where malaria kills nearly 3,000 children a day despite the widespread use of artemisinin…” (Ives/McNeil, 11/21).

Reuters Health: Proposed cuts in foreign aid could cause malaria resurgence
“If U.S. President Donald Trump cuts 44 percent of the President’s Malaria Initiative (PMI) funding, a significant proportion of the global budget for malaria control, there would be a worldwide resurgence of malaria, British researchers say. … If PMI funding is maintained, it will prevent 162 million more cases of malaria and save 692,589 lives between 2017 and 2020, the researchers calculate. But if the PMI budget is reduced by 44 percent, as proposed in President Trump’s [budget request] released earlier this year, there will be an additional 67 million cases of malaria and 290,649 deaths from it over the same four years, according to the analysis published online November 21 in PLoS Medicine…” (Weinstock, 11/21).

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U.S. Secretary Of State Declares Violence Against Rohingya Muslims As 'Ethnic Cleansing'; Repatriation To Begin But Expected To Take Years

The Hill: Tillerson declares Myanmar violence is ‘ethnic cleansing’
“Secretary of State Rex Tillerson on Wednesday declared the violence against Rohingya Muslims in Myanmar ‘ethnic cleansing,’ while warning the U.S. government could impose new penalties on Myanmar. In a statement, Tillerson vowed to hold those responsible for the violence to account, and warned that the U.S. could pursue that accountability through targeted sanctions…” (Greenwood, 11/22).

Wall Street Journal: Myanmar, Bangladesh Agree on Return of Rohingya Refugees
“Myanmar and Bangladesh agreed to begin repatriating ethnic Rohingya Muslims who fled a crackdown in Buddhist-majority Myanmar, in a process that could take years to complete and could bar people from returning to their own homes…” (Otto et al., 11/23).

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U.N. Leaders Call For Global Action To Stop Violence Against Women, Reach Gender Equality On International Day

The Guardian: Sexual violence in war zones at ‘worst ever’ as drive to protect women falters
“The head of U.N. Women has condemned the inadequate response to the widespread use of rape and sexual violence in conflicts, and warned that the amount of money dedicated to fighting such war crimes is shrinking…” (Ratcliffe, 11/25).

U.N. News Centre: U.N. urges global action so women and girls everywhere can live free from all forms of violence
“Achieving gender equality and the full empowerment of women is the answer to ending violence against women, United Nations Secretary-General António Guterres said Wednesday, calling for collective global action on this cause. ‘Violence against women is fundamentally about power,’ Mr. Guterres said in his remarks alongside U.N. Women Executive Director Phumzile Mlambo-Ngcuka at a special event held at U.N. Headquarters in New York to commemorate International Day for the Elimination of Violence against Women, which is annually observed on 25 November…” (11/22).

U.N. News Centre: No man will reach full potential unless women reach theirs, U.N. says on Day of Eliminating Violence
“Unless the international community tackles violence against women, the world will not eradicate poverty or reach any of the other Sustainable Development Goals, Secretary-General António Guterres said in his message [Saturday] for the International Day for the Elimination of Violence against Women…” (11/25).

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U.N. Security Council Resolution Urges More Action Against Human Trafficking, Slavery; Researchers Say Issues Should Be Treated As Global Health Problems

Thomson Reuters Foundation: U.N. Security Council approves tougher action on human trafficking
“A resolution urging tougher action to crack down on human trafficking and modern slavery worldwide was unanimously approved by the United Nations Security Council on Tuesday. The resolution called on countries to adopt anti-trafficking laws, ramp up efforts to investigate and dismantle criminal networks and provide greater support for survivors of slavery. U.N. Secretary-General Antonio Guterres said that trafficking was not just a crime, but also a development issue…” (Guilbert, 11/21).

Thomson Reuters Foundation: Treat trafficking as a health problem to break cycle of abuse — academics
“The debilitating scars left by modern slavery, ranging from depression to lost limbs, often fuel the exploitation of survivors’ children, academics said on Wednesday, calling for human trafficking to be tackled as a global health problem. Victims who cannot work may instead force their children into abusive or dangerous jobs, from producing palm oil in Indonesia and mining mica in India to farming tobacco in the United States, said a study in the journal PLoS Medicine…” (Guilbert, 11/22).

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Peter Sands To Begin In March As Global Fund ED, Aims To Improve Fund's Efficiency, Effectiveness

The Lancet: Peter Sands appointed head of the Global Fund
“Peter Sands, the former head of Standard Chartered Bank, was appointed on Nov 14 as the new executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria. ‘Leading the fund in its next phase, my overarching view is we should be lifting the ambition, both in terms of the scale of the resources we deploy and in terms of the effectiveness with which we turn those resources into impact,’ Sands told The Lancet. Sands, who will start in March as head of the Geneva-based fund, which raises and invests nearly US$4 billion a year to support programs in poor countries, said: ‘There is a prospect of not just saving many more millions of lives but of also achieving an irreversible, decisive victory, against these three diseases’…” (Zarocostas, 11/25).

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Aid Workers, Vaccines Arrive In Yemen After Loosening Of Port Blockades; Aid Organizations Warn More Action Needed To Prevent Famine

Associated Press: UNICEF: Vaccines cargo to blockaded Yemen can’t be one-off
“The U.N. child agency said Sunday that it has flown 1.9 million doses of vaccines to war-torn Yemen, its first aid delivery since a Saudi-led coalition fighting Shiite rebels tightened a sea and air blockade earlier this month. Regional UNICEF Director Geert Cappelaere described Saturday’s shipment as a ‘very small step’ at a time of immense need and warned that it must not be a one-off…” (Laub, 11/26).

CNN: Vaccines and aid workers arrive in Yemen after blockade
“…Passenger planes carrying aid workers and around 1.9 million vaccine doses — enough for 600,000 children — landed in Sanaa, United Nations World Food Programme (WFP) spokeswoman Abeer Etefa said. Three types of vaccines were sent to protect against at least eight deadly diseases, including whooping cough, tetanus, tuberculosis, diphtheria, pneumonia, and meningitis…” (Hutcherson et al., 11/26).

The Guardian: British risk complicity in Yemen ‘famine crime,’ says Alex de Waal
“Britain is in danger of becoming complicit in the use of starvation as a weapon of war in Yemen, academic and author Alex de Waal has said. ‘The U.K. and the U.S., and others on the [U.N.] Security Council risk becoming accessories to the worst famine crime of this decade,’ said De Waal…” (Lamble, 11/23).

New York Times: Yemen’s War Is a Tragedy. Is It Also a Crime?
“…United Nations experts have warned that some of the actions carried out by the warring parties — the Saudi-led coalition and the Iran-backed Houthi rebels — could amount to crimes against humanity because of their systematic and widespread execution. … Which aspects of the war could amount to crimes against humanity? And what, if anything, can be done to hold the perpetrators accountable?…” (Specia, 11/22).

New York Times: As Aid Arrives in Yemen, U.N. Warns It Must Not Be a ‘One-Off’
“…The Saudi-led coalition began the blockade of sea, air, and land ports on Nov. 6 after it said a missile fired by Houthi rebels from within Yemen was intercepted near Riyadh, the Saudi capital. The blockade was later loosened, but until this weekend had kept key Houthi-held ports sealed. The Saudi coalition has been fighting the rebel group since 2015…” (Specia, 11/26).

Washington Post: Saudi Arabia just reopened two key ports in Yemen. That won’t prevent a famine.
“…[A]id groups alone simply can’t get enough food, water, and medicine into Yemen fast enough to feed and help the millions of people who need it. To stem a famine, USAID says, Yemen needs ‘large-scale imports of essential goods.’ That means commercial shipments, not just supplies from the United Nations, which must go through rigorous inspections that slow delivery…” (Erickson, 11/22).

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Frontline Health Workers Recognized For Efforts To Eradicate Guinea Worm

Devex: Frontline workers push Guinea worm disease to the brink of eradication
“…Last week, [Dr. Adamu Keana Sallau of the Carter Center’s Northern Nigeria office] was among half a dozen other frontline health workers honored for their roles in pushing Guinea worm to the brink of eradication through the inaugural Recognizing Excellence around Champions of Health, or REACH, awards. The awards were given by Abu Dhabi Crown Prince Mohammed bin Zayed Al Nahyan at the Reaching the Last Mile global health summit last Wednesday…” (Dickinson, 11/23).

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More News In Global Health

Associated Press: After the outbreak: Med schools boost Ebola-wrecked Liberia (Melia, 11/23).

Devex: Will the global food system sink the SDGs? (Kumar, 11/23).

Devex: Could innovations in male contraception be the future of family planning? (Edwards, 11/23).

Devex: Q&A: Sustainable development should be profitable, says Belgian minister (Cheney, 11/21).

Financial Times: HIV and the future of medicine (Jack, 11/22).

Fortune: Youth Obesity Is At New Highs Globally. See Where It’s Increased the Most Over the Past 20 Years (Rapp/O’Keefe, 11/22).

The Guardian: ‘Facing disaster’: children starve in siege of Syria’s former breadbasket (Shaheen/Wintour, 11/24).

The Guardian: Why climate change is creating a new generation of child brides (11/26).

Reuters: Venezuelans suffer as malaria outbreak spreads in drug-short nation (Ramirez, 11/24).

VOA News: We Have the Tools to End AIDS Now (Pearson, 11/27).

Washington Post: Indonesia, where smoking is widespread, just placed tough restrictions on e-cigarettes (Bevins, 11/27).

Xinhua News: Experts seek more innovations to boost global health care (11/24).

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Editorials and Opinions

Trump Administration Needs 'Firmer Initiative' For Puerto Rico's Post-Hurricane Recovery Efforts

New York Times: Mr. Trump’s Paper Towels Aren’t Helping Puerto Rico
Editorial Board

“Two months after Puerto Rico was devastated by Hurricane Maria, a sense of desperation seems to be yielding to resignation at best. More than half of the island is still without power, and hundreds of thousands of residents are fleeing to the American mainland in an extraordinary exodus. … The underlying question is what leadership role the federal government will play. … [A] far firmer initiative and plan for the island’s recovery is needed from President Trump and administration officials. Mr. Trump is unfortunately remembered on the island for his scornful critique of local leaders ‘not able to get their workers to help.’ He tweeted, ‘They want everything to be done for them when it should be a community effort.’ Rather than offering defeatist salvos, the president has a sworn responsibility to offer the support that Puerto Ricans deserve as American citizens trapped in a dire emergency” (11/25).

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Governments, Private Sector Should Pilot Incentive Programs For New Antibiotic, Vaccine, Diagnostic R&D

Project Syndicate: Turning AMR Words Into Action
Jim O’Neill, honorary professor of economics at Manchester University and former chair of the Review on Antimicrobial Resistance

“…The [U.K. government’s Review on Antimicrobial Resistance (AMR)] showed that even as the world runs out of effective antibiotics, we are overusing those that still work. … In the Review’s final recommendations, increasing public awareness was one of our Ten Commandments. … Among the other Ten Commandments on which some progress has been made, I am particularly excited about three. First, a promising amount of money is flowing into early-stage research and development … Second, more researchers seem to be focusing on AMR … And, third, the misuse of antibiotics in agriculture has been reduced more than I would have expected … Unfortunately, action has been lacking in the development of new diagnostics, vaccines (and vaccine alternatives), and antibiotics. Since the Review published its final report, there has been a lot of talk about these three crucial recommendations, particularly from the pharmaceutical industry. … And yet no concrete action has been taken. To change that, the top 20 antibiotics producers could ask their respective governments to ‘pilot’ a funding mechanism for taking new drugs through clinical trials and to market. … We also recommended that those developing new vaccines or alternatives and state-of-the-art diagnostics be eligible for … rewards…” (11/27).

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Addressing Stigma Vital To Ending AIDS By 2030

The Conversation: Three decades on, stigma still stymies HIV prevention and treatment
Linda-Gail Bekker, professor of medicine and deputy director of the Desmond Tutu HIV Centre at the Institute of Infectious Disease and Molecular Medicine at the University of Cape Town

“…Unless stigma is addressed, the aim of ending the AIDS epidemic by 2030 — one of the United Nations’ Sustainable Development Goals — is unlikely to become a reality. … The good news is that stigma can be reduced if three basic interventions are put in place. Firstly, through the implementation of effective and sustained mass media campaigns and health promotion aimed at dispelling the common myths. These campaigns should involve HIV-positive people as message bearers. Secondly, normalizing and promoting the interaction with HIV prevention services. What is needed here are more people openly engaging about HIV testing and taking PrEP (pre-exposure prophylaxis). And thirdly, laws and policies that protect those living with the virus from discrimination and promote them being able to access health care services. These are especially important for key population groups living in countries where criminalization disrupts public health strategies” (11/22).

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Global Community Should Take 'Coordinated Action' To Improve Food Systems

Devex: Opinion: Our food systems are perpetuating malnutrition — and stalling development
John Beddington, senior adviser at the Oxford Martin School, professor of natural resource management at Oxford University, and co-chair of the Global Panel on Agriculture and Food Systems for Nutrition; and John Agyekum Kufuor, former president of Ghana and co-chair of the Global Panel on Agriculture and Food Systems for Nutrition

“…Thanks to leadership at the global and regional levels, a fundamental shift has started to take hold to ensure that all parts of food systems work together to deliver high-quality diets. … But our window for action is closing. Climate change, population growth, and rapid urbanization will continue to place stress upon our food systems. … Policymakers, businesses, civil society, and others have an opportunity to improve consumers’ ability to access food that is safe, nutritious, and affordable. This will require concerted action across many different sectors to connect and break down traditional silos, along with coordinated action across several policy domains. Doing so would not only accelerate progress toward meeting the Sustainable Development Goal [(SDG)] to end hunger (Goal 2), but would help achieve all the SDGs. Addressing poor quality diets and malnutrition would boost the development potential of individuals and nations alike. … We’ve heard the call to prioritize nutrition — now let us heed that call by ensuring food systems deliver safe and healthy diets for all” (11/21).

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New Global Fund Executive Director Likely To Emphasize 'Economic Aspects Of Infectious Disease Threats'

The Lancet: Offline: Who is Peter Sands?
Richard Horton, editor-in-chief of The Lancet

“…[W]ho is Peter Sands? … For several years he has built a reputation as a thoughtful advocate for greater attention to the economic costs of infectious diseases. … As a former banker, he speaks directly — and with considerable credibility — to the business community about the economic impact of unexpected infectious disease shocks. … Sands acknowledged that he ‘might appear at first glance an unconventional candidate.’ But that very unconventionality is his greatest strength. … Sands looks likely to re-engineer the Global Fund to take more seriously the economic aspects of infectious disease threats. In an email to The Lancet last week, Sands stressed that, ‘one of the things I want to do at the GF is strengthen the economic arguments.’ In the wake of SARS, MERS, Ebola, and Zika, his refreshing new vision comes not a moment too soon” (11/25).

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Policymakers Must Help Nations Provide Access To NCD Care For Newly Arrived Refugees

Foreign Affairs: The Hidden Refugee Health Crisis
Jude Alawa, student at Yale University

“…[M]illions of refugees [are] suffering from chronic non-communicable diseases — maladies such as diabetes, cancer, and mental illness that cannot pass from person to person but can be devastating if left untreated. As host countries have taken in the world’s displaced, they have too often failed to consistently treat these ailments. Governments must change course: non-communicable diseases increase countries’ health care costs in the long term and prevent refugees from building productive, sustainable lives in their new communities. If policymakers do not provide reliable health care to displaced people, chronic diseases could turn the global refugee crisis into an even greater burden. … Policymakers should develop public health programs in the native languages of refugees to teach them about health services, risk factors for chronic ailments, and the consequences of leaving those conditions untreated. Because chronic diseases require long-term care, governments should also expand temporary health insurance plans and work to help refugees finance costly treatments and medications for chronic illnesses…” (11/23).

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North Korean Soldier's Health Condition Offers Insight Into Country

New York Times: The Parasites Feeding on North Koreans
Brian H. Hook, director of policy planning and senior policy adviser at the State Department

“…[South Korean] doctors soon discovered just how grave [a North Korean soldier’s] condition was: Along with the bullet wounds [he obtained while fleeing North Korea], he also had hepatitis B, pneumonia, and ‘an enormous number’ of parasitic worms in his intestines, some up to 11 inches long. … The worms can burrow into fresh wounds, with potentially devastating effects. This defector’s plight is a window onto North Korean life. For all the regime’s spending on sophisticated weapons, monuments to the Kim family, and bribes for elites in Pyongyang, even trusted soldiers suffer terrible malnourishment. A vast majority of other North Koreans endure still worse. Such is the cruelty of North Korea’s regime — and such is the responsibility of those foreign governments that enable it…” (11/24).

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From the Global Health Policy Community

Continued U.S. Investments In Global Health Programs Can Improve Nation's Security

Friends of the Global Fight: How Investments in Global Health Promote U.S. Security
Berk Ehrmantraut, communications intern at Friends of the Global Fight, discusses the importance of investing in global health security, writing, “Strengthening health systems around the world, ending deadly epidemics, and preventing outbreaks at their sources saves lives and protects millions of Americans. … Continued funding for these programs can save lives while also improving our nation’s own health security” (11/21).

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CGD Examines Ghana Case Study, Offers Suggestions For Finding Efficiencies In National Health Spending

Center for Global Development’s “Global Health Policy Blog”: More Health for the Money through Better Purchasing Decisions: The Case of Ghana
Kalipso Chalkidou, director of global health policy and senior fellow at CGD, discusses an analysis that examines the role of Ghana’s national health insurance scheme (NHIS) in managing hypertension in the country, writing, “According to the … analysis, what drives inefficient spending boils down to two questions: a. What hypertension medicines is Ghana’s NHIS buying? b. How much is Ghana’s NHIS paying for the medicines it buys? … The global health community ought to help Ghana and countries like it strengthen their national systems for allocating resources including when selecting, negotiating prices, and procuring medicines for their populations” (11/21).

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FT Health Discusses Progress On HIV, Features Interview With Former U.S. President Jimmy Carter

FT Health: HIV — reasons to be cheerful
The latest issue of the Financial Times’ weekly global health newsletter discusses UNAIDS’ recently released data on HIV treatment and prevention access. The newsletter also includes an interview with former U.S. President Jimmy Carter, co-founder of the Carter Center and supporter of the recently launched Reaching the Last Mile fund, and features a roundup of other global health-related news stories (Dodd/Jack, 11/24).

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New PLOS Collection Examines Intersection Of Human Trafficking, Exploitation, Health

PLOS BLOG’s “Speaking of Medicine”: Human Trafficking, Exploitation, and Health: a new PLOS Collection
“PLOS Medicine Associate Editor Colleen Crangle introduces the PLOS Collection on Human Trafficking, Exploitation, and Health. … A special Collection launched [last Wednesday] at PLOS — Human Trafficking, Exploitation, and Health — with Guest Editors Cathy Zimmerman and Ligia Kiss of the London School of Hygiene and Tropical Medicine — examines this global crisis. Five essays in PLOS Medicine and two research articles in PLOS ONE testify to the broad scope of the problem, while at the same time showing the many specific ways in which people are exploited…” (11/22).

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From the U.S. Government

CDC, State Department, USAID Recognize 16 Days Of Activism Against Gender-Based Violence

CDC’s “Our Global Voices”: Creating Strength in Numbers to End Violence Against Women & Girls
Recognizing the 16 Days of Activism Against Gender-Based Violence campaign that takes place annually between the International Day for the Elimination of Violence against Women on November 25 and Human Rights Day on December 10, Daniela Ligiero, executive director and CEO of Together for Girls, writes, “At Together for Girls, we believe that in order to effectively prevent and respond to violence, we must first understand it — and it starts with the data.” Ligiero describes the Violence Against Children Surveys (VACS), led by CDC in partnership with Together for Girls, which collects data on violence against youth worldwide (11/22).

U.S. Department of State’s “DipNote”: Let’s Recommit to Ending Violence Against Women and Girls
Rahima Kandahari, director of operations in the Secretary’s Office of Global Women’s Issues, writes, “Throughout the 16 Days of Activism, the U.S. Department of State and U.S. diplomatic missions around the world are stepping up global efforts to engage communities, continue support to survivors, and invest in prevention. After all, this form of violence can be a human rights issue, a health issue, an economic issue, and a security issue. … When we stand up for women and girls’ rights, the entire world benefits” (11/25).

USAID: 16 Day of Activism Against Gender-Based Violence
This site outlines ways USAID is recognizing and contributing to the 16 Days campaign, including “by supporting efforts to prevent and respond to gender-based violence, or GBV, in more than 40 countries worldwide. USAID-supported interventions to combat gender-based violence include confidential medical care, counseling, legal assistance, and community-based action and awareness programs…” (11/24).

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MMWR Article Examines Polio Eradication Efforts In Pakistan

CDC’s “Morbidity and Mortality Weekly Report”: Progress Toward Poliomyelitis Eradication — Pakistan, January 2016-September 2017
This article provides summaries of immunization and surveillance activities related to polio eradication efforts in Pakistan (Elhamidi et al., 11/24).

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