Kaiser Daily Global Health Policy Report

In The News

DRC's Latest Ebola Outbreak Unlike Others Due To Experimental Vaccines, Treatments, Situation In Conflict Zone

Al Jazeera: Why Ebola crisis in DRC is unlike anything before
“…[The Democratic Republic of Congo’s] North Kivu and Ituri provinces are among the most unstable and densely populated in the country, and subject to some of the highest levels of human mobility in it. At the same time, there are warnings that a ‘perfect storm’ of insecurity, community resistance about vaccinations, and political manipulation threatens the efforts to contain the spread of the virus. These factors collectively make the latest outbreak unlike anything the DRC, which is scheduled to hold a crucial presidential election on December 23, has experienced before…” (Essa, 11/27).

New York Times: Battle Against Ebola in Congo Pits Medical Hope Against Local Chaos
“The battle against Ebola now underway in central Africa is like no other. It is the first for which doctors have both a promising vaccine and treatments to offer. These medical innovations are experimental, but the vaccine seems to work well, the four new treatments have given preliminary hints of curative powers and a clinical trial of them began Monday. … [I]t is unique in another way: it’s the first to erupt in an area rived by gun battles…” (McNeil, 11/27).

NPR: Ebola Treatment Trials Launched In Democratic Republic Of The Congo Amid Outbreak
“…It is already the Democratic Republic of the Congo’s largest Ebola outbreak ever on record. Still, the country’s health minister, Oly Ilunga, expressed hope Monday that the new randomized trials mark a turning point on how to treat the virus. ‘Our country is struck with Ebola outbreaks too often, which also means we have unique expertise in combating it,’ he said. ‘These trials will contribute to building that knowledge, while we continue to respond on every front to bring the current outbreak to an end'” (Dwyer, 11/27).

Link to individual story

Number Of New HIV Cases Continues To Grow In Eastern Europe, New Report Shows, Calls For Urgent Action

CNN: HIV diagnoses at all-time high in Eastern Europe, report says
“The HIV epidemic in Europe is still growing at an alarming rate, particularly in Eastern Europe, according to a new report. The number of new HIV diagnoses in the region continued to rise in 2017, but the pace of the increase is slowing, according to the report from the European Center for Disease Prevention and Control and the WHO Regional Office for Europe…” (Britton, 11/28).

Radio Free Europe/Radio Liberty: Report: Most New European HIV Cases Last Year Arose In Ukraine, Russia
“Almost 160,000 people were newly diagnosed with HIV in Europe last year, with three-quarters of the new cases arising in Ukraine and Russia, two European health agencies said on November 28. … The overall trend suggested the European region would not achieve the U.N. target of eliminating HIV/AIDS by 2030…” (11/28).

Reuters: New cases of HIV rise in Eastern Europe, decline in the West
“… ‘It’s hard to talk about good news in the face of another year of unacceptably high numbers of people infected with HIV,’ said Zsuzsanna Jakab, director of the WHO regional office. Calling on governments and health officials to recognize the seriousness of the situation, she urged them: ‘Scale up your response now’…” (11/27).

Link to individual story

Chinese Researcher Defends Gene-Editing Embryos With Goal Of Making HIV-Resistant Infants; Unverified Claim Spurs Controversy Among Researchers

Associated Press: Chinese researcher claims first gene-edited babies
“A Chinese researcher claims that he helped make the world’s first genetically edited babies — twin girls born this month whose DNA he said he altered with a powerful new tool capable of rewriting the very blueprint of life. If true, it would be a profound leap of science and ethics…” (Marchione, 11/26).

New York Times: Chinese Scientist Claims to Use CRISPR to Make First Genetically Edited Babies
“…The researcher, He Jiankui, said that he had altered a gene in the embryos, before having them implanted in the mother’s womb, with the goal of making the babies resistant to infection with HIV. He has not published the research in any journal and did not share any evidence or data that definitively proved he had done it…” (Kolata et al., 11/26).

STAT: An outsider claimed to make genome-editing history — and the world snapped to attention
“…The claim, which has not been verified by outside researchers, was heralded by a few as a scientific milestone, an unprecedented step toward preventing all sorts of diseases. But others viewed it as quite the opposite: the reckless breaking of a scientific taboo for personal gain. After all, many far more experienced and respected researchers had the technical know-how to attempt what He did, but they honored the widely accepted ethical barriers. Such research is also illegal in the United States…” (Joseph et al., 11/26).

Washington Post: Chinese genomics scientist defends his gene-editing research in first public appearance
“He Jiankui, the Chinese researcher who claimed this week to have helped produce the world’s first genetically altered babies, said Wednesday there was another ‘potential pregnancy’ involved in his study as he defended a procedure that has shaken the scientific world. Appearing in public for the first time since revealing he had successfully altered the DNA of twin girls while they were embryos to [attempt to] make them resistant to HIV infection, the Stanford-trained bioengineering professor said he felt ‘proud’ of his work and its implications for public health in the face of nearly universal condemnation…” (Shih/Johnson, 11/28).

Additional coverage of this story is available from The Atlantic, Bloomberg, Forbes, The Guardian, HuffPost, New York Times, NPR (2), Reuters, STAT (2), Wall Street Journal, and Washington Post.

Link to individual story

Children In Middle East, North Africa At Risk As Temperatures Drop, UNICEF Warns, Citing Funding Shortfall

U.N. News: ‘Dire consequences’ for a million children in the Middle East, North Africa, as funding dwindles
“Amidst a $33 million funding shortfall, plunging temperatures in the Middle East and North Africa pose a major threat to children in the region, the U.N. Children’s Fund (UNICEF) said on Tuesday. With cold and rainy weather sweeping through, nearly one million children affected by crises across the region face the risk of life-threatening or debilitating illness…” (11/27).

Link to individual story

U.K. Government Pledges £35M In New Funding To Assist Afghanistan With Worsening Food Crisis

The Guardian: U.K. pledges £35m to Afghanistan as food crisis worsens
“The U.K. government has announced £35m of new funding to help the growing crisis in Afghanistan as a new report warns that almost half of the rural population — 10.6 million people — are likely to be affected by severe food insecurity. The report, by independent multi-agency body the IPC, highlighted the spread of conflict and the ongoing drought which has displaced over 250,000 people, impacting Afghan incomes and leading to widespread malnutrition among children…” (Austin, 11/27).

Thomson Reuters Foundation: Drought drives desperate Afghans to marry off children for money — U.N.
“Afghanistan’s worst drought in decades has driven tens of thousands of people from their homes and is pushing families to marry off their children in exchange for dowries in order to survive, the United Nations said on Tuesday. About 223,000 people have been uprooted from their homes in the drought-hit western provinces of Herat, Badghis, and Ghor this year, according to the U.N. children’s agency (UNICEF)…” (Ferrie, 11/27).

Link to individual story

Fractional Dosing Of Yellow Fever Vaccine Offers Immunity Up To 10 Years, Study Shows

CIDRAP: Study affirms fractional dosing with yellow fever vaccine
“According to a study … in the Annals of Internal Medicine, fractional dosing of the yellow fever vaccine offers recipients protective antibodies for up to 10 years without a booster dose. The results could inform the use of fractional dosing in preventive vaccination campaigns, and not just outbreak settings. … In related developments, the Nigeria Centre for Disease Control (NCDC) confirmed more cases in an ongoing outbreak in Edo state. … Nigeria is in the midst of the second phase of the largest yellow fever vaccination campaign ever, which aims to reach 26.2 million people to establish a high level of immunity in that country…” (Soucheray, 11/26).

Link to individual story

More News In Global Health

Devex: In Ethiopia, a multipronged approach to tackle avoidable blindness (Mednick, 11/28).

Devex: Women Deliver launches local Deliver for Good campaigns (Roby, 11/28).

The Guardian: Powdered polio vaccine brings hope to Nigeria and Pakistan (Davis, 11/27).

Homeland Preparedness News: Fewer companies support antibiotic drug research, development (Adrien, 11/27).

NPR: Why The Abortion Rate In Pakistan Is One Of The World’s Highest (Hadid, 11/28).

Reuters: UNICEF, WHO launch polio vaccination campaign in Yemen (Eltahir, 11/27).

Reuters: South Africa’s Aspen launches three-in-one HIV drug (Dludla, 11/27).

U.N. News: Better housing means better health and well-being, stress new WHO guidelines (11/27).

World Politics Review: Latin America’s ‘Double Burden’ of Malnutrition: Rising Obesity and Undernourishment (Radwin, 11/27).

Link to individual story

Editorials and Opinions

Increased Funding Critical To Scaling Up Treatment Through PEPFAR, Ending HIV/AIDS Epidemic

STAT: PEPFAR, launched as an emergency response to AIDS, has built a bridge to the future
Myron S. Cohen, architect and principal investigator of the HPTN 052 trial, professor at the University of North Carolina at Chapel Hill, and advisory board member for Merck and Gilead

“…Initiated as an emergency response to the global AIDS crisis, PEPFAR’s renewal every five years since 2003 has tracked the evolution of an unprecedented, multifaceted attack on a single disease. Along the way, it has provided a model of sustainable, evidence-based action against other preventable illnesses and deaths. … Through all of this, PEPFAR has maximized all possible efficiencies. It can no longer scale up treatment without cutting other key endeavors. The spread and toll of HIV remains a crisis and the need to confront it is urgent. … The House of Representatives approved the PEPFAR reauthorization on Nov. 13. I hope the Senate will swiftly follow suit. Earlier this year, the Senate proposed a $50 million increase for PEPFAR, while the House proposed an additional $41 million for USAID’s TB program. For this year’s reauthorization, increasing funding for the program will be critical. We know what to do: Diagnosing and treating everyone with HIV leads to normal life spans and stops the spread of the virus. On its own, that won’t be enough to end the threat of HIV. The quests for a vaccine and a cure continue. But the course is clear, and staying the course is imperative, with PEPFAR as a bridge to a world in which HIV no longer presents a public health threat to any population in any country” (11/28).

Link to individual story

U.K. Pledge Of £50 To End FGM In Africa Should Spur Other Governments To Act Worldwide

Devex: Opinion: U.K.’s commitment to end FGM is vital — but we must look beyond Africa
Julia Lalla-Maharajh, founder of the Orchid Project

“Last week, the United Kingdom government made a historic commitment aimed at ending female genital cutting across Africa by 2030. According to the government, the £50 million ($64 million) investment is the largest ever put toward the issue by an international donor. … Put simply, the U.K. government is doing what is right for women’s bodies; and we are one step closer to achieving a world free from female genital cutting. … What brings me great hope on first looking at this package of funding is that it seems to be truly holistic in nature. DFID recognizes female genital cutting as a social norm, held in place by a confluence of different actors and expectations. … Equally inspiring is the scale of this funding. … What we have yet to see is which countries will be eligible for funding, and what DFID’s commitment to supporting work at the grassroots actually means in practice. While this is fantastic news for the Africa-led movement to end female genital cutting, we are still missing large-scale recognition that the practice takes place outside Africa, in the Middle East, and Asia … I hope that this is the first major step by governments around the world to prioritize women’s and girls’ bodies, rights, sexuality, and health, so that all girls everywhere can live free from female genital cutting” (11/28).

Link to individual story

Building Trust Within Communities Vital To DRC's Ebola Response

HuffPost: The Most Important Tool For Doctors Fighting DRC’s Ebola Crisis Isn’t Medicine
Abraar Karan, global health physician at Brigham and Women’s Hospital and Harvard Medical School

“My experience as a public health practitioner has convinced me that a lack of trust has become a critical driver of modern epidemics. We are seeing this unfold right now in the Ebola epidemic raging in the Democratic Republic of the Congo… Epidemics require quick action, but we cannot cut corners when it comes to understanding a community’s knowledge, attitudes, and practices before employing interventions. … Some patients may be amenable to vaccination, some to treatment, some to testing, and some to none of these. Nonetheless, public health responders must use every opportunity to build rapport, establish trust, and prove to communities that they are there in the best interests of the community’s health. … We may not convince every single person to do everything we ask, but if we can convince a community to trust that we are there because we are concerned about them as people — not just as transmitters of disease — we will begin to see a very different response” (11/25).

Link to individual story

From the Global Health Policy Community

Oxfam Policy Adviser Discusses Opportunity For U.S. To Consolidate, Improve Foreign Assistance Data Dashboards

Modernizing Foreign Assistance Network: Transparency of the Future: A High-Quality, Highly Usable U.S. Foreign Aid Dashboard
Aria Grabowski, policy adviser for Accountable Development Finance at Oxfam America, discusses the importance of transparency and access to data, highlighting the opportunity to consolidate the U.S. government’s ForeignAssistance.gov and Foreign Aid Explorer dashboards. Grabowski writes, “A unified dashboard should have … real world use cases in mind as it is designed, and provide as much interconnected data as possible. It should also be created on a solid foundation so it can be easily updated and changed, adding new components both when it becomes feasible, but also as demands and needs are identified. Accounting for users and their needs will take U.S. data a step further in supporting aid effectiveness” (11/27).

Link to individual story

Journal Of Infectious Diseases Supplement Examines Advances Against Ebola, Marburg Viruses

IDSA’s “Science Speaks”: Ebola studies highlight long-delayed momentum in face of unprecedented obstacles
Antigone Barton, senior editor and writer at “Science Speaks,” highlights a Journal of Infectious Diseases special supplement marking 50 years since the discovery of the Marburg virus, and how advances against that virus, as well as Ebola, “have gathered force in the last half decade.” Barton notes the issue “includes coverage of advances in epidemiology, diagnosis, treatment, and prevention, including a look at how research toward effective treatment can, and must, continue even in the midst of responses” (11/27).

Link to individual story

CFR Publishes Summary Of Council of Councils Session Addressing NCDs, Global Health Challenges

Council on Foreign Relations’ “International Institutions and Global Governance Program”: Council of Councils Eleventh Regional Conference
This post provides a summary of sessions from the 11th regional conference of the Council of Councils (CoC) in South Korea, including a summary of a session focused on noncommunicable diseases and global health challenges (11/27).

Link to individual story

BMJ Global Health Article Examines Attacks On Ambulances In Syria

BMJ Global Health: Ambulances under siege in Syria
C. Hayes Wong, physician and assistant professor at the Department of Emergency Medicine at the Columbia University Medical Center, and Christine Yen-Ting Chen, physician at the Department of Emergency Medicine at Mount Sinai St. Luke’s and Mount Sinai West Hospitals, present “the summary of a literature review on attacks against ambulances in Syria from 2011 to 2018, as well as a descriptive secondary data analysis on individual attacks reported by the Syrian Network for Human Rights from January 2016 to December 2017.” The authors conclude, “Ambulances have been intentionally and repeatedly targeted throughout the Syrian conflict as part of a war strategy. Real challenges in monitoring and systematically tracking attacks on ambulances exist, but as a result, they are understudied and likely under-reported” (November 2018).

Link to individual story

From the U.S. Government

U.S. Secretary Of State Announces PEPFAR's Latest Results

U.S. Department of State’s “DipNote”: Secretary Pompeo Announces Latest Lifesaving PEPFAR Results
This post highlights U.S. Secretary of State Michael Pompeo’s remarks at the PEPFAR Faith Communities and HIV Technical Summit, during which Pompeo announced PEPFAR’s latest results (11/27).

Link to individual story

New Issue Of NIH Fogarty International Center's 'Global Health Matters' Newsletter Available Online

NIH Fogarty International Center: Global Health Matters
The most recent issue of the Fogarty International Center’s newsletter contains various articles addressing global health topics, including an article on Congress’s approval of an increase for the Fogarty Center’s FY2019 budget and multiple articles discussing NIH research focused on the global suicide burden (November/December 2018).

Link to individual story