KFF Daily Global Health Policy Report

In The News

Bipartisan Group Of Senators Requests State Department Review Of Mexico City Policy Impact

ELLE: Sen. Shaheen Leads Bipartisan Letter to the State Department, Seeking to Measure the Harm of Trump’s “Global Gag Rule”
“…Sens. Jeanne Shaheen (D-N.H.), Patty Murray (D-Wash.), Richard Blumenthal (D-Conn.), and Lisa Murkowski (R-Alaska) have written to the State Department, urging officials examine the impact of the [Mexico City policy, or global gag rule (GGR)]. ‘We ask that you commit to comprehensive public review of the GGR policy, and in these reviews, include assessments of any harm caused by this policy to women and girls in countries that receive U.S. global health assistance,’ the bipartisan coalition of senators write…” (Kahn, 11/28).

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U.S. Secretary Of State Tillerson Addresses State Department Restructuring, Says 'No Hollowing Out' Of Agency

POLITICO: Tillerson fends off ‘redesign’ critics
“Secretary of State Rex Tillerson on Tuesday dismissed mounting criticism of his plan to restructure the State Department, insisting ‘there is no hollowing out’ of the agency but that it can be run more efficiently and with less funding. Addressing questions after a speech on U.S.-European relations in Washington, Tillerson shed some new light on his largely veiled plans to reshape the department. He also said many of the reports about a loss of diplomatic personnel and sunken interest in the Foreign Service were exaggerated or incorrect…” (Toosi, 11/28).

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Trump Administration, Populist Movements Threaten Global Health Funding, Efforts Worldwide, Laurie Garrett Says

Deseret News: Trump endangers funds that prevent pandemics, Pulitzer winner and ‘Contagion’ consultant says at BYU
“President Trump and other populist world leaders are dismantling funding that protects the world from future epidemics as they put national interests ahead of global health, a Pulitzer Prize-winning expert said Tuesday at Brigham Young University. Isolationist movements are challenging globalization and defunding global development programs, threatening to undermine massive gains made over the past 17 years in life expectancy, child mortality, and the eradication of deadly diseases, said Laurie Garrett, an global health and infectious diseases expert who served as a technical adviser for the film ‘Contagion’ and spent 13 years as a senior fellow at the Council on Foreign Relations…” (Walch, 11/28).

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Positive Trend Toward Malaria Elimination Could Reverse Without More Funding, Prevention Efforts, WHO Report Warns

Devex: Fight against malaria stalling and could reverse, warns 2017 World Malaria Report
“Between 2015 and 2016, there were five million more malaria cases globally, and Rwanda saw the greatest increase in malaria cases, with nearly a million people contracting the mosquito-borne disease, according to the World Malaria Report, released on Wednesday. The report also warned progress in fighting the virus has stalled and could reverse…” (Cheney, 11/29).

The Guardian: Malaria is back on the rise as lack of funds stalls push to wipe out disease
“…The WHO director general, Tedros Adhanom Ghebreyesus, warned of a ‘troubling shift’ in the downward trajectory of malaria, one of the biggest killers in poorer countries, and until recently, one of the greatest public health success stories. There is a real chance malaria could be eliminated, this year’s World Malaria Report suggests, but only if funding increases…” (McVeigh, 11/29).

Los Angeles Times: The world is off track in its goal to eliminate malaria. Here’s why.
“…Reasons for the slowdown differed across specific regions and countries, health officials said. But contributing factors included insufficient funding, a lack of interventions to prevent spread of the disease, risks posed by conflict in malaria endemic zones, irregular climate patterns, and the emergence of parasite resistance, the report said…” (Simmons, 11/28).

Nature: Rise in malaria cases sparks fears of a resurgence
“… ‘For the first time, we can confidently say that we have stopped making progress,’ says Pedro Alonso, the director of the Global Malaria Programme at the WHO in Geneva, Switzerland. Alonso worries that governments and donors have become complacent about malaria, given that deaths from the disease fell by an estimated 62 percent between 2000 and 2015. ‘We know what happens when we stop applying pressure,’ Alonso says. ‘Malaria comes back with a vengeance’…” (Maxmen, 11/29).

Reuters: WHO fears complacency as progress against malaria stalls
“…Malaria infected around 216 million people in 91 countries in 2016, an increase of 5 million cases over the previous year, the WHO said in its annual World Malaria Report. It killed 445,000 people, about the same number as in 2015. The vast majority of deaths were in children under the age of five in the poorest parts of sub-Saharan Africa…” (Kelland, 11/28).

VOA News: WHO: Global Progress Against Malaria at Risk as Funding Stalls
“…In addition to improving the coverage of existing methods of malaria prevention, the WHO calls for urgent investment in new tools. ‘More research is needed to develop an effective malaria vaccine that could cover the populations that, at the moment, have high malaria rates and that, perhaps, do not use the available interventions even when they are being funded,’ [David Conway, a professor from the London School of Hygiene and Tropical Medicine,] said…” (Ridgwell, 11/29).

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Approximately 10.5% Of Drugs Fake, Substandard In Low-, Middle-Income Countries; Counterfeits Potentially Contribute To Tens Of Thousands Of Deaths, WHO Reports Say

Associated Press: U.N.: About 11 percent of drugs in poor countries are fake
“About 11 percent of medicines in developing countries are counterfeit and likely responsible for the deaths of tens of thousands of children from diseases like malaria and pneumonia every year, the World Health Organization said Tuesday…” (Cheng, 11/28).

FOX Business: 10% of drugs are bogus in developing countries, Americans at risk too
“…Since 2013, WHO said it has received 1,500 reports of bogus drug cases, with antimalarials and antibiotics being the most commonly reported. However, the problem extends to everything from cancer drugs to contraceptive pills…” (Scipioni, 11/28).

Reuters: Tens of thousands dying from $30 billion fake drugs trade, WHO says
“…The scale of the problem is hard to quantify precisely, but a WHO pooled analysis of 100 studies from 2007 to 2016, covering more than 48,000 samples, showed 10.5 percent of drugs in low- and middle-income countries to be fake or substandard. With pharmaceutical sales in such countries running at nearly $300 billion a year, this implies that trade in fake medicines is a $30 billion business…” (Hirschler, 11/28).

VICE News: These are the deadly consequences of fake drugs around the world
“…Such drugs have real consequences. Up to 158,000 people may die annually from fake malaria medication in sub-Saharan Africa, a separate WHO review discovered Tuesday. More than 40 percent of the reports to the World Health Organization about fake drugs came from areas where the agency works in Africa. Another 21 percent came from Europe; 21 percent of the reports also originated in the Americas…” (Sherman, 11/28).

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RESULTS Report Warns Of Potential Gaps Left By Ending Of Global Polio Eradication Initiative

Devex: The Global Polio Eradication Initiative is winding down. What are the risks?
“As global polio programs enter the final stages of eradication activities, with certification expected in the next three years, the Global Polio Eradication Initiative, or GPEI, is beginning the process of winding down its activities and will eventually cease to exist. But a new report from RESULTS is warning about the gap this will leave — and they are urging donors and health organizations to begin planning now for how the current funds can be transferred to target other diseases and global immunization programs…” (Cornish, 11/29).

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Lack Of Access To Food Driving Global Hunger, FAO Head Says

U.N. News Centre: Ensuring family farmers’ access to food key to tackling global hunger — U.N. agency
“Family farmers need more support and access to food, the head of the United Nations agriculture agency has said, urging lawmakers to consider legislation that improves productivity and boosts social protections to tackle the global hunger challenge which, he warned, is at an ‘inflection point.’ ‘The main cause of hunger nowadays is not the lack of food, but the lack of access to it,’ José Graziano da Silva, the director general of the U.N. Food and Agriculture Organization (FAO), said in his speech to the All-Party Parliamentary Group on Agriculture and Food for Development in London on Monday…” (11/28).

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Gains Made In Improving Access To Safe Abortion In Humanitarian Crises, But Challenges Remain, Advocates Say

Devex: Advocates make progress on access to safe abortion in humanitarian crises
“Advocates campaigning for refugees to have access to safe abortion in humanitarian settings say they have made major progress at a recent high-level meeting — but they added that ‘political sensitivities’ among countries and some United Nations agencies are holding back efforts to get the full spectrum of sexual and reproductive health services to those who need them…” (Edwards, 11/29).

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Security Breach Of Software Platform Could Expose Aid Organizations' Data On Recipients

IRIN: Security lapses at aid agency leave beneficiary data at risk
“Aid agencies have put some projects on hold while reviewing the security of a popular online system for handling aid distributions, IRIN has learnt. Sensitive personal and financial data on tens of thousands of people in humanitarian aid projects is at risk from hackers, according to a damning security analysis by a financial technology startup. … The incident is a real-world reminder of the possibility of personal details of aid beneficiaries falling into the wrong hands and the potential for fraud, as aid agencies increasingly turn to voucher systems and digital cash transfers as more efficient forms of assistance…” (Parker, 11/27).

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More News In Global Health

Al Jazeera: Diphtheria in Yemen: More than 100 infected, 14 deaths (Smith, 11/23).

Associated Press: Rising HIV infections see Iran challenge notions about sex (Fattahi/Vahdat, 11/29).

Healio: Diabetes, high BMI cause nearly 6% of cancers worldwide (Schaffer, 11/28).
HealthDay News: 6% of Cancers Caused by Excess Weight, Diabetes (Preidt, 11/28).

NPR: Why A Brazilian State Went From 0 Cases Of Dengue To 35,000 A Year (Beaubien, 11/28).

Reuters: WHO fears deadly diphtheria outbreak among Rohingya refugees (Miles, 11/28).

Xinhua News: Outbreak risks remain in summer though Zika cases down 92 pct in Brazil (11/28).

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Editorials and Opinions

Continued U.S. Leadership On HIV/AIDS, Investment In Global Fund Important, U.S. Should Not Bear Responsibility Alone

The Hill: U.S. can’t be the only one to shoulder the financial responsibility of AIDS
Mark Dybul, professor at Georgetown University School of Medicine, board member at Friends of the Global Fight Against AIDS, Tuberculosis and Malaria, and former executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria

“…The U.S. government is the largest contributor to the Global Fund, but with a caveat. For every dollar provided, other countries must donate two. … The U.S. government effectively leverages contributions to the Global Fund from other countries to ensure the response to the top infectious disease killers is global and does not rest entirely on the backs of U.S. taxpayers. … As budgets tighten, there is temptation to slip back to the false dichotomy and tension between bilateral and multilateral investments in HIV — and global health and development more generally. For 15 years, bipartisan administrations and Congresses have rightly resisted that temptation across party lines. The data are clear. The U.S. government cannot and should not shoulder the global financial or programmatic responsibility alone. By maintaining leadership through both PEPFAR and the Global Fund, Americans reap a remarkable return on investment in the moral authority of the U.S. increased resources from the rest of the world, and many millions of lives saved. That is a legacy to celebrate, and to pledge to continue on World AIDS Day” (11/29).

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U.S. Should Prioritize Addressing Violence Against Women, Girls In Foreign, International Security Policy

Foreign Affairs: Violence Against Women and International Security
Michelle Sieff, gender, conflict, political economy consultant

“…What … can be done to ensure that domestic violence against women and girls is prioritized in U.S. foreign policy and international security policy more generally? First, the Trump administration can build on its passage of the Women, Peace, and Security Act and strengthen the institutions within the U.S. government that are spearheading global efforts to prevent domestic violence. … In addition, the Trump administration should ramp up funding to prevent domestic violence against women and girls globally. … Finally, women’s rights activists can themselves do more to ensure that domestic violence is prioritized by implementers of the women, peace, and security agenda, as well as in international security conversations more generally. … The theme of this year’s activities [for the 16 Days of Activism Against Gender-Based Violence campaign], ‘Leave No One Behind: End Violence Against Women and Girls,’ reinforces the international community’s commitment to reaching the most marginalized women and girls. It is an ambitious agenda, and one that will be achieved only if violence in the home is treated with the seriousness that its prevalence demands” (11/28).

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Increased Private Sector Involvement In International Development Could Fragment U.S. Influence, Threaten Sustainability, Weaken Accountability

American Interest: Arrested Development
Alexander Wooley, director of partnerships and communications, and Jacob Sims, senior program manager in the Policy Analysis Unit, both with AidData

“…A balanced public-private sector approach toward international development offers an opportunity for immense good. … However, optimism for unbridled private sector-led international development should be cautious at best. We identify below three key likely consequences of its expansion. Fragmented Influence … Threatened Sustainability … Weakened Accountability … The sun may indeed be setting on U.S. governmental leadership of the international order. If the retreat becomes extreme enough, the growing influence of ‘free market’ development initiatives could open the door to an increasing array of less benevolent private sector actors with their own agendas. … Even if the worst-case scenarios never occur, unrestrained private sector influence in international development could undermine a global agenda that includes economic growth, social empowerment, [and] environmental protection. … Corporate and philanthropic aid groups will continue to pursue their missions as the size of their endowments or budgets permit, regardless of the scale of U.S. foreign assistance, presidential tweets, or congressional pushback. The question remains one of strategy. Does the U.S. government want to continue projecting its influence and core values overseas? If the answer is yes, it must continue to invest globally” (11/28).

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More Focused Prevention Measures, Improved Access To Treatment Critical To Curb Growing HIV Epidemic In Russian Federation

PLOS Medicine: The expanding epidemic of HIV-1 in the Russian Federation
Chris Beyrer, professor at the Center for Public Health and Human Rights in the Department of Epidemiology at Johns Hopkins Bloomberg School of Public Health, and colleagues

“…The continuous growth of the Russian HIV epidemic is a failure of public policy and practice. The current list of interventions with demonstrable efficacy in reducing HIV spread and improving treatment outcomes includes opioid agonist substitution therapy, needle and syringe exchanges, treatment as prevention, preexposure prophylaxis, and tailored interventions for key populations including [people who inject drugs (PWID)], [men who have sex with men (MSM)], sex workers, prisoners, and migrants. In the [Russian Federation (RF)], all of these interventions are either not available or are unavailable at the scale necessary to control HIV. This is a true public health crisis and one that could largely have been avoided. Unless evidence-based prevention measures aimed at the most at-risk population groups are brought to scale in the RF, and unless access to treatment is significantly increased for all HIV-infected people, the likelihood of greater HIV incidence, and consequently greater AIDS morbidity and mortality, will only increase” (11/28).

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From the Global Health Policy Community

UNDP Launches New Blueprint For Development In 21st Century

UNDP: A new plan for a new era: U.N. development agency charts course for development in 21st century
“The U.N.’s development agency, the United Nations Development Programme, [Tuesday] launched a new and ambitious blueprint for development in the 21st century at the United Nations headquarters in New York. … The plan identifies six ‘signature solutions’ against which UNDP will now align its resource and expertise, to make a real impact on poverty, governance, energy access, gender equality, resilience, and environmental sustainability…” (11/28).

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Blog Post Explores Global Fund's Efforts To Control Malaria, Address Drug Resistance Globally

Friends of the Global Fight: How the Global Fund Is Responding to Resistance Threats in Malaria Control
In this blog post, the second in a series of posts exploring the threat that drug resistance poses in addressing the HIV/AIDS, TB, and malaria, Anna Carroll, intern, and Mark P. Lagon, chief policy officer, both with Friends of the Global Fight, discuss efforts to control malaria and address drug resistance. The authors write, “The Global Fund’s goal to eliminate malaria from the Greater Mekong subregion is the sort of bold action that is needed to counter the tremendous threat posed by drug resistance. Without this ambitious programming, insecticide- and drug-resistant strains will continue to spread, jeopardizing the significant progress that has been made in the fight against malaria. Continued U.S. leadership can act as a catalyst for more funding commitments to the Global Fund, which can help stop the spread of disease and save millions of people at risk of malaria worldwide” (11/29).

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MSF Calls On Gavi To Prioritize Children's Health In Its Funding Model

Médecins Sans Frontières: MSF Press Statement: 20 countries about to fall off Gavi funding ‘cliff,’ risking their ability to pay for lifesaving vaccines for children long term
“As the board of directors of Gavi, the Vaccine Alliance, meets this week in Vientiane, Laos, the international medical humanitarian organization Médecins Sans Frontières (MSF) is calling on Gavi to ensure sustainable access to lifesaving vaccines by putting children’s health at the center of its funding model. Among other topics, the board will discuss how to deal with countries that are in the process of losing Gavi support…” (11/28).

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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 326 of the “Global Fund Observer.” The newsletter includes articles on various topics, including one on the Board’s approval of a second batch of grants for 2017-2019 and another on “minor delays” in implementing the third objective of the Global Fund Strategy 2017-2022 — to promote and protect human rights and gender equality (11/29).

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From the U.S. Government

USAID Blog Post Profiles Ghanaian Chef's Efforts To Address Hunger, Food Waste

USAID’s “IMPACTblog”: Ghanaian Chef Works to End Hunger by Reducing Food Waste
Fridah Wanjiku, digital communications specialist and virtual student foreign service intern with USAID, profiles Elijah Amoo Addo, a chef in Ghana who launched Food for All Africa, the first community food bank in Ghana. Wanjiku writes, “The center creates efficient and sustainable nutrition streams for low-income and vulnerable communities by redistributing surplus food from restaurants [and] working with rural smallholder farmers to connect their produce to urban hospitality companies. … Today, Food for All Africa recovers up to $5,700 worth of food each month from businesses within the food supply chain — including manufacturers, importers, farmers, and hotels…” (11/28).

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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 issues, including an article on Fogarty’s Global Infectious Disease (GID) research training program and an opinion piece by Fogarty Director Roger I. Glass (November/December 2017).

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From KFF

Kaiser Family Foundation Examines Public Health Impacts Of Hurricane Maria On Puerto Rico

Kaiser Family Foundation: Public Health in Puerto Rico after Hurricane Maria
The public health impacts of Hurricane Maria on Puerto Rico “have been compounded by pre-existing fiscal, societal, and health challenges. Drawing on federal and Puerto Rican government statistics and official statements, along with media reports, this issue brief provides a snapshot of key public health challenges in Puerto Rico after Hurricane Maria” (11/17).

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Kaiser Family Foundation, Funders Concerned About AIDS To Host Web Briefing On Future Of HIV Funding

Kaiser Family Foundation: Web Briefing: What is the Future of HIV Funding?
On Friday, December 8 at 12:30 p.m. ET, the Kaiser Family Foundation (KFF) and Funders Concerned About AIDS (FCAA) will host a web briefing to look at the latest data on funding for HIV, trends over time, and what we might expect going forward. The briefing will include time for audience Q&A (11/28).

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