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Kaiser Daily Global Health Policy Report

In The News

Climate Change Already Creating Health Risks Worldwide, Lancet Report Says

CNN: Climate change is already here, and heat waves are having the biggest effect, report says
“Climate change is here and affecting our health, with extreme heat in particular also having effects on productivity, food supply, and disease transmission, a new global report finds. More people than ever are vulnerable to heat exposure globally, and numbers are rising, according to The Lancet Countdown on Health and Climate Change report by an international group of researchers, published Wednesday…” (Avramova, 11/28).

New York Times: Study Warns of Cascading Health Risks From the Changing Climate
“…The report, published Wednesday in the public health journal The Lancet, incorporates the work of [27 global institutions, including United Nations agencies,] and follows a major climate assessment issued last week by the United States government. The two studies represent the most serious warnings to date that climate change is posing a series of interconnected health risks for the global population…” (Sengupta/Pierre-Louis, 11/28).

Additional coverage of The Lancet report is available from The GuardianReuters, and Thomson Reuters Foundation.

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3 New Reports On Nutrition Call For Increased Efforts To Reach Zero Hunger, Address Climate Change, Fix Global Food System

Associated Press: U.N.: Climate change, depleted resources leave world hungry
“Feeding a hungry planet is growing increasingly difficult as climate change and depletion of land and other resources undermine food systems, the U.N. Food and Agricultural Organization said Wednesday as it renewed appeals for better policies and technologies to reach ‘zero hunger.’ Population growth requires supplies of more nutritious food at affordable prices, but increasing farm output is hard given the ‘fragility of the natural resource base’ since humans have outstripped Earth’s carrying capacity in terms of land, water, and climate change, the report said. About 820 million people are malnourished. The FAO and International Food Policy Research Institute released the report at the outset of a global conference aimed at speeding up efforts to achieve zero hunger around the world…” (Kurtenbach, 11/28).

The Guardian: Global food system is broken, say world’s science academies
“The global food system is broken, leaving billions of people either underfed or overweight and driving the planet towards climate catastrophe, according to 130 national academies of science and medicine across the world. Providing a healthy, affordable, and environmentally friendly diet for all people will require a radical transformation of the system, says the report by the InterAcademy Partnership (IAP). This will depend on better farming methods, wealthy nations consuming less meat, and countries valuing food which is nutritious rather than cheap…” (Carrington, 11/28).

Thomson Reuters Foundation: ‘What we’re eating is killing us’: global nutrition report
“Poor diets are among the top causes of ill health globally, accounting for nearly one in five deaths, according to a study published on Thursday that called on governments and businesses to do more to improve eating habits. Eating unhealthy food, or not having enough food — including children unable to breastfeed — contribute to widespread malnutrition, said researchers behind the latest Global Nutrition Report. The report is an independently produced annual analysis of the state of the world’s nutrition…” (Win, 11/29).

Additional coverage of the reports is available from Al Jazeera, Axios, Devex, and U.S. News & World Report.

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Surge In Malaria Cases In DRC's Ebola Outbreak Zone Prompts Widespread Treatment Effort; Experts Call For Outbreak To Be Declared International Emergency

CIDRAP News: Malaria spike in Ebola zone prompts mass treatment efforts
“A surge in malaria infections — with symptoms that can mimic Ebola — in the Democratic Republic of the Congo’s (DRC’s) main Ebola hot spot prompted the launch [Wednesday] of a four-day mass malaria drug administration campaign, the World Health Organization (WHO) announced. Meanwhile, the DRC’s health ministry [Wednesday] reported one more illness, raising the overall total to 422 cases…” (Schnirring, 11/28).

MedPage Today: Experts: Declare Ebola in Congo an International Health Emergency
“The World Health Organization (WHO) should declare a public health emergency of international concern (PHEIC) for the current Ebola outbreak in the Democratic Republic of the Congo (DRC), and CDC experts should be allowed by the U.S. to return to the area, two public health experts argued…” (Walker, 11/28).

Additional coverage of the Ebola outbreak and response is available from Agence France-Presse, HuffPost, and Reuters (2).

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PEPFAR Concludes Program For Children Orphaned, Affected By AIDS In Nigeria, Updates Funding To Programming In Namibia

The Guardian Nigeria: USAID ends $45.3 program for kids orphaned by AIDS
“The United States Agency for International Development, (USAID) has concluded a five-year activity that provided support for 500,000 children orphaned or made vulnerable by the AIDS epidemic, and 125,000 of their caregivers. At a ceremony yesterday in Abuja, USAID disclosed that since 2013, the $45.3 million Sustainable Mechanisms for Improving Livelihoods (SMILE) activity, funded by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), scaled up support services for orphans and vulnerable children…” (Akeregha, 11/29).

Namibia Economist: USAID Provides Additional N$395 Million to Fight HIV/AIDS
“The Agency for International Development (USAID), and the government this week signed an amendment to their 2007 bilateral grant agreement to add N$395 million of funding under the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). … According to a statement, these resources will fund activities under the 2018 PEPFAR Country Operational Plan; October 2018 to September 2019…” (Matthys, 11/29).

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NIH To Test Effectiveness Of Experimental Male Contraceptive Topical Gel

ABC News: This male birth control comes as a topical gel and will be tested in a clinical trial
“The National Institutes of Health recently funded a study to see if a topical gel for men could prevent pregnancy, potentially giving couples who don’t want children a new contraceptive option…” (Strauss, 11/28).

Bloomberg: A Male Birth Control Gel Is Getting Closer to Reality
“…The study is being conducted by the National Institutes of Health and will involve 420 couples. The experimental treatment is a gel, applied to the back and shoulders, that combines two types of hormones to halt the production of sperm while maintaining the energy and libido benefits of testosterone…” (Cortez, 11/28).

NBC News: Birth control for men: researchers test a male contraceptive gel
“…The gel formulation, called NES/T, includes a progestin-containing compound called segesterone acetate, which is made under the brand name Nestorone, along with a dose of testosterone…” (Fox, 11/28).

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DFID Permanent Secretary To Defend Department's Goal Of Spending At Least 75% Of U.K. ODA

Devex: DFID will defend its budget, top U.K. civil servant tells MPs
“…DFID Permanent Secretary Matthew Rycroft told members of the International Development Committee on Wednesday that he was keen to ensure his department spends at least 75 percent of the U.K.’s official development assistance and that he will make a ‘confident proposition’ on this to Treasury officials as part of the DFID spending review due to kick off next year…” (Edwards, 11/29).

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Summit Denounces Gene Editing Claim, Calls For 'Translational Pathway' To Human Trials

NPR: Science Summit Denounces Gene-Edited Babies Claim, But Rejects Moratorium
“A Chinese scientist’s claims that he created the world’s first gene-edited babies is a ‘deeply disturbing’ and ‘irresponsible’ violation of international scientific norms, according to a formal conclusion issued Thursday by organizers of the Second International Summit on Human Genome Editing in Hong Kong. The summit was jolted by scientist He Jiankui’s surprise and unverified claims earlier this week that he had edited the genes of twin girls who were born last month…” (Stein, 11/29).

Science: Organizers of gene editing meeting blast Chinese study but call for a “pathway” to human trials
“…[The conference statement] did not call for a global moratorium on similar studies, as some scientists had hoped; instead it called for a ‘translational pathway’ that might eventually bring the ethically fraught technology to patients in a responsible way. … The first summit, held in Washington, D.C. in December 2015, concluded with a statement that specifically said that unless and until safety, efficacy, and ethical and regulatory issues are resolved, ‘it would be irresponsible to proceed with any clinical use of germline editing,’ a reference to genetic modifications that can be passed on to the next generation. But that is exactly what Chinese researcher He Jiankui did…” (Normile, 11/29).

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Niger Health Ministry Orders Closure Of Marie Stopes International Clinics Claiming They Performed Abortions

Reuters: Niger closes U.K. charity’s health centers, says they performed abortions
“Niger’s health ministry has ordered two family planning centers run by British charity Marie Stopes International (MSI) to close because it performed abortions, the ministry said on Wednesday. Abortion is banned under Nigerien law except in cases when the pregnancy endangers the mother’s life…” (11/28).

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More News In Global Health

Associated Press: HIV cases in children dropping but still too slowly, U.N. says (11/29).

Bloomberg Quint: Google’s Parent Has a Plan to Eliminate Mosquitoes Worldwide (Brown, 11/28).

Devex: A strained welcome awaits Venezuelans in Colombia (Daniels, 11/29).

Devex: Innovation at WFP: A safe space combined with scale (Cheney, 11/29).

Fox News: One-third of migrants in caravan are being treated for health issues, Tijuana health official says (Mikelionis et al., 11/29).

Homeland Preparedness News: USC researchers create polio vaccine that no longer needs refrigeration (Galford, 11/28).

SciDev.Net: Q&A: Privacy ‘not keeping pace’ with digital health (Makri, 11/28).

Thomson Reuters Foundation: Russia risks HIV epidemic as cases rise — experts (Savage, 11/28).

Thomson Reuters Foundation: Ambulances ‘repeatedly targeted’ in Syria conflict: study (Elks, 11/27).

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Editorials and Opinions

G20 Offers Opportunity For Trump Administration To Take Leadership Role In Advancing Women's Economic Empowerment

The Hill: G20 gives Trump opportunity to champion women’s empowerment
Lyric Thompson, director of policy and advocacy at the International Center for Research on Women (ICRW) and adjunct professor at George Washington University

“…[The G20 is] an opportunity for the Trump administration, which champions women’s economic empowerment and is rumored to be developing a global initiative on the issue. … [U]nveiling Ivanka Trump’s promised initiative on women’s economic empowerment [at the G20] would be a logical place to begin the United States’s badly needed return to multilateralism and global economic cooperation. … [M]any of the barriers that prevent women from advancing economically are the very issues [the Trump administration] has targeted for attack, such as recent efforts to deny asylum for survivors of domestic violence, one of the leading issues suppressing women’s economic participation, or efforts to reduce lifesaving access to family planning and reproductive health care, which are perhaps the most critical components enabling women’s economic participation. Together with other advocates, I’m calling for meaningful investment in women’s economic empowerment, which is a smart investment for America, but only if done right. That means unlocking the full potential of women as active citizens in their families, economies, and societies, by leveraging the power of U.S. leadership across aid, trade, and diplomatic engagement…” (11/27).

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U.S., International Community Should Ramp Up Political Attention, Financial Commitments To End DRC Ebola Outbreak

JAMA: Ebola and War in the Democratic Republic of Congo: Avoiding Failure and Thinking Ahead
Lawrence O. Gostin and Matthew M. Kavanagh of the O’Neill Institute for National and Global Health Law at Georgetown University Law Center, and Elizabeth Cameron of the Nuclear Threat Initiative

“…Uncontrolled Ebola outbreaks can expand quickly, as occurred in West Africa in 2014. Averting that outcome in the DRC requires rapid action including a strengthened public health response, security, and community outreach. If violence escalates, it could compromise a fragile response. Yet resources are insufficient. The United States and other countries are not permitting personnel deployment to the epicenter, including from the Centers for Disease Control and Prevention (CDC) and U.S. Agency for International Development (USAID). … The United States and international community should launch high-level political mobilization, with diplomatic, human, and economic resources. It is critical to recognize that future health crises will occur in fragile, insecure settings. To prepare, the international community needs long-term planning and enhanced capacities to improve the safety and effectiveness of epidemic response operations…” (11/29).

New England Journal of Medicine: Ramping Up the Response to Ebola
Jennifer B. Nuzzo and Thomas V. Inglesby of the Center for Health Security and the Department of Environmental Health and Engineering at the Johns Hopkins Bloomberg School of Public Health

“…The WHO recently convened an emergency committee to determine whether the outbreak should be declared a Public Health Emergency of International Concern (PHEIC) — a designation applied to only four past outbreaks. The committee decided that the outbreak did not yet constitute a PHEIC but said that it ‘remains deeply concerned by the outbreak and emphasized that the response activities need to be intensified’ and that otherwise the situation is likely to ‘deteriorate significantly.’ Given the rapidly growing case numbers, limited ability in the field to conduct contact investigations, and high potential for cross-border spread, we believe that declaration of a PHEIC seems warranted now. It would increase both political attention and the financial resources flowing to the control effort. But leaders need not wait for such a declaration before they deepen their commitments: in recognizing the urgency of the concern expressed by the emergency committee, they can act now. … We … believe that the U.S. government should allow CDC staff to return to the field for as long as the WHO and others deem necessary. … If we do not act now, the outbreak may become far harder and more expensive to stop…” (11/28).

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Washington Post Editorial Highlights Ethical Challenges, Promise Of Gene Editing

Washington Post: A stunning claim in China highlights the perils and promise of gene editing
Editorial Board

“The claim on Monday by a Chinese scientist that he successfully edited the genetic makeup of a human embryo followed by live births is a moment for serious worry. Rapid advances in gene editing have been pointing toward this for a few years. If confirmed, the research must trigger a fresh reexamination of the procedures for research that could alter the basic blueprint of humankind. Vigilance, transparency, and oversight are vital bulwarks against dangerous research, and this experiment appears to have skirted them all. … The extraordinary promise of CRISPR is that genetic material can be modified to prevent or eliminate disease. But if the changes become heritable, they could have serious and unpredictable consequences through future generations. … In the end, this wonderful new technology must be supervised, regulated, and carried out for the good of humanity, without mistakes, malicious intent, or runaway experiments” (11/28).

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Opinion Piece Discusses China's One-Child Policy, Implications Of Gene-Editing Technology

New York Times: Before the Claims of Crispr Babies, There Was China’s One-Child Policy
Mei Fong, author

“…[W]hen it comes to gene editing and designer babies, [China] has an extra advantage: a population that has been conditioned to manipulating reproduction as a tool for progress. I’m referring, of course, to the three decades of family-planning rules known as the one-child policy. … China’s unprecedented reproductive experiment, officially ended in 2015 although many restrictions continue, has created a people accustomed — in many cases, forcibly so — to controlling the number and gender of their offspring. The one-child policy was established ostensibly to curb population growth, but China’s leaders were not shy about exhorting the country’s people to reduce quantity to improve quality, shading the policy with eugenic undertones. … From all this to ‘designer babies’ is not so great a leap. An openness to gene editing’s worst excesses may prove to be the one-child policy’s most unfortunate legacy…” (11/28).

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From the Global Health Policy Community

FCAA Releases New Report On Philanthropic Support For HIV/AIDS

Funders Concerned About AIDS: Philanthropic Support to Address HIV/AIDS
Funders Concerned About AIDS (FCAA) released its 16th annual Philanthropic Support to Address HIV/AIDS report, which found that HIV/AIDS philanthropic disbursements decreased by five percent, or $37 million, in 2017 (11/29).

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WHO Recognizes 30th Anniversary Of World AIDS Day

WHO: Why the HIV epidemic is not over
This post marks the 30th anniversary of World AIDS Day, which takes place annually on December 1, and provides a summary of global efforts to control HIV/AIDS, as well as resources on HIV/AIDS (November 2018).

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Health Security Journal Supplement Highlights Lessons On Implementing Activities To Enhance Global Health Security

Johns Hopkins Bloomberg School of Public Health Center for Health Security: CDC and Partners Build Foundation of Evidence Base for Global Health Security Implementation in Special Supplement of Health Security
Nick Alexopulos, director of communications at the Johns Hopkins Center for Health Security, highlights a special supplement to the journal Health Security. Alexopulos notes, “In the articles, CDC and global health security partners describe outcomes and lessons learned from multiple countries throughout Africa, Asia, and Latin America that are implementing activities to enhance public health capacities in disease prevention, detection, and response” (11/27).

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Experts From Queen's University Belfast Discuss Role Of U.N. Special Procedures In Advancing Global Health

Georgetown’s O’Neill Institute for National & Global Health Law: What’s “Special” About the System of United Nations Special Procedures?
Thérèse Murphy, professor of law and director of the Health & Human Rights Unit at Queen’s University Belfast, and Amrei Müller, Leverhulme early career fellow within the Health & Human Rights Unit, discuss the role of the U.N. Special Procedures — “a system of independent experts appointed to monitor and report on human rights violations, and more generally to advise and assist in promoting and protecting rights” — and highlight five features that make them “special.” The authors write, “A wide range of Special Procedures hold mandates in the health field, requiring a new way of thinking about human rights law. … If more of us were willing to study the Special Procedures, … we would have a better chance of harnessing the potential of human rights law for meeting global health’s grand challenges” (11/27).

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Aspen New Voices Fellows Discuss National Climate Assessment, Call For Action On Climate Change

PLOS Blogs’s “Public Health Perspectives”: Guest Post: How climate action can save global health
Junaid Nabi, research associate in surgery at Harvard Medical School; Thilmeeza Hussain, former deputy ambassador of the Maldives to the U.N.; Abhilasha Karkey, medical microbiologist at the Oxford University Clinical Research Unit in Kathmandu, Nepal, and all 2018 New Voices fellows at the Aspen Institute, discuss findings from the fourth National Climate Assessment, writing, “Climate change, together with health inequality and infectious diseases, is a major challenge in public health in [South Asia] and around the globe. It is likely to influence mortality and morbidity due to mosquito- and animal-borne diseases, water-borne diseases, flooding, and malnutrition. It is essential to recognize that while the challenge of global warming may seem insurmountable, and the available time to act running out, we still have an opportunity to preserve the beauty and sustainability of our planet” (11/28).

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PATH Program Officer Discusses Importance Of WASH Services In Quality Health Care Delivery

PATH’s “DefeatDD Blog”: Hospitals Without Water, Toilets, or Soap Make the Sick Even More Vulnerable to Infection
Adam Drolet, program officer at PATH, discusses the importance of WASH services in health care facilities, writing, “Without clean and safe water, sanitation, and hygiene, patients and providers are at a much higher risk for hospital-acquired infections … Without these basic WASH services, quality health care cannot be delivered” (11/28).

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From the U.S. Government

PEPFAR Releases Latest Results, New Report On DREAMS Partnership

PEPFAR: Latest Results Show PEPFAR Has Saved Over 17 Million Lives and Accelerated Progress Toward HIV Epidemic Control
“In advance of World AIDS Day 2018, the U.S. Secretary of State Michael R. Pompeo [on Tuesday] announced the latest results achieved by American leadership and partnerships through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), which has now saved more than 17 million lives. … A new PEPFAR report released [on Tuesday] highlights that, in the past year, new HIV diagnoses among adolescent girls and young women continued to decline in 85 percent of the highest HIV burden communities/districts that are implementing the program’s DREAMS public-private partnership…” (11/27).

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USAID Administrator Delivers Remarks At PEPFAR Event

USAID: U.S. Agency for International Development Administrator Mark Green’s Remarks at the PEPFAR Faith Communities and HIV Technical Summit
During remarks at the PEPFAR Faith Communities and HIV Technical Summit, USAID Administrator Mark Green recognized U.S. global HIV/AIDS efforts, noting, “In the fight against AIDS, we are re-dedicating ourselves, working through PEPFAR, and with all of you [partners] to empower communities and countries to gradually assume ownership of their own health care challenges. We’ll incentivize reforms, strengthen in-country capacity, and we will help prepare a generation to claim their rightful leadership roles” (11/28).

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USAID Releases November 2018 Issue Of Innovation And Impact Newsletter

USAID: Innovation and Impact Newsletter — November 2018
The latest issue of USAID’s Innovation and Impact Newsletter features an article on a Saving Lives at Birth Grand Challenge innovation that “has been scaled up in hospitals across Malawi and is now scaling up across Africa and the world.” The issue also highlights upcoming events and provides a news round-up of articles on various development and global health innovations (November 2018).

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