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Kaiser Daily Global Health Policy Report

In The News

Number Of Child Brides In Africa Set To More Than Double By 2050 Without Intervention, UNICEF Report Shows

News outlets highlight findings from a UNICEF report on global child marriage trends.

Agence France-Presse: Child marriages set to soar in Africa: UNICEF
“Child marriages in Africa are set to more than double by 2050 unless urgent steps are taken, UNICEF warned Thursday as delegates met in Zambia to discuss how to halt the practice…” (11/26).

Agence France-Presse: ‘Child brides’ suffer, but African Union seeks to end custom
“…[Last] week, the African Union [met] in Zambia to hold its first conference on ‘Ending Child Marriage in Africa’ — a small step in efforts to protect girls…” (Barbier, 11/25).

Al Jazeera America: Africa falling behind on fight against child marriage
“…The report, released at the start of the African Union Girls Summit in Zambia on Thursday, predicts that without significant shifts in policy, the number of child brides in Africa will increase from 125 million to 310 million by 2050…” (Moskowitz, 11/25).

CNN: Africa’s child brides expected to double by 2050
“…Slow rates of reduction and ballooning populations are the main cause of the projected increases. Early marriage is most prevalent in a vast belt across Africa stretching from Somalia in the east to Guinea in the west…” (McKenzie, 11/26).

Deutsche Welle: U.N. predicts rise in African child brides by 2050
“…With a higher likelihood of contracting HIV, young girls married early could also face a host of health complications. The report added that it was important to increase girls’ access to reproductive health services in order to ensure that they had fewer, safer pregnancies…” (11/26).

Thomson Reuters Foundation: Number of African child brides to soar by 2050 as population grows: U.N.
“…African governments also need to make sure that more girls’ births are registered so that their age is known, and to enforce laws prohibiting child marriage, UNICEF said…” (Migiro, 11/25).

Thomson Reuters Foundation: Factbox: Child brides in Africa to more than double by 2050
“…Here are some facts about child marriage in Africa and worldwide. * Every year 15 million girls around the world marry before the age of 18, about 41,000 a day or 28 every minute…” (Guilbert, 11/25).

U.N. News Centre: Child brides in Africa could more than double to 310 million by 2050 — UNICEF
“…The statistical report, A Profile of Child Marriage in Africa, reveals that in all other regions of the world, current rates of reduction and demographic trends mean there will be fewer child brides each year. By 2050 Africa will surpass South Asia as the region with the highest number of women aged 20 to 24 who were married as children…” (11/26).

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AIDS-Related Death Leading Cause Of Adolescent Mortality In Africa, Second Globally, UNICEF Data Show

News outlets discuss findings from UNICEF’s Statistical Update on Children, Adolescents and AIDS.

Agence France-Presse: Adolescent deaths from AIDS tripled since 2000: UNICEF
“The number of adolescents dying from AIDS has tripled over the last 15 years, most of them having acquired the disease when they were infants, according to figures released Friday by UNICEF…” (11/26).

Associated Press: UNICEF: AIDS leading cause of death for African teenagers
“While the global push to eradicate HIV may have saved over a million babies, AIDS is now the leading cause of death for African teenagers and the second most common killer for adolescents across the globe, the United Nations’ agency for children said on Friday…” (Chutel, 11/27).

CNN: Adolescent deaths from AIDS have tripled since 2000, UNICEF study finds
“…The UNICEF study found that 26 adolescents are infected every hour, and only one in 10 adolescents in sub-Saharan Africa is tested for HIV. Girls in the region are disproportionately affected, accounting for seven of 10 new infections among 15-19-year-olds, the study found…” (Gigova, 11/29).

International Business Times: Adolescent Deaths From AIDS Have Tripled Over The Last 15 Years Despite Overall Decline
“…Since 2000, nearly 1.3 million new infections among children have been averted — largely due to advances in the prevention of mother-to-child transmission of HIV. However, despite this progress, nearly 2.6 million children under 15 are still living with HIV, of which only one in three are on treatment…” (Pandey, 11/27).

U.N. News Centre: Adolescent deaths from AIDS have tripled since 2000, warns new UNICEF study
“… ‘Among HIV-affected populations, adolescents are the only group for which the mortality figures are not decreasing,’ according to UNICEF…” (11/27).

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U.N. Marks International Day For The Elimination Of Violence Against Women

News outlets report on the International Day for the Elimination of Violence Against Women, recognized on November 25.

U.N. News Centre: U.N. urges ‘zero tolerance at the highest levels of leadership’ to end violence against women and girls
“Ending gender-based violence is a top priority for achieving the United Nations founding mission of peace, development, and human rights, Secretary-General Ban Ki-moon said [Wednesday], noting his specific concerns about rising violent extremism and its impact on women and girls, and calling for global collective action to end the scourge…” (11/25).

VOA News: U.N. Focuses on Global Effort to End Violence Against Women
“…November 25 is International Day for the Elimination of Violence Against Women. The U.N.’s ‘Orange the World’ campaign runs through December 10, International Human Rights Day, and will attempt to raise awareness about the violent realities faced by many of the world’s women and girls…” (11/25).

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TB Research Funding Falls Short Of Global Targets, TAG Report Shows

Thomson Reuters Foundation: Tuberculosis funding gap threatens elimination goals
“Funding for tuberculosis research fell $1.3 billion short of global targets last year, threatening worldwide goals to eliminate the disease between 2030 and 2035, researchers said on Monday. The Treatment Action Group (TAG), an independent think tank, said the $674 million of total funding in 2014 amounted to just a third of the $2 billion experts say is needed per year for research and development to rid the world of TB…” (11/29).

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Devex Examines USAID's Integration Of Climate Change Risk Screenings Into New Strategies

Devex: A look at USAID’s climate change policy integration
“The U.S. Agency for International Development is in the midst of a climate change transformation in response to an executive order from U.S. President Barack Obama in 2014. The order requires the agency to integrate climate change risk screenings in any new strategy and include climate impact assessments in programs beginning in 2016…” (Saldinger, 11/25).

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Despite Sufficient Supplies, HIV Medications Often Do Not Reach Sub-Saharan African Patients, MSF Report Says

Agence France-Presse: HIV drug stocks not reaching African patients: report
“Efforts to get lifesaving antiretrovial drugs to HIV-positive patients in many sub-Saharan African countries are routinely failing at ‘the last mile,’ an international medical group said on Monday. Despite stocks being available, the drugs often do not reach clinics because of ‘cumbersome procedures, logistical challenges, or lack of resources,’ Médecins Sans Frontières said in a report released at the International Conference on AIDS and STI (sexually transmitted infections) in Africa in Harare…”

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News Outlets Report On Ebola In Liberia, Guinea, Epidemic Recovery In West Africa

Foreign Policy: How Liberia’s Latest Ebola Case Slipped Through the Cracks
“…[Fifteen-year-old Nathan] Gbotoe’s case, which was announced on Nov. 20, put an end to Liberia’s official ‘Ebola free’ designation for a second time this year … While the source of Gbotoe’s infection is currently being investigated, the mismanagement of his case at the nation’s largest public hospital raises questions about Liberia’s preparedness to handle future outbreaks. What went wrong? Seemingly a lot…” (MacDougall, 11/26).

Reuters: Guinea’s last Ebola case, a baby girl, leaves hospital
“A one-month-old baby girl who was Guinea’s last reported Ebola case left hospital on Saturday, delighting medical staff and putting the country on course to be declared free of the deadly virus. Guinea will become officially Ebola-free after 42 days if no new cases are reported following the recovery of baby Nubia — thought to be the first baby to survive after being born to an infected mother…” (Farge, 11/28).

U.N. News Centre: West Africa cannot recover from Ebola epidemic on its own — senior U.N. health official
“… ‘The response to Ebola — the national leadership, community engagement, so many people working so hard for such a long period of time with such dedication — if that can be translated into efforts beyond Ebola, then actually all three countries have a bright future ahead of them,’ Peter Graaff, the U.N. regional inter-agency coordinator on Ebola, told the U.N. News Centre. ‘But they cannot do it alone,’ Mr. Graaff said of efforts to end transmission of the virus that has killed more than 11,000 people in Guinea, Liberia, and Sierra Leone…” (11/27).

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Extreme Weather Events Increasingly Impacting Food Security Worldwide, FAO Study Shows

News outlets report on a study by the U.N. Food and Agriculture Organization examining the links between climate and food security.

Reuters: Extreme weather poses growing threat to food security — U.N.’s FAO
“Drought, floods, and other extremes of weather have become more frequent and severe in the past 30 years and pose a rising threat to food security in developing countries, the United Nations food agency said on Thursday. Natural disasters caused worldwide damage worth $1.5 trillion, more than the annual GDP of Australia, between 2003 and 2013 and hit agriculture hard, the U.N. Food and Agriculture Organization (FAO) said in a report…” (Binnie, 11/26).

U.N. News Centre: Surge in climate change-related disasters poses growing threat to food security — U.N.
“…The FAO report is based on a review of 78 on the ground post-disaster needs-assessments conducted in developing countries coupled with statistical analyses of production losses, changes in trade flows, and agriculture sector growth associated with 140 medium and large scale disasters, defined as those affecting at least 250,000 people. The report demonstrates that natural hazards — particularly extreme weather events — regularly impact heavily on agriculture and hamper the eradication of hunger, poverty, and the achievement of sustainable development…” (11/26).

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U.N.'s Ban Urges Commonwealth Nation Leaders To Commit To Ending Polio

U.N. News Centre: In Malta, Ban urges Commonwealth leaders to join U.N. in ‘final push’ to wipe out polio
“A world that may have once seemed unimaginable is within reach — a polio-free world, Secretary-General Ban Ki-moon said [Saturday], urging leaders gathered in Malta for the Commonwealth Summit to build on the momentum that has been generated in recent years and join the United Nations in making ‘the final push to wipe out polio forever’…” (11/28).

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Gambian President Announces Immediate FGM Ban

The Guardian: The Gambia bans female genital mutilation
“The Gambia has announced it will ban female genital mutilation (FGM) after The Guardian launched a global campaign to end the practice. The president, Yahya Jammeh, said [November 23] that the controversial surgical intervention would be outlawed. He said the ban would come into effect immediately, though it was not clear when the government would draft legislation to enforce it…” (Lyons, 11/24).

Huffington Post: Gambia Bans Female Genital Mutilation
“… ‘The ban is an essential first step towards ending FGM,’ Mary Wandia, FGM program manager at Equality Now, said in a statement provided to the Huffington Post. ‘A law must now be enacted and … the government needs to show strong commitment and prioritize this issue in a country where three quarters of women have been affected and reductions in prevalence have been slow to materialize’…” (Goldberg, 11/24).

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Zika Viral Infection Linked To Birth Defects In Brazilian Infants, Health Officials Say

Associated Press: Brazil links dengue-like virus to birth defects in babies
“The dengue-like Zika virus has been linked for the first time to cases of babies being born with small heads, or microcephaly, Brazil’s government said. … Researchers with the U.S. Centers for Disease Control and Prevention are coming soon at the request of Brazil’s government to study the link between the rare neurological condition and Zika…” (Licon, 11/29).

Reuters: Brazil confirms Zika virus link to fetal brain-damage outbreak
“…The link between Zika, first medically identified as a new disease half a century ago, and birth defects has never been made. Initial analysis shows that the virus can be passed to a fetus and that the fetus is at greatest risk from the virus during the first three months of pregnancy, the statements said. More tests and studies are needed to clarify the exact method of transmission and infection, the statement added…” (Blount, 11/29).

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Editorials and Opinions

Editorials, Opinion Piece Discuss Reforms To Strengthen WHO's Responses To Ebola, Other Disease Outbreaks

The Lancet: Ebola: lessons for future pandemics
Editorial Board

“…[A report from the Harvard-London School of Hygiene & Tropical Medicine Independent Panel on the Global Response to Ebola] endorses 10 recommendations across four themes: preventing major outbreaks, responding to outbreaks, research, and governing a global health system that has overall stewardship responsibility for disease outbreaks. Of the 10, some already have political momentum, such as the creation of a global financing facility for outbreak-related research and development; others will not require substantial funds but can be implemented quickly, such as establishing a freedom of information policy within [the] WHO. The message from the panel’s discussion event in London this week was clear: there is a moral obligation to ensure the same mistakes are not repeated in the future. Strong political will to rebuild confidence, internationally and nationally, is needed. But the global health community also has a shared responsibility to not only learn the lessons from the West African Ebola outbreak but also to show leadership in the future” (11/28).

New York Times: What It Will Take to Fight the Next Epidemic
Editorial Board

“…Chief among [the Harvard-LSHTM report’s recommendations to bolster the WHO’s response against disease outbreaks] was a call for leadership at the top of the organization that is willing to confront political leaders who go into early denial about the presence of diseases to protect their economies and head off public panic, thereby feeding epidemics. … The report also recommended the creation of a separate unit at the center of the WHO for combating infectious diseases, with its own budget and accountability, as well as more global funding of research. Above all, the study found the world as a whole needs a focused strategy, clearer standards, and a rapid response to future threats, one with transparent management. … [T]he new report makes it clear that wholesale changes must be made, and quickly, before the next epidemic threatens an increasingly interconnected world” (11/26).

Washington Post: Everything went wrong in the Ebola outbreak. We’re still not ready if it happens again.
Editorial Board

“…[The Harvard-LSHTM report] describes a cascade of failures and serves as a reminder that the existing methods of coping with infectious disease outbreaks are fragmented and fragile. The panel … found that during the Ebola outbreak, the WHO fell down in all of its core functions: helping nations build up health care capacity, providing early warning, establishing technical norms, and mobilizing resources. … [T]he panel recommends bolstering the WHO’s ability to respond quickly, including with a worldwide research and development fund for diagnostics, drugs, and vaccines for diseases that have been neglected by the pharmaceutical industry. … It is also essential that governments give early warning of disease, regardless of the consequences. Response teams must take into account not only health and science concerns but also the beliefs, traditions, cultures, and fears of local populations…” (11/28).

The Guardian: Ebola overwhelmed the World Health Organization: it must never happen again
Matshidiso Moeti, regional director for Africa at the WHO

“…At the 65th session of the WHO regional committee for Africa in N’Djamena, Chad, health ministers and senior officials from WHO Afro’s 47 member states endorsed a transformation agenda … [to] make WHO Afro the responsive, transparent, and effective health agency the region needs and deserves. Our reform efforts focus on four key areas. We will promote and instill shared values … We will focus the technical work of the WHO secretariat on the region’s most important health problems … We will build responsive strategic operations and strengthen management capacity to improve the way in which resources are matched to pressing health challenges. And we will enhance strategic partnerships and more effectively articulate and communicate our contribution to health development across the region. … WHO Afro stands ready to lead in this new era…” (11/26).

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WHO Executive Board Should Spearhead Global Health Security Conversation To Promote Peace

The Lancet: Offline: What the war against ISIL means for health
Richard Horton, editor-in-chief of The Lancet

“…The negative effects of ISIL on health are all too clear. First, there will be higher rates of conflict-related mortality. … Second, there will be serious damage to health systems — their infrastructure, services, medical supplies, and information systems. … Third, the so far neglected subject of refugee health will become increasingly important in global health. … Fourth, ecosystems will be harmed, thereby further threatening the health of human populations. Finally, political priorities will likely shift away from traditional domestic concerns … Global health could make peace a central part of its vision post-2015. How might it do so? By making peace through health (and health through peace) a critical aspect and action of its work. One opening might be the new attention being given to global health security. WHO could seize first-mover advantage to kick-start this dialogue. There would be no better place to do so than the gathering of its Executive Board in January, 2016” (11/28).

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Congress Must Take Action To Support Antibiotic R&D

The Hill: Discovery of new superbug gene underscores the need for Congress to act now
Johan Bakken, president of the Infectious Diseases Society of America

“…[A]ntibiotic research and development (R&D) continues to lag behind existing patient needs and upcoming threats. Fortunately, Congress can help combat the threat of these deadly infections, but we must act now. First, Congress can pass funding legislation that provides the increases requested by the president for the Centers for Disease Control and Prevention (CDC), National Institute for Allergy and Infectious Diseases (NIAID), Biomedical Advanced Research and Development Authority (BARDA), Food and Drug Administration (FDA), and U.S. Department of Agriculture (USDA). … Second, Congress can provide urgently needed new incentives to stimulate the development of antibiotics to treat superbugs. … Lastly, Congress can address the regulatory barriers to antibiotic R&D…” (11/27).

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OIC Nations Should Work With U.S. Partners, Others To Scale Up NTD Control, Elimination

PLOS Neglected Tropical Diseases: Impact of the Neglected Tropical Diseases on Human Development in the Organization of Islamic Cooperation Nations
Peter J. Hotez, co-editor in chief of PLOS Neglected Tropical Diseases and U.S. science envoy for the Middle East and North Africa; and Jennifer R. Herricks, postdoctoral fellow at Rice University’s Baker Institute for Public Policy and the National School of Tropical Medicine at Baylor College of Medicine

“…[Neglected tropical diseases (NTDs) are] important because of their potential to emerge or re-emerge in the setting of conflict and post-conflict situations, as we have seen in Africa and the Middle East. Therefore, the leadership of the [Organization of Islamic Cooperation (OIC)] may wish to further emphasize targeting the NTDs for control and elimination … [This] will require both a scale-up of global and integrated mass treatment programs, as well as the advancement of new technologies for NTDs. Given that the charter of the OIC includes scientific cooperation and advancing technologies, such efforts are within its scope. … Potential partners include programs such as the U.S. Science Envoy Program, created by the White House and State Department under the Obama administration in order to reach out scientifically to OIC countries through science and vaccine diplomacy, as well as programs like the NTD Support Center … [S]cientific cooperation could produce a new generation of ‘antipoverty’ drugs, diagnostics, and vaccines in order to combat the major NTDs now affecting selected OIC countries as well as other nations trapped in poverty” (11/25).

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Reforming Global Food Systems Critical To Overcoming Hunger, Malnutrition; Congress Should Pass Global Food Security Act

Inter Press Service: Opinion: Better Nutrition for Better Lives
Jomo Kwame Sundaram, coordinator for economic and social development at the Food and Agriculture Organization

“…Creating healthy, affordable, and sustainable food systems for all is the most effective way to [overcome hunger and malnutrition in the 21st century]. … Food systems must become more responsive to people’s needs, including food insecure, socially excluded, and economically marginalized households. … Strong political commitment is required to prioritize nutrition and to improve food systems. … [F]ood system reforms need to be accompanied by needed complementary interventions, including public health, education, employment and income generation, as well as social protection to enhance resilience. Governments, consumers, producers, distributors, researchers, and others need to be more involved in the food system…” (11/26).

The Hill: From farm to table to Capitol Hill: A chef’s perspective on ending global hunger
Spike Mendelsohn, chef ambassador for CARE, TV food-show contestant and host, and restaurant owner

“…The Global Food Security Act of 2015 (S 1252/HR 1567) seeks to incorporate natural resource management into our U.S. food security work, a critical factor in ensuring we have a more sustainable food system. It would also strengthen existing programs, encourage transparency, and build capacity to help communities better cope with unexpected hunger challenges, including floods, drought, and conflict. … With the passage of the Global Food Security Act, the U.S. [would] be closer to ensuring that critical coordination is taking place and that food and nutrition security remains a priority of the U.S. government’s development work for years to come…” (11/26).

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Pope Francis Should End Catholic Church's Condom Ban To Help Halt Spread Of HIV

Slate: Pope Francis Should End the Ban on Condoms
Justin Lynch, editorial fellow at the New America Foundation and journalist

“…[T]he Catholic Church, where its intervention is needed most, has taken a fundamental stance against any use of contraception. … When Pope Francis visit[ed] Kenya, Uganda, and the Central African Republic from Nov. 25-30, he [visited] three countries with some of the highest HIV infection rates in the world, and three countries with large populations of Catholics, for whom condom use is not allowed. He could save lives here by reversing the Catholic Church’s rule. Some observers thought that Francis would at least relax the ban on condoms. He has not. The only church-approved method of contraception is abstinence…” (11/25).

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From the Global Health Policy Community

Updated Kaiser Family Foundation Analysis Examines Donor Funding For Health In LMICs Between 2002-2013

Kaiser Family Foundation: Donor Funding for Health in Low- & Middle-Income Countries, 2002-2013
This updated analysis “presents trends in donor funding for health in low- and middle-income countries between 2002 and 2013. Funding during the period increased more than five-fold, rising from $4.4 billion to $22.8 billion, an increase even after adjusting for inflation and exchange rates. In 2013, donor funding for health increased by $2.7 billion compared to 2012, the largest percentage increase (13.5 percent) since the early part of the previous decade when increases were largely spurred on by the creation of several new funding initiatives and mechanisms such as the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR)…” (11/24).

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Blog Post Examines New Ross Fund For Malaria, Questions Establishment Of Separate Fund

Center for Global Development “Global Health Policy Blog”: Right Idea on Ross Malaria Funding, Wrong Execution
Amanda Glassman, vice president for programs, director of global health policy, and senior fellow at CGD, and Andrew Rogerson, a senior research associate at the Overseas Development Institute, comment on the establishment of the $1.5 billion Ross Fund by the U.K. government and the Bill & Melinda Gates Foundation, and question why a new fund was created instead of the money being contributed to the existing Global Fund to Fight AIDS, Tuberculosis and Malaria. “…Reform of our existing Global Fund rather than creation of yet another new fund is the answer. We call on the U.K. and Gates to consider this option seriously,” they conclude (11/25).

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Health Screenings At West African Borders Help Detect Ebola, Prevent Spread

USAID’s “Impact”: Strong Border Management is Vital to the Fight against Ebola
Al Dwyer, the USAID Ebola Disaster Assistance Response Team leader, discusses the importance of health screening stations at border crossings between West African countries as part of USAID’s and partners’ efforts to detect new Ebola cases and prevent the disease’s spread (11/27).

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Toolkit, Blog Posts Address International Day For The Elimination Of Violence Against Women

WHO: WHO launches toolkit to help countries respond to sexual violence
“On 25 November, WHO joins partners in calling for the elimination of all forms of violence against women and girls to ensure their health, well-being, and human rights. … The organization, together with the U.N. Office on Drugs and Crime, is launching a toolkit to help countries strengthen the medico-legal response to sexual violence. This initiative is also supported by U.N. Action against Sexual Violence in Conflict…” (11/25).

ONE Blog: How Safecity is helping women and girls speak out and protect others
ElsaMarie D’Silva, a 2015 Aspen New Voices fellow and co-founder and managing director of Safecity, discusses the Safecity app, “an online platform that encourages anonymous reporting of personal experiences of sexual violence in public spaces through crowd-sourced data,” as well as related initiatives to eliminate violence against women (11/25).

U.S. Department of State’s “DipNote”: In War-Torn DRC, This Doctor Empowers Survivors
Catherine M. Russell, ambassador-at-large for global women’s issues at the State Department, interviews Dr. Denis Mukwege, who for the past 20 years “has treated patients who have survived serious injuries from sexual violence perpetrated as a tactic of war in the Democratic Republic of Congo (DRC)…” (11/27).

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WHO Framework For TB Research Outlines Steps To Advance Field Over Next Decade

Center for Global Health Policy’s “Science Speaks”: WHO’s new TB research framework to help high burden countries take leadership
Rabita Aziz, policy research coordinator for the Center for Global Health Policy, discusses the WHO’s Global Action Framework for TB Research, which “outlines steps at global and national levels to advance tuberculosis research over the next 10 years, with a particular focus on empowering high burden, low- and middle-income countries to develop a strong and self-sustained TB research community…” (11/25).

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New Issue Of 'Global Fund News Flash' Available Online

Global Fund to Fight AIDS, Tuberculosis and Malaria: Global Fund News Flash
The latest issue of the Global Fund News Flash includes articles discussing ending HIV as an epidemic, eliminating malaria in southern Africa, building impact using data, and educating teenagers about sexual and reproductive rights (11/25).

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