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Kaiser Daily Global Health Policy Report

In The News

White House Plan Seeks To Transition Secretary Tillerson Out Of State Department

New York Times: White House Plans Tillerson Ouster From State Dept., to Be Replaced by Pompeo, Within Weeks
“The White House has developed a plan to force out Secretary of State Rex W. Tillerson, whose relationship with President Trump has been strained, and replace him with Mike Pompeo, the CIA director, perhaps within the next several weeks, senior administration officials said on Thursday. … It was not immediately clear whether Mr. Trump has given final approval to the plan, but he has been said to have soured on Mr. Tillerson and in general is ready to make a change at the State Department. John F. Kelly, the White House chief of staff, developed the transition plan and has discussed it with other officials…” (Baker/Haberman, 11/30).

Additional coverage on this developing story is available from ABC News, Associated Press, CNBC, The Hill, Los Angeles Times, Reuters, Slate, and Vox.

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Trump Administration's Proposed Cuts To HIV/AIDS Funding Threaten Decades Of Gains, ONE Report Shows; Advocacy Groups Urge Congress To Maintain Funding

Associated Press: Health groups urge Congress not to allow AIDS fight to wane
“A coalition of nearly 40 advocacy groups said Wednesday they’re concerned about the Trump administration’s commitment to the global fight against AIDS so they’re urging senior members of Congress to make sure money for key prevention programs isn’t cut back. The groups wrote in a letter sent Wednesday to congressional leaders that they have ‘profound concern’ about the direction the Trump administration appears to be taking in the response to AIDS…” (Lardner, 11/29).

CBS News: Trump budget cuts could result in millions of new AIDS-related infections, says new report
“Leading up to World AIDS Day, the ONE Campaign released a damning report on the potential impact of the White House’s proposed … cut[s] to HIV/AIDS efforts that experts predict could result in millions of new HIV infections and hundreds of thousands of deaths, reversing progress the world has made in the fight against AIDS. ‘The FY 2018 budget proposal would have led to the first global increase in new HIV infections since 1995, with nearly 200,000 additional HIV infections in the first year,’ the report, entitled ‘Red Ribbon or White Flag, The future of the U.S. Global AIDS Response,’ reads. ‘If these cuts were maintained, nearly 600,000 additional people could be infected by 2020, dragging the world back to levels of new infections last seen in 2011’…” (Alemany, 11/29).

Devex: ONE Campaign slams Trump administration’s ‘retreat’ from HIV leadership
“… ‘Federal agencies have been instructed to make even deeper cuts in their FY 2019 proposals, which can only make matters worse,’ the report reads, citing a White House memorandum. So far, the U.S. Congress has rejected the White House’s proposal to slash funding to these programs. PEPFAR, in particular, enjoys broad bipartisan support on Capitol Hill, and multiple lawmakers have voiced their opposition to funding reductions…” (Igoe, 11/29).

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USAID Announces New Development Impact Bond For Maternal, Child Health In India

Devex: USAID announces a new development impact bond
“Mark Green, administrator of the U.S. Agency for International Development, will announce a new development impact bond aimed at reducing maternal and newborn deaths in India, during the closing plenary of the 2017 Global Entrepreneurship Summit. Launched Thursday, the Utkrisht Impact Bond, named for the Hindi expression for excellence, will fund maternal and newborn health in the Indian state of Rajasthan…” (Cheney, 11/30).

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Dengvaxia Effective Only Among People Previously Infected With Dengue, Sanofi Announces

Bloomberg: Dengue Vaccine Only Helps Those With Prior Infection, Sanofi Says
“Sanofi said its dengue vaccine only helps people who’d been previously infected with the virus, cutting the value of its stockpiles in yet another setback for a product whose ambitions keep being scaled down…” (Fourcade/Paton, 11/30).

CNN Philippines: Drug firm warns of ‘severe disease’ from dengue vaccine for people with no prior infection
“…In a statement, Sanofi said Dengvaxia provided persistent protection against dengue fever to those who had prior infection. ‘For those not previously infected by dengue virus, however, the analysis found that in the longer term, more cases of severe disease could occur following vaccination upon a subsequent dengue infection,’ it said…” (11/30).

Reuters: Sanofi expects $120 million hit as dengue vaccine hits major snag
“…Sanofi said it was writing to national regulatory agencies proposing that vaccination should not be recommended for individuals who have not been previously infected by dengue virus…” (Blamont/Hirschler, 11/29).

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2 Large HIV Prevention Studies Focused On Women Begin In Sub-Saharan Africa

Reuters: New vaccine, long-acting drug trials buoy hopes in HIV fight
“Researchers announced the launch of two big studies in Africa on Thursday to test a new HIV vaccine and a long-acting injectable drug, fueling hopes for better ways to protect against the virus that causes AIDS…” (Hirschler, 11/30).

Reuters: Hopes for HIV vaccine buoyed by start of second big trial
“…The start of the new trial involving 2,600 women in southern Africa means that for the first time in more than a decade there are now two big HIV vaccine clinical trials taking place at the same time. The new study is testing a two-vaccine combination developed by Johnson & Johnson with the U.S. National Institutes of Health (NIH) and the Bill & Melinda Gates Foundation. The first vaccine, also backed by NIH, began a trial last November…” (Hirschler, 11/30).

Reuters: GSK starts big African study of injectable drug to prevent HIV
“ViiV Healthcare, GlaxoSmithKline Plc’s HIV unit, said on Thursday it started an African study to evaluate a long-acting injectable drug for the prevention of HIV infection in sexually active women. The cabotegravir study seeks to enroll 3,200 women aged 18 to 45 years from sub-Saharan African countries, ViiV Healthcare said in a statement. The HPTN 084 Phase III study will evaluate injections given every two months, ViiV Healthcare said. The study is being conducted through public-private funding by ViiV Healthcare, the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH), and the Bill & Melinda Gates Foundation, the company said…” (Patnaik, 11/30).

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Gavi To Purchase $85M In Typhoid Vaccines To Immunize Children In Endemic Nations

Reuters: Vaccine alliance backs typhoid shots for poor with $85 million
“The Gavi global vaccine alliance has earmarked $85 million to help support the introduction of typhoid vaccines in poor countries where millions of children are at risk of the often deadly disease. The funds, agreed by GAVI at a meeting on Thursday, will go towards bulk-buying of new typhoid vaccines including one developed by privately held Bharat Biotech, the alliance said in a statement…” (Kelland, 11/30).

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South-South Cooperation Can Advance Humanitarian, Development Goals, U.N. Official Says

U.N. News Centre: Antalya: South-South cooperation can spur great humanitarian, development impact — U.N. relief official
“With actors from the Global South increasingly among the frontline responders in fragile and protracted crises, fully leveraging the comparative advantage of South-South cooperation has the potential to have great humanitarian and development impact, … Ursula Mueller, the assistant secretary general for humanitarian affairs, [said] to the final Leadership Roundtable of the Global South-South Development Expo 2017, which is under way in Antalya, Turkey…” (11/29).

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Insecticide-Resistant Mosquitoes Threaten Malaria Progress In Africa, Genetic Study Shows

Reuters: Insecticide resistance spreads in Africa, threatens malaria progress
“The largest genetic study of mosquitoes has found their ability to resist insecticides is evolving rapidly and spreading across Africa, putting millions of people at higher risk of contracting malaria. British scientists who led the work said mosquitoes’ growing resistance to control tools such as insecticide-treated bed nets and insecticide spraying, which have helped cut malaria cases since 2000, now threatens ‘to derail malaria control’ in Africa…” (Kelland, 11/29).

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Inside Philanthropy Highlights Funders Taking Action On Malnutrition

Inside Philanthropy: It’s the World’s Biggest Health Problem. Who’s Paying Attention to Malnutrition?
“Malnutrition — a blanket term covering conditions such as wasting, stunting, obesity and lack of adequate vitamins and minerals — is the world’s biggest health problem. … So while malnutrition doesn’t get the attention of global health problems like malaria and HIV/AIDS, you can see why some top funders would be paying close attention…” (Moses, 11/29).

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More News In Global Health

Deutsche Welle: World Health Organization: Malaria treatment stalls as funding flatlines (11/29).
U.N. News Centre: Malaria response at ‘crossroads,’ risks backward slide — U.N. (11/29).

The Guardian: Rohingya girls as young as 12 compelled to marry just to get food (MacGregor, 11/30).

Los Angeles Times: As parts of Zambia beat back malaria, the nation sets a lofty goal: zero transmissions (Simmons, 11/30).

PRI: A lack of clean and safe toilets leaves women vulnerable to rape and attacks (Tong, 11/29).

Quartz: Africa is the dumping ground for 40% of the world’s reported fake medicines (Chutel, 11/29).
U.N. News Centre: One in 10 medicines in developing countries substandard or falsified — U.N. health agency (11/29).

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Editorials and Opinions

Diplomatic Professionals' Exodus From U.S. State Department Is National Security Emergency

Washington Post: The national security emergency we’re not talking about
Madeleine K. Albright, former U.S. secretary of state

“…It is simply a fact that the United States relies on diplomacy as our first line of defense — to cement alliances, build coalitions, address global problems, and find ways to protect our interests without resorting to military force. … There is nothing normal about the current exodus [of diplomatic professionals from the State Department]. … Sadly, the official who should be highlighting the State Department’s vital role has not done so. On Tuesday, Secretary of State Rex Tillerson denied that the department is being hollowed out even while defending the president’s plan for a massive reduction in his agency’s budget. … According to [the American Foreign Service Association], the number of individuals taking the Foreign Service exam this year is on track to plummet by more than 50 percent. If the U.S. military were facing a recruitment and retention crisis of this magnitude, few would hesitate to call it a national security emergency. Well, that is what we are facing. And while it saddens me to criticize one of my successors, I have to speak out because the stakes are so high. … The government is us, and public service is both a great privilege and a shared responsibility. This is our republic. We must do all we can to keep it strong” (11/29).

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Global Community Must Recognize Health As Fundamental Human Right

Project Syndicate: The Right to Health Is Universal
Michel Sidibé, executive director of UNAIDS, and Dainius Puras, U.N. special rapporteur on the right to physical and mental health

“…Health … is a fundamental human right, encompassing both freedoms and entitlements. … Today, we call on world leaders to confront health injustices wherever they see them, and to take action to respect, protect, and uphold the right to health for all people. … Empowering global health citizens will require progress in at least three policy areas: popularizing participation, democratizing data, and eliminating discrimination. … It is clear that ending AIDS will require social — not just medical — breakthroughs. Governments must redouble their efforts to protect individuals against discrimination, and create effective mechanisms for people to seek redress when private or state actors violate their right to health. We call on all health care practitioners and institutions to resist discriminatory laws, policies, or practices. Safeguarding the right to health provides the foundation needed to enable everyone to realize their potential and their dreams. We should demand nothing less” (11/29).

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Tobacco Taxation 'Arguably The Single Most Effective Tool' To Discourage Smoking

The Conversation: A tax increase that’s proven to save lives
Jeffrey Drope, professor in residence of global health at Marquette University, and Otis W. Brawley, professor at the Department of Hematology and Medical Oncology at Emory University

“…Arguably, the single most effective tool [to address smoking-related illnesses], both in terms of cost and population-level effects, is tobacco taxation. A large body of evidence demonstrates that applying excise taxes on tobacco products on a sustained basis so that people cannot afford them is currently the most effective policy instrument to discourage smoking. … From a health and political perspective, there could be significant co-benefits — governments could reinvest revenue in priorities such as improving health systems as well as disease prevention and treatment. This would thereby deliver significant savings in future health care costs. … In global meetings, this potential for revenue generation has led governments to conclude that tobacco taxes should be leveraged as a domestic source of development financing … But politicians need to demonstrate the will to translate intent into action. … Progress is not possible if we let the tobacco industry shape health policy, so the wider health and development community must join the cancer community in being visible and vocal advocates for high tobacco taxes” (11/29).

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Enforcing Policies Outlawing Child Marriage, Addressing Underlying Factors Critical To Protecting Girls

The Guardian: The Guardian view on child marriage: wedlock is a padlock for girls
Editorial Board

“…Worldwide, a girl under 18 is married every two seconds … Child marriage is linked to poverty, curtailed education, domestic violence, and maternal mortality. Young brides are under pressure to have children when they still have the bodies of children. Ending child marriage by 2030 is included in the U.N. Sustainable Development Goals. The proportion of young women who married before 15 has dropped from 12 percent to eight percent since the early 1980s. But population growth means the absolute numbers will continue to rise. And despite improvements in laws and practice, the situation is deteriorating in places. … Good laws alone will not protect girls. … Enforcement is key, but so is tackling the underlying factors driving child marriage. These range from patriarchal attitudes through to a lack of economic opportunities, access to contraception, and conflict. … For the U.S. there can be no hesitation. … Changing state laws to safeguard them would not only protect its own girls but send a powerful global message. Wedlock is a trap for children. Free them” (11/29).

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From the Global Health Policy Community

New Development Impact Bond To Improve Maternal, Newborn Health Launches In India

Brookings Institution: Rallying behind maternal and newborn health: A new impact bond launches in India
Emily Gustafsson-Wright, fellow for global economy and development, and Izzy Boggild-Jones, research analyst, both at the Center for Universal Education, discuss the launch of a new development impact bond (DIB) to improve maternal and neonatal mortality rates in Rajasthan, India; highlight the use of DIBs in general; and announce an upcoming webinar that “will explore the potential applications for impact bonds for health” (11/29).

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Blog Post Discusses Role Of Voluntary Medical Male Circumcision Services In Reaching AIDS-Free Generation

IntraHealth International’s “Vital”: We Need to Ramp Up Voluntary Medical Male Circumcision Services to Reach an AIDS-Free Generation
Julia Brasileiro, program officer at IntraHealth International, discusses the role of voluntary medical male circumcision (VMMC) in controlling HIV, writing, “[W]e should prioritize the scale-up of VMMC interventions — because it’s cost-effective and increases the possibility of a generation free from HIV and AIDS” (11/29).

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PAHO/WHO, Special Olympics Aim To Increase Access To Health Care For People With Intellectual Disabilities

PAHO/WHO: PAHO/WHO and Special Olympics agree to improve health access for people with intellectual disabilities
“The Pan American Health Organization (PAHO) and Special Olympics [on Tuesday] signed a memorandum of understanding aimed at increasing access to quality health care for people with intellectual disabilities. Under the agreement, the organizations will collaborate to train health workers, educate policymakers, create partnerships, disseminate information, and mobilize some 365,000 athletes and partners in the Special Olympics movement in Latin America…” (11/28).

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From the U.S. Government

USAID Webpage Describes New Development Impact Bond To Improve Quality Of Maternal, Newborn Care In Rajasthan, India

USAID: The Maternal and Newborn Health Development Impact Bond
“The Utkrisht Impact Bond — so named for the Hindi expression for ‘Excellence’ — is the world’s first health impact bond. It was developed by partners including USAID, Merck for Mothers, the UBS Optimus Foundation, PSI, Palladium, and HLFPPT. … This partnership will reach up to 600,000 pregnant women with improved care during delivery and save as many as 10,000 lives over a five-year period by improving the quality of private health care facilities that support a region of 75 million people…” (November 2017).

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USAID Highlights Non-Traditional Funding Tools To Finance Global Health Programs

USAID/Medium: 8 Ways USAID Drives Investments in Global Health
In this post, Bea Spadacini, senior communications adviser, and Leeza Kondos, data scientist, both in the Bureau for Global Health, highlight “the [changing] ways in which USAID and other donors finance global health programs in developing countries … Here are examples of how we’re using non-traditional funding tools that capitalize on investor interest. Development Impact Bond … Loan Guarantees … Co-funding/Global Development Alliance … Debt Swaps … Pooled Investment Fund … Social Insurance … Seed Funding/Flexible Grant Capital … Milestone-Based Payments … (11/30).

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USAID Announces New $1M Effort To Address Stigma Surrounding TB In India

USAID: U.S. Support for Ending Tuberculosis Epidemic in India
On Wednesday, “USAID [announced] a new $1 million effort to bring greater awareness to TB’s stigma — which disproportionately affects women — to support Prime Minister Modi’s ultimate goal of securing a TB-free India by 2025. … USAID has supported the TB program of the Government of India (GOI) since 1998, and has invested more than $140 million to strengthen the capacity of national, state, and district-level TB programs. USAID has also introduced new tools and approaches to reach, cure, and prevent TB in India successfully…” (11/29).

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