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Kaiser Daily Global Health Policy Report

In The News

Uganda Begins Vaccinating HCWs For Ebola Amid Fears Of Spread From DRC; Experts Call For Action From U.S.

CIDRAP News: DRC Ebola total grows by 2, health experts push for high-level support
“The Democratic Republic of Congo (DRC) [Friday] reported two new Ebola cases as Uganda announced plans to vaccinate health workers. In another development, two global health experts said urgent high-level support is needed to update the outbreak battle plan and quick action is needed to shore up U.S. leadership…” (Schnirring, 11/2).

Reuters: Uganda begins Ebola vaccinations amid Congo transmission fears
“Uganda says it will start to vaccinate some of its health workers against Ebola on Monday, amid fears that the viral hemorrhagic fever could spread from Democratic Republic of Congo which is battling an outbreak…” (Biryabarema, 11/2).

VOA News: Uganda to Deploy Ebola Vaccine to Health Workers on DRC Border
“…Uganda has no confirmed cases of Ebola, but as the threat worsens in the DRC, the preventive measure is seen as necessary because of heavy border traffic. More than 20,000 people cross from the DRC into Uganda and back every week, the ministry says…” (Athumani, 11/2).

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U.N. Calls For End To Conflict In Yemen As Aid Supplies Blocked, Children Die Of Starvation

The Guardian: ‘End war on Yemen’s children’: conflict escalates around Hodeidah hospital
“Fighting has intensified around the largest hospital operating in the port city of Hodeidah, preventing access to severely malnourished and vulnerable children, the U.N.’s children’s agency has warned. The escalation in conflict follows U.S. calls for a ceasefire and suggestions that peace talks may be held in Sweden…” (Ratcliffe, 11/2).

Reuters: Yemeni children die as warring sides block aid deliveries: UNICEF
“Yemeni children are dying from starvation and disease as trucks with life-saving supplies are blocked in port, leaving medical staff and desperate mothers imploring aid workers to do more, a senior U.N. official said…” (Nebehay, 11/2).

U.N. News: Yemen: U.N. chief hails ‘signs of hope’ in world’s worst man-made humanitarian disaster
“Welcoming recent indications that peace talks could resume soon to end Yemen’s brutal civil conflict, United Nations Secretary-General António Guterres said on Friday there is ‘no room for complacency,’ and called on the warring parties and the international community to ‘halt the senseless cycle of violence’ and ‘reach a political settlement’…” (11/2).

Additional coverage of the humanitarian crisis and conflict in Yemen is available from Agence France-Presse, Al Jazeera, CBS News, CNN, New York Times, and U.N. News.

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U.N., Red Crescent Convoy Reaches Remote Syrian Camp To Deliver Humanitarian Aid, Vaccinations

Associated Press: Aid workers reach remote Syrian camp for 1st time
“U.N. officials and volunteers from the Syrian Arab Red Crescent offered children vaccinations and distributed desperately needed aid on Sunday, the first such assistance since January to reach thousands in a remote camp for the displaced on Syria’s border with Jordan…” (Aji/El Deeb, 11/4).

U.N. News: Syria: U.N. chief welcomes first aid convoy to Rukban camp since January, joint agency operation assists 50,000
“…In a statement welcoming the aid convoy, Secretary-General António Guterres recognized that while ‘the long-needed delivery is an important achievement, the overall humanitarian access to this informal desert camp remains wholly inadequate.’ As such, he called on all relevant actors ‘to ensure continued, full, safe, sustained, and unimpeded humanitarian access to the tens of thousands of displaced Syrians in this remote area, and to all people in need throughout the country’…” (11/3).

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Asia-Pacific Region Must Recommit To Ending Malnutrition, Hunger As Part Of Global Effort To Achieve SDG, U.N. Report Says

U.N. News: ‘Colossal human loss’ threatens Asia, Pacific as hunger fight stalls — U.N. agencies
“Well over half the world’s undernourished people live in the Asia-Pacific region, making it a critical part of the global push to end extreme hunger and malnutrition in line with the Sustainable Development Goal (SDGs), cautioned a new United Nations report on Friday. The Regional Overview of Food Security and Nutrition, warns of ‘colossal human loss’ to Asia and the Pacific, and its economies, if countries do not recommit themselves to ending malnutrition and achieving zero hunger by 2030…” (11/2).

Additional coverage of the report is available from VOA News and Xinhua News.

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U.S., E.U. Respond To Dar Es Salaam Administrator's Anti-Gay Remarks, Actions; National Government Distances Itself From Comments

The Hill: State Department warns citizens of anti-gay crackdown in Tanzania
“The State Department is warning U.S. [citizens] in Tanzania of a crackdown against gay people in the East African country. The State Department said in a notice on its website that citizens should ’employ sound security practices’ and review their ‘internet footprint and social media profiles’…” (Burke, 11/4).

Reuters: E.U. reviews relations with Tanzania over homosexuality crackdown
“The European Union has recalled its envoy in Tanzania and will review its relations with the country in response to a planned crackdown homosexuals. Brussels also criticized what it saw as growing human rights violations in Tanzania. … Paul Makonda, administrative chief of the capital Dar es Salaam, said last Wednesday that a special committee would seek to identify and punish homosexuals, prostitutes, and online fraudsters in the city from this week…” (Malalo et al., 11/5).

VOA News: Tanzanian Government Distances Itself from Calls for LGBTQ Crackdown
“Nearly a week after a local administrator called for a crackdown on gay people living in Dar es Salaam, Tanzania’s biggest city, the government is distancing itself from his remarks. … In a statement published Sunday in Swahili on the Ministry of Foreign Affairs and East African Cooperation’s website, the government said Makonda’s call is only his opinion and not reflective of the country’s official stance…” (Solomon/Shomari, 11/4).

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More News In Global Health

Devex: Ebola vaccine technology could speed up development of other vaccines (Ravelo, 11/5).

Devex: A rising star of French aid? (Chadwick, 11/5).

The Guardian: ‘They killed my children and raped me’: sexual violence remains rife in Congo (Burke, 11/2).

Health Policy Watch: Multilateralism Key To Addressing Many Health Issues, Austrian Health Official Says (New, 10/31).

Health Policy Watch: Austria’s Director General For Health Clemens Auer Discusses Goals For E.U., Drug Pricing (New, 11/2).

IRIN: Old drains and dirty water: Zimbabwe’s chronic cholera crisis (Mukeredzi, 11/2).

Science: In win for open access, two major funders to bar grantees from publishing in hybrid journals (Stokstad, 11/5).

VOA News: Somali Towns Get Health Care After 30 Years of War (Schlein, 11/4).

Xinhua News: WHO seeks to contain cholera outbreak in Somalia amid decline in cases (11/2).

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Editorials and Opinions

Currency, Exchange Rate Important Factors When Comparing Spending For HIV/AIDS, Health

The Lancet: Comparing estimates of spending on health and HIV/AIDS
Jose Antonio Izazola-Licea and Ana Yakusik, both special advisers for strategic information at UNAIDS, and Deepak Mattur, officer for strategic information at UNAIDS

“We commend the Global Burden of Disease (GBD) Health Financing Collaborator Network … for publishing HIV spending estimates. However, we are concerned that some readers could interpret the GBD’s reported estimates to mean that the global HIV-resource needs have been met. The GBD estimate of total spending for HIV responses in low-income and middle-income countries (LMICs) in 2015 … appears to exceed the U.N. General Assembly commitment to fully fund the global HIV response and reach ‘overall financial investments in developing countries of at least 26 billion dollars per year by 2020.’ … However, if the global and regional components of the development assistance for HIV are included in the LMIC aggregates, then the GBD estimate for 2015 and the UNAIDS estimates are remarkably similar. … Both analyses come to similar conclusions: increases in domestic expenditures are being offset by reductions in development assistance. We agree with the authors that more investment is needed to achieve global health and HIV goals, and that investment for in-country HIV resource tracking is also needed” (11/3).

The Lancet: Comparing estimates of spending on health and HIV/AIDS — Authors’ reply
Annie Haakenstad and Mark Moses, both researchers at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, and Joseph L. Dieleman, assistant professor at IHME

“We are appreciative of the constructive and helpful comments made to our article by Jose Antonio Izazola-Licea and colleagues and commend UNAIDS on its recently released estimates of domestic and external financing of HIV/AIDS. We agree with the authors’ assertion that the world remains far from realizing global goals for HIV/AIDS investments. Evidence that the decline in HIV incidence is slowing down is particularly concerning in light of the investment gap. … [H]owever, we stress the crucial importance that readers and practitioners always consider the currency in which estimates are being reported in, especially when making comparisons across countries. The appropriate exchange rate information will be particularly important as we investigate further how much domestic resources can be raised for HIV/AIDS…” (11/3).

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DARPA Agricultural Effort Raises Questions Over Dual-Use Biological Research, Holds Potential

Washington Post: A Pentagon program involving insects comes with risks — and huge potential
Editorial Board

“…The end goal [of the $45 million research effort announced by the Defense Advanced Research Projects Agency (DARPA) in November 2016] will be to conduct large, contained greenhouse demonstrations in which maize and tomato plants are infected by viruses transported by insects … The hope is that viruses could be precisely tailored using sophisticated tools to deliver a specific result in the plant, far more quickly than, say, attempting to stimulate changes across generations of plant growth. … [I]f it works, [this research effort] could be of significant benefit to mankind. Without question, [some] European skeptics are right to raise questions about this dual-use research, meaning the program could be adapted, in theory, for malign intent. But much research in biology is dual-use by its very nature. Research facilities that produce lifesaving drugs and therapies can be used to create harmful agents and weapons. … The skeptics say … that they worry the DARPA program could be ‘easily weaponized.’ … No one can ever be sure that bad actors won’t attempt something foolish, but fear should not paralyze a research program of such large potential. The best antidote to these concerns is rigorous oversight, transparency, and regulation, which DARPA argues it has put in place. The right course is to proceed, with caution and care” (11/4).

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Political Will, Improved Data Key To Strengthening Primary Health Care, Achieving UHC

Project Syndicate: The Keys to Universal Health Coverage
Jakaya Kikwete, member of the International Commission on Financing Global Education Opportunity and former president of Tanzania

“…The best way for countries to achieve a more integrated approach [to expanding access to health care] is to strengthen primary care, which is most people’s first point of contact with the health system. … Having recognized these potential benefits, world leaders recently met at the Global Conference on Primary Health Care in Astana, Kazakhstan, to endorse a new declaration that commits them to strengthening primary care systems within their respective countries. … With national leaders considering how best to meet their new commitment, I would emphasize two factors that are integral to making progress. First, we need to maintain the political will to strengthen primary care and achieve universal health coverage. … The second key to progress is improved data so that we can monitor what we have accomplished and what work remains to be done. … With high-level political commitments and new tools for promoting access to care and fostering accountability, I am confident that we can make this ambitious vision a reality” (11/5).

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Market-Entry Reward Co-Financed By Government, Private Sector Could Incentivize Antibiotic R&D

Project Syndicate: An Earnest Proposal for Tackling AMR
Jim O’Neill, chair of Chatham House

“…[I]t is time for the U.K. to join with pharmaceutical companies in piloting a new model of finance for investment in research and development of new antibiotics. … [W]hen the right conditions are put in place, there can indeed be a market for developing new antibiotics. Better yet, we still have other ways to strengthen incentives. … There are now a number of academic studies showing that a $1 billion annual prize could bring a host of new antibiotics down the pipeline in the coming years. … [N]ow is the time to introduce a market-entry reward. … Assuming that everyone is on board, I would propose that instead of expecting the government to put up the whole $1 billion for a market-entry reward — and in order to avoid inviting a revocation of industry-friendly regulations — British pharmaceutical companies should come together to contribute 50 percent. Imagine how encouraging it would be to see industry leaders standing next to the prime minister to announce the roll-out of a jointly financed award for the creation of life-saving antibiotics…” (11/2).

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From the Global Health Policy Community

CSIS Brief Examines Eastern Congo's Ebola Outbreak, Provides Recommendations For U.S. Response

Center for Strategic & International Studies: North Kivu’s Ebola Outbreak at Day 90: What Is to Be Done?
J. Stephen Morrison, senior vice president and director of the Global Health Policy Center, and Judd Devermont, director of the Africa Program, both at CSIS, discuss the Ebola outbreak in North Kivu province in eastern Congo, writing, “There is an urgent need for high-level political attention focused on generating an updated game plan to improve security, train and deploy community health workers and Congolese public health experts, and win community trust and cooperation. The United States — vitally important to the international response in West Africa 2014-2016 — has chosen thus far, out of security concerns, to limit its engagement to the periphery of the outbreak. Quick action is needed to affirm U.S. leadership in eastern Congo, better understand the specific security threats at play, and come up with practical solutions that permit the safe deployment of a small U.S. expert contingent into the center of the outbreak, where seasoned U.S. talent is most needed” (11/1).

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13 Countries Across Asia & The Pacific Develop Roadmaps To Expand PrEP, HIV Self-Testing

Unitaid: Thirteen countries from Asia and the Pacific plan scale-up of PrEP and HIV self-testing
“Representatives from 13 countries across Asia and the Pacific gathered in Bangkok, Thailand, from 29 to 31 October to develop road maps to implement and expand pre-exposure prophylaxis (PrEP) and HIV self-testing in the region. In discussions on building capacity for the roll-out of PrEP and HIV testing innovations in Asia and the Pacific, policymakers, health care providers, researchers, and advocates from key populations discussed barriers to scale up these tools and shared lessons learned…” (11/1).

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November 2018 Issue Of WHO Bulletin Available Online

WHO: Bulletin of the World Health Organization
The November 2018 WHO Bulletin features articles on various topics, including an editorial on results-based financing in health, an article on the need for more health workers to achieve universal health coverage, and research on the accuracy of diabetes screening methods used for people with tuberculosis in Indonesia, Peru, Romania, and South Africa (November 2018).

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FT Health Discusses Health, Economic Impacts Of Global Air Pollution

FT Health: Tackling toxic air
The latest issue of the Financial Times’ weekly global health newsletter highlights the health and economic impacts of global air pollution and provides a round-up of global health-related news stories (Dodd, 11/2).

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From the U.S. Government

U.S. Participates In 5th GHSA Ministerial Meeting To Launch Next 5-Year Phase Of Agenda

HHS: U.S. Government Participates in Fifth Annual Global Health Security Agenda Ministerial Meeting
“On November 4-6, 2018, Health and Human Services Deputy Secretary Eric Hargan will attend the Fifth Global Health Security Agenda (GHSA) Ministerial Meeting in Indonesia, which will officially launch the next five-year phase of GHSA, known as GHSA 2024. Delivering on President Trump’s commitment to global health security, he will lead the multi-sectoral U.S. delegation, including representatives from the Departments of Health and Human Services, State, Defense, Agriculture, the U.S. Agency for International Development, and the National Security Council…” (11/2).

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USAID Recognizes International One Health Day

USAID: USAID Celebrates International One Health Day
In this bulletin, USAID recognizes International One Health Day, which takes place annually on November 3, and discusses U.S. efforts to promote the One Health approach in which “multiple disciplines work together to attain the best health for people, animals, and the environment” (11/3).

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