KFF Daily Global Health Policy Report

In The News

Syria's Polio Outbreak May Threaten Europe, Scientists Warn

“In [an article] published Thursday in the medical journal The Lancet, two German public health experts warn that Syria’s [polio] outbreak may threaten Europe,” National Journal reports (Koren, 11/7). “Dr. Martin Eichner of the University of Tubinge in Germany and Dr. Stefan Brockmann of the Reutlingen Regional Public Health Office wrote Thursday in [the journal] hundreds of thousands of people are fleeing Syria and seeking refuge in neighboring countries and Europe,” United Press International notes (11/7). “Vaccinating only Syrian refugees against polio may not be enough to prevent the crippling viral disease from re-infecting Europe where it has not been seen for decades,” they warned, according to Reuters, which adds, “[T]hey said the risk to Europe from a re-emergence of polio in Syria was partly due to the type of vaccine generally used in regions that have not had the disease for many years” (Kelland, 11/7). “They say because only one in 200 people infected develops paralysis it could take a year of ‘silent transmission’ before an outbreak is detected,” BBC News writes, adding, “In that time hundreds of individuals could be carrying the infection” (Walsh, 11/7).

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GlobalPost Examines Oxfam's 'Behind The Brands' Initiative

GlobalPost’s “Pulse” blog examines how Oxfam is challenging large food companies such as Coca-Cola and Nestle “to identify agricultural policies that could be perpetuating hunger, poverty and human rights abuses.” The blog states, “As part of the project, called ‘Behind the Brands,’ Oxfam is acting as a sort of consultant to the 10 biggest food companies, including Pepsico, General Mills and Kellogg’s,” adding, “At the same time, though, Oxfam has been loudly trumpeting the companies’ wrongdoings to the world using petitions and social media campaigns.” The blog notes “Raymond Offenheiser, president of Oxfam America, presented the project’s progress at the American Public Health Association Annual Meeting in Boston this week,” and writes, “His presentation was one of several examining ways the public health community can work with the private sector to tackle issues like hunger and malnutrition” (Stuart, 11/7).

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Spain Reports First Case Of MERS Virus

“Spain’s Health Ministry says the country has its first case of the new respiratory virus known as MERS and the female victim is believed to have contracted the virus in Saudi Arabia,” the Associated Press reports. “A ministry statement says the Moroccan-born Spanish resident was admitted Nov. 1 to a Madrid hospital,” the news service writes, noting the woman had traveled to “Saudi Arabia in October and was diagnosed there with pneumonia.” The news service adds, “The ministry said Thursday the woman is progressing favorably and her case poses no public health threat.” According to the AP, “About 50 have died from the new virus over the past year, most in Saudi Arabia where the outbreak is centered” (11/7).

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Israel Working To Stem Silent Spread Of Polio Within Its Borders

“Twenty-five years after it had been dispatched, wild poliovirus [is] back in Israel and spreading fast,” Science magazine reports, adding, “Retrospective analysis of sewage samples has shown that the virus has been circulating since February but, surprisingly, has caused no cases of paralysis.” According to Science, “The country is now scrambling to quash the silent outbreak before it spreads further. … And other wealthy countries, including the United States and the United Kingdom, are watching closely, hoping to draw lessons for their own vaccination and monitoring strategies.” The magazine examines the country’s use of the inactivated polio vaccine (IPV) versus the oral polio vaccine (OPV), which can be more effective at preventing the virus’s spread but “can in rare instances regain its neurovirulence and cause paralysis.” The country has implemented new vaccination campaigns using OPV, but “the virus is still circulating in Israel. The most pressing question now is how much OPV is needed to stop transmission — Israel is gearing up for another national vaccination round with OPV — and how long it will take,” Science writes (Roberts, 11/8).

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False Information, Attacks On Health Workers Hindering Polio Efforts In Pakistan

Deutsche Welle examines how “[a]ttacks against health workers and the willful dissemination of false information are deterring the fight against polio in Pakistan.” “While in the rest of the world polio vaccines have reduced the number of polio cases, polio vaccination teams are endangered by al Qaeda extremists in Pakistan, who tell parents it’s dangerous for their children to get vaccinated,” the news agency writes, adding, “As a result, hundreds of thousands of children are not being vaccinated, posing the threat of a comeback for the disease.” According to the news service, “More than 36,000 parents have refused vaccination for their children this year alone, the majority of them in tribal areas of northwestern Pakistan.” The news service highlights “false information” being spread by Islamist groups, noting they are “threatening parents and telling them to not have their children vaccinated,” and discusses violence against health workers in the country, writing, “This year alone, 11 polio health workers were shot in different cities throughout Pakistan.” The news service adds, “With new infections, Pakistan could be labeled as a state unwilling to help create a polio-free world,” which “could not only have direct consequences on international financial assistance, but could also damage Pakistan’s foreign policy” (Sumbal, 11/8).

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Zambia Sets Out To Create New National Strategic Framework On HIV/AIDS

“Zambia is in the process of coming up with another national strategic framework on HIV/AIDS as the southern African nation presses on with its resolve to eliminate the pandemic,” Xinhua reports in an article examining the country’s efforts. Joshua Banda, chair of the National AIDS Council, “who was speaking at the start of a three-day convention called to review the progress made in fighting the pandemic and shaping a new roadmap for the fight, said the government is now more than resolved to overcome the specter of HIV using multi-pronged approaches, adding that the country has so far made tremendous gains in the HIV response with a review of its strategies for the last five years showing impressive epidemiological indicators,” the news agency writes. “As the country embarks on a process of coming up with a new strategic framework, which will run from 2016 to 2020, there is need to come up with high-impact interventions,” according to Xinhua (11/7).

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CRIEnglish.com Examines Sexual, Reproductive Health Among Chinese Adolescents

CRIEnglish.com reports on the Forum on Adolescent Pregnancy, held in Beijing on October 31, “to discuss challenges facing Chinese youth regarding sexual and reproductive health.” Noting the recent release of the UNFPA’s 2013 State of World Population Report, which discussed the challenge of motherhood in childhood, the news service features quotes from Arie Hoekman, UNFPA representative in the China office; Zhang Lei of the Population Research Institute of Beijing University; and Yu Yang, “director of a volunteer organization in Renmin University that is dedicated to promoting sexual and reproductive education among university students” (Li, 11/7).

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Media Outlets Report On Lawsuit Seeking Reparations From U.N. For Haitian Cholera Outbreak

CBS News examines the cholera epidemic in Haiti and “an unprecedented lawsuit” against the U.N., whose peacekeepers are suspected of bringing the disease to the country following the 2010 earthquake. However, “[t]he U.N. said it has legal immunity and will not accept claims for compensation,” according to the news service, which features a video news segment on the issue (Glor, 11/7). LiveScience reports on how the strain of cholera imported to Haiti has now spread to the Dominican Republic, Cuba, and Mexico (Parry, 11/6).

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Editorials and Opinions

Opinion Pieces Address UNFPA Report On 'Motherhood In Childhood'

The following is a summary of two opinion pieces addressing the 2013 State of World Population report, titled “Motherhood in Childhood: Facing the Challenge of Adolescent Pregnancy,” released by UNFPA last week.

  • Babatunde Osotimehin, Huffington Post’s “Global Motherhood” blog: UNFPA Executive Director Osotimehin examines the issue of adolescent pregnancy, noting, “Every day, 20,000 girls below the age of 18 give birth in … developing nations.” He states, “[A]dolescent pregnancy isn’t just a problem … for the nations of the developing world. It’s a problem for us all,” adding, “Teen pregnancies are contributing to [global] population growth and damaging the economic potential of many nations in the developing world.” He writes, “Adolescent pregnancy diminishes the life opportunities of girls everywhere, but the cost goes beyond the burden borne by the girls themselves. And that is why it is our collective responsibility to address this problem” (11/7).
  • Saundra Pelletier, Huffington Post’s “Global Motherhood” blog: The report “provid[es] more concrete and stark evidence that girls are being compromised — globally, and particularly in the developing world,” Pelletier, CEO of WomanCare Global, writes. “[T]here is a wide range of issues that are responsible for this problem, but one of the more obvious triggers has to do with social customs that encourage young children, young girls, to get married and have children,” she states. “There are no quick and easy remedies — no obvious answers, but there are opportunities,” such as “sexual education and improved health care delivery …, both of which can help raise awareness of and access to contraception,” she notes. She adds, “We know that increasing the availability and reliability of contraception improves the lives of women and girls” (11/7).

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India's Government 'Must Act Urgently' To Address Child Mortality

Despite its success in reducing the number of deaths among children under age five from 2.5 million in 2001 to 1.5 million in 2012, “India alone still accounts for 20 percent of child mortality worldwide — and a shocking 48 percent of Indian children under the age of five are chronically malnourished,” a New York Times editorial states. “According to a report published by The Lancet in September, half of India’s child mortality occurs in just 81 of its 597 districts,” some of which are in the country’s richest states, the editorial writes. Noting “gender remains the biggest factor in an Indian baby’s chance of survival,” the editorial concludes, “The way forward is clear. The government of India must act urgently to find out why some districts are failing and to provide wider access to sanitation, nutrition and health services — meanwhile redoubling efforts to make sure girls are not forced to become mothers before they are ready and, in general, to give them the same life chances as boys” (11/8).

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U.S., International Community Must Maintain Commitment To Global Fund To Advance Progress

“[C]rucially, the establishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria in 2002 — with key support from the United States during President George W. Bush’s administration — has made the worldwide fight against AIDS (and the other daunting diseases) a winnable one,” columnist Fannie Flono writes in a Charlotte Observer opinion piece, highlighting progress made against the three diseases. “But continued treatment and thus prevention efforts depend on continued financial support,” she writes, noting, “The Global Fund is seeking $15 billion worldwide to support even more ambitious and aggressive strategies to combat these diseases with the goal of saving 10 million lives.” She states, “Organizers of the December Global Fund meeting are making a particular push for the United States to continue its commitment and pledge $5 billion over the next three years,” and she concludes, “The U.S. has been a leader over the last decade in tackling these diseases. Now, when science and treatments are putting us at the precipice of eradicating these scourges, the world can’t afford for the U.S. to step back” (11/7).

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Humanitarian Agencies Need Unhindered Access Within Syria

In Syria, it is “abundantly clear that political conflict is severely impacting public health,” Abdelhadi Eltahir, senior health coordinator at the International Rescue Committee (IRC), writes in the Huffington Post’s “Global Motherhood” blog. “Government-supported clinics closed down months [ago], meaning the most at-risk population of mothers, babies and the elderly have nowhere to turn after two years of civil war,” and “health facilities have been destroyed by fighting or abandoned by doctors, midwives, nurses and other health providers who have fled the country,” he writes. “But we are making progress,” he adds, noting, “The IRC has already served close to 30,000 patients this year. In that time, we’ve inoculated more than 2,100 children against polio,” which has been confirmed in the country. “The humanitarian community must immediately be provided open access across borders and within Syria itself. Without that, preventable malnutrition, illness and disease will only worsen during the long winter ahead,” Eltahir concludes (11/7).

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International Community Must Address Barriers To Health, Economic Well-Being Of Women

“Within a few days, thousands of members of the global family planning community will come together in Addis Ababa, Ethiopia, to talk about ways to advance the health and economic well-being of women worldwide by improving the delivery of family planning services and information,” James Gribble, a principal associate and expert in monitoring and evaluation, reproductive health and family planning at Abt Associates, writes in a Devex opinion piece. Gribble highlights “four barriers or practices that must end to address the health and well-being of individuals, families, and nations”: a lack of education among women and girls; “economic inequalities for women, such as limiting inheritance or owning property”; a preference for boys over girls in some societies; and the issue of child marriage, “which is deeply rooted in many social and cultural norms and is heavily influenced by poverty.” He writes, “[W]e must recommit to addressing the persistent social policies and gender norms that continue to keep women on unequal footing,” and he concludes, “Let’s put women at the center of policies — addressing everything from economic opportunity to education — to truly achieve a world where women can reach their full potential” (11/7).

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Community Health Workers Vital To Service Delivery

Noting a global focus on frontline health workers at recent conferences, including the upcoming Global Forum on Human Resources for Health that starts in Brazil on Sunday, Helen Morton, head of communications and external affairs at Cochrane, writes in The Guardian’s “Global Development Professionals Network” blog, “A new review from Cochrane, analyzing evidence from over 50 qualitative studies of community health worker programs globally, has identified eight key factors that could help … [governments] ensure that the impacts of community health workers can be maximized within, and beyond, the homes and communities in which they deliver health care.” She outlines the factors, including community connection, incentives, participation, training, working conditions, integration, low/no cost services, and communication and support. She states, “Community health workers don’t represent a ‘silver bullet’ for global health care. They do, however, deliver services that will be central to meeting health and development targets in the decades to come” (11/8).

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Most Countries Have Made 'Enormous Progress' In Health, Development In Recent Decades

In a BBC News Magazine opinion piece, Hans Rosling, professor of global health at Sweden’s Karolinska Institute and co-founder of Gapminder, highlights five facts that show “the enormous progress most countries have made in recent decades.” Rosling discusses the slowing of global population growth, says the divide between “developed” and “developing” countries has lessened, highlights the growing average life expectancy in the world, notes progress in the education of girls globally, and states that the “end of extreme poverty is in sight,” noting “the number of people in extreme poverty, according to the World Bank, has fallen from two billion in 1980 to just over one billion today” (11/6). Rosling on Thursday appeared on BBC Two’s “This World” program to discuss global population growth and extreme poverty, according to the program’s webpage (11/6).

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Blog Highlights Kaiser Survey On American Public's Knowledge, Opinions Of U.S. Global Health Efforts

Writing in the Washington Post’s “Wonk Blog,” contributor Ezra Klein highlights a survey, released by the Kaiser Family Foundation on Thursday, which “found that Americans think 28 percent of the [U.S. government’s] budget goes to foreign aid,” an amount “[t]hat would make foreign aid pricier than Social Security, Medicare, Medicaid, or all defense spending.” However, only “[a]bout one percent of the budget goes toward foreign aid,” Klein states, noting “the Kaiser poll found that when you tell people that fact, it changes their opinions.” He provides an infographic from the survey depicting this change in opinion and adds, “But as of yet, budget wonks haven’t had a shadow of success at convincing the country that foreign aid is a tiny sliver of federal spending” (11/7).

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From the Global Health Policy Community

Blog Highlights USAID Official's Comments Regarding Hormonal Contraception, HIV

The Center for Global Health Policy’s “Science Speaks” blog highlights comments made by Chelsea Polis, senior epidemiological adviser at USAID, at a recent Washington, D.C., event about hormonal contraception and HIV. Data regarding how hormonal contraception affects HIV transmission are inconclusive, the blog notes, and includes a link to a USAID technical brief (.pdf) on the issue (Barton, 11/7).

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Five Reasons To Pay Attention To Human Resources For Health Forum

Writing in IntraHealth’s “Vital” blog, Kate Tulenko, senior director of health systems innovation at IntraHealth International, outlines five reasons the proceedings of the upcoming Global Forum on Human Resources for Health are important to those working in global health. She says the reasons include country commitments on health workforces; conversations about the future of global health workforce leadership; trends on funding, country ownership and accountability; announcements on innovative programs; and the exchange of ideas (11/7).

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UNAIDS 'Expresses Deep Gratitude' To Ambassador Goosby For Work On HIV/AIDS

In a press release, UNAIDS “expresses deep gratitude to Ambassador Eric Goosby for his outstanding work on the AIDS response as United States Global AIDS Coordinator and head of the Department of State’s Office of Global Health Diplomacy.” Goosby resigned his position on November 1, the press release notes, adding, “UNAIDS congratulates Ambassador Goosby for his passionate humanitarianism and is grateful for his visionary leadership that has positioned PEPFAR to make even more critical contributions towards reaching an AIDS-free generation” (11/7).

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U.N. Foundation Official Releases Statement Regarding Award For Frontline Polio Workers

A United Nations Foundation press release highlights a statement released Tuesday by Ambassador John Lange, a senior fellow for global health diplomacy at the foundation, regarding “the announcement that the United Nations Association of the USA will honor frontline polio workers at its Global Leadership Dinner in New York City.” “This award is one small but important recognition to showcase the essential role that frontline workers play in the fight against polio, and a call to action to step up efforts to eradicate polio from the globe,” Lange said in the statement, according to the press release (11/6).

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