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Kaiser Daily Global Health Policy Report

In The News

USAID Administrator Green Discusses Melania Trump's Africa Tour, Foreign Investment In Continent On VOA News Show

VOA News: Plugged In with Greta Van Susteren: Winning Africa
“This week, Plugged In looks at the changing perceptions of Africa, starting with First Lady Melania Trump’s tour of four African countries. Is U.S. policy on Africa changing? Why is Beijing pumping so much money into the continent? And is the U.S. ignoring the potential of one of the fastest-growing parts of the world?” Van Susteren interviews USAID Administrator Mark Green as part of the show (beginning around 5:00). A full transcript of the interview is available from USAID (Van Susteren, 10/10).

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Dina Powell Withdraws As Potential Candidate To Replace U.S. Ambassador To U.N. Haley

POLITICO: Dina Powell out as contender for U.N. post
“Dina Powell, a Goldman Sachs executive and former aide to President Donald Trump, has withdrawn her name from consideration to replace outgoing U.S. Ambassador to the United Nations Nikki Haley, according to two people familiar with her decision…” (White/Orr, 10/11).

Reuters: Dina Powell withdraws from consideration for U.S. envoy to U.N. — source
“…Powell told President Donald Trump by phone that she was honored to be considered but planned to stay at Goldman Sachs, the source told Reuters. Trump, who says a number of people want the job, is also considering the U.S. ambassador to Canada, Kelly Craft, for the position, a source familiar with the matter said. Interior Secretary Ryan Zinke is also a candidate, another source said…” (Holland, 10/11).

Washington Post: Dina Powell no longer in running to succeed Nikki Haley
“…Powell and Trump also spoke Wednesday, and the president conveyed to some confidants that she was one of his top choices for the job. At the time, a senior White House official described Powell as one of two leading candidates…” (Parker/Sonmez, 10/11).

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U.S. Prevents American Aid Workers From Visiting N. Korea As Groups Report Country's Child Malnutrition Worsened In 2017

UPI: North Korea malnutrition worsened in 2017, humanitarian agencies say
“More North Korean children were hungry in 2017 than there were a year ago, according to international humanitarian organizations. In its annual 2018 Global Hunger Index, Concern Worldwide, German World Hunger Aid, and the U.S.-based International Food Policy Research Institute, ranked North Korea as a country at serious risk, South Korean news agency Yonhap reported Thursday…” (Shim, 10/11).

Wall Street Journal: U.S. Blocks Aid Workers From North Korea
“U.S. officials are preventing American aid workers from making humanitarian trips to North Korea, according to people familiar with the matter, inhibiting the flow of food and medical assistance to the isolated country ahead of a new round of diplomacy over Pyongyang’s nuclear program. The decision was made by Secretary of State Mike Pompeo, two of these people said, part of an attempt to tighten the screws on North Korea in response to perceived foot-dragging on dismantling its nuclear program…” (Cheng, 10/11).

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Publish What You Fund CEO Calls For More User-Friendly Data To Improve Development Aid Transparency

Devex: Time to make aid transparency actionable, says new campaign chief
“The new CEO of a major aid transparency group says the movement needs to change its ways, and make its data more user-friendly to encourage civil society groups to hold donors to account, during a new strategy launch Wednesday. In July, Gary Forster took over as head of Publish What You Fund, which was established at the 2008 high-level meeting on aid effectiveness in Accra, Ghana, in response to concerns that information about development aid was scarce and difficult to access…” (Edwards, 10/11).

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The Atlantic Examines Global Abortion Policies, Impacts On Women

The Atlantic: When Abortion Is Illegal, Women Rarely Die. But They Still Suffer.
“…If other countries are a guide, abortion restrictions won’t reduce the number of abortions that take place … But abortion-related deaths are much less common than they were a few decades ago, especially in countries with functional health care systems. … This is despite the fact that about 45 percent of all the abortions in the world are still performed in ‘unsafe’ circumstances—meaning without the help of a trained professional or with an outdated medical method. Unsafe abortions are more common in countries where the practice is illegal…” (Khazan, 10/11).

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Researchers Call For More Conservative Use Of C-Section Deliveries In Lancet Study Showing Increased Rate Since 2000

CNN: C-section deliveries nearly doubled worldwide since 2000, study finds
“…The number of births by cesarean section is on the rise, climbing from about 16 million (12.1 percent of all births) in 2000 to 29.7 million (21.1 percent of all births) in 2015, according to a study published Thursday in the journal The Lancet…” (Howard, 10/11).

Deutsche Welle: Doctors warn of alarming C-section ‘epidemic’
“…There is an urgent need for intervention in the medical field to reduce the use of cesarean sections, the researchers said. The authors suggested women be provided with more information and consultations about C-sections. They also advocated for increasing midwifery care and ensuring doctors are making evidence-based decisions to use C-sections…” (10/12).

Reuters: C-section births rise rapidly to more than 20 percent worldwide
“…Experts estimate that between 10 and 15 percent of births medically require a C-section due to complications such as bleeding, fetal distress, hypertension, or a baby being in an abnormal position. While the procedure can save lives — of both mothers and newborns — it can also create complications and side effects, including higher risks for future births…” (Kelland, 10/11).

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More Political Will, Government Investment Needed To Reduce Road Deaths, Bloomberg Experts Say

Devex: Greater political will needed to help reduce road deaths, support Bloomberg Philanthropies work
“Greater political will is needed to reach the goal of halving road traffic deaths and injuries by 2020 and meeting one of the Sustainable Development Goals targets, according to experts at Bloomberg Philanthropies and Vital Strategies. Bloomberg Philanthropies has invested $259 million over the last decade to reduce road traffic accidents, which claim 1.3 million lives each year and cause 50 million injuries. But much of the onus still rests with cities, many of which have traditionally lacked strong data and policies to create safer road environments…” (Lieberman, 10/12).

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Challenges Mount For Ebola Control In Conflict-Hit DRC Region

Devex: Tedros: Ebola outbreak highlights weakness for panic-based response
“As the Ebola outbreak in the Democratic Republic of the Congo threatens to spiral out of control — amid intense fighting near the country’s borders with Rwanda and Uganda — the global health community is reminded of the 2014 Ebola outbreak in West Africa: Has the international community learned its lesson? And is it responding differently to the present crisis? … WHO Director-General Tedros Adhanom Ghebreyesus [spoke with] Devex, at the sidelines of the 69th regional meeting of its Western Pacific office in Manila…” (Ravelo, 10/12).

The Lancet: Fighting Ebola in conflict in the DR Congo
“…The emergence of Ebola virus disease exacerbates an already dire humanitarian situation in this restive part of the [Democratic Republic of Congo (DRC)]. North Kivu is a region that has long experienced conflict, and when the new outbreak was declared on Aug. 1, vast swathes of the countryside were already no-go zones for international and national health workers…” (Moran, 10/13).

Thomson Reuters Foundation: Spike in Ebola cases pushes Congo outbreak to ‘tipping point’: aid workers
“Aid agencies said on Thursday that the Ebola outbreak in Democratic Republic of Congo could be tipping into a wider crisis as the number of new cases spiked and violence grounded health workers for a second time…” (Peyton, 10/11).

Additional coverage of the DRC Ebola outbreak and response is available from Al Jazeera, Bloomberg, CIDRAP News, Reuters, and Vox.

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More News In Global Health

Associated Press: Child hunger ‘serious’ in India while its economy grows fast (10/12).

BuzzFeed News: The U.S. Is Sending Its Addiction Problem Over The Border (Stanton, 10/11).

CNN: India hit with its biggest outbreak of Zika to date, with 32 confirmed cases (Suri, 10/12).

Devex: Indonesia disaster reveals community preparedness shortfalls (Rogers, 10/12).

IRIN: Oasis amid the drought: Local water systems give Afghans a reason to stay home (Glinski, 10/11).

The Lancet: 2018 World Food Prize recognizes advances in nutrition (Burki, 10/13).

The Lancet: Nobel Prizes: cancer, phages, and fighting sexual violence (Burki, 10/13).

ProPublica/TIME: Unprotected (Young/Flynn, 10/11).

SciDev.Net: Empowering Pakistan’s women key to polio eradication (Shaikh, 10/11).

Washington Post: Doctors trying to help suicidal asylum seekers in Nauru have been banned from treating them (O’Grady, 10/11).

Xinhua News: Cholera outbreak kills 42 in Somalia in 10 months: U.N. (10/12).

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Editorials and Opinions

U.S. Foreign Assistance Vital To Ending FGM, Empowering Women, Girls Worldwide

The Hill: U.S. foreign aid empowers women and girls worldwide
Rep. Ami Bera (D-Calif.), vice ranking member on the House Foreign Affairs Committee

“…[Sierra Leone] has one of the highest rates of [female genital mutilation (FGM)] globally, and each year more than three million girls are at risk of undergoing this dangerous procedure. The practice results in preventable deaths and carries lifelong health risks for those who do survive, including infections, hemorrhaging, and birth complications. … [T]he Girls Access to Education (GATE) program implemented by Plan International … [works] in Sierra Leone with families, local authorities, and village chiefs to stop FGM and help young women who have suffered the practice move forward with their lives. The program also empowers girls and women to become advocates for change, helping tackle issues like gender-based violence and girls education. … When I think of my time in Sierra Leone and learning about the incredible young women … working to improve their communities, I was proud to know that these programs were partially funded by U.S. foreign assistance. That funding is vital for women and girls … fighting to educate communities and stop female genital mutilation. … So, on this International Day of the Girl, we should recognize just how important these programs are. We should celebrate today by continuing to fund U.S. foreign assistance. The future stability and growth of countries like Sierra Leone … will certainly depend on it” (10/11).

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War, Conflict Threaten Global Public Health

The Lancet: DR Congo: managing Ebola virus in war
Editorial Board

“The latest Ebola virus outbreak across DR Congo is testing international and local health responses under conditions of extreme stress. The country is deep in a protracted conflict, and efforts to control Ebola virus in the conflict zone are hampered by conditions of war, which have led to a fractured society, a weakened health system, and widespread poverty and hunger. … Violence and war are, and have always been, a risk factor in public health emergencies. Cholera, a treatable disease, reached record levels in Yemen last year, and is on the rise this year. Neglected diseases, such as leishmaniasis, and diseases that should be on the way to eradication, such as polio, are resurging in conflict areas. … Long and protracted wars are common-place, and are a threat to us all. Violence and conflict are compounders of public health crises. What is happening in DR Congo means that a fragile political situation, a complex virus, and a raging conflict puts the whole world under threat” (10/13).

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Multi-Sector, Integrated Approach Critical To Eradicating TB In Africa

Project Syndicate: Winning the War on Tuberculosis
Ibrahim Assane Mayaki, CEO of the New Partnership for Africa’s Development (NEPAD) and former prime minister of Niger

“…Infectious diseases have no borders, and as African countries deepen their trade ties and intra-Africa migration grows, the threat of regional pandemics will only increase. This makes it all the more critical that Africa begin developing a multi-sector, integrated approach to containing, controlling, and eventually eradicating public health challenges like TB. … But before a specific framework can be agreed upon, three issues require urgent attention. First, African health care planners and disease specialists must set country, regional, and local containment targets. … Moreover, to end TB completely, Africa will need new and sustained financial commitments from the public and private sectors. And, finally, disease control strategies must be designed to support the economic and health care priorities of the [the Regional Economic Communities (RECs)]. … [Sustaining] progress [against TB] in Africa will require significant regional coordination, not to mention a lot more money. … [T]he recent gathering at the [U.N. General Assembly (UNGA)] marked a critical turning point in the world’s war on the disease. But even as commitments are made and declarations signed, we must remember that in Africa, the battle is far from over” (10/12).

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From the Global Health Policy Community

U.S. Senators Request Increase In U.S. Pledge To Global Fund For Next Replenishment Cycle

Friends of the Global Fight: Bipartisan Group of Senators Requests Increased U.S. Pledge to the Global Fund
“[On Thursday] a bipartisan group of 18 U.S. senators urged Secretary of State Mike Pompeo and the administration to increase the United States’ pledge to the Global Fund to Fight AIDS, Tuberculosis and Malaria (The Global Fund) for 2020-2022. The U.S. pledged $4.3 billion for the last three-year funding cycle in 2016. In a letter … the senators note: ‘…Given the Global Fund’s impressive results and the continuing, urgent priority to save lives and end three of the major infectious disease killers in the world, we believe the United States should make a 6th Replenishment pledge for 2020-2022 that exceeds the last Replenishment’…” (10/11).

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Wilson Center Experts Discuss U.S. Stance On Global Water Scarcity, Threats To National Security

Council on Foreign Relations’ “Strength Through Peace/Center for Preventive Action”: Who Controls the Tap? Addressing Water Security in Asia
In this guest post, Sherri Goodman, senior fellow for the Environmental Change and Security Program and the Polar Initiative at the Wilson Center, and Zoe Dutton, intern at the Wilson Center, write, “Growing global water scarcity threatens U.S. national security by undermining peace and stability around the world. Increased competition for water resources raises the stakes in regional power struggles, yet the United States’ lackluster support for allies’ water security points to a failure to comprehend this danger. Nowhere is the dynamic more apparent than in the absence of a U.S. response to China’s encroachment on Asia’s rivers…” (Stares, 10/10).

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Lancet Series Examines Global Rates, Impacts Of Cesarean Section

The Lancet: Optimizing cesarean section use
This “three-part Lancet Series on Optimizing Cesarean Section Use reviews the global epidemiology and disparities in cesarean section use, as well as the health effects for women and children, and lays out evidence-based interventions and actions to reduce unnecessary cesarean sections” (10/12).

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Lancet Commission To Explore Value Of Death Globally

The Lancet: Lancet Commission on the Value of Death
Richard Smith, member of the Lancet Commission on the Value of Death, discusses issues surrounding death, writing, “The Lancet Commission on the Value of Death will explore the relationship of medicine to death, consider failures in the relationship, and share ideas on how it might be improved. … The [Commission] will have a global focus and concentrate on four issues: the medicalization and possible demedicalization of death; how people die and think of death in different countries and cultures; whether the battle with death is beggaring us financially and spiritually; and the utility of attempts to tame death, including advance decisions, assisted suicide, palliative care, the concept of a good death, and the pursuit of immortality…” (10/13).

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From the U.S. Government

U.S. Global AIDS Coordinator Discusses Impact Of DREAMS On International Day Of The Girl

U.S. Department of State’s “DipNote” blog: Supporting Girls to Fulfill their DREAMS
In recognition of the International Day of the Girl Child, which takes place annually on October 11, Deborah Birx, U.S. global AIDS coordinator and U.S. special representative for global health diplomacy, discusses the impact of PEPFAR’s DREAMS partnership on adolescent girls and young women (10/11).

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USAID Administrator Recognizes International Day Of The Girl, Discusses U.S. Commitment To Improving Girls' Lives

USAID: U.S. Agency for International Development Administrator Mark Green on the 2018 International Day of the Girl
In a statement recognizing the International Day of the Girl, USAID Administrator Mark Green says, “I am … very proud of USAID’s programs to serve girls worldwide to ensure they can be safe, healthy, educated, and strong to make a positive impact on their communities. … Empowering girls is a force for strengthening the global economy, and reducing gender disparities is equally critical to achieving U.S. national-security and foreign-policy objectives” (10/11).

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USAID Expert Discusses Lessons From Securing Water For Food Grand Challenge

USAID’s “IMPACTblog”: It’s All In the Evidence: Water Challenge Demonstrates the Power of Doing Development Differently
Ku McMahan, team lead for Securing Water for Food: A Grand Challenge for Development, discusses a USAID-hosted session at World Water Week, during which experts and innovators working to improve water use in farming shared lessons learned on topics such as “how to build momentum among innovators, the timing of funding, promoting women’s participation, and the importance of local knowledge and context” (10/11).

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