KFF Daily Global Health Policy Report

In The News

WHO's Chan Speaks About Ebola Outbreak Lessons, Antimicrobial Resistance In ScienceInsider Interview

ScienceInsider: In wake of Ebola epidemic, Margaret Chan wants countries to put their money where their mouth is
“As director-general of the World Health Organization (WHO), Margaret Chan is often ranked among the most powerful women in the world. But her agency appeared to be powerless to stop a devastating epidemic of Ebola last year. Critics have slammed WHO’s performance, and reviews have called for drastic reforms. … Science spoke to Chan on 10 October [in Berlin], where she talked about the lessons from Ebola and the dangers of antimicrobial resistance at a meeting of the G7 health ministers…” (Kupferschmidt, 10/14).

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Geneva Conventions Commission Awaits U.S., Afghan Government Permission To Begin Investigation Into Bombing Of MSF Kunduz Hospital

New York Times: Inquiry Into Kunduz Hospital Strike Awaits U.S. and Afghan Approval
“The aid group Doctors Without Borders said on Wednesday that an independent investigation into the American military airstrike that gutted the group’s trauma hospital in the northern Afghan city of Kunduz on Oct. 3 would begin pending the agreement of the United States and Afghan governments…” (Schreuer, 10/14).

Reuters: Global panel seeks to investigate U.S. bombing of Afghan hospital
“…[Médecins Sans Frontières (MSF)] has been demanding that the independent humanitarian commission created under the Geneva Conventions in 1991 be activated for the first time to handle the sensitive inquiry. ‘The commission has already offered its services to the governments of the USA and Afghanistan,’ a Swiss foreign ministry spokesman said in an email to Reuters on Wednesday. ‘Any investigation would require the agreement of both governments, however’…” (Nebehay, 10/14).

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U.S. Program To Develop Ebola Treatment Halted By 'Political Brinkmanship In Congress' In 2012, NOVA Next Reports

NOVA Next: Ebola Drug Killed by Congressional Inaction Less than Two Years Before Outbreak
“A decade before last year’s Ebola epidemic, the United States Department of Defense embarked on a research program that eventually produced a promising drug to treat the disease, one that was fast-tracked for review by the Food and Drug Administration. Then, in late 2012, a year and a half before the first case of Ebola was reported in West Africa, the program was abruptly halted, the victim of political brinksmanship in Congress…” This article is part of the “Next Outbreak” series, a collaboration between NOVA Next and the GroundTruth Project in association with WGBH Boston (Calma, 10/14).

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British Ebola Nurse 'Critically Ill' Months After Initial Infection; Case Highlights Unknowns About Viral Persistence, Experts Say

Agence France-Presse: British Ebola nurse now ‘critically ill’: hospital
“A British nurse who was successfully treated in January after contracting Ebola in Sierra Leone is now ‘critically ill’ due to a resurgence of the virus, the hospital treating her said Wednesday…” (Haddon, 10/14).

Associated Press: Condition of hospitalized Ebola nurse in U.K. worsens
“…[Pauline] Cafferkey was treated for Ebola after returning from Sierra Leone last year. She was released from the hospital’s high-level isolation unit in January but she suffered a relapse last week and was flown by military plane into London for treatment…” (10/14).

New York Times: Ebola Survivor From Scotland Is Critically Ill
“…[T]he case … points to how much is still unknown about the virus and its long-term effects. Doctors are grappling with why Ms. Cafferkey’s current illness happened so many months after her initial infection in Sierra Leone, where she had gone as a volunteer, and why similar cases have not been well documented in the three West African countries that are now home to thousands of survivors…” (Fink, 10/14).

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Ebola Virus Can Persist In Semen Of Male Survivors For Up To 9 Months, Studies Show

News outlets discuss two reports published Wednesday in the New England Journal of Medicine that examine the persistence of Ebola virus in bodily fluids of survivors. One study describes a case of sexually transmitted Ebola in Liberia and another study shows Ebola can be present in male survivors’ semen up to nine months.

Associated Press: Study: Ebola in male survivors can survive up to 9 months
“Doctors have found that Ebola can linger in some male survivors for up to nine months but aren’t sure if that means they might still be infectious, according to new research…” (Cheng, 10/14).

NPR: How Long Can Ebola Linger In The Semen Of Male Survivors?
“…The research is part of a long-term study of Ebola survivors by the World Health Organization, the U.S. Centers for Disease Control and Prevention, and the Sierra Leone Ministry of Health and Sanitation, which announced this month that it will launch a national program in mid-November to regularly test the semen of male survivors…” (Bichell, 10/14).

Reuters: Ebola survivors can harbor virus in semen for at least nine months
“…In preliminary results that raised questions about how and when the West African epidemic might be brought to an end, researchers said they did not know if the traces of virus that were discovered were live or potentially infectious…” (Kelland/Nebehay, 10/14).

Science: New evidence that parts of Ebola virus hide in semen for months
“…[WHO] guidelines now advise survivors to abstain from sex or use a condom for six months or until their semen tests negative. Given that there are thousands of male survivors who could spread the virus through sex, ‘the chances of seeing sporadic cases igniting small outbreaks is very real,’ says Jonathan Ball, a virologist at the University of Nottingham, in the United Kingdom…” (Kupferschmidt, 10/14).

TIME: We Now Know More About Sexually Transmitted Ebola
“…The CDC says that until more is known about how Ebola can be passed sexually, the over 8,000 male Ebola survivors in Liberia, Sierra Leone, and Guinea need to be counseled and undergo regular testing to monitor whether the virus continues to be in their semen. They also need take precautions so as not to infect their partners…” (Sifferlin, 10/14).

VICE News: Ebola Virus Remains in Semen Up to Nine Months After Illness Onset
“…[Education and precautions are] ‘critical because the patient is otherwise well and is going to resume normal activities including sexual intimacies with partners,’ said Dr. William Schaffner, chair of preventive medicine at Vanderbilt University, who was not involved in the study. ‘That can set up transmission of the virus and set up a new chain of transmissions. That’s the time bomb that’s ticking’…” (Lupkin, 10/14).

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Most HCWs Infected With Ebola In Sierra Leone Exposed To Virus In Non-Ebola Hospital, Residential Settings, Study Shows

CIDRAP News: Study: Most health workers infected in non-Ebola settings
“Ebola infections in health care workers (HCWs) were much more likely to occur in a non-Ebola hospital or at home than in an Ebola treatment center, according to a study [published] yesterday in BMC Infectious Diseases that involved 293 infected HCWs in Sierra Leone…” (Wappes, 10/14).

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Include Food Security In Global Climate Change Discussions, FAO Head, French Official Urge

U.N. News Centre: U.N. agency and French government urge inclusion of food security in global climate change debate
“Targeted policies and investments in food security and agriculture should be at the center of debates on climate change, according to a top U.N. official and the French minister for agriculture, speaking at the Committee on World Food Security (CFS) in Rome this week…” (10/14).

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WHO Western Pacific Regional Committee Discusses Concerns Over Viral Hepatitis

Pacific Daily News/USA TODAY: Viral hepatitis in Pacific a chief WHO concern
“Viral hepatitis, a disease that kills many in the Western Pacific region, was the first issue the World Health Organization Western Pacific Regional Committee discussed Tuesday. Guam is hosting the WHO Regional Committee for the Western Pacific this week … The disease kills more than 1,500 a day in the region, more than HIV, tuberculosis, and malaria combined, a WHO report states…” (Sablan, 10/14).

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BBC Examines Child Stunting In Area Of Madagascar With Sufficient Food

BBC News: Mystery of Madagascar’s stunted children
“People in Madagascar are puzzled why some children aren’t getting enough nutrients — so are shorter than their peers — in an area where there is plenty of food…” (Vogl, 10/15).

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Editorials and Opinions

More Attention Needed On Critical Role Of Skilled Birth Attendants For Maternal, Newborn Health

Washington Post: My son was born in our car. He was still safer than if he’d been born in 21 other countries.
Mark Leon Goldberg, editor of U.N. Dispatch and host of the Global Dispatches Podcast

“…In the United States, 99 percent of all births happen in some form of controlled medical setting, often with a midwife or obstetrician present. But in many developing countries, less than half of all births occur under the supervision of what the World Health Organization calls a ‘skilled birth attendant.’ … According to the Kaiser Family Foundation, there are now 21 countries in which fewer than 50 percent of all births are attended by someone with medical training — down from 28 countries five years prior. Globally, maternal mortality has decreased 45 percent from an estimated 523,000 deaths in 1990. Newborn deaths are down, also, from 24.9 deaths per 1,000 live births in 2006, to 19.2 deaths per 1,000 live births this year. These improvements are profound. But the number of mothers who die as a result of pregnancy and newborns who do not live past one month are still shockingly high. … [E]very baby deserves the care of someone [with medical training] to increase the chances of a safe and healthy delivery for mother and baby — at home, in a medical facility or, in some cases, in an old car” (10/14).

Global Dispatches: My Wife Gave Birth to Our Son the Passenger Seat of Our Car, So This Episode is about Maternal and Newborn Health
In this episode, Goldberg discusses his child’s birth with his wife and interviews Luc de Bernis, senior maternal health adviser at the U.N. Population Fund, about maternal and infant health worldwide (10/14).

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Agreement Possible On Details Of Pandemic Emergency Financing Facility To Mitigate Global Health Threats

Washington Post: Larry Summers: How finance can fight disease epidemics
Lawrence H. Summers, Charles W. Eliot university professor at Harvard and former treasury secretary and director of the National Economic Council in the White House

“During the annual IMF-World Bank meetings last week in Lima, Peru, I was part of a discussion on a proposed pandemic emergency financing facility. … The idea under discussion is a potentially powerful one: some public entity would issue bonds to investors which would be deemed to default in the event of an epidemic, assuring the availability of resources to respond before the epidemic takes on pandemic proportions. … But there are two hurdles that will have to be overcome if this initiative is to succeed. … First, a suitable price has to be found for these bonds: a price that works for both investors and for those who will issue them. … Second, a suitable contract has to be drafted specifying when exactly the bonds will default. … I think these problems are solvable…” (10/14).

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U.S. Government, International Partnerships Play Vital Roles In Ending Hunger, Malnutrition

Huffington Post: The Fight to End Hunger: The Role of U.S. NGOs and Global Leadership
Samuel A. Worthington, president of InterAction

“…The U.S. government has been at the forefront in the fight to end chronic hunger, and it must continue this momentum. The U.S.’s Feed the Future initiative has made tremendous gains in the last five years. In 2013, the partnership of farmers, entrepreneurs, scientists, and civil society leaders meant 12.5 million children had better nutrition. … To build upon these gains and ensure strong U.S. leadership in ending hunger and malnutrition, we must encourage Congress to pass the Global Food Security Act (HR 1567 and S 1252). To end hunger by 2030, NGOs, governments, private businesses, and universities need to think of new ways to work together. As we have witnessed since 1990, significantly decreasing hunger is possible. Now is the time for us to pave the pathway toward eradicating hunger and building more healthy, just, and peaceful societies for the future” (10/14).

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Agricultural Productivity Gains Essential To Achieving Global Food Security

Des Moines Register: World still falling short of feeding 9 billion
Editorial Board

“…According to the 2015 edition of the Global Agricultural Productivity Report released in Des Moines on Wednesday by the Global Harvest Initiative, average global growth was stagnant for the second year in a row. Productivity is a measure of how much more can be produced from the same amount of land, labor, fertilizer, feed, and machinery. … Many factors go into the global food security equation, not the least of which is getting food from the field to the table, a serious challenge in developing countries … Other roadblocks to improved or even sustained production of food include droughts, extreme weather events due to climate change and, in many parts of the world, political instability and a lack of access to capital for small-scale farmers. … Even assuming those roadblocks could be cleared, agricultural productivity must also increase to keep pace with population growth because only so many acres of arable land and resources are available for producing food…” (10/14).

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Political Will Required To Address Childhood Malnutrition, Stunting In India

New York Times: Half the Kids in This Part of India Are Stunted
Nicholas Kristof, New York Times op-ed columnist

“…In a remarkable failure of democracy, India is the epicenter of global malnutrition: 39 percent of Indian children are stunted from poor nutrition, according to government figures (other estimates are higher). … Here in Uttar Pradesh, a vast state of 200 million people in India’s north, the malnutrition is even more horrifying. By the government’s own reckoning, a slight majority of children under age five in this state are stunted — worse than in any country in Africa save Burundi, according to figures in the 2015 Global Nutrition Report. … [W]hen hundreds of millions of children are unnecessarily malnourished, holding them back all their lives, that should be a global priority. … Manmohan Singh, India’s former prime minister, called child malnutrition ‘a national shame’ — but there’s still no political will to address it…” (10/15).

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Religious Leaders Have Opportunity, Moral Obligation To Promote Family Planning Within Local Communities

The Guardian: Leap of faith: why religious leaders have a moral duty to promote family planning
Canon Grace Kaiso, theologian, Anglican priest, and general secretary of the Council of Anglican Provinces of Africa; and Ahmed RA Ragab, professor of reproductive health and vice chair of the Faith to Action Network

“…[F]aith leaders worldwide have an unparalleled opportunity — indeed, a moral obligation — to prioritize conversations about family planning and close the contraception gap. … Many faith-based organizations are already taking a leading role in the promotion of family planning in developing countries, while respecting the core tenets of their faith. Examining their successes provides a valuable blueprint for faith-based solutions. … To enact change on a global scale, religious leaders must embrace their community responsibilities, educate themselves about the various contraceptive options for couples, and engage their local governments and health care providers on the topic. Local action is the only tool that will allow us to meet the family planning needs of millions and build a better world for future generations…” (10/15).

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From the Global Health Policy Community

World Food Day To Focus On Importance Of Social Protection, Agricultural Development Programs In Ending Poverty, Hunger

Food Dive: José Graziano da Silva: Breaking the bonds of rural poverty, once and for all
U.N. Food and Agriculture Organization Director-General José Graziano da Silva discusses World Food Day, recognized annually on October 16, writing, “[T]winning social protection with agricultural development programs makes compelling sense. This is why FAO chose social protection and agriculture as the theme of World Food Day this year…” (10/14).

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West Africa Passes 2-Week Mark With No Recorded Ebola Cases, WHO Report Says

WHO: Ebola Situation Report — 14 October 2015
According to the latest WHO Ebola Situation Report, “No confirmed cases of Ebola virus disease (EVD) were reported in the week to 11 October. This is the second consecutive week with zero confirmed cases…” (10/14).

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Pulitzer Center Project Examines Access To Health Care In Rural Uganda

Pulitzer Center on Crisis Reporting: Uganda: Looking at an Under-Resourced Health Care System
“…Washington University student fellow Jae Lee’s project in Uganda examines rural people’s access to health care by sharing stories from community health workers, victims of poor health care, and lower-tier health care providers.” The project includes an article on the consequences of poor access to medical care and a video profiling one man’s health care experience in Uganda (Lee, 10/13).

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Blog Post Examines India's Efforts To Eliminate Lymphatic Filariasis, Other NTDs

Global Network for Neglected Tropical Diseases’ “End the Neglect”: Celebrating NTD Success Stories: India’s Historic NTD Progress
Emily Conron, a resource development associate at the Sabin Vaccine Institute, writes, “During the month of October, END7 student supporters are celebrating NTD Success Stories from Haiti, India, Sierra Leone, and the Philippines. Each country we are spotlighting has overcome their own challenges, ranging from earthquakes to the Ebola epidemic, to make sure communities receive NTD treatment and progress towards disease control and elimination. … [T]his week we’re looking across the globe to India, a historic leader against [lymphatic filariasis] and many other NTDs…” (10/14).

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