KFF Daily Global Health Policy Report
In The News
- News Outlets Examine Lingering Impacts Of U.S. Government Shutdown On Science Research
Noting “[t]he U.S. Senate and House of Representatives on Wednesday night voted to end a partial shutdown of the U.S. government that has paralyzed science funding agencies, disrupted research projects and meetings, and threatened to wipe out an entire season of field studies,” Science Insider examines what the end of the shutdown means for researchers whose work had been affected, such as those working with the NIH and the National Science Foundation, the National Oceanic and Atmospheric Administration, and NASA, among others. “In some cases, it may take days or longer to resume normal operations,” the magazine writes, adding, “And the shutdown’s impacts could linger for months, as government officials attempt to wade through piles of grant applications, e-mails, and paperwork that piled up during the weeks they were required, by law, to stay away from their official e-mail and phone messages” (10/17).
ABC News reports on how the shutdown affected research at NIH, writing, “The labs, which are home to some of the most cutting-edge disease research in the country, at least had electricity throughout the government shutdown, sparing precious cells and tissues stored at sub-zero temperatures,” but “the shutdown still managed to stall research on cancer and other deadly diseases by halting experiments and delaying funding decisions, officials said.” The news service adds, “The true impact of the shutdown on NIH may become more clear on Friday, [a] spokeswoman said” (Moisse, 10/17).
- U.N. Calls On International Community To Do More To Eradicate Poverty
“Urging greater support for people struggling to escape poverty and build better lives, [U.N.] Secretary-General Ban Ki-moon and the United Nations marked the International Day for the Eradication of Poverty by calling on the world to ‘do more to listen to the voices that often go unheard,'” the U.N. News Centre reports. “Ban noted that the day comes as the international community is pursuing twin objectives: intensifying efforts to reach the Millennium Development Goals (MDGs), and formulating the next set of goals to guide our efforts after the MDG 2015 deadline,” the news service writes. “Stressing that too many, especially women and girls, continue to be denied access to adequate health care and sanitation, quality education and decent housing, he also said that rising inequality in many countries — both rich and poor — is fueling exclusion from economic, social and political spheres, and the impacts of climate change and loss of biodiversity hit the poorest the hardest,” according to the news service, which quotes several other U.N. leaders (10/17).
- WFP Head Warns Against 'Donor Fatigue' As Global Conflicts Increase Need For Food Aid
“Conflicts around the world mean there must be no ‘donor fatigue,’ the head of the World Food Programme [WFP] told AFP in an interview, as the United Nations marks World Food Day on Wednesday,” Agence France-Presse reports. “Ertharin Cousin warned aid funds were running out for forgotten but ongoing humanitarian crises like North Korea or Yemen, as money shifts to conflicts such as Syria, where the media attention is stronger,” the news agency writes. “WFP supplies aid to about 97 million people in 80 countries, including 20 states that are mired in constant crises like Afghanistan, Haiti or Sudan,” AFP notes, adding, “WFP operations in and around Syria are costing around $31 million a week, but Cousin said this could not come at the expense of other crises.” Cousin discusses aid efforts in other countries, including Yemen, North Korea, Central African Republic, and Democratic Republic of Congo, according to the news agency (10/17).
- Food Insecurity, Poverty, Lack Of Access To Health Services Hindering Recovery Efforts In Mali
The Guardian examines recovery efforts in Mali after a coup in 2012 left many displaced, food insecure, and without access to health services. “The interlinked fortunes of [Mali and Libya] in the sparely populated Sahara region have played a complex role in the causes of Mali’s conflict and also the coping strategies people … have employed to survive,” the newspaper notes. The Guardian continues, “Insecurity has meant there are no up-to-date figures on the malnutrition rate in the region,” adding, “Flight and displacement have disrupted farming, livestock activities and trade, and the collapse of state institutions — only now beginning to reform in towns such as Gao — form a complex set of pressures on already vulnerable people.” The newspaper highlights World Food Programme (WFP) efforts to provide “school feeding programs in 576 schools in northern Mali, including around 250 in Gao” (Hirsch, 10/16).
- Scientific American Reviews Findings Presented At AIDS Vaccine 2013
“Given that the AIDS pandemic has been around for 30 years …, the long-awaited goal [of developing an HIV vaccine] might finally be attainable, according to researchers attending the AIDS Vaccine 2013 conference last week in Barcelona,” Scientific American reports in an article summarizing clinical trial findings presented at the conference. “The future will probably … see much greater cooperation among the various camps within the field: vaccinologists and pathogenicists, preventive and therapeutic vaccines, vaccine and microbicide approaches,” the magazine writes, noting, “As a matter of fact, the Barcelona meeting was the last AIDS Vaccine conference.” Scientific American adds, “Next year the gathering will be called the HIV Research for Prevention Conference (H4P) and will bring together the fields of vaccines, microbicides and antiretroviral drugs” (Furtado, 10/18).
Editorials and Opinions
- Successful Transitions To Country Ownership Of Global Health Programs Possible With Care
“Increased country engagement, or so-called country ownership, in HIV and health programming is central to achieve adequate scale in service delivery, improve the acceptability of interventions, increase domestic investments in health, and advance integration of HIV programming with national health goals and systems,” Chris Collins, vice president and director of public policy for amfAR, The Foundation for AIDS Research, and Chris Beyrer, director of the Johns Hopkins Fogarty AIDS International Training and Research Program and Center for Public Health & Human Rights, write in a Lancet opinion piece. “Increased country ownership is fundamental to long-term progress in global health, but too rapid a transition runs the very real risk of undercutting access to services and squandering the potential to accelerate progress in HIV/AIDS,” they write, adding, “Four areas raise particular concern and deserve close attention.”
“First, rapid transitions could decelerate scale-up of effective HIV services, including antiretroviral treatment, prevention of mother-to-child transmission services, and voluntary medical male circumcision,” Collins and Beyrer write. “Second, in many settings, country ownership could undermine the nascent response to HIV in many of the most vulnerable populations, including marginalized groups such as men who have sex with men, transgender people, people who inject drugs, and sex workers,” they state, adding, “Third, the transition to increased country ownership will require attention to the participation of various stakeholders in health decision making.” They continue, “Finally, adequate financing remains a crucial challenge as countries assume a greater role in their AIDS responses.” Collins and Beyrer describe three tiers of transitioning to country ownership, using the Avahan program in India as an example of success. They conclude, “At this pivotal point in tackling the epidemic, we need to advance nationally owned decision making while acting decisively on the evidence of what works to accelerate the end of AIDS” (10/17).
- Despite Achievements, GAVI Alliance Continues To Face Challenges In Childhood Immunization Efforts
A Lancet editorial discusses the GAVI Alliance’s 2013 Mid-Term Review, released this week, noting the report “examines the organization’s progress midway through the period 2011-15” and states that “by 2014, 73 countries with GAVI’s support will introduce five-in-one pentavalent vaccines, including fragile states — Haiti, Burma, Somalia, and South Sudan.” The editorial states, “Despite the achievements documented in the report, challenges remain: looking for better ways to collect country-level data and ensuring supply chains are more reliable; addressing low-income countries’ unique and challenging needs with individualized approaches; and ensuring sustainability of immunization programs in countries wealthy enough to no longer be eligible for GAVI support.” The journal adds, “GAVI should continue to work hard and successfully to address these issues, to ensure that all children are protected against vaccine-preventable diseases, wherever they live.” The Lancet notes, “The report is published ahead of a mutual accountability meeting on October 30, in Stockholm, Sweden, to take stock of GAVI’s progress in immunization and resource mobilization since 2011” (10/19).
- Eradicating Poverty Benefits Everyone
“October 17 marks the International Day for the Eradication of Poverty, and it falls amid a global movement working to end extreme poverty — not in 100 years, not in 50, but by 2030,” Sam Worthington, president and CEO of InterAction, writes in a Devex opinion piece. “The target of ending extreme poverty in our generation is bold, but achievable. Already, extreme poverty rates are half what they were two decades ago,” he adds. “This week, for the International Day for the Eradication of Poverty, the NGO alliance InterAction and our 180-plus members — U.S.-based non-governmental organizations — are highlighting programs around the world that already are making an impact,” he states, adding, “Youth, women farmers, people living with HIV and AIDS and others are changing their lives through these programs — many with the support of the American people and U.S. foreign assistance.” Worthington summarizes some of these programs, continuing, “When people lift themselves out of poverty, we all benefit. By focusing on it, we not only improve lives but promote stability and create markets around the globe. Greater global stability and economic opportunity are good for all” (10/16).
- International Community Must Address Trauma As Growing Public Health Issue In Sub-Saharan Africa
“Trauma has become a silent epidemic in Africa, an epidemic that will only spread as the economy grows,” Ola Orekunrin, a trauma doctor and the managing director of Flying Doctors Nigeria, an air ambulance service, writes in a New York Times opinion piece. “Sub-Saharan Africa has the world’s smallest number of motorized vehicles but the highest rate of road traffic fatalities, with Nigeria and South Africa leading the pack,” she notes, adding, “The World Bank predicts that in the next two years, road accidents could be the biggest killer of African children between five and 15,” and “[b]y 2030, according to the Global Burden of Disease study, road accidents will be the fifth leading cause of death in the developing world, ahead of malaria, tuberculosis and HIV.”
“And yet, trauma receives only a tiny fraction of the attention and money given to these three infectious diseases,” Orekunrin continues. “Over the last decade, billions of dollars have poured into Africa with the laudable aim of defeating these killer diseases. But that most basic killer, injury, remains neglected,” she states, adding, “Part of the problem is that the solutions are so complex.” According to Orekunrin, “We need to put in place systems to provide lifesaving care for accident victims,” including fully equipped hospitals, improved roads, a high-quality ambulance system, and paramedic schools. She notes, “Africa’s challenge will require an African response — and international support” (10/17).
- Humanitarian Assistance For Displaced Malian Women Needed To Prevent 'Survival Sex'
Writing in an opinion piece in The Hill’s “Congress” blog, Marcy Hersh, a senior advocate at Refugees International, says that some displaced Malians are resorting to “survival sex, a form of prostitution used by those in extreme need.” She notes, “One year ago, following a coup that ousted Mali’s president, insurgent groups moved in and occupied much of the north,” forcing people to leave the war-torn region. “‘Displaced women in Bamako who engage in survival sex will often have multiple clients to be able to pay for their rent, food, and clothes,’ [a] humanitarian worker explained,” Hersh notes, adding, “There is no way to know how many women and girls are engaging in survival sex in Bamako, but local humanitarian organizations say it is a highly visible problem.” She states, “The humanitarian response to the scourge of survival sex in Mali should be straightforward. Increasing humanitarian assistance to these communities by offering basic support in the form of food, cash, and health care could potentially eliminate the need for survival sex” (10/17).
- Search For HIV/AIDS Vaccine 'A Roller Coaster Ride Marked By Highs And Lows'
The AIDS Vaccine 2013 conference that concluded last week in Barcelona “may best be described as a roller coaster ride marked by highs and lows,” Linda Villarosa, the journalism program director at City College in Harlem, writes in the Huffington Post’s “Healthy Living” blog. She summarizes several study results presented at the conference, writing, “Many in the vaccine field hope to build on the recent successes … [b]ut even so-called failures can provide teaching moments” in the search for an effective vaccine. “In the meantime, prevention strategies like circumcision, microbicides, pre-exposure prophylaxis (PrEP) and treatment as prevention are speeding ahead of vaccines,” Villarosa states, noting, “Beginning next October, scientists and advocates from all prevention disciplines will convene together in Cape Town to encourage more ‘interconnection'” (10/16).
From the Global Health Policy Community
- Rep. Clarke Introduces 'Global Sexual And Reproductive Health Act Of 2013'
The Center for Global Health Policy’s “Science Speaks” blog reviews HR 3206 [.pdf], “the Global Sexual and Reproductive Health Act of 2013, introduced by Rep. Yvette Clarke (D-N.Y.) on September 27.” The bill was “[r]eferred to the House Foreign Affairs Committee that day, just a few days before the government shutdown, [and now] has 30 co-sponsors,” the blog notes. “Clarke has introduced it twice before, in the 111th Congress and the 112th,” but the bill “died in committee both times, and the body’s make-up has not changed in ways that make its success this time more likely,” the blog states. Jamila Taylor of Ipas, which supports the bill, said, “We hope the bill can be used to educate policymakers about the importance of packaging reproductive health services in a way that meets the needs of women and girls throughout the lifespan,” according to the blog (Barton, 10/17). The Kaiser Family Foundation’s “Policy Tracker” provides additional information about the bill (9/27).
- European AIDS Conference Begins With Emphasis On Epidemics Of Drug Use, HIV, TB In Eastern Europe
“Eastern Europe is facing quadruple, intersecting epidemics of injecting drug use, HIV, tuberculosis (TB) and hepatitis C, and governments must act to tackle these problems in the only region of the world where the HIV epidemic is still expanding, the U.N. Secretary-General’s Special Envoy on HIV in Central and Eastern Europe, Michel Kazatchkine, told the opening session of the 14th European AIDS Conference” in Brussels on Tuesday, aidsmap reports in an article on its webpage. “The 14th European AIDS Conference opened with a strong political emphasis on Eastern Europe,” the article notes, adding, “The European AIDS Clinical Society, the organizers of the conference, issued a strong condemnation of a new Russian law that forbids ‘propaganda of non-traditional sexual relations amongst minors'” (Alcorn, 10/16). In an accompanying article, aidsmap examines a statement issued on the opening day of the conference in which the European AIDS Clinical Society called on the Russian Federation to abolish the recent legislation (Alcorn, 10/16).
- PLOS Blog Highlights New Articles Published In PLOS NTDs, PLOS Pathogens
The PLOS “Speaking of Medicine” blog highlights several new articles published in PLOS Neglected Tropical Diseases (NTDs) and PLOS Pathogens this week. In one highlighted PLOS NTDs article, Francisco Luquero of the Epicentre in Paris, France, and colleagues examine the use of an oral cholera vaccine, Shanchol, by Médecins Sans Frontières (MSF) staff “working during the 2012 cholera outbreak in Guinea and how it fits into existing outbreak response strategies.” Also in PLOS NTDs, a study by Sara Dabirian of the Pasteur Institute of Iran and colleagues examines a treatment option for cutaneous leishmaniasis, and a study by Robert Tweyongyere of Makerere University in Kampala, Uganda, and colleagues conducted in the Entebbe peninsula region around Lake Victoria in Uganda “examine[s] what effects praziquantel treatment has on susceptibility to S. mansoni [schistosomiasis] in the children born to women given this drug while pregnant.” Studies published in PLOS Pathogens examine the causes of dental caries, and research into treatments for Ebola virus and skin damage (10/17).