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Kaiser Daily Global Health Policy Report

In The News

E.U. Should 'Stay Generous' On Foreign Aid To Help Maintain U.S. Levels, Gates Tells European Parliament

Devex: Bill Gates to Europe: ‘Stay generous’ on aid to stop U.S. cuts
“Bill Gates entered the debate over the European Union’s next seven-year budget Wednesday, telling a packed meeting of the European Parliament’s development committee that maintaining high levels of E.U. aid would prevent budget cuts in Washington. ‘In terms of U.S. foreign aid, as long as Europe stays generous, I believe there is a bipartisan consensus where the U.S. overall it may cut a few things, but the overall level I believe will be maintained,’ Gates told European parliamentarians, researchers, and aid advocates in Brussels. ‘The [U.S.] Congress has a longer timeframe, what I would call a more responsible view of cooperation, than the current executive branch position’…” (Chadwick, 10/18).

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Bill Gates, Ban Ki-moon, Kristalina Georgieva Spearhead Global Commission On Adaptation To Address Climate Change

Business Insider: Bill Gates and Ban Ki-moon are recruiting mayors, heads of state, and finance pros around the world on a last-ditch quest to save us from catastrophic heat, drought, and flooding
“The bad news about our planet released last week from the Intergovernmental Panel on Climate Change (IPCC) suggests that time is running very short to get serious about the threat of disastrous floods, storms, fires, droughts, and extreme poverty that could soon hit as a result of climate change. The news is so dire, it’s prompted a new last-ditch effort to help the world better deal with these coming disasters. Dubbed the Global Commission on Adaptation, it will be led by philanthropist Bill Gates, former U.N. Secretary-General Ban Ki-moon, and World Bank CEO Kristalina Georgieva…” (Brueck, 10/16).

The Guardian: Leaders move past Trump to protect world from climate change
“… ‘We were very much united until December 2015 in Paris,’ Ban told the Guardian. ‘Now unfortunately the level of solidarity is being loosened, especially by the Trump administration. Even though it is just one country, it has caused big political damage.’ Adaptation measures to safeguard people’s homes, food, water, and energy are being implemented in some places, but at far too small a scale, the commissioners said…” (Carrington, 10/16).

National Geographic: Bill Gates launches effort to help the world adapt to climate change
“…The new group, on a two-year mission, intends to bolster funding and search for sensible solutions … The commission has recruited 28 commissioners and political leaders from 17 nations, including Germany, Canada, Mexico, China, India, and Britain. (The United States is not part of the group.) Additionally, 25 leaders from around the world, including China’s environment minister, Germany’s economic development minister, and the mayors of Paris and Miami, also signed on to the group…” (Parker, 10/16).

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German Chancellor Merkel, WHO DG Tedros, Global Fund Chief Sands Speak At World Health Summit On Global Health Security, Data Procurement

The Guardian: Merkel calls for international unity in the face of global health threats
“Angela Merkel has urged countries to work together in the fight against global health threats, warning that disease and epidemics are security risks that do not respect national borders. Addressing international health experts in Berlin [at a joint meeting held by the World Health Summit and Grand Challenges], the German chancellor acknowledged that global cooperation was under pressure, but said nations cannot ignore health challenges. … ‘God forbid, if we have a very potent airborne disease, it could be influenza,’ [Tedros Adhanom Ghebreyesus, director general of the World Health Organization,] told delegates. ‘We are not ready. We are as strong as our weakest link, and there is a lot of vulnerability. If there is no health security it can trigger political, economic and social upheaval on a global scale’…” (Ratcliffe, 10/17).

The Telegraph: What global health experts could learn from bankers
“Bankers may not be held in the highest regard but they could teach the global health world a thing or two about speedy data collection. Peter Sands, executive director of the Global Fund to Fight Aids, Tuberculosis and Malaria, told a briefing of journalists at the World Health Summit in Berlin, that efforts to control malaria were being hampered by the slow pace at which information on the disease was made available. He said that if he could get quarterly information on the number and location of malaria cases around the world, the fund could double its impact…” (Gulland, 10/17).

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WHO Calls For Additional Resources In DRC Ebola Response, Does Not Declare Global Emergency

The Hill: WHO says recent Ebola outbreak not a global emergency
“The World Health Organization (WHO) said Wednesday that an outbreak of the deadly Ebola virus in two eastern provinces of Congo does not rise to the level of a global public health emergency. But the group said it is increasingly concerned about insecurity in an area where armed rebel groups operate freely, threatening public health workers who are racing to contain the spread of the virus…” (Wilson, 10/17).

Science: Ebola outbreak in Congo is not yet international emergency
“…The PHEIC designation hinges on the risk of the virus jumping borders, whether the outbreak is ‘extraordinary,’ and whether an international response is necessary, says the panel’s chair, epidemiologist Robert Steffen of the University of Zurich in Switzerland, who spoke [Wednesday] at a press conference at WHO headquarters in Geneva, Switzerland. In theory, such a designation would help better coordinate and ramp up the response…” (Cohen, 10/17).

STAT: WHO raises concerns over Ebola outbreak, but declines to declare a global health emergency
“…There was nothing to be gained from declaring a PHEIC, and potentially some problems triggered by doing so, Steffen said. … He suggested some countries might use the declaration of a PHEIC as an excuse to bar travel from DRC or the region. … Professor Lawrence Gostin, faculty director of the O’Neill Institute for National and Global Health Law at Georgetown, said he believed the committee made the wrong call. Declaring a PHEIC would have led to the mobilization of more resources, he said…” (Branswell, 10/17).

Wall Street Journal: WHO Calls for More Resources to Fight Ebola Outbreak
“The World Health Organization called for an intensified response to a worsening Ebola outbreak in the Democratic Republic of Congo, including more assistance from United Nations peacekeeping troops, as rebel violence and other challenges are preventing health workers from stopping the virus’s spread. … WHO Director-General Tedros Adhanom Ghebreyesus said the agency recently briefed the U.N. Security Council and is expecting ‘more response’ from Monusco, the U.N. peacekeeping mission for Congo. The WHO has more than 250 experts deployed in Congo, he said, and is able to fill the gap left by U.S. experts who have had to leave…” (McKay et al., 10/17).

Washington Times: Ebola in DRC not yet a global emergency: WHO
“…WHO wants the U.N. Security Council to stay engaged in the response, saying it will help restore order and allow responders to regain community trust as a result. Countries should continue to stockpile trial vaccines and seek final licensure of the shots, and areas neighboring the affected part of DRC should consider vaccinating their front-line health workers, the WHO’s Emergency Committee advised. … ‘It is time for the global community — especially the United States — to step up their efforts in this outbreak,’ [Ron Klain, White House Ebola response coordinator from 2014-2015,] said in a statement posted to Twitter. ‘This particularly falls on the Trump administration, which to its credit has provided some resources to date — but should and must do more.’ He said global partners need to secure the area, so on-the-ground experts from the U.S. Centers for Disease Control and Prevention aren’t pushed to the sidelines. He also said the U.S. Agency for International Development should offer more aid” (Howell, 10/17).

Additional coverage of the WHO Emergency Committee meeting on Ebola is available from the Associated Press (2), CIDRAP News, CNN, HuffPost, New York Times, Reuters, TIME, and VOA News.

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Improved Access To Family Planning Services, Strengthened Reproductive Rights Will Bolster Global Social, Economic Development, UNFPA Report Says

Devex: All countries need to strengthen health systems, reproductive rights, UNFPA report says
“Continued progress on decreasing fertility rates and family size is dependent on health systems providing universally accessible reproductive health services, according to the United Nations Population Fund 2018 ‘State of the World Population: The Power of Choice: Reproductive Rights and the Demographic Transition’ report…” (Lieberman, 10/17).

U.N. News: World population set to grow another 2.2 billion by 2050: U.N. survey
“The world’s population is set to grow by 2.2 billion between now and 2050, the U.N. said on Wednesday, and more than half of that growth — 1.3 billion — is likely to be in sub-Saharan Africa, where women’s rights are hampered by limited access to health care and education, along with ‘entrenched gender discrimination’…” (10/17).

Additional coverage of the State of the World Population 2018 report is available from CBS News, UPI, and VOA News.

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U.S. Ban On American Aid Workers Traveling To North Korea Affecting Humanitarian Efforts, Advocates Say

New York Times: U.S. Bars American Aid Groups From Traveling to North Korea
“The Trump administration has barred American aid workers from going to North Korea as it pressures Pyongyang to dismantle the country’s nuclear weapons program, according to humanitarian groups and a former United States ambassador. … North Korea is one of the world’s poorest nations, and its citizens grapple with food shortages. … Barring aid workers from traveling affects humanitarian programs in North Korea, including efforts to alleviate tuberculosis and provide medical training and farming assistance…” (Wong/Sang-Hun, 10/17).

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HIV Prevention Study Using PrEP Should Be Replicated After Success In Australia's NSW, Researchers Say

The Guardian: Groundbreaking Australian HIV trial should be replicated, researchers say
“High-income countries with people at high risk of HIV should replicate a groundbreaking trial in Australia, which has seen new infections [among men who have sex with men in New South Wales] fall by 25 percent in one year following the rapid rollout of free HIV medication, researchers say. … Professor Andrew Grulich, from the Kirby Institute at UNSW Sydney, led a study that followed … gay and bisexual men … Only two of the men acquired HIV, and neither of those had been taking PrEP as prescribed…” (Davey, 10/17).

Reuters Health: HIV prevention drugs could dramatically cut new infections
“… ‘(This is) a really important study because it documents the benefit of HIV prevention pills at a population level,’ said Dr. Jeffrey D. Klausner of the University of California, Los Angeles, who wasn’t involved in the new research’…” (Carroll, 10/17).

Additional coverage of the PrEP study is available from Bloomberg, CNN, NBC News, and STAT.

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More News In Global Health

CNN: Zika spreads rapidly in India, with 94 cases confirmed (Gupta, 10/17).

CNN: Spain to lead Japan in global life expectancy, U.S. continues to slide (Picheta, 10/18).

Devex: The world’s leading ‘cholera hospital’ looks to the future (Bader, 10/18).

Devex: Controversy as investigated charity takes on key role in U.K. safeguarding scheme (Abrahams, 10/18).

Financial Times: Aid workers face tighter vetting in wake of Oxfam scandal (Mance/Hughes, 10/16).

Global Post/PRI: Italian cities ‘turn back the clock’ on women’s reproductive rights (de Fazio, 10/15).

Newsweek: Antibiotic-Resistant Tuberculosis: Glimpse of Hope for Most Deadly Infectious Disease in the World (Hignett, 10/17).

New York Times: Queensland Becomes Latest Australian State to Decriminalize Abortion (Rojas, 10/17).

STAT Plus: Why HIV vaccine research is now about much more than HIV (Branswell, 10/17).

Thomson Reuters Foundation: Rising hunger pushes Congo’s children into sex work and mines — charities (Lazareva, 10/16).

U.N. News: ‘Virginity testing’: a human rights violation, with no scientific basis — U.N. (10/17).

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Editorials and Opinions

Letter To Editor Discusses Potential Impacts Of Mexico City Policy On Women's Health

Washington Post: Letter to the Editor: Trump’s health policy does not protect life
Serra Sippel, president of the Center for Health and Gender Equity

“In the Oct. 11 front-page [Washington Post] article … there was an essential breach between the Trump administration’s words and the effect of its foreign policy. … The reality of the [impacts from the Protecting Life in Global Health Assistance — otherwise known as the Mexico City policy or “global gag rule” –] could not be further from this misnomer. … It also causes organizations that can’t comply with the rule to lose U.S. funding and [thereby] prevents them from providing essential services, such as contraception provision, HIV/AIDS treatment, and cancer screenings. … I challenge the Trump administration to realize that when abortion access is restricted, women’s lives are threatened…” (10/17).

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Public-Private Partnerships Can Help Address Health Challenges Worldwide

Devex: Opinion: How public-private partnerships can tackle global health challenges
Damian Halloran, Abbott’s vice president of infectious disease in emerging markets and rapid diagnostics

“…[I]f the business community is going to help scale up efforts to deliver real progress [on the Sustainable Development Goals (SDGs)], it’s crucial that it look beyond its own operations and proactively partner with the public sector to tackle the world’s most difficult global health challenges through the formation of public-private partnerships. … [T]he following three principles of partnership … we believe are essential to ensuring sustainability and could be applied to others looking to embark on partnerships for change: Listen and collaborate … Align resources with needs … Systems matter … Clearly, there is much work to be done to tackle global health challenges such as HIV/AIDS, malaria, and a host of other communicable and noncommunicable diseases. By bringing together highly engaged organizations across both the public and private sectors, public-private partnerships can help improve the lives of those in greatest need around the world” (10/18).

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Eliminating TB Requires Innovative Tools, Approaches, More Ambition

The Conversation: To eliminate TB we need imagination and ambition
Madhukar Pai, director of global health and professor at McGill University

“…The fact that we are still using century-old tools to tackle the biggest killer infection betrays a complete lack of ambition. So, before we can eliminate TB, we must end our lack of ambition. Only when we become more ambitious will our heads of state come around, rally, and support us. … [T]he field urgently needs to develop new tools, as well as adopt and implement the science of quality improvement. The TB community must think beyond coverage and demand high quality care for all patients in all countries. More importantly, we need to reinvent the way we are managing TB, and, as medical anthropologist and physician Paul Farmer put it, we must overcome our collective failures of the imagination” (10/17).

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New Roadmap Offers Path To Finding Better Ways To Prescribe Antibiotics In Effort To Help Address Resistance

Nature: Progress on antibiotic resistance
Editorial Board

“…Speeding up [the process of ensuring a patient who is ill receives effective treatment] will require major advances in what microbiologists call antimicrobial susceptibility testing. … Advances in genomics mean that rapid DNA sequencing can identify bacteria within hours. It can also quickly and accurately detect antibiotic resistance and susceptibility for tuberculosis. Developed further, this and other technologies could deliver results within an hour of a sample being taken from a patient. That would be a game-changer — but it has not yet happened. Why? Talk to the people involved — physicians, researchers, testing labs, regulators, and commercial firms among them — and all will offer their own reasons. One result of such discussion is published this week — a consensus statement that seeks to find common ground on defining the obstacles and recommending ways to overcome them. … Policymakers repeatedly say that action is needed on antibiotic resistance. The community has responded with a way forward” (10/17).

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From the Global Health Policy Community

CSIS Podcast Episode Features Interview With Global Fund Executive Director Peter Sands

Center for Strategic & International Studies’ “Take as Directed”: Executive Director of The Global Fund Discusses Next Steps
In this podcast, Sara Allinder, executive director and senior fellow at the CSIS Global Health Policy Center, speaks with Global Fund Executive Director Peter Sands “about his reflections on his first seven months in that post, takeaways from the UNGA High-Level Meeting on Tuberculosis, as well as his expectations for the lead-up to the 2019 Global Fund replenishment conference … [Sands] also discusses the importance of creative financing needed to achieve the Global Fund’s goal of investing resources to end the pandemics of HIV/AIDS, tuberculosis, and malaria” (10/17).

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Aidspan Publishes New Issue Of 'Global Fund Observer'

Aidspan: Global Fund Observer
Aidspan, an independent watchdog of the Global Fund to Fight AIDS, Tuberculosis and Malaria, published Issue 344 of the ‘Global Fund Observer.’ The newsletter includes articles on various topics, including the release of a report on the 2017 Office of the Inspector General advisory review on governance; an interview with Scott Filler, senior disease coordinator for malaria at the Global Fund; and an analysis discussing the low proportion of funding for HIV prevention among adolescents and youth in Africa’s Eastern and Southern regions relative to the disease’s impact on the population (10/17).

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Co-Chairs Of CORE M&E Working Group Discuss Observational Bias In Health Quality Research

IntraHealth International’s “Vital”: Hiding Outside the Spotlight: Don’t Miss the Real Impact of Your Development Efforts
Allison Annette Foster, senior adviser for human resources for health at IntraHealth International; Mai-Anh Hoang, public health specialist at Chemonics; and Todd Nitkin, senior adviser at World Vision International, all co-chairs of the CORE Monitoring & Evaluation Working Group, discuss results from the recent Lancet Global Health Commission report on high-quality health systems and highlight the observational bias that can occur when measuring quality of care and health system performance. The authors write, “The streetlight effect is a type of observational bias that occurs when we search for something only where it is easiest to look. Coverage, utilization, and access have been easier to quantify — and they are important health systems indicators — but they do not adequately measure quality of care and health system performance. … This means we have to venture outside of the light and work a little harder to find the answers…” (10/17).

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From the U.S. Government

NIH Highlights R&D On Lassa Fever Vaccine, Genomic Analysis

NIH: Scientists develop novel vaccine for Lassa fever and rabies
“A novel vaccine designed to protect people from both Lassa fever and rabies showed promise in preclinical testing, according to new research published in Nature Communications. … There are currently no approved Lassa fever vaccines…” (10/11).

NIH: Genomic analysis offers insight into 2018 Nigeria Lassa fever outbreak
“A surge in Lassa fever cases in Nigeria in 2018 does not appear to be linked to a single virus strain or increased human-to-human transmission, according to a genomic analysis published in the New England Journal of Medicine. … The research serves as a model for investigating infectious disease emergencies by combining genomic information with traditional epidemiological data to inform response strategies, the authors note” (10/18).

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U.S. Ambassador To Holy See Discusses U.S. Efforts To Address Human Trafficking, Involvement Of Survivors

U.S. Department of State’s “DipNote”: The Power of Heroes in the Fight against Human Trafficking
Callista L. Gingrich, U.S. ambassador to the Holy See, discusses U.S. efforts to address human trafficking, writing, “Leveraging input from human trafficking survivors is critical to combating human trafficking. … Pope Francis has called for a victim-centered approach to this endeavor, a method U.S. law enforcement has adopted for some time. Under President Trump’s leadership, the United States will not rest until human trafficking is eradicated. And the U.S. Embassy to the Holy See will continue to join heroes … and our Vatican partners in this cause” (10/18).

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