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Kaiser Daily Global Health Policy Report

In The News

Al Jazeera America Examines WHO's Efforts To Establish Sanctions Against Nations For Deviating From IHR

Al Jazeera America: WHO wants sanctions against countries for mishandling epidemics
“…[WHO Director-General Margaret] Chan is on a panel set up by U.N. Secretary-General Ban Ki-moon, who instructed the group to think of ways to hold countries accountable for how they manage public health crises and punish those who violate the [International Health Regulations (IHR)]. … Australia’s decision, for example, to forbid all travel to Ebola-affected regions … at the height of the epidemic to appease rising panic at home hurt West African economies and slowed their recovery, said Joshua Michaud, an associate director of the global health policy team at the Kaiser Family Foundation and a lecturer at the John Hopkins University School of Advanced International Studies…” (De Bode, 10/22).

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WHO Calls For Urgent Action To Prevent Cholera's Spread In Middle East, Africa; Iraq Plans Mass Vaccination Campaign

VOA News: WHO: Cholera Outbreaks Threaten Africa, Mideast
“The World Health Organization is stepping up efforts to control multiple cholera outbreaks in Africa and the Middle East to prevent the disease from spreading and threatening the health of thousands of people. More than 10,700 cholera cases and 170 deaths are reported in five countries in the Eastern Mediterranean and African regions, Iraq, Bahrain, Kuwait, Democratic Republic of Congo, and Tanzania…” (Schlein, 10/22).

Agence France-Presse: Iraq set for cholera vaccine campaign amid fear of international spread: WHO
“Iraq plans to hold a mass vaccination campaign to halt a cholera outbreak that has infected more than 1,800 people amid fears it could spread among refugees in the region and beyond, the World Health Organization said Thursday…” (Larson, 10/22).

Agence France-Presse: Nearly 5,000 cholera cases, 74 deaths in Tanzania: WHO
“Tanzania is facing a major cholera outbreak, counting nearly 5,000 cases and dozens of deaths, the World Health Organization said Thursday, calling for urgent action to stop the disease from spreading to neighboring countries…” (10/22).

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Refugee Children Face Multiple Health Risks As Winter Arrives In Balkans, Aid Workers Say

Reuters: Aid workers warn looming Balkan winter threatens migrant children
“…Aid workers in Serbia warn children struggling across the Balkans on their way to western Europe face serious health risks as cold winter months approach. Many children arriving here are already coughing from colds caught along the route…” (Bytyci et al., 10/22).

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Africa Holds 40 Of 50 Nations With Highest Traffic-Related Deaths, WHO Report Shows

The Economist: Road deaths in Africa: Worse than malaria
“Road accidents are the leading cause of death among 15- to 29-year-olds globally, according to a report published by the World Health Organization on October 19th. Forty of the 50 countries with the highest road-death rates across all ages are in Africa…” (10/24).

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South African Miners Take Class Action Suit To High Court, Alleging Mining Companies Failed To Protect Health

NPR: Gold Miners Breathe The Dust, Fall Ill: ‘They Did Not Give Me Nothing’
“Miners in South Africa have some of the highest rates of silicosis in the world. … Now, thousands of current and former South African miners are asking the country’s highest court for the right to proceed with a lawsuit against the gold mining industry. They argue that mining companies failed to protect their health. If it’s certified, the class action would be the biggest ever brought in the country…” (Schmidt, 10/22).

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Surgeon, Author Atul Gawande Speaks With Devex About Health Systems Performance, Evaluation

Devex: Dear primary health systems, it’s time for your checkup
“…[MacArthur Fellow and National Book Award finalist Atul Gawande,] who spoke to Devex last month in New York, has known the human body as only a surgeon can; but his wide-angle view of the role health systems play in enabling or obstructing health care is uncommon in such a specialized field. … Last month the prominent health writer moderated the unveiling of a new effort, the Primary Health Care Performance Initiative, launched by the Gates Foundation, World Health Organization, and the World Bank…” (Igoe, 10/22).

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Fred Hutchinson Breast Health Global Initiative Director Speaks With NPR About Rising Rates Of Breast Cancer In Developing Countries

NPR: Breast Cancer In The Developing World: Rising Rates, Shrouded In Silence
“…We spoke to [Ben Anderson, a surgical oncologist who is the director of the Breast Health Global Initiative at the Fred Hutchinson Cancer Research Center in Seattle,] to learn why there is hesitancy to report a breast lump in some countries. We also asked about a new study he co-authored, showing that the rate of breast cancer cases and the number of deaths from the disease are increasing in countries ‘undergoing rapid changes in human development,’ such as Colombia, Ecuador, and Japan…” (Silver, 10/22).

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Editorials and Opinions

Basic Health Care Access Critical To Further Reduce Maternal, Newborn Mortality In Rwanda, Worldwide

New Times: Reducing maternal and newborn mortality to advance Rwanda’s future
Melinda Gates, co-chair of the Bill & Melinda Gates Foundation

“…New data released this week confirm that Rwanda is making progress battling maternal and newborn mortality. … [The Sustainable Development Goals], which call specifically for further reductions in maternal and newborn deaths, have the potential to accelerate progress even further if we stay focused on what works to save lives. … Simple interventions go a long way. These include exclusive breastfeeding, keeping a newborn’s umbilical cord wound clean and dry to prevent infection, and promoting skin-to-skin contact between newborns and their mothers to regulate the baby’s body temperature and breathing. … Providing women with greater access to family planning and other essential services, as well as nutritious food, can help to ensure that women and their children stay healthy and strong enough to contribute to the development of their families and communities. We also need to help countries strengthen their primary health care systems so that more women and newborns have access to quality services and vital medicines before, during, and after delivery. … If we take these steps, I believe that we can end most preventable maternal and newborn deaths — as well as eliminate the health disparities within and among countries so that every child has the chance to prosper — within a single generation…” (10/21).

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Continued International Commitment Needed To Eradicate Polio

CNN: Ending polio: ‘We’re on the verge of making history’
Sue Desmond-Hellmann, CEO of the Bill & Melinda Gates Foundation

“…For the first time in recorded history, the entire African continent has gone a full year without a child paralyzed by wild poliovirus. To officially certify Africa polio free, we must protect this progress through 2017. … Africa’s success should inspire and energize the world’s efforts to end polio once and for all. But our reflection shouldn’t stop there. This is also a reminder of the momentum we must sustain to wipe out polio in the two remaining endemic nations: Pakistan and Afghanistan. … [I]t will take the continued commitment of developing countries, wealthy nation governments, and individual donors to ensure we wipe out one of humanity’s oldest scourges. … As long as polio exists anywhere, we risk its resurgence — especially among the poorest and most vulnerable people. Now is the time to make certain that no child will be paralyzed from polio ever again…” (10/23).

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Understanding Political Context Around Islamist Opposition To Polio Vaccination Programs Essential To Public Health Policy, Eradicating Disease

Project Syndicate: Militant Islamism and Vaccine Skepticism
Jonathan Kennedy and Domna Michailidou, both teaching fellows at the University College London’s School of Public Policy

“…What is standing in the way of the [polio] virus’s eradication is not medical or technical constraints, but political resistance to the vaccination effort. … If the virus is to be defeated, we will have to move beyond caricatures of Islamists as violent zealots opposed to Western science and look closely at the specific political contexts in which the eradication effort has so far been unsuccessful. … The stance Islamist insurgents take toward polio vaccination campaigns has less to do with anti-Western zealotry than with the specific dynamics of the conflict in which they are involved. This has important implications for public health policy. Only by understanding the political context in which vaccination programs operate will those committed to eradicating polio succeed” (10/22).

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Pakistan's Lady Health Workers At Frontlines Of Anti-Polio Campaign

Foreign Policy: The Polio Capital of the World
Arsla Jawaid, former managing editor at the Institute of Strategic Studies in Islamabad

“As the world prepares to mark World Polio Day on Oct. 24, Pakistan remains at the center of the global effort to eradicate the virus. Despite facing a host of challenges, Pakistan’s military operation in the country’s northwest paved the way for much needed progress. Sustaining said progress will prove to be the real test for the government. … Lady Health Workers are at the fore of the anti-polio campaign, often receiving grave threats from the Taliban yet rarely receiving their salaries on time. … With Nigeria now removed from the WHO list of polio-endemic countries and Afghanistan recording just 13 cases this year, Pakistan may be the last place on Earth to eradicate the virus. The one thing it can bet on is the determination and perseverance of its Lady Health Workers” (10/22).

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Investment In, Strengthening Of Health Systems Crucial To Preventing Ebola, Other Disease Outbreaks

The Lancet: Ebola: forgotten but not gone?
Editorial Board

“On October 16, two new Ebola cases were reported in Guinea, indicating the continuing danger of Ebola virus even after progress in bringing the West African Ebola outbreak under control. … Salutary lessons are still being learned from the West African Ebola outbreak — opportunities for and benefits of research will be greatest in the communities most affected. WHO’s Director-General Margaret Chan believes the world is ‘dangerously ill-prepared’ for further infectious disease outbreaks spread through the air or contagious during an incubation period. Strengthening of and investment in health systems in countries most at risk of infectious disease outbreaks are key to prevention, and in the worst case scenarios control, of health emergencies” (10/24).

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Policies Must Ensure Access To Essential Medicines

The Lancet: Essential medicines are still essential
Andy L. Gray, Veronika J. Wirtz, Ellen F. M ‘t Hoen, Michael R. Reich, and Hans V. Hogerzeilemail, all members of the Lancet Commission on Essential Medicines Policies

“On October 21, WHO published the full report of the 20th Expert Committee on the Selection and Use of Essential Medicines, with its new WHO Model List of Essential Medicines (EML). … However, … [t]he EML is only a first step in the policy process towards assuring access to these medicines, as part of broader global health and sustainable development goals. Comprehensive essential medicine policies are still needed, covering many different aspects, such as appropriate research and development, financing mechanisms, generic policies including various measures to overcome patent barriers, quality assurance, supply systems, and safe and cost-effective use. The 2016 report of the Lancet Commission on Essential Medicines Policies will show how such policies remain essential and will recommend ways of implementing them through concrete actions at the national and global levels” (10/24).

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Funding, Promoting Innovation For New Antibiotics, Diagnostics Can Prevent Drug Wastage, Antimicrobial Resistance

Project Syndicate: Wasted Drugs and the Creation of Superbugs
Jim O’Neill, commercial secretary to the U.K. Treasury, honorary professor of economics at Manchester University, visiting research fellow at Bruegel, and chair of the Review on Antimicrobial Resistance

“…To achieve the objectives identified by the G7 [around antimicrobial resistance], an especially promising target is drug wastage. … Today, I published a set of three specific interventions to address this problem. Together, these recommendations can limit overuse and build on current efforts to change doctors’ and patients’ behavior within the current system. … My first recommendation is to establish a global innovation fund to jumpstart research and development … My second recommendation is to tie incentives to the public-good aspect of diagnostics. … The third intervention is to support the large, objective studies that are needed to prove a new product’s clinical and cost effectiveness … If we are to defeat superbugs, … patients, doctors, health ministries, and companies worldwide must work together to change the way we use antibiotics, especially by supporting and embracing transformational technology” (10/23).

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From the Global Health Policy Community

Report Discusses, Makes Recommendations For Pakistan's Anti-Polio Efforts

International Crisis Group: Winning the War on Polio in Pakistan
This report discusses and makes recommendations for Pakistan’s anti-polio campaign. “…If Pakistan is to make a durable transition out of its current polio-endemic status, it should complement eradication successes with wider routine immunization coverage, through the Expanded Program on Immunization (EPI), and significantly improved basic health care and sanitation. In the conflict zones, such as FATA, this requires better governance and security. Success countrywide will also depend on the government’s willingness to partner with civil society and local and international NGOs to protect children from contracting a disease that has been eradicated in most of the world…” (10/23).

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Congressional Panel, Report Examine Role Of Health Innovations In Achieving SDGs

Center for Global Health Policy’s “Science Speaks”: Accessible global health innovations critical to achieving Sustainable Development Goals
Rabita Aziz, policy research coordinator for the Center for Global Health Policy, discusses a recent “congressional panel focused on the role of new vaccines, drugs, diagnostics, and devices in achieving Sustainable Development Goals,” hosted by the Global Health Technologies Coalition and its partners, as well as findings from PATH’s Innovation Countdown 2030 report (10/22).

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PLOS Viewpoint Pieces Argue Mass Deworming Cost-Effective Investment In Children's Health

The following PLOS Neglected Tropical Diseases viewpoint pieces discuss recent findings on the potential impacts of mass treatment for intestinal worms among children in endemic areas.

PLOS Neglected Tropical Diseases: Cochrane Reviews on Deworming and the Right to a Healthy, Worm-Free Life
Nilanthi de Silva of the Department of Parasitology at the University of Kelaniya and colleagues discuss the Cochrane Library’s recently published review by Taylor-Robinson et al. on deworming drugs, disagreeing with the review’s methodology and conclusion that mass drug administration does not benefit nutritional status, school performance, or other indicators. “…In questioning the value of mass deworming by using inappropriate methodology, Taylor-Robinson et al. jeopardize funding for deworming programs that will benefit hundreds of millions of children in developing countries” (10/22).

PLOS Neglected Tropical Diseases: The Case for Mass Treatment of Intestinal Helminths in Endemic Areas
Joan Hamory Hicks and Edward Miguel, both at the University of California Berkeley, and Michael Kremer of Harvard University, highlight two articles published earlier this year in the International Journal of Epidemiology (1, 2). “[W]e discuss the content and relevance of these articles to the policy debate, and review the broader research literature on the educational and economic impacts of deworming. We conclude that existing evidence still indicates that mass deworming is a cost-effective health investment for governments in low-income countries where worm infections are widespread” (10/22).

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Investment In African Family Planning Programs Can Help Achieve Development Goals

Humanosphere: OpEd: Africa’s challenging demographic future
In a guest post, John Bongaarts, a vice president and distinguished scholar at the Population Council, discusses new estimates for population growth through 2100, with most of the upward trend “largely confined to one area of the world — sub-Saharan Africa.” He argues success in preventing and treating HIV, as well as neglect of family planning initiatives have pushed the increased estimate, which could threaten reaching development goals, writing, “A straightforward and highly desirable solution exists: invest in voluntary family planning programs…” (10/22).

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Blog Post Examines Emerging Field Of Global Mental Health

BMJ Blogs: Alexandra Caulfield: Mental health in Africa — challenges and progress since 2008
Alexandra Caulfield, a researcher with Polygeia and a student on the Cambridge graduate course in medicine, discusses the emerging field of global mental health, “and its application to Africa in particular…” (10/22).

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