KFF Daily Global Health Policy Report

In The News

CDC Director Says He Argued To Keep U.S. Experts In DRC Ebola Zone; More Cases Reported In Beni

CIDRAP News: Ebola cases in Beni top 100 as 6 more cases reported
“Medical teams have confirmed Ebola in six more people in the Democratic Republic of the Congo (DRC) outbreak, all from the hot spot in Beni where violence over the weekend has slowed vaccination activities, the country’s health ministry said [Tuesday]. Also, the World Health Organization (WHO) detailed renewed concerns about fresh violence undermining the response and the increasing numbers of Ebola infections in children…” (Schnirring, 10/23).

STAT: CDC director says he pushed to keep U.S. experts in Ebola zone but was overruled
“The director of the Centers for Disease Control and Prevention said Tuesday that he argued that American experts should stay in the outbreak zone of the latest Ebola epidemic but was overridden by others in the Trump administration because of security concerns. ‘Those decisions are security decisions that really are outside the realm of my public health expertise,’ said the director, Robert Redfield, who said he made a case to the Department of Health and Human Services about why public health experts should remain in the outbreak area but that, at the end of the day, his argument didn’t win out…” (Swetlitz, 10/23).

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Sen. Rubio Defends U.S. Aid To Central American Countries Following Trump's Threats To Reduce Funding

The Hill: Rubio defends U.S. aid to Honduras and Guatemala: ‘Helps us more than them’
“Sen. Marco Rubio (R-Fla.) on Tuesday pushed back against President Trump’s threat to cut off aid to Honduras and Guatemala over the caravan of migrants approaching the U.S. border. ‘I understand instinct to cut U.S. aid to punish countries for failing to stop illegal migration. But our aid to #Honduras & #Guatemala isn’t cash,’ Rubio wrote on Twitter. ‘It’s primarily equipment & training to stop drugs headed to U.S. & to deal with the gangs causing people to leave those countries’…” (Keller, 10/23).

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More Resources Needed To Complete Polio Eradication, GPEI Spokesperson Says On World Day

Arab News: World Polio Day: What needs to be done to rid the world of the disease forever
“…As World Polio Day is marked across the globe on Wednesday, the Global Polio Eradication Initiative (GPEI) said while the disease is at the lowest-ever levels — being 99 percent on the way to being a polio-free world — unless more resources are mobilized to immunize children, save lives, and protect communities, the disease could come ‘roaring back across the world’…” (Bell, 10/24).

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Millions In Yemen Face 'Pre-Famine Conditions,' U.N. Report Says; Malnutrition Fueling Cholera Resurgence

CBS News: 8.4 million Yemenis depend on emergency food aid, says U.N. report
“A report published Tuesday on the risk of famine in Yemen says 8.4 million Yemenis are ‘severely food insecure and depend on emergency food assistance.’ It concludes that the crisis is directly related to ongoing conflict in the country. The report, which was published by the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) and submitted to the U.N. Security Council, says that 75 percent of Yemen’s population — 22 million people — require some form of assistance and protection…” (Falk, 10/23).

IRIN: Cholera returns to Yemen, with powerful allies
“…[C]holera is now making a comeback, and something about this spike is different, says Elham Twaiti, a nurse who is busy admitting a line of new patients. … ‘The new development here is that the economic crisis has left many people in hunger, and cholera hits malnourished children easily,’ she says, adding that pregnant women are also vulnerable to the disease…” (Mamoon, 10/23).

U.N. News: Half the population of Yemen at risk of famine: U.N. emergency relief chief
“Around 14 million people in Yemen, or half the total population of the country, are facing ‘pre-famine conditions,’ said the U.N. Under-Secretary-General for Humanitarian Affairs [Mark Lowcock], in a briefing to the Security Council on Tuesday…” (10/23).

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Devex Highlights Insights From U.N. World Data Forum

Devex: Making the invisible visible: Insights from the U.N. World Data Forum
“Making the invisible visible within national data systems was an important area of discussion at the United Nations World Data Forum. Invisible population groups in data are commonly the most vulnerable populations — women and girls, people with disability, refugee and migrants, and the elderly…” (Cornish, 10/24).

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More News In Global Health

CIDRAP News: U.K. parliament urges making antimicrobial resistance a priority (Dall, 10/23).

NPR: A 24-Year-Old Midwife Was Taken Hostage In March — And Killed This Month (Harper, 10/23).

Reuters: Vaccine confidence low in Europe, raising disease outbreak risk (Kelland, 10/23).

U.N. News: Dramatic funding shortages a ‘severe catastrophe’ for people of Gaza: U.N. Coordinator (10/23).

U.N. News: Feeding families remains complex task in war-torn Syria — U.N. relief agency (10/23).

VOA News: Medical Drugs Hit Zimbabwe’s Black Market (Mavhunga, 10/23).

Xinhua News: WHO commends South Sudan’s efforts in tackling epidemics, maternal deaths (10/24).

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Editorials and Opinions

Opinion Piece Discusses USAID Transformation Plan, Says Congress Should Complete Due Diligence

Devex: Opinion: Uniting policy, resources, and performance for better decision-making at USAID
George Ingram, co-chair of the Modernizing Foreign Assistance Network and senior fellow at the Brookings Intuition

“Plans for the transformation of the United States Agency for International Development have been approved by the U.S. Office of Management and Budget and are now before Congress for review. … Among the noteworthy aspects of the transformation proposal is joining the functions of policy, budget, and accountability — currently dispersed among five operating units — into a new, single Bureau for Policy, Resources, and Performance for greater coherence and to better reconcile competing budget and policy priorities. … As reported to Congress, the three most significant objectives of consolidation are to align resources, promote a culture of learning, and project a unified voice. But each objective has serious hurdles to overcome. … The proposed structure is to be lauded, and these potential complications should contribute to the conversation on how they can be managed and how to encourage stakeholders to help overcome the hurdles. Congress should complete its due diligence and provide its input expeditiously so this commendable restructuring can move to implementation” (10/24).

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Editorial, Opinion Pieces Discuss U.S. Foreign Aid To Central America

Washington Post: Trump’s response to the migrant caravan will only make things worse
Editorial Board

“…[Severing or substantially reducing foreign aid to El Salvador, Guatemala, and Honduras is] a prescription for more migration, not less. Even in war-torn and impoverished places, people leave their homes and communities reluctantly, abandoning their property, familial roots, and sense of belonging only under extreme economic or physical duress. U.S. aid to Central America is a tiny percentage not just of overall government spending but also of foreign aid generally, but it is critical to countries that are grappling with enormous hardship and migrant outflow. … A more rational policy would double down on U.S. aid programs, with a focus on crime-fighting and security, while allowing would-be migrants to apply and be screened for asylum in their home countries. That could avoid the spectacle of north-bound caravans, such as the one making its way through Mexico right now…” (10/22).

Globe and Mail: Trump can’t stop the migrant caravan by cutting foreign aid and closing the border
Sarah Bermeo, associate professor of public policy and political science at Duke University’s Sanford School of Public Policy and author

“U.S. President Donald Trump has threatened to cut foreign aid and close the border with Mexico in response to the migrant caravan that recently left Honduras bound for the United States. These actions will not stop migration, but they will make the U.S. less secure. … Foreign aid targets economic development and security concerns in Central America. … The path to security and economic growth for these countries will be long and complex. Aid can help, but change will take time. … Respecting norms for the treatment of refugees is not advocating for open borders. Open borders allow anyone to come, for any reason. Granting protection to people fleeing violence lets in those who have a genuine fear for their safety. This is consistent with long-held American values and will enhance border security and economic prosperity” (10/23).

The Hill: American foreign aid can be catalyst for change
Rep. Michael C. Burgess (R-Texas), chair of the Energy and Commerce Subcommittee on Health

“…While I am encouraged by the work of USAID and non-governmental organizations working in this region, I have been disappointed in the lack of executive leadership in these countries. … [F]oreign aid can be a powerful motivator for our international neighbors. That’s why I first introduced legislation back in July 2014 that would reduce America’s foreign assistance to the countries that send their children to be cared for in the United States. My reasoning is two-fold: First, America’s taxpayers should not be charged twice for the same purpose, in both foreign assistance and [Department of Health and Human Services’ Office of Refugee Resettlement (HHS-ORR)] funding. Second, America’s taxpayer dollars must not be permitted to continue to line the pockets of corrupt government officials; Congress must ensure that American aid reaches the organizations on the ground that are truly working to create a better life for these citizens. Some critics of this strategy claim that this approach is harsh or unfair. … To change the status quo and create a better life for those who otherwise would be driven to trek across the Mexican desert to our southern border, the American government must act” (10/23).

Bloomberg: Trump’s Cuts to Central America Aid Will Lead to More Caravans
Shannon O’Neil, senior fellow for Latin America studies at the Council on Foreign Relations

“As several thousand Central American migrants moved through [the region] and into Mexico on their way toward the United States, President Trump tweeted that he would begin cutting off foreign aid to these countries. … Not only would such a pullback swell this human tide, it would squander the hard-earned gains and lessons of a decade-long effort to make Central American nations better places to live than to leave. … And dollar for dollar, individual by individual, programs designed to give Central Americans a better future at home are arguably much more cost-effective than the thousands of dollars it can cost per capita to detain, prosecute, and then deport them. For an administration that wants to stop immigration, cutting aid to improve, however modestly, day-to-day conditions in Central America is nonsensical. … [R]educing present or future aid will just send more Central Americans north. … That’s why U.S. aid to these nations must continue. And why the U.S. needs to fix its immigration system, so that would be migrants don’t have to caravan to find a path to safety and opportunity…” (10/23).

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U.S. Government Cannot Advance Global Agenda Of Women's Empowerment Without Addressing, Assessing Reproductive Rights

Foreign Policy: The Trump Administration Is Erasing Reproductive Rights at Home and Abroad
Stephanie Schmid, U.S. foreign policy counsel at the Center for Reproductive Rights

“…In April, the U.S. State Department published its annual congressionally mandated Country Reports on Human Rights Practices without the prepared reproductive rights subsection… Deleting reproductive rights from the annual reports erases women, girls, and other people who need reproductive health services from global debates on public health and puts the lives of some of the world’s most vulnerable communities at risk by allowing abuses to occur unchecked and unreported, emboldening the violators and compounding the amount and severity of future rights deprivations. … The U.S. government cannot credibly advance an agenda of women’s political, economic, and social empowerment without addressing and assessing the global status of reproductive rights. … Congress must continue to play a forceful role in halting this administration’s backslide from promoting, protecting, and defending the human rights of women and girls worldwide. … Through its oversight function, Congress must also continue to press officials in this administration to explain their harmful actions and urge them to reverse course, to ensure that reproductive rights are not treated as mere spoils in a political contest but instead respected and protected as fundamental human rights” (10/23).

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Journalists Must Think Critically About Coverage Of Health, Development Issues

Vox: Ebola was incredibly important to TV news until Republicans decided it shouldn’t be
Matthew Yglesias, Vox senior correspondent

“The large, ongoing Ebola outbreak in the Democratic Republic of Congo is not attracting much coverage on American television news because TV news producers believe (likely for good reason) that the American viewing public is not incredibly interested in public health in sub-Saharan Africa. That said, there was a time when TV news covered Ebola in Africa a lot: in the immediate runup to the 2014 midterms, when Republican Party political operatives decided that trying to alarm people about Ebola would be a good way to win votes. … Today, of course, a new ongoing Ebola outbreak that happens to coincide with a U.S. midterm election is not something the Republican Party wants to emphasize in its midterm messaging. Consequently, the question of African public health continues to languish in its customary obscurity. … When pressed as to why they are allowing President Trump to serve as their assignment editor, most reporters tend to say that presidential statements are inherently newsworthy — if Trump says something is a national emergency, then that’s big news. I would urge people involved in the industry to think about this question honestly…” (10/23).

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One Health Approach To Tracking Potential Disease Outbreaks Could Improve Returns On Investments

The Conversation: What’s needed to do a better job of pre-empting disease outbreaks
William B. Karesh, executive vice president for health and policy at EcoHealth Alliance and adjunct professor at the Icahn School of Medicine at Mount Sinai

“The concept of One Health is deceptively simple: it’s the recognition that human, animal, and environmental health are all inherently linked. … Taking on health issues from different angles simultaneously has the benefit of saving time, money, and lives, rather than addressing a challenge in one area only to later find it emerge in another. … Research coordinated by EcoHealth Alliance, a global environmental health organization, set out to show how we can better anticipate disease outbreaks by joining forces. … Our research found that by tracking a disease with a combined, One Health approach, we could get a bigger, more accurate picture of the way it was spreading. … Our research in the field also found that a One Health approach saved up to 35 percent in spending on staffing and resources when compared to conducting separate surveillance or studies. … We can be better prepared to tackle diseases before they take hold and avoid the devastating consequences, but only if environmental scientists, veterinarians, and doctors work together and with the public. This is no easy or inexpensive task but our findings indicate that the returns on investment are manifold, for all of us who share one health” (10/18).

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Cross-Collaboration Could Help Advance Progress Against Drug Resistance

Science Signaling: A call to arms: Unifying the fight against resistance
Editorial Board

“…Rather than respond to the consequences of [antibiotic drug] resistance, perhaps shared strategies to avoid resistance can be developed if agriculture and medicine worked together. … The Gordon Research Conference (GRC) on Drug Resistance met in July 2018 with the goal of bringing together scientists, clinicians, and regulators from agriculture, infectious disease, and cancer to share experiences and insights. Common themes were readily apparent among the questions each field is asking with respect to the evolution of resistance, the role of population heterogeneity, the use of multi-agent combinations, and the design of  ’resistance-resistant’ drugs, pesticides, and herbicides. … The drug resistance landscape is in flux, with academic and industry partners moving in and out of the space, with ever-evolving pathogens and cells, and with the emergence of new tools to study and combat disease. For this reason, it is critical to reevaluate where we stand on a regular basis. We look forward to these reflections and the opportunity to explore new ways to cross-collaborate toward common goals when we meet again in 2020 and points in between” (10/23).

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From the Global Health Policy Community

WHO Recognizes Success Toward Polio Eradication On World Day

WHO Regional Office for Europe: World Polio Day celebrates history in the making
“Thanks to the widespread use of safe and effective vaccines, poliomyelitis (polio) is expected to become the second human disease ever to be eradicated (after smallpox). Only 20 cases of wild poliovirus have been detected so far this year in the three remaining endemic countries (Afghanistan, Nigeria, and Pakistan). World Polio Day, on 24 October, celebrates this progress and the people who make it possible by getting their own children vaccinated and those working to reach every last child until no child’s future is threatened by the crippling impact of this disease…” (10/23).

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MSF Releases New Report On DR-TB Treatment, Urges Company To Halve Price Of Newer TB Drug Bedaquiline

Médecins Sans Frontières: High prices restrict access to best drug-resistant tuberculosis treatment
“People with drug-resistant tuberculosis (DR-TB) continue to be deprived of today’s best-possible treatment in part because of high drug prices, according to a new report — DR-TB Drugs Under the Microscope — released [Tuesday] by Médecins Sans Frontières (MSF) at the 49th Union World Conference on Lung Health in The Hague. MSF is calling, in particular, on U.S. pharmaceutical corporation Johnson & Johnson (J&J) to cut the price of the newer TB drug bedaquiline in half, so more lives can be saved…” (10/23).

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ONE, Gavi CEOs Discuss Challenges, Future Of Global Health

ONE: A healthy world is possible, but we need to do more
Katie Ryan, research assistant at the ONE Campaign, summarizes an interview featuring Gayle Smith, president and CEO of ONE, and Seth Berkley, CEO of Gavi, the Vaccine Alliance, in which they discuss the challenges and future of global health. In particular, Smith and Berkley talk about the need for a new global health action plan, Germany’s role as a global health leader, and the importance of vaccines. The full conversation is available on Facebook Live (10/23).

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Women Deliver President/CEO Discusses Quality Health Care For All, Gender Equality With WHO Director General

Women Deliver: To Deliver Health for All We Must Prioritize Gender Equality: A Q&A with Dr. Tedros Adhanom Ghebreyesus
In this interview, Katja Iversen, president and CEO of Women Deliver, speaks with WHO Director-General Tedros Adhanom Ghebreyesus about the link between primary health care, gender equality, and the Sustainable Development Goals (SDGs) (10/23).

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Patient Advocates Discuss Alma Ata, Astana Declarations, Efforts To Improve Health Care Access

BMJ Opinion: Alma Ata, Astana and beyond — patients and communities as the core of universal primary health care
Noting the 40th anniversary of the Alma Ata Declaration on Primary Health Care, Anya de Iongh, patient editor for the BMJ; Sarah Markham, member of the BMJ Patient Advisory Panel; and Rakhal Gaitonde, member of the BMJ Patient Advisory Panel, reflect “on primary health care and its position in the wider landscape of health, as well as the virtues and realities of bold global visionary documents.” They highlight the Astana Declaration on Primary Health Care 2018, as well as the Alternative Civil Society Astana Statement on Primary Health Care, recently released by the People’s Health Movement (10/24).

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Public Health Expert Discusses Findings From Lancet Study Roundtable Discussion On Forecasting Global Health Outcomes

Global Health Hub: Forecasting global health outcomes to 2040: new Lancet study roundtable at Grand Challenges Annual Meeting 2018
Suchita Shah, family doctor, public health consultant, writer, editor, and primary care tutor at Oxford University, highlights a recent Grand Challenges roundtable, where experts discussed findings from a Lancet study forecasting how key drivers of health might affect life expectancy and mortality in countries worldwide. Shah highlights several remarks made by roundtable participants, including Sally Davies, chief medical officer for England and adviser to the U.K. government; Tore Godel, special adviser on global health to the Norwegian government; and Anita Zaidi, director of the Vaccine Development, Surveillance, and Enteric and Diarrheal Disease Programs at the Bill & Melinda Gates Foundation (10/24).

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Newly Formed UNESCO Chair In Global Health, Education Aims To Improve Health, Well-Being Of Young People Globally

WHO: Launch of Global Health and Education UNESCO Chair
“Pressing issues around the health of children and young people across the globe are to be addressed by a newly formed United Nations Educational, Scientific, and Cultural Organization (UNESCO) chair in global health and education, focusing on health education and promotion. … The UNESCO chair will act as a strategic resource for knowledge creation, knowledge transfer, and capacity building for policy and practice, to improve the health and well-being of children and young people worldwide…” (10/23).

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From the U.S. Government

USAID Highlights Participation In 5th Global Symposium On Health Systems Research

USAID: Join USAID’s Health Research Program at the Global Symposium on Health Systems Research, Liverpool 2018
This webpage highlights USAID-supported sessions at the Fifth Global Symposium on Health Systems Research (HSR2018), which was held October 8-12 in Liverpool. The sessions discussed various topics, including developmental evaluation, implementation research through local engagement, and respectful maternal care (October 2018).

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From KFF

KFF Updates Fact Sheet On Global Polio Efforts, U.S. Role
Kaiser Family Foundation: The U.S. Government and Global Polio Efforts

The Kaiser Family Foundation updated this fact sheet, which provides a snapshot of global polio eradication efforts and examines the U.S. government’s role in addressing polio worldwide (10/22).

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