KFF Daily Global Health Policy Report

In The News

USAID Administrator Green Speaks With Devex About Resilience, Program Design

Devex: Q&A: Mark Green on how USAID transformation will impact program design
“USAID Administrator Mark Green discusses the true meaning of resilience, why USAID is streamlining its program design and implementation cycles, and how that will make the agency’s work more responsive to needs in the field…” (Welsh, 10/25).

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U.S. Government Shutting Down USAID's Predict Program Investigating Disease Jumps From Animals To Humans

New York Times: Scientists Were Hunting for the Next Ebola. Now the U.S. Has Cut Off Their Funding.
“In a move that worries many public health experts, the federal government is quietly shutting down a surveillance program for dangerous animal viruses that someday may infect humans. … Ending the program, experts fear, will leave the world more vulnerable to lethal pathogens like Ebola and MERS that emerge from unexpected places, such as bat-filled trees, gorilla carcasses, and camel barns. The program, known as Predict and run by the United States Agency for International Development, was inspired by the 2005 H5N1 bird flu scare. Launched 10 years ago, the project has cost about $207 million…” (McNeil, 10/25).

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Weekly Ebola Cases In DRC Trending Lower But Movements Of Patients Complicate Response, WHO Says

CIDRAP News: Officials track movement of Ebola patients from DRC hot spot
“Health officials confirmed six more Ebola cases in the Democratic Republic of the Congo (DRC) outbreak, and in a weekly snapshot of the outbreak, the World Health Organization (WHO) said though the weekly number of cases is still trending lower, movements of high-risk patients from the current hot spot pose a risk of recurrence in other areas…” (Schnirring, 10/24).

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No Country Fully Prepared For Major Disease Outbreak, New Global Health Security Index Shows

CIDRAP News: Inaugural Global Health Security Index notes wide readiness gaps
“At a briefing in Washington, D.C., [Thursday], experts from three health groups unveiled a new Global Health Security (GHS) Index, which provides preparedness benchmarks for 195 countries and is designed to help nations fill gaps in their capacity to address infectious disease outbreaks. The initial report found that no country is fully prepared to handle a major epidemic or pandemic. The index is a joint project of the Johns Hopkins Center for Health Security (CHS), the Nuclear Threat Initiative, and The Economist Intelligence Unit (EIU)…” (Schnirring, 10/24).

Washington Post: None of these 195 countries — the U.S. included — is fully prepared for a pandemic, report says
“…Unlike other ratings, the Global Health Security Index benchmarks health security in the context of tools critical to fighting outbreaks, such as robust health systems, adherence to global norms, and political and security risks, including public confidence in government. The United States does well in five of six preparedness categories but ranks 19th — after Australia, Canada, Singapore, and more than a half-dozen European countries — in an assessment of overall risk and vulnerability to biological threats. The factors driving down the U.S. score include the risks of social unrest and terrorism, and low public confidence in government. Liechtenstein ranked No. 1 on this measure…” (Sun, 10/24).

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Experts, Lawmakers Call For More Investment In R&D Of New Drugs To Treat Antimicrobial-Resistant Microorganisms

Homeland Preparedness News: Experts, lawmakers call for improved drug pipeline to treat superbugs
“Antimicrobial resistant (AMR) microorganisms, also known as superbugs, increasingly threaten every person on Earth, according to the World Health Organization (WHO) and national experts. … [T]here’s only a certain amount of antibiotics in the pipeline, which needs to increase alongside the growing list of ever-changing infections and diseases, but which currently isn’t keeping pace, experts say…” (Riley, 10/24).

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U.N. Agencies Announce Progress In Worldwide Efforts To Eradicate Polio On World Day

U.N. News: World is closer than ever to seeing polio disappear for good
“In a ‘historic achievement for humanity,’ two of three wild poliovirus strains have been eliminated worldwide, the World Health Organization (WHO) announced on Thursday, following the conclusion by a group of experts that WPV3, type three of the disease, has been eradicated completely. The deadly viral disease is ‘very close’ to disappearing altogether, with the number of affected children having dropped by 99 percent since 1988, the U.N. Children’s Fund (UNICEF) announced on World Polio Day, marked each 24 October, positioning the world closer than ever to its total eradication…” (10/24).

Additional coverage of the announcement and World Polio Day is available from Al Jazeera, NPR, VOA, and Vox.

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More Investment Needed To Meet 2030 Energy Goals, Reduce Unhealthy Cooking Methods, Report Says

The Telegraph: Lack of investment in clean energy risks leaving world’s poorest behind
“People in some of the world’s poorest countries are at risk of being left even further behind because of a lack of investment in renewable energy and clean sources of cooking, a report warns. A report by the organizations Sustainable Energy for All and the Climate Policy Initiative, has mapped investment into electricity and clean cooking sources in 20 countries in sub-Saharan Africa and Asia and has found that investment is severely lagging behind…” (Gulland, 10/22).

Thomson Reuters Foundation: Energy aid neglects ‘health emergency’ fueled by dirty cooking
“Governments, development banks, and businesses are providing less than 1% of the money needed each year to wean 3 billion people off dirty, health-harming cooking by an international deadline of 2030, new data on energy access showed on Tuesday. In 2017, the latest figures available, funding commitments for clean cooking in 20 countries in sub-Saharan Africa and Asia with the largest needs plummeted by 73%, to $32 million, from the average in the previous two years, found a report tracking finance towards global goals on energy…” (Rowling, 10/22).

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More News In Global Health

Associated Press: U.N. investigator: 11 million North Koreans are undernourished (Lederer, 10/22).

Devex: Donors launch a new club for social enterprises (Cheney, 10/24).

Global Health NOW: Intimate Partner Violence Deters Breastfeeding (10/23).

Globe and Mail: Polio, propaganda and public mistrust: In Pakistan, vaccine workers have three diseases to fight (Farooqui, 10/24).

IPS: Nutrition — the Best Investment for a Developing Africa (Bafana, 10/25).

NPR: Hospitals Around The World Have A Dire Shortage Of Blood (McDonnell, 10/22).

NPR: Which Countries Do Best — And Worst — At Keeping Big Tobacco Out Of Politics (Aizenman, 10/21).

Reuters: ‘White death’ in Argentina: The hunger of poverty feeds tuberculosis (Druscovich, 10/24).

The Telegraph: Chained to a tree for 40 days: Afghanistan’s shrine to ‘cure’ mental illness (Glinski, 10/22).

Xinhua: Libya’s health ministry condemns attacks against hospitals in southern Tripoli (10/25).

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Editorials and Opinions

Disease Outbreaks In Conflict Zones Complicate U.S., International Responses, Opinion Piece Says

Washington Post: The U.S. has stopped Ebola before. It may never repeat that success.
Reid Wilson, author and journalist

“… The Liberia [Ebola] triumph seemed like a template on which future responses to public health emergencies could be based. In truth, it was an outlier. … The outbreak today [in DRC] offers a better look at global pandemics to come — ones that begin in regions where international public health workers are unable to move freely to contain the spread of a virus, where the U.S. Army would not be welcomed with open arms. … [I]n many of the sickest nations, … civic institutions are collapsing, and the international and nongovernmental organizations dedicated to propping up health systems are stretched to a breaking point. … In Congo, Afghanistan, and beyond, public health officials worry that the breakdown of institutional authority and the accompanying isolationist turn against national or international institutions will have profound effects that aren’t yet clear. … But one thing is clear: The spread of preventable diseases — Ebola, polio, malaria, measles — is not something the United States will always be able or welcome to fight” (10/24).

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Editorial, Opinion Piece Discuss Efforts To End Tuberculosis, Improve Treatment Adherence

The Lancet: End the tuberculosis emergency: a promise is not enough
Editorial Board

“…The Lancet Commission on tuberculosis recommended actions for meeting global [tuberculosis (TB)] targets. Latent tuberculosis must be diagnosed and treated, Gene Xpert technology deployed worldwide to determine drug susceptibility, point-of-care diagnostics scaled up to minimize treatment delay, and safe drugs made affordable to retain patients with active tuberculosis in treatment. These interventions hinge on engagement by public and private sectors, strengthened management of tuberculosis programs, and increased investment in program support. These recommendations should focus future efforts, not least when stakeholders gather for the 50th Union World Conference on Lung Health in India on Oct. 30. … It is time for a civil society movement and a whole-of-society engagement to harness political commitment, transform promises into real advances, and consign this emergency to history” (10/26).

STAT: The resurgence of tuberculosis is behavioral, not medical. Nudges can fix it
Erez Yoeli, research scientist at the MIT Sloan School of Management and co-director of MIT’s Applied Cooperation Team; Jon Rathauser, founder and CEO of Keheala; and David Rand, associate professor of management science and brain and cognitive sciences at the Sloan School, director of MIT’s Human Cooperation Laboratory, and co-director of the Applied Cooperation Team

“…The cause of TB’s resurgence is not medical; a highly effective though burdensome treatment has existed for the disease since the mid-1940s. Instead, the cause is mostly behavioral: Faced with the prospect of extended treatment and isolating stigma, many people are slow to seek treatment or quit partway through. This fuels the tuberculosis epidemic by giving the disease ample opportunities to spread and mutate into drug-resistant strains … If the fuel is behavioral, then the solution should be as well. … Keheala — a homophone of the Hebrew word for community — is a platform designed to address the behavioral causes of not completing treatment by providing motivation and support throughout the arduous course of therapy. … To make the platform as motivating as possible, we incorporated principles from behavioral science, the same principles that have been successfully employed to promote charitable giving, volunteering, and resource conservation. … With millions of dollars being spent on medical solutions, our results suggest that we should pause and consider allocating more of that budget to behavioral solutions, so all that good medical research doesn’t go to waste” (10/25).

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Governments Must Invest In, Pay Community Health Workers, Last Mile Health CEO Writes

TIME: Community Health Workers Are Vital; Governments Should Be Paying Them
Raj Panjabi, CEO of Last Mile Health and assistant professor at Harvard Medical School

“…Community health workers save lives. … Community health workers also lower health care costs. … For every $1 a country invests in community health workers, $10 is returned to society. … In September, 15 countries made commitments to invest in community health workers. If this were scaled globally, 3 million deaths could be prevented each year. … But to realize this future of health for all, we must confront an injustice. … [M]ost community health workers remain unpaid. A recent World Health Organization report found that the poorest women in the world subsidize health care with their unpaid work to the tune of $1 trillion — a figure that’s larger than the economies of over 150 countries. As a doctor, I’m not expected to go without fair pay for my work, so why aren’t community health workers paid fairly for theirs? Now is the time to join arms … and demand our governments invest in community health workers…” (10/24).

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Better Use Of Data Analytic Tools Can Help Community Health Workers Improve Care, Opinion Piece Says

TIME: Big Data Can Improve the Health of the World’s Most Vulnerable: Mothers and Children
Naveen A. Rao, medical doctor and senior vice president of the Health Initiative at The Rockefeller Foundation

“…Unfortunately, the best minds in technology and data science tend not to focus on empowering community health workers with data analytic tools. Private sector innovation is not reaching the developing world, especially community health workers, because there is limited commercial opportunity. This leads to lack of investment, data infrastructure, information quality, and talent. To help remedy that, The Rockefeller Foundation — for which I work as Senior Vice President of Health — announced in September 2019 a $100 million initiative to bring data science innovations to community health workers around the world, starting in 10 countries, with the goal of saving at least 6 million lives over the next decade. Although change will not happen overnight, I am optimistic we can achieve a shift in mindset across governments and the private sector that says technology should be for the benefit of everyone…” (10/24).

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From the Global Health Policy Community

New CSIS Resources Discuss HIV Prevention Technology, Address U.S. Role In Funding, Advancing Efforts

Center for Strategic & International Studies: The Evolution and Future of HIV Prevention Technology: An HIV Policy Primer
Maggie McCarten-Gibbs, program manager, and Sara M. Allinder, executive director and senior fellow, both with the CSIS Global Health Policy Center, authored a paper examining HIV prevention technology. A summary of the paper states, “There is an opportunity now to address critical implementation challenges for [HIV] prevention tools with several novel HIV prevention tools at different stages of development. Elevating prevention now will have to be a political, policy, and financial choice that puts more resources toward accelerating access to important new HIV technology with the goal of driving down the infection rate. As the U.S. government remains the leading funder of global HIV efforts, a systematic reassessment of U.S. prioritization of and commitment to prevention should be conducted before development of a new strategy for 2021 and beyond starts over the next year” (McCarten-Gibbs/Allinder, 10/22).

Center for Strategic & International Studies: Improving Access to Innovative HIV Technology
This video shows an event hosted by the CSIS Global Health Policy Center on October 22, that intended “to explore recent developments in HIV prevention and treatment technology, examine successes and challenges in integrating those products into existing service delivery, and discuss how global programs, such as PEPFAR and the Global Fund, need to adapt to ensure access and uptake” (10/22).

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World Bank, Global Fund Sign Co-Financing Framework Agreement For Health Efforts

World Bank: World Bank and Global Fund Deepen Partnership with Co-Financing Agreement
“The World Bank and the Global Fund have signed a co-financing framework agreement to accelerate efforts by countries to end HIV, tuberculosis, and malaria and build sustainable systems for health. The framework agreement outlines a new approach for joint financing of investment-type operations between the two organizations, as well as results-based financing…” (10/22).

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WHO Study Examines Reasons For Contraception Discontinuation In Cases Of Unintended Pregnancy

World Health Organization: High rates of unintended pregnancies linked to gaps in family planning services: New WHO study
“A new study conducted by the World Health Organization (WHO) in 36 countries found that two-thirds of sexually active women who wished to delay or limit childbearing stopped using contraception for fear of side effects, health concerns and underestimation of the likelihood of conception. This led to one in four pregnancies being unintended. Whilst unintended pregnancies do not necessarily equate to pregnancies that are unwanted, they may lead to a wide range of health risks for the mother and child, such as malnutrition, illness, abuse and neglect, and even death. Unintended pregnancies can further lead to cycles of high fertility, as well as lower educational and employment potential and poverty — challenges which can span generations…” (10/25).

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From the U.S. Government

CDC's Center For Global Health Director Marks World Polio Day, Highlights CDC's Eradication Efforts

CDC: Message from Rebecca Martin, PhD, Director of CDC’s Center for Global Health
In this post, Rebecca Martin, director of CDC’s Center for Global Health, marks World Polio Day and discusses current successes and challenges related to polio eradication efforts. Martin also mentions the CDC’s activities, writing, “CDC, along with our Global Polio Eradication Initiative (GPEI) partners, is working closely with leadership and partners in the two endemic countries and countries experiencing cVDPV outbreaks to urgently implement new and proven strategies for strengthening immunization and surveillance” (10/25).

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New Issue Of NIH Fogarty International Center's 'Global Health Matters' Newsletter Available

NIH Fogarty International Center: FIC Global Health Matters
The most recent issue of the Fogarty International Center’s newsletter contains various articles addressing global health topics, including pieces on mobile health research in low- and middle-income countries, a project in Madagascar aimed at predicting the spread of zoonotic diseases, and scientific capacity-building in Botswana and Uganda (September/October 2019).

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From KFF

KFF Provides First Comprehensive Summary Of Donor Funding For DRC Ebola Response

Kaiser Family Foundation: Data Note: Donor Funding for the Current Ebola Response in the DRC
The ongoing Ebola outbreak in the Democratic Republic of the Congo (DRC) has required increasing amounts of external support from donors (for more information on the outbreak, see KFF’s explainer). Yet there has been limited information about donor funding to date and a lack of a centralized reporting mechanism for tracking funding. This data note provides the first comprehensive summary of donor funding for the DRC Ebola response (Moss/Michaud/Kates, 10/25).

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