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Kaiser Daily Global Health Policy Report

In The News

Global Health Experts Express Concern Over Trump Administration's Response To DRC Ebola Outbreak, First In War Zone

Vox: Trump officials have barred health experts from helping end one of the worst Ebola outbreaks in history
“One of the largest Ebola outbreaks in history shows no signs of slowing — and the Trump administration barred U.S. health experts who want to help at the outbreak’s epicenter in the Democratic Republic of Congo from traveling there. … Centers for Disease Control and Prevention officials were working in Beni, the city that’s ground zero for the outbreak in eastern DRC, for a few days in late August and early September. … But then the White House’s National Security Council (NSC) coordinated a government review of the security risks, involving representatives from multiple government agencies and departments. The review determined that CDC officials could not return to areas where militant attacks threaten security, including Beni. … The relatively tepid response from the U.S., at a time when the outbreak is spiraling, has former CDC officials and global health experts concerned…” (Belluz/Ward, 10/26).

WIRED: An Ebola Outbreak In A War Zone Is About As Bad As It Gets
“…Right now the DRC is experiencing a world-first: an Ebola outbreak in a war zone. While disease hunters have learned a lot from previous tragedies, like the … outbreak that killed more than 11,000 people in West Africa, this is the one scenario no one’s been able to prepare for. … Despite the setbacks, health workers have so far succeeded in vaccinating more than 20,000 people, according to the WHO’s latest numbers. … Although the WHO has not yet declared the latest Ebola outbreak an international public health emergency, its latest report warned that the volatile security situation is making the risk of disease spread to neighboring countries very high…” (Molteni, 10/25).

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U.N. Member States Unanimously Approve Declaration Of Astana To Strengthen Primary Health Care

U.N. News: ‘Essential step’ towards universal health care made at pivotal U.N. conference
“United Nations Member States have unanimously vowed to strengthen primary health care, as an ‘essential step’ towards achieving universal health coverage for all. The commitment came at the Global Conference on Primary Health Care, being held in the capital of Kazakhstan this week. Known as the Declaration of Astana, it reaffirms the historic 1978 Declaration of Alma-Ata, which was the first accord reached by world leaders on primary health care. Thursday’s declaration is also intended to help the world achieve Sustainable Development Goal 3: ‘Ensure healthy lives and promote well-being for all at all ages’…” (10/25).

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OECD Development Assistance Committee Agrees To New Rules On Untied Aid, Country Eligibility

Devex: Donors agree new rules on untied aid and eligibility
“Leading aid donors set new rules Thursday making it possible for countries to become re-eligible for official development assistance if their income levels fall back below the threshold. Donors also agreed to expand the number of places where aid should be ‘untied’ — that is, where they should not reserve aid contracts for their own companies. The rule changes were reached in Paris, France, at a delegate-level meeting of the Organisation for Economic Co-operation and Development’s Development Assistance Committee, a group of 30 leading donor countries that set the international rules for ODA…” (Chadwick, 10/26).

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Devex Examines Takeaways From U.N. World Data Forum

Devex: Takeaways from the U.N. World Data Forum
“The 2018 United Nations World Data Forum has concluded with new commitments and partnerships to push forward an agenda that will enable data to better support the delivery of the Sustainable Development Goals. While there were some notable achievements, there were also challenges. Devex has the key takeaways from the three days of discussion…” (Cornish, 10/26).

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Researchers Discuss Advancements In TB Treatment, Prevention At International Conference

Agence France-Presse: New weapons drawn in global TB fight
“From a revolutionary way of testing children for tuberculosis to a cure for a previously untreatable strain, scientists from across the globe launched a fresh broadside Thursday against the world’s deadliest infectious disease. … More than 4,000 experts on lung health are gathering this week in The Hague and on Thursday they unveiled several new weapons in the battle against tuberculosis. One potential game changer is a new method of testing children under five for the disease…” (10/25).

CNN: New vaccine and drug combo offer hope against world’s biggest infectious killer
“…[A] special trial, beaming the number ’54,’ woke [researchers] from resignation and gave the first signs of hope in years. The number stood for a percentage — 54 percent. It meant that a tuberculosis vaccine that crosses a coveted efficacy threshold may soon be possible — and effective. The vaccine, known as M72/AS01E, has been developed by GlaxoSmithKline and is the first vaccine of many recent attempts to show more than 50 percent protection against people developing TB, as published in the New England Journal of Medicine…” (Senthilingam, 10/25).

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Uganda Implements Alcohol, Soft Drinks Tax To Help Fund HIV Treatment

The Guardian: Tax on drinks to raise funds for HIV treatment in Uganda
“Taxes levied on alcohol and soft drinks in Uganda will be used to fund the country’s HIV treatment programs, in a move designed to make the country less reliant on donors. The government believes $2.5m a year will be generated from the two percent total tax levies collected from drinks, including beer, spirits, and waragi, a local liquor, which will be channeled into a new HIV and AIDS trust fund (ATF)…” (Okiror, 10/26).

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AP Investigates Congolese Hospitals' Detention Of Patients Who Cannot Afford Bills In 2nd Part Of Series

Associated Press: AP Investigation: Congo hospitals openly imprison patients
“…An Associated Press investigation found that only one of more than 20 hospitals visited in the copper-mining metropolis of Lubumbashi did not routinely imprison patients. Though government officials condemn the illegal practice, a Ministry of Health official in Kinshasa noted that ‘health officials cannot be everywhere’…” (Cheng, 10/26).

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IRIN Examines Venezuela's Health Care, Humanitarian Crises

IRIN: “Worse off than a war zone”: Inside Venezuela’s health care crisis
“…Stark evidence of the humanitarian crisis swirling within Venezuela’s borders can be found in the country’s medical system: severe drugs and equipment shortages, hospitals and clinics in disrepair, people dying needlessly because they can’t find or afford medicine. The government, however, maintains that a crisis does not exist within the country. … It’s a sign of a larger health crisis in Venezuela, where plummeting oil prices and fiscal mismanagement have left the economy on its knees and the country unable to import what it needs. More than 1.6 million Venezuelans have fled the country since 2015, sparking a humanitarian emergency throughout the region…” (Schulman, 10/25).

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More News In Global Health

Bloomberg: World’s Biggest Health Care Program Must Educate a Half-Billion Beneficiaries (Beniwal, 10/25).

The Economist: Famines are becoming more frequent in the Sahel (10/25).

HuffPost: What It Means That ‘Virginity Tests’ Are Still Common In Morocco (Ouazzani, 10/25).

The Lancet: Urgent medical attention needed for people on Nauru (McCall, 10/27).

The National: Bill Gates in talks over plan to open UAE center to eliminate diseases (Duncan, 10/24).

Quartz: Trans rights are under threat in the U.S., but Uruguay is massively expanding them (Schlanger, 10/22).

SciDev.Net: Pesticides blamed for rise in colon cancer deaths (de Oliveira Andrade, 10/25).

Washington Post: India wrestles with first significant outbreak of Zika virus (Slater, 10/25).

Xinhua News: UNICEF delivers vaccines for millions of Libyan children (10/26).

Xinhua News: China donates 1.5 mln USD to South Sudan to enhance Ebola prevention (10/26).

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Editorials and Opinions

U.S. Leadership On Global Food Security Critical To National Security

Statesman: McRaven and McCaul: National Security Dimensions of Global Food Insecurity
Bill McRaven, retired Navy four-star admiral and former chancellor of the University of Texas system, and Rep. Michael McCaul (R-Texas)

“…Global hunger is a major national security concern. … With a population bulge already under way in sub-Saharan Africa and South Asia, malnutrition and food insecurity could be a primary driver for countries and regions moving toward greater poverty and instability. This poses a direct threat to the national security of the U.S. Therefore, we must adopt a comprehensive strategy to address global food insecurity at its root causes. … Over the last several years, the U.S. government has increasingly focused on food security by including it as a foreign policy and national security priority. … In Congress, members of both parties have been working to improve policy and increase resources for programs combating global hunger and malnutrition. … The United States has the opportunity to be a leader in funding programs, enacting policies, and building on these multi-stakeholder partnerships to end hunger. Our leadership will not only save lives and ensure economic prosperity, it will decrease conflict and protect Americans both here and abroad” (10/25).

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Opinion Pieces Examine Media Coverage Of Migrant Caravan, Ebola Outbreaks

Esquire: The Media Is Failing on The Caravan, Just Like It Failed on The Emails and The Great Ebola Panic
Jack Holmes, associate editor for News & Politics at Esquire

“…The fact that [the migrant caravan] is getting exhaustive coverage is just the latest failure in a campaign homestretch from the mainstream media in this country, following a 2016 meltdown over Hillary Clinton’s email security protocol and a 2014 cycle where the media went apocalyptic over an Ebola outbreak in [western] Africa…” (10/24).

The Hill: Democrats have to beat the Republican fear campaigns
Former Rep. Steve Israel (D-N.Y.)

“Fear works in most elections. Reason does not. … In 2018, it’s the migrant caravan. In 2014, the last midterm election, it was the Ebola virus. … Cable television became ‘Ebola Central.’ … Panic about Ebola crowded out any Democratic midterm message and it had an impact…” (10/24).

New York Times: Trump’s Ignoring Our Real ‘National Emergies’
Nicholas Kristof, opinion columnist at the New York Times

“…Ebola, like the Central American caravan, is a reminder of the distinction between grandstanding and governing. [President] Obama’s technocratic Ebola program … may have worried voters, but it was effective. Instead of careening around the world to kill millions and devastate the global economy, the Ebola virus was contained and eventually burned out. Good governance often turns out to be bad politics, and vice versa” (10/24).

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Opinion Pieces Discuss Importance Of Primary Health Care, Steps To Reaching UHC

Medium: Putting People at the Center of the Health Care Picture
Chris Elias, president of global development at the Bill & Melinda Gates Foundation

“…The Bill & Melinda Gates Foundation believes that access to quality primary health care (PHC) is the first and most critical step to delivering on the promise of universal health coverage. … When managed well, it’s a powerful tool for health equity … To get a clear picture of what’s working with this approach, countries and donors need to commit to measuring what matters. … We need … performance data to identify the barriers that still prevent hundreds of millions of people from accessing basic services. … Over the past two decades, the world has made unprecedented progress in reducing the global burden of infectious disease and shrinking major gaps in health equity. But these gains remain fragile and could be easily reversed if we don’t invest in the people and systems that will play an essential role in reaching the unreached and delivering on the principle that everyone deserves the opportunity to lead a healthy and productive life…” (10/24).

Global Health NOW: Let’s End the Fuzziness in Universal Health Coverage
Gavin Yamey, professor of global health and public policy at Duke University and director of the Center for Policy Impact in Global Health at the Duke Global Health Institute, and David Watkins, assistant professor of general internal medicine at the University of Washington and physician at the Harborview Medical Center

“…When governments say they will provide [universal health coverage (UHC)], they shouldn’t use vague notions: UHC should be a guaranteed promise of explicitly defined, publicly funded services. In our new paper, … we try to clarify the fuzziness surrounding UHC. … [W]e define a package of 218 unique interventions as ‘essential UHC’ (EUHC), based on being locally relevant, feasible to implement, pro-poor, and providing high value for money. … To be clear, we passionately believe that health care for all must be the goal … But where public resources are scarce, investments should be distributed fairly in a way that gets the most health for the money and that disproportionately benefits the poor. As countries’ economies grow, they can expand their UHC packages. Countries will also need to contextualize and adapt EUHC and use it as one of many inputs into their pathway towards high-quality, affordable services for all…” (10/25).

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Research Community Should Consider Long-Acting Technologies' Potential For Reducing Drug Resistance Risk In LMICs

The Lancet: Long-acting technologies for infectious diseases in LMICs
Lelio Marmora, executive director at Unitaid, and colleagues

“…Could the risk of resistance to medications for infectious diseases be reduced through the use of long-acting (LA) patches, implants, or injectable drugs? Thanks to scientific and technological advances, these scenarios might be feasible over the next decade. In high-income countries, the shift from daily oral medication to weekly, monthly, and less frequent LA formulations has been reported to have better adherence and health outcomes across many areas … [W]e need to be thinking ahead about LA technologies for infectious diseases. That is why Unitaid is working with a wide range of partners and stakeholders to explore these issues, including through a global technical consultation in Geneva, Switzerland, on Nov 1-2, 2018, that will consider the science and market landscapes for LA technologies. Our shared goal should be to accelerate the development and implementation of these new approaches so that they have the greatest possible impact against global epidemics” (10/24).

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WHO Should Heed Calls For Reform To Global Vaping Policy

Financial Times: WHO is refusing to listen to the evidence on vaping and harm reduction
Lizi Jenkins, board member at the U.K. Vaping Industry Association, and colleagues

“Calls for reform to global vaping policy have fallen on deaf ears. Following the Eighth Session of the Conference of Parties (COP8) in Geneva this month, the World Health Organization’s tobacco control group has once again refused to acknowledge the need to treat vaping distinctly from smoking. At COP7 two years ago, the WHO invited member states to ban vaping products outright despite recognizing their potential to help reduce global smoking rates — a position as confusing for consumers as it was for public health officials and regulators. International vaping bodies and campaigners … have issued a call to action to the WHO to remedy this contradiction. … Yet it appears that the WHO’s tobacco control group is sticking its fingers in its ears. Not content with expelling journalists and industry from the proceedings, it has gone as far as to claim that ‘there is no independent research to confirm’ that vaping is less harmful than smoking. … Discouraging policymakers from embracing harm reduction could not only be costing lives … but prevent us from alleviating a substantial public burden” (10/25).

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From the Global Health Policy Community

Alma-Ata 40 Roundtable Members Discuss Lessons From Declaration, Implementation Of Astana To Reach Primary Health Care For All

Health Affairs Blog: Implementing The Astana Declaration — What Alma-Ata Taught Us
Members of the Alma-Ata 40 Roundtable, a group of policymakers and scholars who in September assessed the impact and current relevance of the 1978 Alma-Ata Declaration, discuss the recent Global Conference on Primary Health Care, which reconfirmed “the world’s commitment to comprehensive primary health care as the keystone of universal health coverage” in the Astana Declaration. The authors write, “Today, recognizing how the ideals declared in Alma-Ata drove effective action, and understanding the ‘best practices’ that are available to continue those advances, are crucial to the coming work of transforming the Astana declaration into better health for all…” (10/25).

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'Science Speaks' Reports From 49th Union World Conference On Lung Health

IDSA’s “Science Speaks”: 49th Union World Conference on Lung Health: GeneXpert can test stool samples to accurately diagnose TB in children (Aziz, 10/25).

IDSA’s “Science Speaks”: 49th Union World Conference on Lung Health: Study shows scaling up TB prevention in children is possible (Aziz, 10/25).

IDSA’s “Science Speaks”: 49th Union World Conference on Lung Health: First promising TB vaccine candidate in 100 years needs more resources, researchers say (Aziz, 10/25).

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From the U.S. Government

CDC's MMWR Provides Global Update On Vaccine-Derived Polioviruses

CDC’s “Morbidity and Mortality Weekly Report”: Update on Vaccine-Derived Polioviruses — Worldwide, January 2017-June 2018
Jaume Jorba of the Division of Viral Diseases at the National Center for Immunization and Respiratory Diseases at the CDC and colleagues provide a global update on vaccine-derived polioviruses (10/26).

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