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Kaiser Daily Global Health Policy Report

In The News

U.S. Military Expects Ebola Efforts To Last At Least One Year, AFRICOM Commander Says

News outlets report on U.S. military efforts to contain Ebola in West Africa.

The Atlantic: The U.S. Military Wages War on Ebola
“The U.S. military campaign to help eradicate Ebola from West Africa sounds anything but surgical. It will take — for now — nearly 4,000 American troops, cost $750 million, and it could last a year or longer. ‘This is not a small effort, and this is not a short period of time,’ the commander of U.S. forces in Africa, General David Rodriguez, said on Tuesday…” (Berman, 10/7).

Foreign Policy: U.S. Commander Foresees a Yearlong Ebola Effort
“The Pentagon’s fight against the Ebola outbreak ravaging West Africa could last a year, the top American general overseeing operations in Africa said Tuesday, marking yet another expansion of the White House’s desperate fight to slow the spread of the deadly virus…” (Brannen, 10/7).

The Hill: Pentagon: U.S. troops to have contact with Ebola virus
“Several dozen U.S. troops could come into contact with Ebola while testing for the deadly disease in Liberia, the Pentagon said Tuesday. The highly trained troops will help operate seven mobile labs, where they could be working with the blood of infected patients, Army Gen. David Rodriguez said. The new details on the military’s response to Ebola reveals a riskier operation than previously announced by the White House, surfacing fresh concerns of troops entering high-risk zones…” (Wong/Ferris, 10/7).

NPR: The U.S. Ebola Hospitals In Liberia Are Going Up … Slowly
“…[O]n Sept. 16, Obama announced a massive response to the outbreak, involving thousands of U.S. troops on the ground to train health care workers, deliver relief supplies, and build 17 Ebola treatment centers for the general public. At the time of the announcement, Obama stressed that time is of the essence. … Yet progress on the hospitals has been slow…” (10/7).

Wall Street Journal: U.S. Military Sends Experts to Mobile Ebola Labs in Liberia
“U.S. military specialists highly trained in dealing with biological threats have been sent to Liberia to operate mobile laboratories being set up to test blood samples for the Ebola virus, the top American commander in Africa said Tuesday. Gen. David Rodriguez, head of U.S. Africa Command, said the U.S. has sent three mobile labs to Liberia, each staffed by three to four military service members who will wear head-to-toe protection as a safeguard against accidental infection. Four more labs have been requested, and the Defense Department is looking to fill that need, Gen. Rodriguez said…” (Barnes, 10/7).

Washington Post: If U.S. troops get Ebola in Africa, they’ll get treatment in the U.S.
“If U.S. troops in Africa get the Ebola virus, they will be taken to the United States on a specially designed plane and get treatment there, said the top U.S. general overseeing operations in Africa…” (Lamothe, 10/7).

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WHO Warns Ebola's Spread In Europe 'Unavoidable'; Spanish Officials Defend Country's Handling Of Ebola Case

News outlets report on the case of a nurse infected with Ebola while treating a patient in Spain and authorities’ concerns and warnings over the likelihood of future Ebola cases in Europe.

The Hill: WHO: Spread of Ebola in Europe ‘unavoidable’
“The World Health Organization is warning Europe to prepare for more cases of Ebola due to the ‘unavoidable’ spread of the virus through air travel. The first European diagnosis of Ebola took place Monday, when officials confirmed a Spanish nurse had contracted the disease…” (Viebeck, 10/7).

New York Times: Spanish Prime Minister Defends Handling of Ebola Case
“Prime Minister Mariano Rajoy defended his government’s handling of Western Europe’s first Ebola case on Wednesday, telling Parliament that he was confident Spain could contain the virus…” (Minder, 10/8).

New York Times: Demands for an Explanation Grow After a Nurse in Spain Contracts Ebola
“Spain’s government came under heavy criticism Tuesday as it dealt with the repercussions of Western Europe’s first Ebola case, quarantining three more people and monitoring dozens who had come into contact with an infected nurse. … The European Commission, the executive arm of the European Union, asked for an explanation, according to news reports. And some opposition politicians called for the health minister, Ana Mato, to resign…” (Minder, 10/7).

Reuters: More cases of Ebola spreading in Europe “unavoidable,” WHO says
“More cases of the deadly Ebola virus will almost inevitably spread in Europe but the continent is well prepared to control the disease, the World Health Organization’s (WHO) regional director said on Tuesday…” (Kelland, 10/7).

Wall Street Journal: Ebola Concerns in Spain Rise as Third Health Worker Enters Hospital
“A third nurse’s aide who treated an Ebola patient in Madrid checked into a hospital Tuesday night and was under observation, the government said on Wednesday. A spokesman for Spain’s regional health department said the hospital worker, whose name wasn’t disclosed, had a slight fever, one possible early symptom of Ebola…” (Brat/Neumann, 10/8).

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Democrats Request Hearing On U.S. Ebola Response Funding

The Hill: Dems ask for hearing on Ebola response funding
“Democrats on a House Appropriations subcommittee with jurisdiction over the Department of Health and Human Services (HHS) are calling for a hearing on funding to combat the Ebola outbreak…” (Shabad, 10/7).

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U.N. Budget Committee Approves Funding For UNMEER Mission

U.N. News Centre: U.N. budget committee approves funding for U.N. Ebola response mission
“The United Nations committee that deals with administrative and budgetary issues today adopted a resolution allocating funding for the newly established U.N. Mission for Ebola Emergency Response (UNMEER) and the Office of the Special Envoy on Ebola. … At the committee’s first meeting on Friday, Secretary-General Ban Ki-moon’s Chef de Cabinet, Susana Malcorra, presented his preliminary funding proposal requesting $49.9 million for the rest of the year…” (10/7).

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Ebola Threatens West African Economic Growth, IMF, World Bank Warn

News outlets report on the World Bank and IMF’s concerns of economic loss that West African economies may face due to the Ebola epidemic.

Agence France-Presse: IMF warns Ebola, budget strains endanger African growth
“Sub-Saharan Africa’s rapid economic growth is set to continue this year and next, but Ebola and budget problems have exposed the region’s vulnerabilities, the IMF said on Tuesday. Forecasting 5.1 percent growth this year and 5.8 percent in 2015 — the fastest growth outside Asia — the Washington-based institution warned ‘the Ebola virus is exacting a heavy economic toll’…” (10/7).

Wall Street Journal: World Bank Warns of Economic Threat to West Africa from Ebola Crisis
“Ebola spreading throughout West Africa could cause up to $33 billion in losses for the region’s economy, the World Bank said Wednesday in a report warning of deeper damage from the crisis…” (Talley, 10/8).

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WFP, FAO Taking Steps To Feed People In Ebola-Hit West African Nations

Media sources report on efforts to feed people in the three countries most affected by the Ebola epidemic, Guinea, Liberia, and Sierra Leone.

CNN: Feeding people on Ebola’s front lines
“…According to Bettina Luescher, the [World Food Programme’s] chief spokeswoman for North America, the WFP has provided food and assistance to more than 430,000 people affected by the Ebola crisis, feeding people for six months starting eight days after the crisis was declared in Guinea. Food distribution is ongoing in [Guinea, Liberia, and Sierra Leone], with more food on the way…” (Westmoreland, 10/7).

U.N. Food and Agriculture Organization: Ebola: FAO launches new initiative to tackle growing food security threat
“FAO [Wednesday] launched a new program to urgently assist 90,000 vulnerable households in Guinea, Liberia, and Sierra Leone whose food supplies and livelihoods are threatened by the disruptive effect the Ebola epidemic is having on rural economies, agricultural activities, and markets…” (10/8).

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E.U. Airlifting Ebola Aid To West Africa, Establishing Aid Worker Evacuation System

Agence France-Presse: E.U. sends Ebola airlift to West Africa
“The European Union said Tuesday it is urgently airlifting relief goods to West Africa to combat the Ebola crisis, as the disease threatened its shores with an infection in Spain. … The E.U. was also setting up a system for the evacuation of international staff from the affected countries if they become infected, it said…” (10/7).

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British Airways Flight Suspensions To Sierra Leone, Liberia Hindering Ebola Efforts, Aid Agencies Say

The Guardian: British Airways accused of hampering Ebola aid effort in West Africa
“…In August, BA announced it was halting flights to and from Sierra Leone and Liberia until December. It has now extended that suspension until the end of March. Médecins Sans Frontières, whose volunteer doctors have been on the frontline of the epidemic from the start, and Save the Children, which will run a new treatment center in Sierra Leone built by the U.K. military, said BA’s decision was causing them problems and sending the wrong message to the world and to people in the region…” (Boseley, 10/7).

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Testing Of Experimental Ebola Vaccine Raises Ethical, Logistical Questions

News outlets discuss the ethical and logistical challenges surrounding the testing of an Ebola vaccine.

Bloomberg News: Ebola Vaccine Trials May Give Placebo to Those at Risk
“As global health officials rush to begin human trials of two promising Ebola vaccines in West African medical workers, a daunting question remains unanswered: Who gets the placebo injection?…” (10/8).

CNBC: Fast-tracking an Ebola vaccine may prove too slow
“GlaxoSmithKline is speeding up trials and scaling production of an Ebola vaccine, but does not expect to be able to make it in mass quantities for 12 to 18 months, Dr. Moncef Slaoui, chairman of research and development at the U.K. pharmaceutical giant, said Tuesday on CNBC. That’s even before there’s any consideration of when it might potentially be available for use, he said…” (Belvedere, 10/7).

CNN: ‘Extraordinary’ race for Ebola vaccine raises ethical questions
“The ‘extraordinary’ rush to develop an Ebola vaccine is moving forward apace, the lead researcher told CNN’s Christiane Amanpour on Tuesday, adding that the fast pace may engender ethical concerns about how the vaccine is eventually implemented…” (Krever, 10/8).

Science Magazine: Tough choices ahead in Ebola vaccine trials
“When Ripley Ballou [of GlaxoSmithKline] came to a Geneva, Switzerland, meeting about Ebola vaccines last week, he had a tough message to sell. In the efficacy tests for such vaccines that may start in West Africa in a few months, half of the volunteers should randomly be assigned into a control arm, Ballou argued — a group of people at risk of becoming infected who would not receive an experimental Ebola vaccine. … It was a controversial opinion. Health care workers at the front lines of Ebola, who will serve as the target group in the first efficacy tests, are so vulnerable that giving them anything other than the experimental vaccine seems inhumane and could create tensions, some contended…” (Cohen/Kupferschmidt, 10/7).

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Ebola Unlikely To Become Airborne, CDC, WHO Say

News outlets report on the public’s skepticism over the transmission of Ebola virus. Both the CDC and WHO have issued statements clarifying how the virus does and does not spread, saying the virus is unlikely to become airborne.

Financial Times: Experts reject fears Ebola could become airborne
“Virologists rejected suggestions on Tuesday that Ebola might mutate to become an airborne virus after a Spanish nurse became the [first] person to contract the virus outside of West Africa. The Ebola virus is transmitted between people only through physical contact with infected body fluids, particularly blood, feces, and vomit…” (Cookson, 10/7).

The Hill: CDC: Airborne Ebola possible but unlikely
“The Ebola virus becoming airborne is a possible but unlikely outcome in the current epidemic, Centers for Disease Control and Prevention (CDC) Director Tom Frieden said Tuesday. The outbreak involves Ebola Zaire, a strain that is passed through bodily fluids, not the air. But some experts have expressed fear about viral mutations due to the unprecedented — and rising — number of Ebola cases. Frieden sought to allay those fears during a call with reporters…” (Viebeck, 10/7).

Los Angeles Times: Some Ebola experts worry virus may spread more easily than assumed
“U.S. officials leading the fight against history’s worst outbreak of Ebola have said they know the ways the virus is spread and how to stop it. They say that unless an air traveler from disease-ravaged West Africa has a fever of at least 101.5 degrees or other symptoms, co-passengers are not at risk. … Yet some scientists who have long studied Ebola say such assurances are premature — and they are concerned about what is not known about the strain now on the loose…” (Willman, 10/7).

USA Today: WHO: Ebola doesn’t spread through the air like a cold
“With some Americans on edge over the news of the country’s first Ebola patient, the World Health Organization issued a statement Monday clarifying how the virus does and doesn’t spread. … Many people are worried that they can catch Ebola because someone coughs on them. While this is a common way to catch the flu, it’s not a major concern for Ebola, the WHO says…” (Szabo, 10/6).

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News Outlets Report On Ebola's Toll On Liberia

News outlets report on issues surrounding the Ebola outbreak in Liberia, including the toll the disease is having on cultural norms, like hugging, the daily routine of an Ebola ward, and the prevalence of orphans in the country.

The Atlantic: Ebola’s Territory: A Land Without Human Touch (Beck, 10/7).
New York Times: Ebola’s Cultural Casualty: Hugs in Hands-On Liberia (Cooper, 10/4).
New York Times: Life, Death and Grim Routine Fill the Day at a Liberian Ebola Clinic (Fink, 10/7).
Washington Post: War-torn Liberia already had too many orphans. Then came Ebola. (Bernstein/Sullivan, 10/7).

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News Outlets Report On Various Aspects Of Ebola Containment Efforts

News outlets report on various aspects of the Ebola epidemic and international efforts to contain the virus and treat infected patients.

New York Times: Experimental Ebola Drug Puts Its Maker, Chimerix, Back in the Spotlight (Pollack, 10/7).
NPR: Why One Public Health Expert Thinks Airport Ebola Screening Won’t Work (Kelto, 10/8).
VOA News: Experts Worry Ebola Panic May Overshadow Other Health Threats (Powell, 10/7).
WBUR’s “On Point”: What America Must Do To Stop Ebola, Now (Ashbrook, 10/8).
Wall Street Journal: Health Care Workers Face Ebola Risks (Hinshaw/Wang, 10/7).
Yahoo News: Ebola outbreak: What the fight against the virus can learn from polio (Gavaghan, 10/7).

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Gates Foundation Official Speaks With Nature About 10 Years Of Grand Challenges

Nature: Gates Foundation Challenges turn ten
“…Steven Buchsbaum, deputy director of discovery and translational sciences for the Gates Foundation, talked to Nature about the lessons learnt from ten years of [Grand Challenges]…” (Hayden, 10/7).

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Pakistan Records 200 Polio Cases In 2014, Highest Number In More Than 12 Years

Washington Post: Polio becomes ‘public health emergency’ in Pakistan as number of cases soars
“As world health officials struggle to respond to the Ebola epidemic, Pakistan has passed a grim milestone in its efforts to combat another major global health crisis: the fight against polio. Over the weekend, Pakistan logged its 200th new polio case of 2014, the nation’s highest transmission rate in more than a dozen years. The spread has alarmed Pakistani and international health experts and is prompting fresh doubt about the country’s ability to combat this or future disease outbreaks…” (Craig, 10/7).

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More Than 23K Infected In South China's Worst Dengue Outbreak In Two Decades

Associated Press: 6 die in dengue virus outbreak in southern China
“The dengue virus has killed six people and infected more than 23,000 in southern China’s worst outbreak of the mosquito-transmitted disease in about two decades, officials said Tuesday…” (10/7).

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Recurrent Floods Putting Pressure On India As Nation Tries To Reach MDG Targets

Inter Press Service: Floods Wash Away India’s MDG Progress
“…Now, the long-term impacts of such natural disasters [as flooding] are proving to be a thorn in the side of [the Indian] government that is racing against time to meet its commitments under the Millennium Development Goals (MDGs), a set of poverty reduction targets that will expire at the year’s end…” (Borpujari, 10/7).

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Emergency Responders Sometimes Worsen Problems Caused By Natural Disasters, Reports Suggest

Inter Press Service: When Helping Hands Make a Disaster Worse
“Relief work done by emergency responders during natural disasters may inadvertently exacerbate problems caused by climate change and lead to further disasters, recent reports suggest…” (Fraser, 10/7).

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Editorials and Opinions

Opinion Pieces Discuss Controlling Ebola Epidemic

The following opinion pieces discuss various aspects of controlling the Ebola epidemic.

Huffington Post: Why the World Must Act Now on Ebola
Michael Elliott, president and CEO of ONE

“…[W]hat has to be done if West Africa is not to slip back, if leaders like Koroma and Johnson Sirleaf — and countless of their citizens — are not to see all their hopes for a democratic transformation dashed? Two things. First, we need to ensure that the pathetic response of the international community to the outbreak this spring and summer … is never repeated. Even now, after weeks of pledges, there is still a need to ensure that supplies and skilled personnel reach the areas most affected with greater urgency. … Second — and this can’t be said too loud or too long — investment in public health is essential. Not just for the obvious reason — it saves lives — but because sound public health systems are a foundational good: they provide the essential undergirding for the prospect of a better future, for happy families, for economic growth…” (10/7).

The Lancet: Ebola: a crisis in global health leadership
Lawrence Gostin and Eric Friedman of the O’Neill Institute for National and Global Health Law at Georgetown University Law Center

“…WHO, with its budget and capacity to respond diminished, has largely been sidelined in the response to Ebola. … The Ebola crisis should become a turning point for WHO reform, and for its member states being willing to fully resource it. No agency can exert leadership when it controls only a small portion of a depleted budget. The World Health Assembly should substantially increase members’ assessed contributions, create an emergency contingency fund, reform its regional organization, and engage non-state actors. … Failures in leadership have allowed a preventable disease to spin out of control, with vast harms to social order and human dignity. If the Ebola epidemic does not spur major reforms, it will undermine the credibility of WHO and the U.N., and enable the conditions for future crises to persist. Major failures in governance and leadership could be repaired if lessons are learned from Ebola…” (10/7).

New England Journal of Medicine: Ebola Vaccine — An Urgent International Priority
Vasee Moorthy and colleagues of the WHO, and Rupa Kanapathipillai, NEJM editorial fellow

“…Another WHO-arranged meeting [on Ebola vaccine candidate research] is planned for November to reevaluate the next necessary steps once preliminary results from the phase 1 trials are available. Even if adequate safety and immunogenicity are demonstrated in the phase 1 studies, vaccines will not be available in substantial quantity until the first quarter of 2015 at the earliest. For that to occur, funding must be secured for production. Even if an effective vaccine can be produced, it is not likely to be 100 percent effective, so to succeed in stemming the current outbreak, a coordinated effort to improve capacity and provide clinical care in affected countries needs to be scaled up urgently” (10/7).

The Lancet: Controlling Ebola: next steps
Jeffrey Sachs and Ranu Dhillon of Columbia University, and Devabhaktuni Srikrishna of Patient Knowhow

“The Ebola epidemic is paradoxical: it is out of control yet readily controllable. The key to epidemic control is rapid diagnosis, isolation, and treatment of infected individuals. This approach was used in past Ebola outbreaks through contact tracing, in which anyone exposed to a person with Ebola was monitored, tested if they developed symptoms, and, if positive, securely transported to a health facility for treatment. … We believe that with a dedicated effort that integrates early diagnosis, secure transport, and effective treatment, the Ebola epidemic could be contained within six months in Liberia and Sierra Leone, and in an even shorter time in Guinea. That is not the current trajectory but could become so if the affected governments and UNMEER quickly adopt a bottom-to-top, integrated, and scaled-up strategy to get ahead of the epidemic” (10/8).

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Addressing Malnutrition 'Critical' To Advance U.S. Global Development Objectives

The Hill: Addressing malnutrition
U.S. Reps. Ander Crenshaw (R-Fla.) and Adam Smith (D-Wash.)

“Malnutrition is the largest single contributor to child mortality worldwide, and according to the World Health Organization is the underlying cause of death for at least three million children every year. As the United States continues its efforts to help end world hunger and poverty, we must address the fundamental problem of malnutrition. … A complex problem like malnutrition demands an innovative and effective foreign assistance solution. Specifically, addressing malnutrition requires coordinated planning and programming of effective nutrition-specific and nutrition-sensitive interventions across multiple sectors, including agriculture, health, nutrition, water and sanitation, social protection, and humanitarian assistance programs. … Recognizing and addressing the world’s malnutrition problem as one of the major underlying impediments to eradicating global poverty and economic growth will not only save lives, it is critical to the success of the U.S. government’s ability to advance our global development objectives” (10/7).

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Women Should Have Access To Safe, Legal Abortions

MSNBC: What happens without legal abortion
Nancy Northup, president and CEO of the Center for Reproductive Rights

“…Over the last two decades, 35 countries have liberalized their abortion laws, according to a new report and updated World’s Abortion Laws map from the Center for Reproductive Rights. … That progress is critical. The reality is restrictive abortion laws result in 22 million clandestine, unsafe abortions annually — killing nearly 50,000 women each year. … A woman’s access to critical health care is a fundamental human right that shouldn’t vary depending on where she lives. Thirty-five nations have moved in the right direction. It’s time for the rest of the world to catch up” (10/7).

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From the Global Health Policy Community

JAMA, Kaiser Family Foundation Produce Infographic With Key Ebola Data

JAMA/Kaiser Family Foundation’s “Visualizing Health Policy”: The 2014 Ebola Outbreak
This infographic, the latest in the “Visualizing Health Policy” series produced in partnership between JAMA and the Kaiser Family Foundation, provides a snapshot of the 2014 Ebola outbreak in West Africa. It includes key facts about the Ebola virus, shows how the number of Ebola cases in the current outbreak outstrips the case total from all previous Ebola outbreaks, and offers a summary of the key U.S. agencies responding to the crisis and the roles they are playing. In addition, it provides a look at the growing 2014 Ebola case count in West Africa compared to U.S. government funding commitments (10/8).

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USAID Blog Post Profiles Liberian Lab Testing For Ebola

USAID’s “IMPACTblog”: The Fight on Ebola Continues in the Lab
Carol Han, press officer for the Ebola Disaster Assistance Response Team at USAID, discusses the Liberian Institute for Biomedical Research (LIBR), which was established in the 1970s to conduct research on viral infections in Africa and is now one of the few laboratories in Liberia testing specimens for Ebola (10/7).

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'Science Speaks' Post Discusses CDC Report On Ebola Preparedness In Liberia

Center for Global Health Policy’s “Science Speaks”: As Ebola gained ground, CDC report on health care resources in Liberia’s remote counties highlights vulnerabilities
Antigone Barton, writer and editor of “Science Speaks” and senior communications officer at the Center for Global Health Policy, discusses a recently released CDC report assessing Ebola preparedness in parts of Liberia (10/7).

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Blog Posts Highlight New Grand Challenge Focused On Women, Girls

The Bill & Melinda Gates Foundation’s “Impatient Optimists” blog published several posts discussing the foundation’s 10th Grand Challenge, “Putting Women and Girls at the Center of Development,” announced October 7.

Impatient Optimists: Grand Challenge: Putting Women and Girls at the Center of Development
Gary Darmstadt, senior fellow at the Bill & Melinda Gates Foundation’s Global Development Program; Sarah Henry, senior consultant with Global Health Visions; and Luca Passerini, program officer with the Gates Fellows Program, discuss the foundation’s “first Grand Challenge on gender equality and women’s and girls’ empowerment, [signaling] a more concerted push to put women and girls at the center of our work.” They write, “‘Putting Women and Girls at the Center of Development’ seeks to accelerate understanding of how to effectively address gender inequalities and empower women and girls, and how to better measure women’s and girls’ empowerment…” (10/6).

Impatient Optimists: Financially Empowering Women, Disrupting Poverty
Liz Kellison, deputy director of the financial services for the poor team at the Bill & Melinda Gates Foundation, discusses the need for financial services for women in the context of the foundation’s new Grand Challenge, “Putting Women and Girls at the Center of Development” (10/7).

Impatient Optimists: Measuring What Can’t Be Counted
Jodi Nelson, director of strategy for measurement & evaluation, and Ritu Shroff, deputy director of strategy for measurement & evaluation at the Bill & Melinda Gates Foundation, outline three obstacles that the foundation’s new Grand Challenge, “Putting Women and Girls at the Center of Development,” will address in order to identify ways to reach and empower women (10/7).

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CFR Releases 'Backgrounder' On WHO's Role, Challenges In Context Of Ebola

Council on Foreign Relations’ “Backgrounders”: World Health Organization
This backgrounder discusses the WHO’s mandate, governance structure, and role in global health emergencies, and outlines some of the challenges facing the organization, particularly those underscored by the current Ebola outbreak (Renwick/Johnson, 10/7).

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Blog Post Addresses Lymphatic Filariasis In Guyana, NTD Efforts in LAC Region

Global Network for Neglected Tropical Diseases’ “End The Neglect”: Inter-American Development Bank’s Documentary Highlights “Big Foot” in Guyana
Segun Adesina of the Global Network discusses lymphatic filariasis (LF) in Guyana, a partnership in Latin America and the Caribbean to address LF in Guyana as well as other NTDs in the region, and a video focused on the disease — Tackling “Big Foot”: A Story of Sanitation and Health in Guyana — developed by the Inter-American Development Bank (10/7).

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