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Kaiser Daily Global Health Policy Report

In The News

Global Fund Replenishment Conference Begins In Canada With Aim Of Raising $13B In Pledges Through 2019

Agence France-Presse: At Canada conference, $13 billion sought for anti-AIDS fight
“International donors gather in Montreal this weekend with a goal of raising another $13 billion for the fight to eradicate AIDS and two other major deadly diseases — tuberculosis and malaria — by 2030. Canadian Prime Minister Justin Trudeau is chairing the conference, held every three years to raise money for the Global Fund to Fight AIDS, Tuberculosis and Malaria. Among those expected to attend are U.N. Secretary-General Ban Ki-moon, a dozen heads of states, and U.S. billionaire Bill Gates…” (Sabourin, 9/15).

Devex: Canada to push Global Fund focus on vulnerable populations
“Canada’s hosting of the Global Fund Fifth Replenishment Conference in Montreal this weekend marks a significant uptick in country’s role in the fight against AIDS, tuberculosis, and malaria. Prime Minister Justin Trudeau has been personally engaged with planning the conference — part of a broader push to elevate Canada’s leadership role in international development. … In addition to refilling the Global Fund to Fight AIDS, Tuberculosis and Malaria’s coffers with a requested $13 billion for 2017 to 2019, Canada will prioritize discussions about how to best reach women and girls, indigenous people, and LGBTQ populations…” (Halai, 9/16).

NPR: Why The U.S. Is Pledging $4.3 Billion To The Global Fund
“The U.S. has pledged up to $4.3 billion to the Global Fund to Fight AIDS, Tuberculosis and Malaria over the next three years. The question is, will it actually make an impact? If previous data are any indication, the answer is yes. ‘The Global Fund has a good track record in terms of impact achieved and funding distributed,’ says Josh Michaud, associate director of global health at the Kaiser Family Foundation, a nonpartisan health policy research group. … What makes the fund different from, let’s say, the World Bank or governments that give aid, is that local NGOs are part of the governing body, says Michaud. That means they have a bigger say in how money is disbursed on the ground…” (Gharib, 9/15).

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Global Maternal Deaths Drop By 44% Since 1990, But Disparities In Care Remain, According To Study Published As Part Of Lancet Maternal Health Series

The Guardian: Maternal deaths worldwide drop by half, yet shocking disparities remain
“The number of women dying from causes related to pregnancy and childbirth has almost halved since 1990, a global report has revealed. Worldwide the annual number of maternal deaths per 100,000 live births fell by 44 percent between 1990 and 2015, from approximately 385 to 216. But the figure came far below the target set by the United Nations as part of its Millennium Development Goals in 2000, which aimed to see a drop of 75 percent by 2015. … [A]ccording to the report — a series of six papers published in the Lancet by an international team of researchers — provision of maternal health care worldwide is hugely variable…” (Davis, 9/15).

The Guardian: Women above 35 who give birth account for 40% of maternal deaths in Australia
“Of the Australian women who give birth, 23 percent are over 35 but these older mothers account for 40 percent of maternal deaths across the country, a study has revealed. Australia has the second highest rate of births to older women among 14 developed countries — behind only Spain, where 35 percent are above that age — and the highest rate of caesarean section births, a study in The Lancet says…” (9/15).

International Business Times: Despite 44% drop in global maternal deaths, study shows disparities prevail in health care facilities
“…While one in 4,900 women in high income nations is prone to maternal death, the figure is an appalling one in 36 for women in sub-Saharan Africa. … The researchers estimated that around 210 million women get pregnant every year and about 140 million babies are born annually. However, since 1990, the gap between the group of countries with the highest maternal mortality rate and the group with the lowest had doubled…” (Ray, 9/16).

The Lancet: Challenges for maternal health efforts
“The U.N. Population Fund (UNFPA) is currently operating with a shortfall of about US$140 million, an amount that exceeds the combined budgetary gap of the previous two years. For the first time this year, donors designated more funding to specified projects and regions rather than supporting the ‘core’ work of the UNFPA. The agency expects the funding shortages to cause rippled setbacks for women’s and maternal health care worldwide…” (Lieberman, 9/17).

Thomson Reuters Foundation: Global goal to reduce maternal deaths threatened by lack of access to quality care — study
“Unequal access to health services and poor quality care for pregnant women is hampering progress in meeting international goals for eradicating deaths during childbirth, researchers said on Thursday. … Nearly 53 million of the poorest women in the world receive no skilled assistance during birth, the study said. Women who struggle the most to get good quality maternal care were teenagers, unmarried women, immigrants, refugees, and internally displaced women, along with indigenous women and women from ethnic or religious minorities, the report said…” (Moloney, 9/15).

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U.N. Official Calls For Cross-Sector Efforts To Address Global Threat Of Antimicrobial Resistance

U.N. News Centre: Ahead of major health meeting, senior U.N. official sheds light on growing threat of antibiotic resistance
“Ahead of a United Nations high-level event on antimicrobial resistance to be held next week, a senior U.N. health official [Thursday] underlined the need for strong commitment from all sectors to address this urgent global threat which has the potential to undermine sustainable development. ‘The emergence of antimicrobial resistance really threatens to send us backwards — to have infections once again become a much larger killer of people,’ Assistant Director-General of the U.N. World Health Organization (WHO) and Special Representative for Antimicrobial Resistance Keiji Fukuda told a news briefing [Thursday] at U.N. Headquarters in New York…” (9/15).

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Case-Control Study Strengthens Association Between Zika Infection, Microcephaly In Newborns

CIDRAP News: Case-control study adds to Zika-microcephaly link
“Brazilian researchers [Thursday] added an eagerly awaited piece of the Zika-microcephaly puzzle, publishing the first case-control study, which found a strong link between the two conditions. …The study, ordered by Brazil’s health ministry, included all babies born with microcephaly in eight public hospitals in the country’s Pernambuco state, a Zika hot spot, between Jan. 14 and May 2. The team published its findings in Lancet Infectious Diseases. Investigators compared each of the 32 microcephaly cases they found with two controls: the first two infants born the following morning without microcephaly…” (Schnirring, 9/15).

The Economist: The Zika virus: A mystery no more
“…At first, scientists knew little more than anyone else. Zika is not new; the virus was first isolated in Africa in 1947. But it was obscure, and therefore little studied. Only during the present outbreak did it become clear that infection among pregnant women was associated with birth defects and neurological problems in babies. But there has been much progress, and scientists now know far more about the disease than they did when the outbreak began…” (9/17).

Los Angeles Times: Researchers strengthen link between Zika and microcephaly
“…Preliminary results from a study commissioned by the Brazilian Ministry of Health found that 13 out of 32 newborns with microcephaly tested positive for the Zika virus. Meanwhile, none of the 62 newborns in a comparison group who had normal-sized heads showed any sign of infection…” (Kaplan, 9/15).

Reuters: Study confirms Zika causes brain birth defects, questions remain
“…After taking samples and conducting brain scans, the researchers found that 41 percent of mothers of babies with microcephaly tested positive for Zika infection in blood or cerebrospinal fluid samples, compared with none of those whose babies did not have microcephaly. A high proportion of mothers of both microcephaly and non-microcephaly babies also tested positive for another mosquito-borne virus, dengue fever, as well as other infections such as herpes, rubella, and toxoplasma. ‘Our findings suggest Zika virus should be officially added to the list of congenital infections,’ said Thália Velho Barreto de Araújo of Brazil’s Pernambuco University, who also worked on the research team. ‘However, many questions still remain to be answered — including the role of previous dengue infection’…” (Kelland, 9/15).

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Global Survey Of Attitudes Toward Immunization Shows Varying Sentiments Among Nations

Humanosphere: Vaccines: Education and access aren’t enough in a skeptical Europe, survey finds
“…Researchers from the London School of Hygiene and Tropical Medicine, Imperial College London, and the Saw Swee Hock School of Public Health in Singapore questioned nearly 66,000 people across 67 countries about their attitudes on immunization. The goal was to take the global temperature on vaccine sentiment and identify countries where confidence is low — and vulnerability to outbreaks is high…” (Nikolau, 9/15).

NPR: Who Has More Faith In Vaccine Safety: Parents In France Or Bangladesh?
“…A survey of nearly 66,000 people about attitudes toward immunization has found some surprising results. In France, 41 percent of those surveyed said they did not have confidence in the safety of vaccines. By contrast, in Bangladesh, fewer than one percent of those surveyed expressed a lack of confidence. … To find out more, we spoke to the lead author, Heidi Jane Larson, director of the Vaccine Confidence Project at the London School of Hygiene and Tropical Medicine…” (Cole, 9/10).

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Clinton Health Access Initiative Would Separate From Clinton Foundation If Hillary Clinton Elected U.S. President

Reuters: Clinton Foundation Plans To Spin Off Flagship Health Project
“The Bill, Hillary & Chelsea Clinton Foundation would spin off its flagship health project into a ‘completely independent’ charity if Hillary Clinton were to win the U.S. presidency in November, the charity announced on Wednesday. The Clinton Health Access Initiative, which has focused on reducing the cost of HIV medicine in sub-Saharan Africa, currently accounts for about two-thirds of the foundation’s annual income and expenses, according to disclosures online…” (Allen, 9/14).

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U.K. Supports Food Fortification Program In Pakistan To Stem Malnutrition

The Guardian: Pakistan fights devastating malnutrition with mass food-fortifying program
“A new program of fortification of everyday foods such as bread and oil is being rolled out in Pakistan in an attempt to tackle chronic and widespread malnutrition. The food fortification program, which is backed with $48m (£36m) of funding from the U.K.’s Department for International Development (DfID), will see nutrients added directly to wheat flour, edible oils, and ghee at source in mills and factories…” (Grant, 9/16).

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Editorials and Opinions

Global Fund Replenishment Essential To Spur Technological Innovations To Improve Health, Development Outcomes

The Lancet: Replenishment of the Global Fund: global solidarity needed
Peter A. Singer, chief executive officer of Grand Challenges Canada

“…The goal of the Fifth Replenishment is to help the Global Fund save an additional eight million lives and avert 300 million new infections by 2020 by mobilizing US$13 billion in 2017-19. … Meeting this goal is the Global Fund’s immediate challenge and translating those funds into lives saved is its mid-term opportunity. In the longer term, the challenge and opportunity is to accelerate progress and reach vulnerable groups that are disproportionately affected by HIV/AIDS, tuberculosis, and malaria — which requires innovation. … Although the Global Fund does not directly support scientific research, it does help to create demand for technological innovations that could improve health and development outcomes. None of these three diseases has a highly effective vaccine; drugs for malaria, tuberculosis, and HIV encounter antimicrobial resistance; point of care diagnosis, especially for tuberculosis, could be improved; better vector control strategies for malaria are needed; and more precise health and outcomes data, including disaggregation by gender, income, and geography, are needed. … The Global Fund replenishment must succeed…” (9/17).

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African Nations Must Invest In Continent's Health Through Partnerships Like Global Fund

Thomson Reuters Foundation: Let’s work together to invest in Africa’s health
Uhuru Kenyatta, president of Kenya

“…In the spirit of shared responsibility and global solidarity, African countries can commit to play a bigger role by investing more in their health through the Global Fund. … [W]e, as African countries, have a key role to play in co-investing in health with our partners. Kenya is pledging US$5 million to the Global Fund for the coming three-year funding cycle. We all must come together and contribute to create enough impetus against HIV, tuberculosis, and malaria and other health concerns that continue to devastate our people. The Global Fund is an example of great partnerships for development that we can form in every sector as we seek to build stronger societies. These types of partnerships recognize that world problems are shared. They re-emphasize that the world must learn to build bridges and look outward rather than inwards. Above all, they provide avenues for low- and middle-income economies to play a prominent role in their own destinies. It is the way to create a transformative impact on people and to reinvigorate our communities and economies…” (9/15).

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World's Leaders Should Commit To Developing, Implementing National Action Plans Against Antimicrobial Resistance, 'Be Held To Account'

Wall Street Journal: Saving Antibiotics So That Antibiotics Can Save Lives
Seth Berkley, CEO of Gavi, the Vaccine Alliance, and Jeremy Farrar, director of the Wellcome Trust

“…[A] central challenge posed by drug-resistant infections is the desperate need to continually stimulate the development of new antimicrobial drugs to replace the ones lost to resistance. … Rewarding pharmaceutical companies that invest in antimicrobial [research and development (R&D)] with financial incentives … is one solution. … Another mechanism currently used in the U.S. is the Orphan Drug Act, which gives companies tax incentives, marketing exclusivity and R&D subsidies to fight diseases that are so rare the market becomes too small for companies to recoup their investments. But these initiatives need leadership. We need to set verifiable targets for the restriction of antibiotics in food production, a plan to achieve public understanding of the issue, investment in global surveillance, real-time diagnostics, and new drugs and vaccines. Leaders at the U.N. General Assembly should commit to supporting countries to develop and implement national action plans. And countries should be held to account. The future of modern medicine and health security rests on the decisions we take now” (9/15).

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Congress Should Pass Reach Every Mother And Child Act

Huffington Post: If Congress Acts, We Can Save Moms and Kids
Mark Shriver, president of Save the Children Action Network

“…[T]he Reach Every Mother and Child Act (Reach Act), would ensure that the U.S. focuses on the poorest and most vulnerable women and children, sets ambitious targets, and has a strategy in place for meeting the targets. By scaling up the kind of low-cost, high-impact interventions that we know will work … we can save the lives of millions. … The amount of momentum around the bill is extraordinary — demonstrating some of the largest bipartisan congressional support for global health and international development in history. There are currently more than 185 cosponsors in the U.S. House of Representatives and 26 in the Senate. Our goal is to reach 200 cosponsors in the House by Thanksgiving. Support of that magnitude would send a powerful message to congressional leaders and help provide the strong momentum necessary for Congress to pass this bill. Investing in maternal, newborn, and child health reduces poverty, stimulates economic growth and, most importantly, saves lives…” (9/15).

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Cancer Moonshot Plans Begin To Take Form

The Lancet: Launching a plan for the Cancer Moonshot
Editorial Board

“…Eight months ago [a Lancet] editorial worried that the aims of the Cancer Moonshot were nebulous and overly ambitious. Now, as the Moonshot plans unfold, we see opportunities for them to be more determined. … Among these, is beginning to plan a commission in consultation with the White House to bring granularity to the new recommendations [to accelerate cancer research]. Led by scientists and clinicians, with broad expertise, it will build on the panel’s 10 recommendations and identify specific, actionable research and investment priorities. Across multiple areas ranging from prevention and vaccine development to immunotherapy, genomics, big data, and pediatric cancer, the commission aims to spell out specific scientific and clinical priorities to focus funding decisions and help accelerate Moonshot plans. … [The report] will complement other public and private Moonshot partnerships, including that of The Lancet’s parent company, Elsevier, which is creating a benchmark of the current landscape of cancer research and collaboration in the USA” (9/17).

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Refocusing HIV/AIDS Funding On Epidemic Control May Inadvertently Contribute To, Reinforce Inequality

Devex: Does epidemic control inadvertently reinforce inequality?
Patrick Fine, chief executive officer of FHI 360

“…There is an irrefutable logic to concentrating resources on the areas where a problem is worst. … But does this logical approach inadvertently reinforce social and economic inequality by allocating scarce health resources to areas and communities that are already economically better off? … Since HIV/AIDS funding makes up the lion’s share of external resources available to the health sector, there seems little doubt that the move away from integrated service delivery towards vertical interventions that concentrate resources in urban areas has reduced funding available to meet the health care needs of rural communities. If this is indeed occurring it poses a dilemma for both U.S. and developing country policymakers. In 2014, USAID made ending extreme poverty the mission statement for U.S. foreign assistance. … While refocusing HIV/AIDS funding on epidemic control has the advantage of being a straightforward proposition [to ending the AIDS epidemic by 2030] …, it is likely to undermine the success health ministries have had leveraging HIV/AIDS resources to strengthen health systems to meet a broad range of health needs in rural areas, and thereby weaken efforts to end extreme poverty. … Combined with structural biases that favor urban spending, it may well be that epidemic control will inadvertently contribute to growing inequality and work against the objective of ending extreme poverty” (9/15).

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From the Global Health Policy Community

Global Health Leaders Discuss New Set Of HIV Response Goals To End AIDS Among Children, Adolescents, Young Women By 2020

Center for Global Health Policy’s “Science Speaks”: Leaders launch ‘a super-fast-track framework for ending AIDS among children, adolescents, and young women by 2020’
Antigone Barton, senior editor and writer of “Science Speaks,” discusses an event that took place on Capitol Hill Wednesday, during which global health leaders, including U.S. Global AIDS Coordinator Ambassador Deborah Birx, National Institute of Allergy and Infectious Diseases Director Anthony Fauci, and UNAIDS Director Michel Sidibé, discussed a new set of HIV response goals to end AIDS among children, adolescents, and young women by 2020 (9/15).

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11 Innovations Could Save 6M Maternal, Child Lives By 2030 If Scaled Up In 24 Countries, PATH Report Shows

PATH: Report: 11 innovations could save more than six million mothers and children by 2030
“The PATH-led Innovation Countdown 2030 Initiative (IC2030) [on Wednesday] launched a new report, Harnessing the Power of Innovation to Save Mothers and Children, that estimates more than six million mother and child lives could be saved by 2030 if just 11 emerging innovations are advanced and scaled up in 24 countries. The results are further evidence of the power of innovation to help reach global targets to end preventable mother and child deaths…” (9/14).

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IDSA Global Health Releases Report On HIV, TB Progress, Challenges Presented At AIDS 2016 Conference

IDSA Global Health: AIDS 2016: Progress and Challenges
This report covers developments and challenges in HIV and tuberculosis research, treatment, prevention, and funding presented at the 21st International AIDS Conference held in July in Durban, South Africa (9/15).

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