KFF Daily Global Health Policy Report

In The News

CDC Report Examines Threat Of Nearly 2 Dozen Antibiotic-Resistant Microbes

“The U.S. faces ‘potentially catastrophic consequences’ if it does not act immediately to combat drug resistance which already kills an estimated 23,000 people a year,” the CDC warned in a report released on Monday, The Guardian reports (McVeigh, 9/17). “In [its] 114-page report, the agency detailed for the first time the toll that nearly two dozen antibiotic-resistant microbes are taking on humans — ranking the threat of each as ‘urgent,’ ‘serious’ or ‘concerning,'” the Washington Post writes, adding, “Should the trend continue, [the report] said, some infections could become essentially untreatable” (Dennis/Vastag, 9/16). According to the report, “at least two million people in the United States develop serious bacterial infections that are resistant to one or more types of antibiotics each year,” Reuters notes. “Antibiotic-resistant gonorrhea, a diarrhea-causing superbug and a class of fast-growing killer bacteria dubbed a ‘nightmare’ were classified as urgent public-health threats” in the report, the news service adds (Steenhuysen, 9/16).

“A worldwide problem, diseases resistant to antibiotics cross international boundaries, spreading from one country to another with ease, the report says,” according to the Center for Global Health Policy’s “Science Speaks” blog, which notes, “With new antibiotic research and development at a standstill, antimicrobial resistance will continue to ‘pose a catastrophic threat to people in every country of the world,’ the report says” (Aziz, 9/18). “The CDC report laid out four core actions for curbing drug resistance: preventing infections in the first place through immunizations, hand-washing and other precautions; tracking resistant bacteria more carefully once they emerge; using antibiotics more judiciously when needed; and promoting development of new drugs to treat — and tests to detect — infections,” the Los Angeles Times writes (Brown, 9/16). In related news, the WHO on September 19-20 “is convening a Strategic and Technical Advisory Group (STAG) in Geneva to bring experts from a range of sectors worldwide to review and help shape a global strategy to tackle the growing challenge of [antimicrobial resistance (AMR)],” the agency reports in a feature on its webpage (September 2013).

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Study Examines Increasing Extent Of Emigration Among African Doctors

“The number of African doctors working in the U.S. soared by almost two-fifths over a decade, according to a study showing the increasing extent of the ‘brain drain’ from developing nations,” the Financial Times reports. “More than 10,000 medical graduates born or trained in sub-Saharan Africa were registered to practice in the U.S. in 2011, raising concerns that some of the poorest countries are subsidizing medicine in the world’s biggest economy,” the newspaper writes, adding, “The figure — up 38 percent from 2002 — was equivalent to more than the entire number of doctors currently working in Ethiopia, Ghana, Liberia, Tanzania, Uganda, Zambia and Zimbabwe combined.” The newspaper notes, “Only in South Africa was there a fall in departing doctors during the first decade of the century.”

“The study, published in the online medical journal PLOS Medicine, showed that on average, African doctors practiced for 6.5 years before entering the U.S.,” according to the Financial Times, which notes, “The greatest increase in emigration among medical workers to the U.S. was from Liberia, which in 2008 had only 1.37 doctors per 100,000 people compared with 250 per 100,000 in the U.S.” The newspaper writes, “Akhenaten Benjamin Siankam Tankwanchi from the Peabody School of Education at Vanderbilt University in Nashville, Tennessee, and his fellow authors concluded that the research highlighted a ‘growing problem’ and a ‘major loss’ to Africa,” adding, “They pointed to a need for improved job satisfaction and enhanced medical education for African doctors and the importance of tackling a culture encouraging emigration, notably at some Nigerian and Ghanaian university campuses where faculty actively encouraged it” (Jack, 9/18).

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U.N. Report Says 'Mosaics' Approach Should Be Taken Toward Food Security, Climate Change

“Governments in rich and poor countries alike should renounce their focus on agribusiness and give more support to small-scale, local food production to achieve global food security and tackle climate change, according to a report from UNCTAD, the U.N. trade and development body,” The Guardian reports. “The 2013 Trade and Environment Review calls on governments to ‘wake up before it is too late’ and shift rapidly towards farming models that promote a greater variety of crops, reduced fertilizer use and stronger links between small farms and local consumers,” the newspaper writes, adding, “Persistent rural poverty, global hunger, population growth and environmental concerns must be treated as a collective crisis, argues the report, which criticizes the international response to the 2008 food-price crisis for focusing on technical ‘quick-fixes'” (Provost, 9/18). The report “says that the goal should be ‘mosaics of sustainable regenerative production systems that also considerably improve the productivity of small-scale farmers and foster rural development,'” according to an UNCTAD press release. “The report cites a number of trends that collectively suggest a mounting crisis,” particularly in developing regions with the highest population growth, such as sub-Saharan Africa and South Asia, the press release states and notes the trends (9/18).

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Al Jazeera America Examines Congo's Improvements In Maternal Health

Al Jazeera America examines maternal health in the Republic of the Congo, noting the country has made significant progress in reducing maternal mortality, especially in the last two years. “David Lawson, the country director for UNFPA, a partner in the maternal health projects, says that if progress continues at the same rate, Congo might, in fact, meet the [maternal health] Millennium Development Goal on schedule, in 2015,” the news service writes. “The government is actually putting the resources and actions where they’re supposed to be. … I have no doubt that the situation will continue to improve,” Lawson said, according to Al Jazeera. “Doctors and public health experts here give much of the credit for that progress to a presidential decree that put [caesarean] birth in reach of even the poorest women: Since 2011, caesarean sections, which had cost upwards of $500, have been a free public health service,” Al Jazeera reports. “The maternal health revolution in Brazzaville is about more than caesareans,” the news service writes, adding, “It’s also about demographics — more than half of the country’s 4.5 million people live in its two biggest cities — and about basic health infrastructure.” The news service notes, “To be sure, there’s more to be done for expectant mothers here,” such as “[i]mproving access to — and the acceptability of — family planning” (Moore, 9/18).

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Yemen Human Rights Minister Demands Parliament Outlaw Child Marriage

Huriya Mashhour, Yemen’s human rights minister, “said she would press parliament for the minimum age of marriage to be set at 18 after [a] child, identified only as Rawan, reportedly died from internal bleeding after marrying a 40-year-old man,” The Guardian reports. “We are asking to fix the legal age for marriage at 18, as Yemen is a signatory to the international conventions on children’s rights,” Mashhour told AFP, according to the newspaper (9/18). “Local officials, however, have denied the story is true,” CNN reports, adding, “CNN spoke with several locals who requested anonymity, as they feared possible reprisals. Many said they’d been ordered to stop discussing the case with the media, insisting officials there were actively downplaying what had happened.” Ahmed Al-Qureshi, who heads the Yemeni children’s rights group Seyaj, said, “The government is informing us that the [child] is in their custody and still alive, while other local sources are saying that she was secretly buried,” CNN notes, adding, “He’s demanding more transparency from officials” (Jamjoom/Almasmari, 9/16). “Those against setting a minimum marriage [age] in Yemen say that it goes against the country’s tradition, culture and religion,” BBC News writes, noting, “But some prominent religious clerics have supported the move, citing Islamic sources” (9/13).

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IRIN Analysis Examines Future Of Humanitarian Aid

An IRIN In-Depth analysis, titled “Humanitarian Futures,” examines “issues confronting the aid world over the next decade.” The analysis features video interviews with key stakeholders; articles on topics such as technology, data collection, innovation, communication, and forecasting; and infographics on spending (9/18).

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Washington Post Blog Interviews Elton John About Philanthropic Work Through AIDS Foundation

The Washington Post’s “Wonkblog” interviews Elton John about his philanthropic work through the Elton John AIDS Foundation, “a major non-profit working on HIV prevention, as well as care and treatment for those with the disease.” According to the interview transcript, John reflects on funding research for vaccine and antiretroviral development, highlights the need for private-sector involvement in AIDS eradication efforts, and examines PEPFAR funding in President Obama’s budget request for next year, among other issues (Matthews, 9/17).

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Editorials and Opinions

Fully Funding Global Fund, Continuing PPPs Will Help Defeat TB, HIV, Malaria

The WHO “projects that as many as two million people may develop drug-resistant strains of [tuberculosis (TB)] worldwide by 2015 — despite everyone’s efforts to achieve the 2015 Millennium Development Goals related to TB,” John Lechleiter, chair, president and CEO of Eli Lilly and Company and chair of the Pharmaceutical Research and Manufacturers of America (PhRMA), writes in a Forbes opinion piece. “Neither governments nor market forces alone can solve this urgent global health problem, but working together in partnership, progress is indeed possible,” he writes, adding, “Strong investments today — starting with the Global Fund to Fight AIDS, Tuberculosis and Malaria — will diminish the threat posed by drug-resistant TB, and enable us to stop the scourge of all three of these diseases.” He continues, “It is absolutely critical to ensure that the Global Fund is fully funded in order to prevent drug resistance from undermining the gains we’ve made against TB, and to keep us on track to get all three of these diseases under control. Taking our eye off the ball now would imperil future generations and result in significantly higher health care costs for governments around the world.”

“Even with full funding, the Global Fund can’t tackle these diseases alone — and fortunately it won’t have to,” as “[a] wave of public-private partnerships have been launched since the U.N. established the Millennium Development Goals in 2000,” Lechleiter writes. “Today, the pharmaceutical industry is engaged in 40 partnerships targeting TB,” he notes, adding, “Another 43 public-private partnerships target HIV/AIDS, and 37 more focus on malaria.” He concludes, “We must fully fund the Global Fund, find new and better treatments, and seek creative solutions through innovative public-private partnerships. Together, we can stop drug-resistant TB — and even see the end of AIDS, TB and malaria once and for all” (9/18).

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Collective Global Action Needed To Sustain Progress Against AIDS

Noting “African leadership on AIDS is on the rise while, with some exceptions, political and financial commitment in the wealthiest nations has been stalled since the end of the last decade,” Rob Lovelace, a senior fellow with the Trade Union Sustainable Development Unit, and Gemma Oberth, a senior researcher for AIDS Accountability International in Cape Town, South Africa, write in the Huffington Post’s “Big Push” blog, “Collective global action is what’s needed to” continue “hard won progress” against the disease. They state that the recently concluded G20 and the June G8 summits “raise reasonable questions about whether political leadership on AIDS is flagging in many of the world’s leading economies,” noting “the G20 accountability report illustrates the premier forum on the global economy continues to neglect health issues.”

“Conversely, efforts to intensify African leadership and commitment may be just hitting stride,” Lovelace and Oberth continue, highlighting the 2013 African Union/NEPAD Accountability Report on Africa-G8 Partnership Commitments, “the first-ever themed accountability report on delivering results to end AIDS, [tuberculosis (TB)] and malaria in Africa,” as an example of progress. “We will know soon enough if the world’s wealthiest countries are ready to get back in the game,” they write, noting the upcoming U.N. Special Event “to take stock of Millennium Development Goals (MDGs) progress and kick off the process of finalizing the post-2015 agenda,” as well as “the 4th Replenishment of the [Global Fund to Fight AIDS, Tuberculosis and Malaria] that takes place before years-end.” They conclude, “Building on forward progress like the 25 percent decline in new HIV infections in sub-Saharan Africa is unlikely without the continued partnership between Africa and the Global North” (9/18).

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International Community Must Agree To Improve Humanitarian Access To Syria

Writing in his New York Times column, Nick Kristof recalls the story of Fawzia, a Syrian refugee who fled to Jordan after “a ferocious conventional shelling of her neighborhood,” and he states, “Talking to Syrians like Fawzia, it seems bizarre and narcissistic that in Washington there is talk of whether the Syrian crisis has been ‘resolved.’ Maybe the politicians’ crisis there has been eased, but the humanitarian catastrophe here just gets worse.” He adds, “Fawzia says she would like to see American missile strikes on her country, in hopes that an assault would degrade the Syrian army’s capacity for mass murder and shorten the war. That seems by far the most common view among refugees here, although it’s not universal.” Kristof states, “Whatever one thinks of a military strike to destroy some of [Syrian President Bashar al-Assad’s] murderous air force — I’m in favor but have very little company in America — we should find common ground in insisting that international negotiations address not only chemical stockpiles but also humanitarian access in Syria.”

“Valerie Amos, the United Nations humanitarian chief, tells me that nearly seven million Syrians will need aid to survive,” he notes, adding, “Humanitarian access could save some of those lives, and also reduce the hemorrhage of refugees.” According to Kristof, “One-third of Syrians are now displaced. On an American scale, that would be equivalent to 100 million Americans having fled their homes.” He continues, “We may not be able to solve Syria’s problems. I’m not even certain that we can mitigate them. But we can try, and a starting point would be a big push for humanitarian access” (9/18).

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Issues Surrounding Food Security Vital To Post-2015 Development Agenda

One of the issues likely to be raised during the U.N. General Assembly’s discussions regarding the post-2015 development agenda is food security. The following summarizes two opinion pieces on the topic.

  • Pierre Ferrari, Huffington Post’s “Impact” blog: “[W]ithout sufficient investment in women farmers, we will fail to feed the world’s booming population, reversing gains made through the Millennium Development Goals [MDGs],” Ferrari, president and CEO of Heifer International, writes. “Women make up 43 percent of the agricultural labor force worldwide,” he writes, adding, “They own less than one percent of the earth’s land, but they produce up to a staggering 80 percent of the developing world’s food.” He provides several examples of women succeeding in agriculture, writing, “It’s worth repeating: The world’s women farmers, most of whom lack access to sufficient land, credit and education, already grow the majority of the food eaten in the developing world.” Ferrari concludes, “Just imagine what they will do when gender equity is realized — when men support them and we invest heavily in them. We will see a world where no child dies from poverty and hunger” (9/18).
  • Michael Zacka, Huffington Post’s “Green” blog: Stating that global population growth predictions “are cause for concern,” Zacka, president and CEO of Tetra Pak, United States and Canada, writes, “Hunger is the most pressing issue we face, especially considering [these] numbers: one out of every eight people in the world today suffers from chronic undernourishment caused by food scarcity, notes the United Nations Food and Agriculture Organization (FAO).” He continues, “Yet paradoxically, and what many don’t realize, today ‘the world produces enough food to feed everyone … 17 percent more calories per person today than it did 30 years ago, despite a 70 percent population increase,’ notes the FAO.” Zacka outlines “several key components that will lead to healthier food systems everywhere” (9/18).

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Skoll World Forum's 'Debate & Series' Examines What Should Be Included In Post-2015 Development Agenda

The Skoll World Forum’s “Debate & Series” — published in partnership with Johnson & Johnson, the United Nations Foundation, the Bill & Melinda Gates Foundation, and the Huffington Post — on Wednesday published a new online debate, “this time focused on critical issues that do not have enough of a spotlight in the discussions on how to achieve the [Millennium Development Goals (MDGs)] or what should be in the next global development framework.” According to the series description, the forum “asked some of the world’s leading experts what’s not being discussed during U.N. Week this year about post-2015, but should be.” Arianna Huffington, president and editor-in-chief of the Huffington Post, highlights the “importance of opening up the conversation and bringing together diverse viewpoints”; Carolyn Miles, president and CEO of Save the Children, discusses “the need for more frontline health care workers”; Kathy Calvin, president and CEO of the United Nations Foundation, highlights issues surrounding women and the economy; Glaucia Barros, chair of Fundación Avina’s Social Progress Network in Brazil, discusses “the need to address the growing challenge of solid waste management”; Ruma Bose, a consultant, serial entrepreneur, investor, philanthropist and author, highlights youth unemployment; Shoba Raja, director for policy and practice for BasicNeeds, discusses global mental health; and John Kluge, co-founder and chief disruption officer at Toilet Hackers, calls for more rigorous analysis of measures of sanitation progress (9/18).

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From the Global Health Policy Community

Melinda Gates Examines Global Progress Toward Achieving MDGs

Noting “[w]e are nearing the 2015 deadline for the Millennium Development Goals [MDGs], a report card first agreed upon in 2000,” Melinda Gates, co-chair of the Bill & Melinda Gates Foundation, writes in the foundation’s “Impatient Optimists” blog, “I know we still have a lot of work to do. But I want to make sure we take a moment to reflect on what’s already been accomplished.” She provides a slideshow examining the progress that’s been made globally toward achieving the MDGs (9/17).

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