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Kaiser Daily Global Health Policy Report

In The News

CDC Report Estimates Up To 1.4M Ebola Cases By January 2015 If Additional Containment Not Achieved

News outlets discuss a new report from the CDC, estimating the number of Ebola cases could surpass one million during the beginning of 2015 if the scale-up in the response is not adequate.

CNN: CDC: Ebola cases could reach at least 550,000 by January
“The number of Ebola cases in Liberia and Sierra Leone could rise to between 550,000 and 1.4 million by January if there are no ‘additional interventions or changes in community behavior,’ the Centers for Disease Control and Prevention said in a report Tuesday. The estimate was derived from a new forecasting tool developed by the CDC…” (Smith-Spark et al., 9/23).

New York Times: Ebola Cases Could Reach 1.4 Million in 4 Months, CDC Estimates
“…In the worst-case scenario, Liberia and Sierra Leone could have 21,000 cases of Ebola by Sept. 30 and 1.4 million cases by Jan. 20 if the disease keeps spreading without effective methods to contain it. These figures take into account the fact that many cases go undetected, and estimate that there are actually 2.5 times as many as reported. The report does not include figures for Guinea because case counts there have gone up and down in ways that cannot be reliably modeled…” (Grady, 9/23).

Washington Post: CDC: Ebola could infect 1.4 million in West Africa by end of January if trends continue
“…[The report’s authors] also said their assumptions may not fully account for sick patients who are turned away from treatment centers that don’t have any spare beds. That suggests the number of underreported cases could be even higher. CDC Director Tom Frieden cautioned that the estimates in the report don’t take into account actions taken or planned since August by the United States and the international community…” (Sun, 9/23).

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WHO Analysis Predicts More Than 20,000 New Ebola Cases By November Without Stepped Up Response

News outlets report on a new analysis examining the Ebola response so far and estimating the possible number of new cases expected over the coming weeks.

Agence France-Presse: Ebola cases to triple in weeks without drastic action: WHO
“The number of Ebola infections will triple to 20,000 by November, soaring by thousands every week if efforts to stop the outbreak are not stepped up radically, the WHO warned in a study on Tuesday…” (9/23).

Associated Press: WHO: 21,000 Ebola cases by November if no changes
“New estimates from the World Health Organization warn the number of Ebola cases could hit 21,000 in six weeks unless efforts to curb the outbreak are ramped up, according to an analysis published online Tuesday by the New England Journal of Medicine…” (Cheng, 9/23).

New York Times: Health Agency’s New Assessment of the Epidemic Is More Dire Still
“…In addition to predicting many more cases and deaths, the new report for the first time raises the possibility that the epidemic will not be brought under control and that the disease will become endemic in West Africa, meaning that it could reach a steady state and become a constant presence there…” (Grady, 9/22).

Politico: WHO says Ebola cases could exceed 20,000 within weeks
“…In addition, the WHO Ebola response team in an article published tonight in the New England Journal of Medicine said more than 70 percent of people who fall sick are dying…” (Kenen, 9/22).

Reuters: Ebola could strike 20,000 in six weeks, ‘rumble on for years’: study
“…In an article in the New England Journal of Medicine, experts from the World Health Organization and Imperial College said that infections will continue climbing exponentially unless patients are isolated, contacts traced and communities enlisted…” (Nebehay/Miles, 9/23).

WHO: Study warns swift action needed to curb exponential climb in Ebola outbreak
“…In the article, public health epidemiologists and statisticians reviewed data since the beginning of the outbreak in December 2013 to determine the scale of the epidemic, better understand the spread of the disease, and what it will take to reverse the trend of infections…” (9/22).

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Ebola Death Toll Exceeds 2,800; Outbreaks Contained In Senegal, Nigeria, DRC

News outlets report on the new Ebola death toll estimate and the containment of the outbreak in Senegal and Nigeria, as well as an unrelated Ebola outbreak in Democratic Republic of Congo.

Agence France-Presse: Ebola kills 2,811, outbreak ‘contained’ in Senegal, Nigeria: WHO
“The deadliest Ebola epidemic ever has now killed 2,811 in west Africa, the World Health Organization said Monday, adding though that in Senegal and Nigeria the outbreak had been basically contained…” (9/22).

Reuters: Ebola toll passes 2,800 but ‘contained’ in Senegal, Nigeria: WHO
“An outbreak of Ebola in West Africa has been largely contained in Senegal and Nigeria, the World Health Organization (WHO) said on Monday, but the disease is still spreading elsewhere and has now killed over 2,811 people in the region…” (Fofana, 9/22).

Reuters: Congo’s Ebola outbreak ‘almost over,’ prime minister says
“An outbreak of the deadly Ebola virus in Democratic Republic of Congo, unrelated to the epidemic in West Africa, is ‘almost over’ with no new cases detected for several days, Prime Minister Augustin Matata Ponyo said. The government body coordinating the response to Ebola released data on Monday showing Congo had recorded 68 cases in Equateur province since August…” (Ross, 9/22).

TIME: Ebola ‘Pretty Much Contained’ in Senegal and Nigeria
“…There have been no new confirmed cases of Ebola in Senegal since the first case was reported Aug. 29, and the last case of Ebola reported in Nigeria was Sept. 8, the WHO’s regional office for Africa said in a statement…” (Sifferlin, 9/22).

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West African Nations, NGOs Prepare For New Ebola Cases

News outlets examine efforts to contain Ebola by West African nations, the U.N., and other aid groups, as Liberia and Sierra Leone brace for new cases.

Agence France-Presse: Liberia warns Ebola may force region back into conflict
“Liberia has warned it may slip back to civil war along with neighboring Sierra Leone if the Ebola epidemic ravaging West Africa is allowed to continue to spread…” (Dosso, 9/23).

Associated Press: Sierra Leone, Liberia brace for new Ebola cases
“Two of the West African nations hardest hit by Ebola were bracing for new caseloads on Monday after trying to outflank the outbreak with a nationwide checkup and a large new clinic…” (Roy-Macaulay/Paye-Layleh, 9/22).

Devex: ‘Aid now, reflection later’
“…At JFK International Airport in New York, Devex Impact reporter Adva Saldinger witnessed on site how an airplane was loaded with 100 tons of supplies for Liberia and Sierra Leone, and heard from two diplomats what these two countries need at this time to not only respond to the virus, but also later on rebuild their public health systems to prevent a future epidemic…” (9/22).

Foreign Policy: Is Ebola the Beginning of the End of the World?
“Dr. Mohammed Sankoh, the medical director of Redemption Hospital, stole a few moments before meeting with his staff to sketch out a sermon in cursive in a blue spiral notebook. … In addition to working at Redemption, Sankoh is a part-time preacher at Philadelphia Church here in Monrovia. But his two roles intertwine these days, as he seeks understanding in a crisis of unprecedented, horrible proportions: the Ebola outbreak…” (MacDougall, 9/22).

IRIN: West Africa gears up to contain Ebola spread
“As the Ebola caseload rises to over 5,350, aid agencies and governments in countries not yet affected by the deadly virus are gearing up for its potential spread across new borders by pre-positioning supplies, training health workers, identifying isolation centers, and disseminating prevention campaign messages, among other activities…” (9/22).

New York Times: Fresh Graves Point to Undercount of Ebola Toll
“…The Ebola epidemic is spreading rapidly in Sierra Leone’s densely packed capital — and it may already be far worse than the authorities acknowledge…” (Nossiter, 9/22).

U.N. News Centre: Advance team of U.N. mission for Ebola response arrives in West Africa
“Laying the groundwork for the effective and coherent action necessary to stop the Ebola outbreak in West Africa that has sickened more than 5,800 people and killed some 2,800, an advance team of the United Nations Mission for Ebola Emergency Response arrived today in Accra, Ghana, to set up the operation’s headquarters…” (9/22).

Washington Post: New effort to fight Ebola in Liberia would move infected patients out of their homes
“Looking for a new approach to blunt the Ebola epidemic sweeping West Africa, the Liberian government, the World Health Organization, and their nonprofit partners here are launching an ambitious but controversial program to move infected people out of their homes and into ad hoc centers that will provide rudimentary care, officials said Monday…” (Bernstein/Sun, 9/22).

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European Countries Continue To Assess Resources For, Response To Ebola

Reuters: Europe reviewing resources for fight against Ebola — Italy minister
“European countries are assessing what resources they have to help fight Ebola and are planning a coordinated response to the worst outbreak of the virus in history, Italy’s Health Minister Beatrice Lorenzin said on the sidelines of a meeting on Monday…” (9/22).

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Experts Learn From Current Ebola Outbreak, Look To Past For Lessons

As the Ebola outbreak progresses, news outlets examine lessons learned over the past six months and from past epidemics.

Associated Press: Lessons learned 6 months into worst Ebola outbreak
“Six months into the biggest-ever Ebola outbreak, scientists say they know more about how the deadly virus behaves. The first cases were reported in Guinea by the World Health Organization on March 23 — before spreading to Sierra Leone, Liberia, and elsewhere. Here’s a look at what scientists have learned so far…” (Cheng, 9/23).

Foreign Policy: Colonial Lines Drawn Again for Ebola Aid
“…[A] United Nations Office for the Coordination of Humanitarian Affairs report released Monday sheds light on a different kind of neocolonialism taking form in the region’s Ebola crisis: Rather than coordinating an effort to combat the massive outbreak, the United States, the United Kingdom, and France are instead sending disproportionate amounts of aid to the territories they once controlled…” (O’Grady, 9/22).

IRIN: Briefing: Ebola lessons from Uganda
“There have been five Ebola outbreaks in Uganda over the past 14 years; these have been quickly contained thanks to a combination of epidemiological luck and a well-coordinated response system operating at several levels of the health service…” (9/22).

NPR: Ebola Battlers Can Learn From Venice’s Response To Black Death
“…Venice’s response to the plague crisis serves as a model for modern cities and nations facing unpredictable threats. That’s the perspective of several experts on risk management who write on Venice’s response in the latest issue of the journal Environment Systems and Decisions…” (Shea, 9/20).

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Bloomberg News Examines WHO's Response To Ebola Outbreak

Bloomberg News: Ebola Is Katrina Moment for WHO’s Chan Hobbled by Budget
“When Margaret Chan was elected to lead the World Health Organization, she said the agency’s priority was to improve the health of people in Africa. Eight years later, the 67-year-old Chan is under attack for letting an Ebola outbreak there spiral beyond control, and this week her group found itself eclipsed as the leader of humanitarian efforts to control the epidemic…” The article includes comments on WHO’s response from several global health experts (Bennett, 9/19).

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Ebola Treatment Trials To Be Fast-Tracked; Regulators Allow Use Of Canadian Drug

News outlets report on progress to develop an Ebola vaccine and allow the use of experimental drugs to treat the disease.

Deutsche Welle: Ebola vaccine: fast-tracked for all?
“Researchers are running human trials on a candidate Ebola vaccine, which, if successful, they hope to roll out by the end of this year in West Africa. Professor Adrian Hill, who heads the Jenner Institute and these trials, tells us more…” (Abbany, 9/22).

Reuters: Ebola drug trials to be fast-tracked in West Africa
“Experimental Ebola drugs including compounds from Mapp Biopharmaceutical, Sarepta, and Tekmira will be tested in affected West African states for the first time in a bid to fast-track trials, the Wellcome Trust said on Tuesday…” (Kelland, 9/23).

Reuters: U.S., Canada allow emergency use of Tekmira’s Ebola treatment
“Canadian drugmaker Tekmira Pharmaceuticals Corp said on Monday that U.S. and Canadian regulators have authorized the use of its Ebola treatment in patients who have confirmed or suspected infections from the deadly virus…” (Penumudi/Nickel, 9/22).

Wall Street Journal: Experimental Ebola Drug Gets Nod From FDA
“…Tekmira said it already has provided its drug, known as TKM-Ebola, to several patients under emergency protocols, and repeated infusions have been ‘well tolerated.’ The company didn’t say how many patients have been treated or where the drug was used…” (Loftus, 9/22).

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U.N. General Assembly Reaffirms Population, Development Goals

News outlets examine leaders’ efforts to reaffirm the tenets of the International Conference on Population and Development (ICPD).

Inter Press Service: Religious Leaders Call for U.N. Action on Sexual & Reproductive Health
“On the eve of a major U.N. special session on population and development, a delegation of religious leaders released a statement calling for action on sexual and reproductive health and reproductive rights…” (9/19).

U.N. News Centre: Cairo+20: General Assembly reaffirms U.N. goals on population, development
“The international community must renew its pledge to protect women and girls as it strives to improve the dignity of all people and secure the future of the planet, senior United Nations officials told the General Assembly [Monday], marking 20 years since a landmark conference that reinforced the principle that people should be at the center of development…” (9/22).

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WFP Head Warns Global Food Aid Demand Outpacing Resources

News outlets report on warnings from the World Food Programme that worldwide demand for food aid is overwhelming its resources.

Associated Press: U.N. says there’s unprecedented demand for food aid
“The World Food Programme’s top official said it’s unprecedented that the U.N. aid agency finds itself simultaneously responding to half a dozen major crises in addition to helping the largest number of refugees in the world since World War II. Ertharin Cousin said in an interview Monday with the Associated Press that the number of people who need food aid continues to grow, and the demands are overwhelming the donor community which has been ‘incredibly generous,’ led by the United States which has given WFP $1.6 billion…” (Lederer, 9/22).

New York Times: U.N. Food Program Warns of Cuts to Its Relief Efforts
“Just months after a United Nations Security Council resolution pressed Syria to open several of its border crossings to humanitarian aid convoys, money has dried up and allotments of grain and lentils are set to shrink significantly next month, the head of the World Food Programme said Monday…” (Sengupta, 9/22).

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Climate Change Poses Challenges To Global Health, Study Says

News outlets discuss a new study showing how climate change might affect global health.

HealthDay: Health Woes to Worsen Due to Climate Change, Study Warns
“Coupled with worldwide marches demanding action on climate change, a new study warns that rising temperatures and altered weather patterns in the United States may soon exacerbate many existing health risks…” (Thompson, 9/22).

TIME: 6 Ways Climate Change is Making Us Sick
“Just a day after the People’s Climate March, one of the largest international environmental marches, a new analysis of 56 studies on climate change-related health problems shows that increasingly, global temperatures and severe weather events will continue to have a major impact on global health…” (Sifferlin, 9/22).

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Flooding Damages Hospitals In Kashmir, Worsening Health Crisis

New York Times: Hospitals in Kashmir Struggle After Flooding, Deepening a Health Crisis
“…In the aftermath of the powerful floods that hit Kashmir early this month, the area is in the midst of a health crisis. Much of the region depends on the premier hospitals in Srinagar, the summer capital of Jammu and Kashmir State, but most were badly damaged by the water. In the aftermath of the floods, people are living in neighborhoods choked by putrid, infectious, and in some spots impassable water…” (Najar/Sharma, 9/19).

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Bill Gates Pledges To Match $100K For Water In Ethiopia

TIME: John Green and Bill Gates Are Teaming Up to Bring Clean Water to Ethiopia
“…[Author John] Green’s biggest fans call themselves ‘Nerdfighters,’ those whose goal in life is to, in Green’s words, ‘decrease world suck,’ and [Bill] Gates seems to have joined the bandwagon, pledging to match the $100,000 Green hopes to raise [to help bring clean water to Ethiopia]…” (Ross, 9/22).

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Editorials and Opinions

More Must Be Done To Contain Current Ebola Outbreak, Prepare For Future Epidemics

New England Journal of Medicine: The Ebola Emergency — Immediate Action, Ongoing Strategy
Jeremy Farrar, director of the Wellcome Trust, and Peter Piot, director of the London School of Hygiene and Tropical Medicine

“…[T]he current Ebola epidemic, which is in grave danger of spiraling out of control, must remain the primary focus of our efforts. We are concerned that without a massive increase in the response, way beyond what is being planned in scale and urgency, alongside the complementary deployment of novel interventions (in particular the use of safe and effective vaccines and therapeutics), it will prove impossible to bring this epidemic under control. But we must also look to the future. There will be more epidemics and outbreaks of Ebola and other new or reemerging infections. … Despite great improvement over the past decade, there is still a need for better surveillance, sharing of data in real time, and rapid action based on the available information. But we cannot think that surveillance alone will bring such events under control. We have become better at picking these things up; we now must also learn to act more effectively” (9/23).

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NTDs Pose 'Threat To All Nations'

The Lancet Infectious Diseases: Neglected tropical diseases: no longer someone else’s problem
Editorial Board

“Neglected tropical diseases were once thought to be restricted to developing countries, largely because climate and inadequate health infrastructures allow the organisms and their vectors to thrive. However, at the beginning of September, Japan reported its first outbreak of dengue since 1945. And over the past year, autochthonous chikungunya has been spreading through the Caribbean reaching mainland USA in July. These worrying developments show that it might be time to reassess the old ideas about the distribution of these diseases. … So, self-interest now provides developed countries with a mandate to intensify their efforts to tackle neglected tropical diseases, both at home and, possibly more affordably, abroad. Now, the neglected tropical diseases are a threat to all nations” (October 2014).

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Opinion Pieces Address Access To Reproductive Health Services

The following opinion pieces address access to reproductive health services for women worldwide.

Devex: Universal access to reproductive health care: A global obligation and opportunity
Kathy Calvin, president and chief executive officer of the United Nations Foundation

“…Ensuring universal access to sexual and reproductive health and rights is a global opportunity, and most importantly, a global obligation. Achieving this goal will empower girls and women, improve global health, and create stronger societies — and it will advance human rights around the world” (9/22).

Huffington Post: Time Every Woman Is Allowed to Decide for Herself
Tewodros Melesse, director general of the International Planned Parenthood Federation

“…We are at a crucial moment. Between September 23rd and 25th, world leaders will be coming together at the United Nations to discuss what needs to be done over the next 15 years to end global poverty and inequality. We know that sexual and reproductive health and rights are key to individual wellbeing, and therefore, it is essential that they are at the heart of the U.N.’s discussions, and integral to the next set of global development targets to be achieved by 2030…” (9/22).

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Men Must Be Involved In Women's Maternal, Reproductive Health Care

Huffington Post: How Can Men Help Stop The Spread of HIV to Infants and Children?
Barbara Bush, CEO and co-founder of Global Health Corps, and Brian Ssennoga, a former Global Health Corps fellow

Bush interviews Ssennoga about his work as a GHC fellow in Uganda, focusing on the importance of men’s investment in women’s maternal and reproductive health and the prevention of mother-to-child HIV transmission. “…Unfortunately, men are often not included in the maternal and reproductive health care of their partners, either by their own choice or because providers in the community do not expect them to be involved. … But this has to change — and it is changing,” Ssennoga said (9/22).

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PLOS Medicine Launches Collection On Universal Health Coverage

PLOS Medicine: The PLOS “Monitoring Universal Health Coverage” Collection: Managing Expectations
Editorial Board

“This week, PLOS Medicine publishes the PLOS Collection ‘Monitoring Universal Health Coverage,’ launched on September 22nd at the Rockefeller Foundation as a side event of the United Nations General Assembly in New York City. … As illustrated in the country case studies in the PLOS Collection, despite a tremendous amount of political will, hard work, and effort, UHC is a distant aspiration for many global citizens. … Providing equitable access to health services for those who need them while striving to eliminate a major cause of poverty — excessive payments for health care — is a crucial catalyst to enable and empower individuals, communities, and populations not only to survive but also to improve their health and quality of life…” (9/22).

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From the Global Health Policy Community

International Community Facing 'Historic Opportunity' To Address Needs Of Women, Girls

U.S. Department of State’s “DipNote”: A Pivotal Moment for Women and Girls
Catherine Russell, U.S. ambassador-at-large for global women’s issues, and Anne Richard, assistant secretary of state for the Bureau of Population, Refugees, and Migration, discuss the challenges women and girls face around the world and highlight some of the U.S. government’s activities to address these challenge. They write, “As officials and diplomats from across the planet convene in New York for the 69th U.N. General Assembly (UNGA) this week, some may not be thinking about how to solve challenges faced by women and girls. But they should be. With data clearly showing the important role women and girls play in peace and prosperity, organizers have planned several high-level events to tackle issues facing women and girls. We face an historic opportunity to make change and we must capitalize on it…” (9/22).

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U.S. Announces Additional Funding For Gender-Based Violence Initiative

U.S. Department of State: U.S. Funding for Safe From the Start Announced at the Call to Action on Protection from Gender-Based Violence in Emergencies
On Monday, Secretary of State John Kerry “announced that the United States is making available an additional $12 million for Safe from the Start to strengthen prevention and response to gender-based violence from the onset of humanitarian emergencies. Secretary Kerry announced the new funding at a high-level event for the Call to Action on Protection from Gender-Based Violence in Emergencies, a multi-stakeholder initiative launched by the United Kingdom in 2013 and now led by the United States. Safe from the Start is a joint effort of the State Department and the United States Agency for International Development (USAID)…” (9/22).

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New PPP Focuses On Strengthening HIV/AIDS Lab Systems In Sub-Saharan Africa

Siemens Healthcare: New Public-Private Partnership Uses E-Learning to Fight HIV/AIDS
“…[On Monday,] at the 2014 Clinton Global Initiative (CGI) Annual Meeting, Siemens Healthcare, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), and the U.S. Centers for Disease Control and Prevention (CDC) announced ‘Stronger Together,’ a new five-year Commitment to Action valued at $15 million, to strengthen laboratory systems in sub-Saharan Africa. In collaboration with five African countries, ‘Stronger Together’ will leverage the expertise of each partner to build laboratory infrastructure and human resources…” (9/22).

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Bill, Melinda Gates Meet With Indian Government To Discuss Development Efforts

Bill & Melinda Gates Foundation’s “Impatient Optimists”: Bill and Melinda Shine a Light on India’s Progress and Offer Hand in Partnership
Girindre Beeharry, director of the Gates Foundation’s India Country office, discusses the recent visit of Bill and Melinda Gates — the foundation’s co-chairs — to India and their meetings with Indian government officials regarding development efforts (9/22).

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CSIS Report Examines GPEI, Polio Activities in India

Center for Strategic & International Studies: Repurposing Global Polio Eradication’s Tool Kit
In this report, Nellie Bristol, a senior fellow with the CSIS Global Health Policy Center, “…describes [the Global Polio Eradication Initiative’s] goals and processes for planning for a polio legacy and examines the opportunities and challenges for moving forward in India” (9/22).

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CGD Podcast, Blog Post Discuss Hospitals in Low-Income, Emerging Market Countries

Center for Global Development’s “Global Prosperity Wonkcast”: Hospitals for Health — Amanda Glassman
In an audio podcast, Lawrence MacDonald, CGD vice president of communications and policy outreach, speaks with Amanda Glassman, senior fellow and director of global health policy at CGD, about a new CGD working group “that is studying the problems that result in a lack of effective hospitals in low-income and emerging market countries…” (9/22). CGD also released a related blog post, “Making a Home for Hospitals in Global Health: The Global Hospitals Collaborative,” by Rachel Silverman, a policy analyst at CGD. Both the podcast and the blog post invite comments on a consultation draft of a report from the working group (9/22).

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