KFF Daily Global Health Policy Report

In The News

Nations Must Invest More In Health Care To Prevent Out-Of-Pocket Spending, U.N. Report Says Ahead Of UHC Summit

Reuters: Health care investment needed to curb out-of-pocket spending: WHO
“Governments must boost spending on primary health care by at least an additional 1 percent of their gross domestic product to widen coverage and stop impoverishing patients, the World Health Organization (WHO) said on Sunday. Despite some progress, more people are having to pay out-of-pocket for often costly medicines and treatment, the U.N. agency said in a report compiled with the OECD and World Bank…” (Nebehay, 9/22).

U.N. News: With 5 billion set to miss out on health care, U.N. holds landmark summit to boost coverage
“Some five billion people risk missing out on health care in 2030, unless countries close glaring gaps in health coverage, a new report revealed on Sunday, as the U.N. prepares to host a landmark summit to speed up progress on universal health care. The study, “Primary Health Care on the Road to Universal Health Coverage”, estimates that around 60 million lives could be saved by upping annual spending on primary health care in low and middle-income countries by some $200 billion per year…” (9/22).

Additional coverage of the report is available from BMJ and Xinhua.

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BMJ, Devex, Financial Times Publish Collections On Universal Health Coverage

The BMJ: Universal health coverage
“The BMJ in partnership with The Harvard Global Health Institute has launched a collection of articles exploring how to achieve effective universal health coverage (UHC). The collection highlights the importance of quality in UHC, potential finance models, how best to incentivize stakeholders, and some of the barriers to true UHC…” (September 2019).

Devex: Healthy Access
“…The international development community has set a clear goal of reaching universal health coverage by 2030 — while leaving no one behind. But how do we ensure access to quality care for all? This series takes a closer look at the technology, practical solutions, and innovative financing tools driving improved access to quality care around the globe…” (Various authors, September 2019).

Financial Times: Special Report: Universal Healthcare
“World leaders have committed to introduce universal health coverage by 2030 as part of the U.N.’s Sustainable Development Goals but, as our three-part report explores, there is a still a long way to go…” (9/23).

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U.N., IFRC Reports Warn Of Potential Impacts Of Climate Change Ahead Of U.N. Action Summit

Al Jazeera: Climate SOS: 5-year period ending 2019 to be hottest on record
“A damning new U.N. report published on Sunday warned the world was falling badly behind in the race to avert climate disaster as a result of runaway warming, with the five years ending 2019 set to be the hottest ever. The report comes ahead of a major United Nations climate summit on Monday when Secretary-General António Guterres will push countries to increase their greenhouse gas reduction targets…” (9/22).

Devex: Report warns of the humanitarian cost of climate change
“In a worst-case scenario, the price of responding to humanitarian needs as a result of climate-related disasters could climb to $20 billion annually by 2030, according to a report by the International Federation of Red Cross and Red Crescent Societies, up from a maximum of $12 billion currently being spent. The number of people in need of humanitarian assistance following droughts, floods, and storms could also double to more than 200 million annually, the report suggests…” (Root, 9/23).

USA TODAY: U.N. Climate Action Summit: How many countries will step up on the world stage Monday?
“…President Donald Trump, who wants to pull the United States out of the ratified 2015 Paris agreement to cut emissions, won’t participate, but United Nations officials and observers say China and about 70 other countries could make big announcements. At least another 40 countries are expected to attend, and might — or might not — end up on stage making new pledges…” (Wilson, 9/22).

Additional coverage of the U.N. report, the climate summit, and the impacts of climate change on food production is available from Associated Press, BBC News, and IPS.

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Leaked Letter From High-Level U.S. Officials Urges Nations To Oppose U.N. Policies Promoting Sexual, Reproductive Health, Rights, Guardian Reports

The Guardian: Leaked letter suggests U.S. is rallying U.N. member states to oppose abortion
“The U.S. is understood to have written to U.N. member states urging them to join a ‘growing coalition’ of countries rallying against abortion, in what seems to be the latest attempt by the Trump administration to rollback women’s rights. A letter, seen by the Guardian, is believed to have been sent to governments deemed sympathetic to the administration’s view on reproductive health. In the letter, apparently signed by the Secretary of State Mike Pompeo and Health and Human Services Secretary Alex Azar, governments are encouraged to sign a joint statement opposing ‘harmful’ U.N. policies that promote sexual and reproductive health and rights. The statement will be presented to a high-level meeting on universal health coverage at the U.N. general assembly on Monday, says the letter…” (Ford, 9/23).

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Supreme Court To Decide Whether To Review Case On U.N. Immunity After Peacekeepers Imported Cholera To Haiti

Fox News: Supreme Court could hear groundbreaking case that challenges U.N. immunity
“As world leaders descend on New York for this year’s U.N. General Assembly, the immunity enjoyed by the organization is being challenged at the U.S. Supreme Court. Following a devastating earthquake in 2010, Nepalese peacekeepers sent to help instead brought cholera to Haiti — a disease unknown to the country at the time. … ‘The U.N. must be held responsible so they know there are consequences for the damage they cause in places like Haiti,’ [the lead plaintiff] said. … Edward Flaherty, a Geneva-based lawyer who filed an amicus brief to the Supreme Court on behalf of Swiss NGO, Hear Their Cries, told Fox News that if the case is accepted for review, it ‘will allow the Court to finally examine the constitutionality of U.N. immunity’…” (Evansky, 9/22).

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Cuban Report Outlines Impacts Of U.S. Sanctions On Nation's Health Sector

Prensa Latina: U.S. Blockade Targets Cuban Health, Says Report
“Between April 2018 and March 2019, the damage caused by the U.S. blockade to Cuba’s health sector totaled more than 104 million dollars. This is stated in the island’s report on U.N. General Assembly resolution 73/8 entitled ‘Necessity of ending the economic, commercial and financial blockade imposed by the United States of America against Cuba’. The report, presented Friday by Foreign Minister Bruno Rodriguez, cites concrete examples of how the encirclement policy exercised by Washington for almost six decades has a negative impact on the health of Cubans…” (9/21).

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WHO, U.S. Officials Urge Tanzania To Share Information On Suspected Ebola Cases

AFP: Tanzania not sharing information on suspected Ebola: WHO
“The World Health Organization has accused Tanzania of failing to provide information on suspected cases of Ebola in the country, potentially hindering efforts to curb the spread of the deadly virus…” (9/22).

Financial Times: WHO criticizes Tanzania for withholding Ebola information
“…In a statement on [Saturday] the WHO said that, despite repeated requests, ‘to date, clinical data, results of the investigations, possible contacts and potential laboratory tests performed … have not been communicated to the WHO’…” (Pilling, 9/22).

Reuters: World Health Organization: Tanzania not sharing information on Ebola
“…WHO said in a statement late on Saturday that it was made aware on Sept. 10 of the death of a patient in Dar es Salaam, and unofficially told the next day that the person tested positive for Ebola. The woman had died on Sept. 8. … WHO said it was unofficially told that Tanzania had two other possible Ebola cases. One had tested negative and there was no information on the other…” (Nebehay/Biryabarema, 9/22).

STAT: WHO signals alarm over possible unreported Ebola cases in Tanzania
“…Tanzanian authorities told the WHO on Monday that they would not agree to outside testing of their samples. … The situation has also been of concern to the United States. On Saturday, the CDC said it was aware of the situation and is working with the WHO to learn more. On Tuesday, Health and Human Services Secretary Alex Azar, who was in East Africa to review the Ebola response in the DRC, urged Tanzania to be more forthcoming. … He later asked Dr. Robert Redfield, director of the Centers for Disease Control and Prevention, to travel to Tanzania. Redfield had been on the mission to East Africa with Azar” (Branswell, 9/21).

Washington Post: WHO accuses Tanzania of withholding information about suspected Ebola cases
“…Tanzania has never reported a case of Ebola. Tourism makes up a significant portion of the country’s economy, and Ebola’s presence there could lead to widespread trip cancellations…” (Bearak, 9/22).

Additional coverage of the suspected Ebola cases and Redfield’s meetings in Tanzania is available from Al Jazeera, The Citizen, and DW.

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MSF Accuses WHO Of Rationing Ebola Vaccine In DRC As Health Authorities Announce Use Of 2nd Vaccine; U.N. Ebola Lead Gressly To Visit U.N. To Appeal For Additional Funds For Outbreak Response

AFP: Doctors Without Borders accuses WHO of rationing Ebola vaccine in DR Congo
“Aid group Doctors Without Borders (MSF) on Monday accused the World Health Organization of rationing the Ebola vaccine in the Democratic Republic of Congo where more than 2,100 people have died of the deadly virus. ‘One of the main problems currently is the fact that in practice the vaccine is rationed by the WHO and that too few people at risk are protected today,’ MSF said in a statement…” (9/23).

CIDRAP News: U.N. Ebola lead Gressly visits Ituri, DRC, promises funds
“In the coming days, David Gressly, the United Nations emergency Ebola response coordinator, will travel to New York City to address the 74th U.N. General Assembly and solicit resources to end the current outbreak in the Democratic Republic of the Congo (DRC), which grew by 7 cases [Friday]. Gressly announced his travel plans yesterday, during his first visit to Ituri province since he was named the response coordinator earlier this summer, according to the U.N. peacekeeping organization MONUSCO…” (Soucheray, 9/20).

Reuters: Congo to deploy second Ebola vaccine
“Health authorities in Democratic Republic of Congo said on Saturday that they plan to introduce a second Ebola vaccine, manufactured by Johnson & Johnson, to counter the second-worst outbreak of the virus in history. The team overseeing Congo’s Ebola response did not say when exactly the J&J vaccine would be introduced. It will complement another vaccine manufactured by Merck, which has been administered to more than 225,000 people since August 2018…” (Mahamba/Ross, 9/21).

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Kenya, Uganda Among African Countries To Make Pledges To Global Fund

East African: Kenya, Uganda $6.5m pledge to the Global Fund
“Kenya and Uganda are among 11 countries to pledge $32 million to the Global Fund ahead of its annual fundraising scheduled for October in France. In its 2019 report, Global Fund … Kenya has pledged $5 million, coming behind Nigeria which offered $10 million, and tied with South Africa, which promised to give $5 million as well. In East Africa, Uganda is the only other contributor — pledging $1.5 million…” (Okeyo, 9/21).

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Financial Times Publishes Special Report On Future Of African Health Care

Financial Times: Special Report: The Future of African Healthcare
“Healthcare systems across Africa are underfunded and understaffed. But clinicians and politicians are campaigning to secure more funds, improve medical training, widen access to vaccines, tackle counterfeit drugs, and develop more affordable medicines.” This series features six articles and an opinion piece on health care in Africa (Various authors, 9/22).

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Drug Resistance Rising In Livestock Due To Increased Production In Nations Where Antibiotic Use Less Regulated, Study Says

CIDRAP News: Antibiotic resistance in farm animals tied to global hot spots
“Resistance to the antibiotics commonly used in livestock production is rising in food-producing animals in the developing world, and China and India are seeing the worst of it, according to a new paper from an international team of researchers. The authors of the paper, published [Thursday] in Science, say the findings are consistent with intensified meat production in many lower- and middle-income countries (LMICs), where antibiotic use in livestock is much less regulated than it is in Europe or the United States, and antibiotics are widely used to promote faster growth and compensate for poor hygiene and less nutritious feed…” (Dall, 9/20).

Additional coverage of the study and vaccinations among animals is available from Healio and The Telegraph.

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More News In Global Health

Borgen Magazine: The U.S. International Development Finance Corporation (Williams, 9/21).

Borgen Magazine: Reducing Child Malnutrition in Peru (Johnson, 9/21).

Devex: For many in Nigeria, cancer care remains out of reach (Adepoju, 9/23).

Devex: Nutrition in Asia-Pacific shows mixed progress (Ravelo, 9/23).

DW: Brazil’s fight against dengue: A race against time (Milz, 9/21).

Fast Company: Is the Gates Foundation putting toilets ahead of human rights? (Paynter, 9/20).

Homeland Preparedness News: Johns Hopkins report finds global preparedness needs improvement to face high-impact respiratory pathogens (Galford, 9/20).

NPR: How To Design A Female-Friendly Toilet (Vaughn, 9/20).

Reuters: Factbox: India, South Korea latest to take steps on e-cigarettes (Cavale et al., 9/20).

VOA: In Cambodia, It’s a Bad Year for Dengue Fever (Narin, 9/22).

Washington Post: A new Greek leader wants people to obey a public smoking ban — for real, this time (Harlan, 9/21).

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Editorials and Opinions

Political Commitment To UHC, Investments In Health Systems Can Contribute To Healthier, More Prosperous Africa, Rwandan President, WHO DG Say

Financial Times: History shows health is the foundation of African prosperity
Paul Kagame, president of Rwanda, and Tedros Adhanom Ghebreyesus, director general of the WHO

“For many people, the current Ebola outbreak in the Democratic Republic of Congo reinforces their stereotype of Africa: a place where people suffer from exotic diseases that have long since disappeared from rich countries, or never arrived there. Africa lags the rest of the world on many health measures. … But these facts only tell part of the story. At a time when the rest of the world is grappling with the challenges of aging populations, Africa has the world’s youngest. Africa is also home to four of the world’s 10 fastest-growing economies and becoming a hub for innovation, research, and development. … At the U.N. General Assembly this month, world leaders will converge for the first high-level meeting focused on universal health coverage. Now is the moment for a new era of partnership among governments, donors, philanthropists, and the private sector, building on past successes. Much work remains to be done to close the gap between Africa and the rest of the world. But with political commitment to universal health coverage and the right investments in strong health systems, the future of Africa is not just healthier, it is also more prosperous and more powerful” (9/22).

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International Community Must Prevent, Resolve Conflicts To Strengthen Global Health Security

CNN: What keeps us from eradicating this deadly, contagious disease?
Mary Ann Peters, chief executive officer of The Carter Center

“…Sadly, the DRC is not the only place where persistent and brutal conflicts hobble campaigns to fight epidemics, eliminate disease, and deliver basic health care. … If we are to defeat Ebola and other diseases that threaten global health security, we must take steps to resolve the conflicts that create a favorable environment for the spread of disease. … We need to allocate meaningful resources to identifying and preventing conflict — because an ounce of prevention is worth much more than a pound of cure. We must address the root causes of the persistent conflicts of this century, like those in the DRC, South Sudan, and Mali, with ideas, funding, and political will. In the short term, we need to find ways to provide greater security to health workers who risk their lives in conflict zones. Investing in peace as part of a global health security strategy will complement investments in research and help ensure a healthier and safer world for all” (9/20).

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World Must Mobilize Collective Efforts To Prevent, Prepare For Pandemics, Opinion Piece Says

Foreign Policy: The World Knows an Apocalyptic Pandemic Is Coming
Laurie Garrett, former senior fellow for global health at the Council on Foreign Relations

“A new independent report compiled at the request of the United Nations secretary general warns that there is a ‘very real threat’ of a pandemic sweeping the planet, killing up to 80 million people. A deadly pathogen, spread airborne around the world, the report says, could wipe out almost 5 percent of the global economy. And we’re not ready. … So far, however, humanity has pushed disease threats out of its collective consciousness shortly after every epidemic ceased. The 1918 influenza pandemic killed some 50 to 100 million people — estimates vary widely. And the plague of the 14th century claimed 60 percent of the European population: roughly 50 million souls. We have already, in my lifetime, failed to stop HIV, which, since its emergence on the global stage in 1981, has sickened 75 million people, killing about 32 million of them. We know there will be another terrible epidemic — perhaps not as large as 1918 flu or the plague, but awful nonetheless. Yet it will likely take much more than expert reports to mobilize serious collective efforts to prevent and prepare catastrophe” (9/20)

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From the Global Health Policy Community

Experts Discuss UHC, Role Of Partnerships, Private Sector In Light Of U.N. Summit

Brookings: Achieving universal health coverage through value-based care and public-private collaboration (McClellan et al., 9/20).

World Economic Forum: Half of the world’s population lack access to essential health services — are we doing enough? (McNeill/Jacobs, 9/20).

World Economic Forum: 7 ways the private sector can contribute to universal health coverage (Akinola/Dimitrova, 9/20).

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Article Examines 90-90-90 HIV Targets, Current Investments, Resource Needs

Current Opinion on HIV/AIDS: The cost of reaching the 90-90-90 targets: are current investments enough?
This review takes stock of the 90-90-90 targets for HIV and “examines what is known about current investments for HIV in low and middle-income countries, resource needs, and the potential for additional investment.” The review finds that there “is a significant gap in resources needed to reach the 90-90-90 targets by 2020. It may be possible to reduce the gap through more efficient allocation of resources. In addition, there are efforts underway to mobilize more investment. Ultimately, any gap that remains has implications for health outcomes and future spending” (Kates/Wexler/Dieleman/Moses/Stover, 9/12).

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From KFF

KFF Analyzes Global Health Aspects Of SFOPs, LHHS FY 2020 Appropriations Bills

KFF: Senate Appropriations Committee Releases Draft FY 2020 State and Foreign Operations (SFOPs) Appropriations Bill
“The Senate Appropriations Committee released the draft FY 2020 State & Foreign Operations (SFOPs) appropriations bill (and accompanying report) on September 18, 2019. The SFOPs bill includes funding for U.S. global health programs at the State Department and the U.S. Agency for International Development (USAID). Funding for these programs, through the Global Health Programs (GHP) account, which represents the bulk of global health assistance, totaled $9.1 billion, an increase of $274 million above the FY 2019 enacted level, $2.8 billion above the President’s FY 2020 request, and $186 million below the House FY 2020 level.” This post includes highlights from the bill, as well as a table comparing global health funding in the FY 2020 Senate SFOPs appropriations bill to the FY 2019 enacted funding amounts as outlined in the “Consolidated Appropriations Act, 2019,” the President’s FY 2020 request, and the House FY 2020 SFOPs bill  (9/20).

KFF: Senate Appropriations Committee Releases Draft FY 2020 Health and Human Services (HHS) Appropriations Bill
“The Senate Appropriations Committee released the draft FY 2020 Labor, Health and Human Services, and Education (LHHS) appropriations bill (and accompanying report) on September 18, 2019. The LHHS appropriations bill includes funding for U.S. global health programs provided to the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH).” This post includes highlights from the bill and a table comparing global health funding in the FY 2020 Senate LHHS appropriations bill to the FY 2019 enacted funding amounts as outlined in the “Consolidated Appropriations Act, 2019,” the President’s FY 2020 request, and the House FY 2020 LHHS bill (9/20).

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