Kaiser Daily Global Health Policy Report
In The News
- Zimbabwe Faces Worst Food Shortages In 4 Years, WFP Warns
“Zimbabwe faces its worst food shortages in four years following a drought and poor harvest, the U.N. World Food Programme [WFP] said on Tuesday, a month after veteran President Robert Mugabe’s ZANU-PF disputed re-election,” Reuters reports (Chinaka, 9/3). “An estimated 2.2 million people [in Zimbabwe] are expected to need food assistance by early next year before the harvest period in March, the [WFP] said” Tuesday, the U.N. News Centre writes, adding, “The predicted levels of hunger, released by the U.N.-supported Zimbabwe Vulnerability Assessment Committee, would be the highest since early 2009, when more than half the population required food support” (9/3). “To meet the increased needs, WFP and its partners will provide regionally procured cereals as well as imported vegetable oil and pulses,” the agency states in a press release (9/3). “The [WFP] said Tuesday additional food handouts will start next month and will be scaled up until the next harvests in March,” according to the Associated Press/Washington Post.
“The agency said rising hunger, mostly in southern districts, was caused by erratic weather, the high cost and shortages of seed and fertilizer in the troubled economy and a 15 percent rise in prices for the corn staple after poor harvests this year,” the AP notes (9/3). “The government blames the shortages on poor rains while critics attribute the low yields to President Robert Mugabe’s land reforms,” Agence France-Presse writes (9/3). In similar news, the U.N. Food and Agriculture Organization (FAO) on Wednesday warned “[a]bout 11 million people in the Sahel are still severely food insecure” and “is appealing to the international community to increase funding for aid to the most vulnerable farmers and herders in the region south of the Sahara,” the organization reports in a press release (9/4).
- PRI's 'The World' Examines Hypertension In Developing World
PRI’s “The World” examines the issue of hypertension in the developing world, noting “[a] recently published study shows that, globally, high blood pressure causes more early deaths than any other preventable risk factor, including smoking, obesity, and childhood malnutrition.” The news service highlights Cambodia as an example, noting “high blood pressure is less common here than in the U.S. — about 11 percent of adults in Cambodia have it, compared with 31 percent in America. But the prevalence is rising much faster in Cambodia than in the U.S.” The news service notes many with the disease go undiagnosed due to a lack of symptoms and because “the average doctor in Cambodia is more attuned to treating infections and trauma than chronic, everyday diseases.” The news service continues, “Even when patients are diagnosed with hypertension, they may still go untreated.”
“On a global level, charities and donor governments have historically paid little attention to non-communicable diseases, such as hypertension, in developing countries. Funding has generally gone to improve maternal and child health, and to fight infectious diseases,” according to “The World.” However, “there is evidence that the ship is beginning to turn,” the news service writes, noting, “At the 66th World Health Assembly in Geneva this May, nations of the world called for greater attention to non-communicable diseases. And in Cambodia, the government has begun working with the World Bank, USAID, and other organizations on a health system that emphasizes diagnosis and treatment of chronic diseases” (Silberner, 9/3).
- WSJ Blog Examines Saudi Arabia's Response To MERS In Lead Up To Hajj
“Saudi Arabia continues to report sporadic new cases and deaths from a lethal new coronavirus, as hajj season in October — when the kingdom expects more than three million pilgrims from 187 countries — approaches,” the Wall Street Journal’s “Middle East Real Time” blog reports. “As of Friday, the Saudi Ministry of Health said it had confirmed 84 cases, with 42 deaths, countrywide from” MERS-CoV, or Middle East Respiratory Syndrome coronavirus, according to the blog. In a recorded briefing Friday at the University of Florida College of Public Health, Ziad Memish, Saudi Arabia’s deputy health minister, “said that the kingdom had recommended, but not ordered, that children, the elderly, the ill, and some others forgo the hajj this year, because of the virus,” the blog reports, noting, “The Saudi Health Ministry did not immediately respond to emails, phone calls and text messages this week and last seeking a briefing on the kingdom’s MERS preparations for the hajj or answers to questions on the outbreak.” The blog includes quotes from several travelers entering or leaving the kingdom who discuss the lack of public health advisories (Knickmeyer, 9/2).
- Congo Health Ministry Confirms No ARVs Currently Available In Country, IRIN Reports
IRIN examines the availability of antiretroviral drugs (ARVs) in Congo, reporting that Germain Cephas Ewangui, chair of the Pan African Association Thomas Sankara (APTS), told the news agency there are no ARVs currently available in the country. The Ministry of Health and Population said “some 16,310 patients in Congo were receiving ARVs, while 38,500 are waiting to get them,” but it “acknowledged that ARV treatment had stopped,” the news agency writes. “‘There was a malfunction. There was a break in the supply and distribution chain, but the situation is being corrected,’ said Executive Secretary of the National Council for the Fight against AIDS (CNLS) Marie-Francke Puruehnce,” according to IRIN. “A consultant from the Ministry of Health, who requested anonymity, told IRIN: ‘Such failures sometimes happen once or twice a year. But they do not last long,'” the news agency writes, noting, “Interruption of ARV therapy risks patients developing resistance to the drugs and can hasten progress to AIDS and death” (9/2).
- Ugandan AIDS Activists Call On Government To Reconsider Decision Against PrEP
Activists in Uganda are calling on the government to reconsider its “dismissal of an emerging prevention protocol demonstrated to be effective in a trial conducted partly in Uganda, and which has been approved by the U.S. Food and Drug Administration,” IRIN reports. “The protocol in question is a form of pre-exposure prophylaxis (PrEP) involving a daily dose of two antiretroviral drugs — marketed as Truvada — taken by an uninfected person who is in a sexual relationship with an HIV-positive partner,” the news service notes. Alex Ario, program manager in the Ministry of Health’s AIDS Control Programme, “said public misunderstanding of the protocol could encourage ‘reckless sex,'” IRIN writes, adding, “Experts say, however, that there is no evidence from PrEP trials to date to indicate that its use increases risky sexual behavior.” According to the news service, “Ugandan activists have called on the government to rethink its decision, especially in light of the fact that the country’s HIV prevalence has risen from 6.4 percent to 7.3 percent over the past five years.” The article includes additional comments from Ario, AVAC Executive Director Mitchell Warren, and activist Milly Katana (9/3).
- Voluntary Male Circumcision Lowers Risk Of HIV Infection, Follow-Up Study Confirms
A follow-up survey to a previous study showing that voluntary medical male circumcision can significantly reduce the risk of HIV infection confirms that finding, Agence France-Presse/GlobalPost reports. “Bertran Auvert, whose pioneering work, unveiled in 2006, helped unleash a circumcision campaign in … sub-Saharan Africa,” and colleagues returned to Orange Farm township in South Africa to survey more than 3,300 men, asking them to have HIV tests and answer questions regarding their sexual behavior, according to AFP. “Multiple partners and condom use were the same, whether the men were circumcised or uncircumcised, the investigation found … [b]ut the risk of HIV infection was 57 to 61 percent lower among those who had been circumcised,” the news agency writes. “The finding ‘gives hope that the epidemic can be reduced in settings [in sub-Saharan Africa] where most men are uncircumcised,’ says the study, published in the peer-reviewed journal PLOS Medicine,” AFP states (9/3). The authors add, “The main implication of this study is that the current rollout of adult [voluntary medical male circumcision], endorsed by UNAIDS and WHO, and supported by international agencies such as PEPFAR, the Global Fund [to Fight AIDS, Tuberculosis and Malaria], and by donors like the Bill & Melinda Gates Foundation, should be accelerated,” according to a PLOS press release (9/3).
- Iron Supplements Do Not Increase Malaria Risk Among Children, But Safety Questioned
A study published Tuesday in the Journal of the American Medical Association (JAMA) showed children in malaria-endemic areas who received iron supplements do not have an increased risk of contracting the disease, but “hospital visits for severe diarrhea episodes were significantly higher among children in Ghana given extra iron, raising questions about its safety, experts said,” Agence France-Presse reports. In the study of almost 2,000 children led by Stanley Zlotkin of the Hospital for Sick Children in Toronto, Canada, “[c]hildren who were given a micronutrient powder (MNP) containing iron for five months showed no higher incidence of malaria than those who did not get the supplements” and “[a]ll were given insecticide-treated bed nets,” the news agency writes. “The Ghana study also raised questions about the safety of iron supplements, however, with its finding that hospital admissions were significantly higher in the iron group (156) than in the non-fortified group (128),” AFP adds, noting an accompanying editorial called for additional study into the safety of the powder used. “The WHO has recently updated its guidelines to urge that in malaria-prone areas, iron be given along with measures to prevent and treat malaria,” the news agency writes (9/4).
- IPS Interviews IFRC's Chatterjee About Global Polio Response
Noting “Africa and Pakistan are now battling outbreaks of polio, threatening the extraordinary progress the world has made in fighting the almost-extinct disease,” Inter Press Service interviews Siddharth Chatterjee — who “has served as the chief diplomat, head of strategic partnerships and international relations at the International Federation of the Red Cross and Red Crescent Societies [IFRC], the world’s largest humanitarian network, since June 2011” — about the global polio response. According to the interview transcript, Chatterjee examines the causes of the current outbreaks, discusses some of the obstacles to eradication, and reflects on the response of the international community, among other issues. He says, “The international community has been awesome, and frankly without their support we would not have got this far in our fight against polio,” according to the transcript (Shen, 9/3).
Editorials and Opinions
- Skoll World Forum 'Debate & Series' Examines Health-Related MDGs
“In the lead up to the U.N. General Assembly, the Skoll World Forum partnered with Johnson & Johnson, the United Nations Foundation and the Bill & Melinda Gates Foundation to produce an online debate focused on the last 850 days before the [Millennium Development Goals (MDGs)] expire in 2015,” the “Debate & Series” summary states, adding, “We asked some of the world’s leading experts what is one thing we must do differently or better to achieve MDGs 4, 5 and/or 6 — all focused on improving public health — by the deadline?” The series includes six opinion pieces, including articles on energy by Kandeh Yumkella, special representative of the secretary general on Sustainable Energy for All and CEO of Sustainable Energy for All; investing in women by John Clemens, executive director of the International Centre for Diarrheal Disease Research, Bangladesh; tracking results by Suprotik Basu, CEO in the Office of the U.N. Secretary General’s Special Envoy for Financing the Health MDGs and for Malaria; management and public-private partnership by Gopi Gopalakrishnan, president of World Health Partners; partnerships to save the lives of women and children by Sharon D’Agostino, vice president of corporate citizenship at Johnson & Johnson; and innovation by Steve Davis, president and CEO of PATH (9/4).
- Increased Harmonization, Coordination Needed To Fully Realize Promise Of Maternal, Child Health Initiatives
“In just a few weeks, global leaders will head to New York City for the annual meeting of the United Nations General Assembly and one of the most important conversations of our time,” United Nations Foundation CEO Kathy Calvin, writes in the Huffington Post’s “Global Motherhood” blog. “The world’s collective efforts to eradicate extreme poverty will take center stage as we celebrate important achievements and discuss how to make even more progress quickly,” she notes, highlighting progress toward achieving the Millennium Development Goals (MDGs), which “have been perhaps the most successful global anti-poverty push in history.” She writes, “On health specifically, women today are more likely to survive pregnancy and childbirth, with maternal mortality down 47 percent since 1990,” and “[c]hild mortality has fallen by 41 percent, due in large part to simple but life-saving interventions, like childhood vaccines and anti-malaria bed nets.”
However, Calvin continues, “significant inequalities in better health outcomes remain — both among and within countries — and more work must be done quickly as we approach the 2015 deadline for the MDGs.” She highlights several existing initiatives, including the U.N. Secretary General’s Every Woman Every Child initiative, “a global movement of governments, multilateral organizations, the private sector and civil society to save 16 million lives by 2015”; A Promise Renewed, “a joint effort of UNICEF and governments around the world, [which] was launched in 2012 as a sustained global effort to end all preventable child deaths by 2035”; and the first-ever Global Newborn Health Conference, which took place in April “to develop a new Global Newborn Action Plan, which will be released this November.” She states, “With increased harmonization and coordination among donors and other partners as well as increased ownership at the country level, the promise of these initiatives can be fully realized” (9/3).
- Current Research Supports Biofortification Interventions, But More Research Needed
“HarvestPlus, as part of the CGIAR research program on agriculture for nutrition and health, has promoted the selective breeding of staple food crops to provide more essential micronutrients as a new potentially important strategy in the fight against micronutrient malnutrition,” Alan de Brauw and Dan Gilligan, both senior research fellows at the International Food Policy Research Institute, write in The Guardian’s “Global Development Professionals Network,” noting “[t]his ‘selective breeding’ is known as biofortification.” They continue, “Though several investments in large-scale biofortification projects are underway, until recently little rigorous evidence has supported the impact of these investments,” adding, “To fill this knowledge gap, with support from the Gates Foundation, HarvestPlus conducted the reaching end users project in Mozambique and Uganda from 2006-2009.”
De Brauw and Gilligan describe the project, which “aimed to reduce vitamin A deficiency among children under five and among women of child-bearing age by introducing provitamin-A-rich orange sweet potato (OSP) to 24,000 farming households,” and they detail the impact evaluation strategy. “The results showed promise for biofortification,” they state and highlight a recent paper in which they “measure[d] the project’s impacts on OSP adoption and nutritional knowledge,” finding “large impacts on farmers’ adoption of OSP.” They state, “Our findings suggest that future biofortification interventions can have similar impacts with even simpler nutrition messages about biofortified crops” and “highlight avenues for further research,” concluding, “More research is needed to better understand how diffusion of biofortified varieties can be promoted to further increase the cost-effectiveness of future biofortification programs” (9/3).
From the Global Health Policy Community
- USAID Blog Examines How Microloan Program Supports People Living With HIV In Vietnam
Writing in USAID’s “IMPACTblog,” Nguyen Thac Phuong, a communications specialist for USAID in Vietnam, examines how M7/CFRC, “a microfinance service provider supported by the USAID HIV Workplace Project,” is helping support people living with HIV/AIDS in the country. “Since 2008, the project, funded under [PEPFAR], has helped 1,400 people living with or affected by HIV in Vietnam,” Nguyen notes, adding, “With microloans from the project, people [living with HIV] have found jobs and realized their dreams of running their own businesses. The success of the microfinance model for people living with HIV has encouraged local microloan providers to commit $1 million in loans to this target group” (9/3).
- PLOS Blog Highlights New Articles Published In PLOS Medicine
The PLOS “Speaking of Medicine” blog highlights a number of new articles published in the current issue of PLOS Medicine. “Sohni Dean and colleagues identify the most important research areas for improving pre-conception care for women in low- and middle-income countries,” including integration of care into the wider health care system and health promotion, among other strategies, according to the blog. “Amanda Mocroft and colleagues conclude that late diagnosis of HIV infection and entry into care remains a substantial problem across Europe,” and “Bertran Auvert and colleagues report that the rollout of voluntary male circumcision services into the community of Orange Farm, South Africa, is linked to reductions in HIV infection levels,” according to the blog (9/3).