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Kaiser Daily Global Health Policy Report

In The News

Number Of Ebola Cases Approaches 10,000, Deaths 5,000, WHO Reports

News outlets report on the latest number of Ebola cases (9,936) and deaths (4,877) reported by the WHO.

Agence France-Presse: Number of Ebola cases nears 10,000
“The number of people with Ebola is set to hit 10,000 in West Africa, the World Health Organization said, as the scramble to find a cure gathered pace. The U.N.’s public health body said 9,936 people in Guinea, Liberia, and Sierra Leone — the three countries at the epicenter of the world’s worst-ever Ebola epidemic — have contracted the disease. In total, 4,877 people have so far died…” (10/22).

Associated Press: WHO: Ebola responsible for 4,877 deaths
“Ebola is now believed to have killed 4,877 people globally and the spread of the lethal virus remains ‘persistent and widespread’ in West Africa, the World Health Organization said Wednesday…” (10/22).

Reuters: Official WHO Ebola toll near 5,000 with true number nearer 15,000
“At least 4,877 people have died in the world’s worst recorded outbreak of Ebola, and at least 9,936 cases of the disease had been recorded as of Oct. 19, the World Health Organization (WHO) said on Wednesday, but the true toll may be three times as much…” (Miles, 10/22).

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CDC Announces 21-Day Monitoring Program For All Inbound Airline Passengers Traveling From Ebola-Hit West African Nations

News outlets report on a CDC announcement that the agency will implement a 21-day Ebola monitoring program for all airline passengers arriving in the U.S. from Liberia, Sierra Leone, or Guinea. The announcement came one day after the U.S. Department of Homeland Security announced tightened screening measures for the same passengers at five U.S. airports.

ABC News: Ebola Prompts CDC to Monitor All Travelers Coming From Guinea, Liberia, Sierra Leone
“All people returning to the United States from Ebola-affected countries will undergo 21-day monitoring, Centers for Disease Control and Prevention announced today…” (Lupkin, 10/22).

CQ News: CDC Imposes 21-Day Monitoring on Travelers From Ebola-Stricken Nations
“…CDC Director Thomas Frieden said the program will begin Monday in six states where about 70 percent of those travelers are located — Georgia, Maryland, New Jersey, New York, Pennsylvania, and Virginia — and that the agency will work with the other states with affected individuals as well…” (Attias, 10/22).

New York Times: U.S. Plans 21-Day Watch of Travelers From Ebola-Hit Nations
“…The new federal rules take effect next Monday. All travelers who have visited Guinea, Liberia or Sierra Leone will be required to provide home and email addresses, telephone numbers, and other contact details for themselves and at least one friend or relative…” (McNeil/Shear, 10/22).

Foreign Policy: Doctors: CDC’s New Ebola Tracking Plan Is Political Theater (Francis, 10/22).
The Hill: CDC to monitor travelers from West Africa for three weeks (Ferris, 10/22).
The Hill: CDC shifts into overdrive on Ebola (Ferris, 10/22).
Huffington Post: Remember When the U.S. Barred Travelers With HIV? An Ebola Ban Could be Worse. (Terkel, 10/22).
Politico: CDC steps up Ebola monitoring of West African travelers (Norman, 10/22).
Reuters: U.S. tightens Ebola monitoring for West African visitors (Berkrot, 10/22).
Wall Street Journal: U.S. to Monitor West Africa Travelers for Ebola Symptoms (Campoy, 10/22).

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President Obama 'Cautiously More Optimistic' About Stopping Ebola In U.S.

News outlets report on President Obama’s statement on Wednesday expressing cautious optimism regarding the Ebola situation in the United States.

Associated Press/Washington Post: Obama: Ebola gave ‘trial run’ for worse epidemic
“President Barack Obama says he’s cautiously more optimistic about the Ebola situation in the U.S., and that the virus has given the government the opportunity to try out the public health system…” (10/23).

The Hill: Obama ‘more optimistic’ about stopping Ebola
“President Obama said Wednesday he is ‘cautiously more optimistic’ about stopping Ebola in the United States as his new czar began his first day of work…” (Sink, 10/22).

Reuters: Obama says cautiously more optimistic about Ebola situation in U.S.
“President Barack Obama expressed cautious optimism about the Ebola situation in the United States on Wednesday after the U.S. government imposed new screening measures for travelers from West Africa…” (Mason/Holland, 10/22).

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Role Of New U.S. Ebola Coordinator Remains Unclear, News Sources Report

News outlets examine the role of the new U.S. Ebola coordinator.

Devex: Obama’s new Ebola czar — and what it means for U.S. aid work on the ground
“…With a background in law and politics, [Ron] Klain will manage the U.S. response to [Ebola]. But what does the role mean for development professionals working on the ground to contain the disease? That’s still unclear, even within the U.S. government’s hefty development agency…” (Tyson, 10/22).

Washington Post: When things go wrong, Obama increasingly relies on his inner circle, not his Cabinet
“As the White House grappled with the unpredictable nature of Ebola on U.S. soil, one aspect of the government’s response was relatively easy to forecast: Sooner or later, President Obama would turn to a fixer to help solve the problem. … On Wednesday, former White House staff member and Democratic strategist Ron Klain will formally join Obama’s staff to oversee the government’s Ebola response…” (Eilperin/Nakamura, 10/22).

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Australia Weighing Personal Request From Obama To Send Ebola Medical Team To West Africa

Associated Press: Australia weighs U.S. request for Ebola Africa team
“Australia’s prime minister said Thursday he was considering a personal request from President Barack Obama to send a medical team to Africa to fight Ebola, but that priority remains responding to an outbreak in the Asia-Pacific region…” (McGuirk, 10/23).

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A.U. Head To Visit Ebola-Hit West African Nations

Agence France-Presse: Africa Union chief to visit Ebola-hit nations
“African Union chief Nkosazana Dlamini-Zuma will travel to three West African nations worst hit by the Ebola crisis, one of the most senior officials to do so since the outbreak, her spokesman said Wednesday. A.U. Commission chair Dlamini-Zuma will visit Guinea, Sierra Leone, and Liberia ‘to assess the situation first hand,’ her spokesman said in a statement…” (10/22).

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WHO Emergency Committee Meeting On Ebola Aims To Increase U.N. Response

U.N. News Centre: Amid ongoing Ebola outbreak, U.N. ramps up organization-wide response
“A United Nations health committee has met for the third time in three months to evaluate the organization’s ongoing response to the global Ebola crisis amid broader agency-wide efforts in confronting the deadly disease, U.N. officials confirmed today…” (10/22).

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Ebola Prompts Food Scarcity, Social Conflict In West Africa

News outlets report on the social and economic impact Ebola could have on West African countries, particularly in terms of food security.

The Guardian: Ebola outbreak prompts food scarcity and threat of social conflict
“Fears are growing that the economic impact of the Ebola crisis could lead to unrest and political crises in West African countries…” (Chonghaile, 10/23).

Inter Press Service: Ebola Outbreak Threatens Food Crisis in West Africa
“The widespread outbreak of Ebola in West Africa, which has resulted in over 4,500 deaths so far, is also threatening to trigger a food crisis in the three countries already plagued by poverty and hunger…” (Deen, 10/22).

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News Outlets Report On How Ebola Is Affecting Liberians

News outlets report on the situation in Liberia, where Ebola is orphaning children, hampering vaccination efforts, creating stigma for survivors, and causing food shortages.

Associated Press: Threat to break isolation in Liberia over food
“Dozens of people quarantined for Ebola monitoring in western Liberia are threatening to break out of isolation because they have no food, the West African nation’s state radio reported Thursday…” (Paye-Layleh/Roy-Macaulay, 10/23).

NPR: Ebola Is Keeping Kids From Getting Vaccinated In Liberia
“…Rumors [about health workers spreading Ebola], combined with the closing of many health facilities, have caused childhood vaccinations rates to plummet in Liberia. Now thousands of children are vulnerable to potentially fatal diseases. The indirect effects of Ebola may prove more deadly than the virus itself…” (Hamilton, 10/23).

Reuters: Ebola survivors in Liberia are symbols of hope and help
“…Once rejected by their communities, survivors are now being seen as part of the solution as scientists try to find a way to use the antibodies in their blood to help treat victims…” (Hussain, 10/22).

Wall Street Journal: In Ebola-Afflicted Liberia, Orphanages Make a Tragic Comeback
“Feimata Dunoh once operated an orphanage outside Monrovia for children uprooted by years of civil war. Ebola has put her back in business…” (McGroarty, 10/22).

Washington Post: Faces of survival: Stories of Liberians who beat Ebola
“Liberia is almost synonymous with Ebola — in no other country in the world has the virus killed more people. Pulitzer Prize-winning photographer John Moore made two trips to the troubled country to document the outbreak for Getty Images. His most recent photographs feature Ebola survivors…” (Kirkpatrick, 10/23).

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Violence Erupts In Sierra Leone Over Ebola; Dozens Of Survivors Released

News outlets report on the impacts of the Ebola epidemic in Sierra Leone, where violence erupted this week over the disease.

Agence France-Presse: Ebola riot in S. Leone kills two as WHO to launch vaccine trials
“Tensions surrounding the Ebola epidemic raging in West Africa sparked a deadly riot in Sierra Leone as the World Health Organization prepared Wednesday to coordinate clinical trials of an experimental vaccine against the killer virus…” (Johnson, 10/22).

Associated Press: Dozens released Ebola-free from Sierra Leone site
“Dozens of Ebola survivors have been discharged from a treatment center near Sierra Leone’s capital and told they were virus-free, as police and residents clashed in other areas of the West African country…” (Kargbo/Roy-Macaulay, 10/22).

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News Outlets Discuss Various Efforts To Develop, Test Ebola Vaccines

News outlets report on various efforts to develop and test Ebola vaccines.

Associated Press: Johnson & Johnson plans Ebola vaccine testing (10/22).
CQ HealthBeat: J&J Plans More Than 1 Million Ebola Vaccine Doses Next Year (Young, 10/22).
Financial Times: GSK expects first doses of Ebola vaccine ready by year end (Ward, 10/22).
The Hill: NIH launches trial of second Ebola vaccine (Viebeck, 10/22).
Reuters: Drugmakers may need indemnity for fast-tracked Ebola vaccines (Hirschler/Nebehay, 10/23).
Reuters: E.U. earmarks $250 million to help develop Ebola vaccines: sources (Hirschler, 10/22).

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Quickly Mobilizing Resources Vital To Successful Ebola Response In West Africa, Experts Say

MSNBC: Ebola aid groups worry about delays and staffing shortfalls
“…[L]eading aid groups warn that staffing shortfalls, logistical challenges, and other bottlenecks could undermine efforts by the U.S and its partners to fight [Ebola in West Africa]. … Concerns about the Ebola response in West Africa go beyond finances. ‘It’s not just money — it’s how to mobilize what is available as quickly as possible. The fire is burning out of control,’ said Jennifer Kates, vice president and director of global health and HIV policy at the Kaiser Family Foundation…” (Khimm, 10/23).

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Slate Examines WHO's Response To Ebola Epidemic

Slate: Why Wasn’t the WHO Ready for Ebola?
“The World Health Organization’s emergency committee is now meeting for the third time to discuss the Ebola crisis amid widespread criticism over what has been seen as a sluggish response to the virus. Mariano Lugli, a Médecins Sans Frontières deputy director who was on the ground in Guinea setting up clinics during the early days of the outbreak, recently told Reuters that he saw no signs that the U.N. agency was playing a coordinating role as Ebola spread…” (Keating, 10/22).

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Improved Data Collection Shows More TB Cases Worldwide, But Progress Made In Curbing Disease, WHO Report Says

Media sources report on the WHO’s annual tuberculosis report, which shows progress against TB but says more effort must be put into tracking and treating those who are infected.

Agence France-Presse: Big strides made in fighting TB, says WHO
“The known tally of people with tuberculosis rose last year but overall ‘major progress’ is being made in rolling back the disease, the World Health Organization (WHO) said Wednesday…” (Ingham, 10/22).

BBC News: WHO revises global tuberculosis estimate up by 500,000
“…In 2013 nine million people had developed TB around the world, up from 8.6 million in 2012, the WHO said. However, the number of people dying from TB continued to decline, it added…” (10/22).

CNN: 1.5 million died last year from this curable disease
“…On Wednesday, the World Health Organization released its 2014 Global Tuberculosis Report, which shows that nine million people developed tuberculosis in 2013 and 1.5 million died, making it one of the world’s deadliest communicable diseases…” (Wilson, 10/22).

Deutsche Welle: WHO: TB one of world’s deadliest infectious diseases
“…Though the overall mortality rate has declined by 45 percent since 1990, the number of deaths — especially of people infected with the hard-to-treat strains resistant to multiple drugs or extensively drug-resistant strains — is still too high, according to WHO…” (10/22).

The Guardian: Drug-resistant tuberculosis poses global threat, warn doctors
“Strains of tuberculosis that are resistant to most of the drugs used to treat them are spreading rapidly across the former Soviet Union and pose a serious global threat, warn doctors…” (Boseley, 10/22).

NPR: Bad And Good News About The Second Deadliest Infectious Disease
“…The report says an ‘unacceptably high’ number of lives are being lost to this curable disease. The death toll represents ‘roughly one sixth of all cases last year,’ says Dr. Mario Raviglione, director of WHO’s global TB program…” (Conant, 10/22).

Reuters: Drug-resistant tuberculosis at crisis levels, warns WHO
“…Furthermore, extensively drug-resistant TB (XDR-TB), which is even more expensive and difficult to treat than multi drug-resistant (MDR-TB) strains, has now been reported in 100 countries around the world…” (Kelland, 10/22).

ScienceInsider: Tuberculosis toll greater than previously estimated, says WHO
“…The higher numbers reflect better data gathering around the world, rather than an actual surge in the disease, the report notes…” (Cornwall, 10/22).

U.N. News Centre: Despite gains against tuberculosis, better research funding required — U.N. report
“…An estimated $8 billion is needed each year for a full response, but there is currently an annual shortfall of $2 billion…” (10/22).

WHO: Improved data reveals higher global burden of tuberculosis
“…A special supplement to this year’s WHO report marks 20 years of anti-TB drug-resistance surveillance. It outlines the MDR-TB response to-date and the priority actions that must now be taken from prevention to cure…” (10/22).

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Climate Change's Effect On Health Systems To Be Top Issue At World Health Summit

EurActiv: Climate change rivals Ebola at World Health Summit
“Climate change is expected to cause 250,000 additional deaths per year between 2030 and 2050, affecting the poorest countries with weak health care systems — a global challenge that rivaled Ebola as one of the top issues at the World Health Summit in Berlin this week…” (10/23).

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Turkey Confirms First MERS Case; Saudi Arabia Announces Efforts To Stop Local Outbreak

CIDRAP News: Turkey has first MERS case; Saudi Arabia acts to stop cluster
“Turkey has confirmed its first MERS-CoV case, involving a man who visited Saudi Arabia, according to media reports, and Saudi Arabia announced steps today to stop an ongoing cluster of cases in Taif, where three more have been reported in the past three days…” (10/20).

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Scientists Express Concern Over Temporary Ban On New Gain-Of-Function Research Funding

Science Magazine: Researchers rail against moratorium on risky virus experiments
“A moratorium on certain risky virology studies imposed by the U.S. government last Friday has gone too far, a number of researchers said [Wednesday]. At a meeting at which experts were tasked with hashing out the risks and benefits of these experiments, the opening session instead was dominated by a litany of concerns that research important to public health is being curtailed…” (Kaiser, 10/22).

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Lawyers Representing Haitian Cholera Victims To Argue Case Against U.N. Should Move Forward

Al Jazeera: Haiti cholera victims get a hearing in U.S. court
“…[A] coalition of U.S. and Haitian lawyers from the Boston-based Institute for Justice and Democracy in Haiti (IJDH) filed a class action against the United Nations for the alleged role of Nepalese peacekeepers in contaminating the country’s waterways [with cholera bacteria]. … IJDH lawyers will get their chance on Thursday to argue that the lawsuit should go forward. … The U.N. is accused of failing to exercise due diligence when, three years before, Nepalese peacekeepers arrived in Haiti with a strain of the bacterium Vibrio cholerae, which causes cholera…” (Crellin, 10/22).

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Chinese AIDS Activist Reportedly Kept From Attending U.N. Conference

New York Times: Chinese AIDS Activist Says She Was Kept From U.N. Conference
“A Chinese AIDS activist says she had to cancel a trip to Geneva this week to attend a United Nations conference on women after local officials seized her passport and forced her to tell conference organizers that she was ‘too sick’ to participate. … The action against Ms. Wang is one of the latest moves by the Chinese authorities to restrict the movement and speech of civil society activists…” (Yu, 10/23).

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Editorials and Opinions

Opinion Pieces Discuss Various Aspects Of Ebola Epidemic

The following opinion pieces discuss various aspects of the Ebola epidemic and the global response to the disease.

Hartford Courant: Ebola Shows Need For Global Health Security Office
Elizabeth Bradley, director of the Yale Global Health Initiative, and Robert Hecht, managing director at the Results for Development Institute and visiting fellow at Yale

New England Journal of Medicine: Where Is the Surgeon General?
Gregory Curfman, Stephen Morrissey, and Jeffrey Drazen, NEJM editors

Washington Post: The politics of Ebola
E.J. Dionne, opinion writer

Foreign Policy: How to Shut Down a Country and Kill a Disease
Laurie Garrett, senior fellow for global health at the Council on Foreign Relations

Salon: Ebola’s grim original secret: How capitalism and obscene military spending got us here
Robert Hennelly, investigative journalist

Wall Street Journal: Ron Klain: The Last Fixer
Daniel Henninger, WSJ deputy editorial page director

New York Times: How to Defeat Ebola
Nicholas Kristof, columnist

The Hill: U.S. needs to ramp up response to stop Ebola
U.S. Rep. Kenny Marchant (R-Texas)

Huffington Post: Partnerships Key to Fighting Ebola Crisis
Doyin Oluwole, executive director of Pink Ribbon Red Ribbon

EurActiv: A woman should be appointed as E.U. Ebola envoy
Mirjam van Reisen, professor at Tilburg University in the Netherlands

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#Commit2deliver Working To Bolster Efforts To Save Lives Of Women, Children

Huffington Post U.K.: Five Things You Need to Know About #Commit2deliver
Allan Pamba, GSK vice president for East Africa

“…Last month I was at an Every Woman Every Child event held in the margins of the United Nations General Assembly week, where heads of state, business leaders, philanthropists — even some celebrities — joined together with the aim to save the lives of 16 million women and children by 2015. … #Commit2deliver, the hashtag used to generate support for such commitments and call for greater accountability from global leaders, was trending on Twitter during the UNGA. Here are the five things I took away from the discussions about #Commit2deliver. 1. The Innovation pipeline is rich and getting richer … 2. Time to be bold & take a chance at scale … 3. People need to work together … 4. It’s all about education too … 5. Support is coming from unlikely places… (10/22).

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Gender Must Be Integrated Into Post-2015 Development Goals

Devex: Gender and poverty interventions: 5 ways to get it right in 2015
Sylvia Chant, professor of development geography at the London School of Economics and Political Science, and Gwendolyn Beetham, senior program coordinator at Douglass Residential College at Rutgers University

“…For gender advocates, one of the main critiques of the MDGs was that gender was not fully integrated throughout each of the eight goals, and that, as a result, the focus on these goals caused gender to remain heavily circumscribed in poverty reduction policy and programming. How can we do better this time around? Researchers and advocates such as the Post-2015 Women’s Coalition have already begun offering suggestions. Following these important contributions, we want to share some of the key lessons learned. … 1. Take household relationships seriously. … 2. Recognize unpaid care work. … 3. Mainstreaming is needed, but so are targeted programs for women. … 4. Targeting women should not mean increasing women’s burden. … 5. The bigger picture? Structural problems need structural solutions…” (10/22).

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Scientific Community Ready For 'Constructive Discussion' Over Gain-Of-Function Research

Nature: A ripe time for gaining ground
Editorial Board

“Late last week, the White House Office of Science and Technology Policy and the U.S. Department of Health and Human Services announced an immediate pause in all new government funding for gain-of-function (GOF) research — experiments to boost the transmissibility, virulence, or host range of pathogens — on influenzas, Middle East respiratory syndrome, and severe acute respiratory syndrome. … The decision to implement another moratorium — and to broaden it to pathogens other than the H5N1 and H7N9 flu viruses — is a belated acknowledgement that the issue of how to handle GOF research is far from resolved. … The climate for constructive discussion is now perhaps better than it was: although opinions remain sharply divided, each side now seems to be listening more to the other. … We need more … balanced analyses, and fewer dogmatic opinions, on both sides” (10/23).

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Recent Releases

New Report Addresses HIV Risk, Prevention Among Adolescent Girls In Ethiopia

Population Council: Building the Assets to Thrive: Addressing the HIV-related Vulnerabilities of Adolescent Girls in Ethiopia
This report, written by Annabel Erulkar, a senior associate and country director for Ethiopia at the Population Council, provides a review of three programs addressing HIV risk among adolescent girls in Ethiopia launched by the Population Council and the country’s government (October 2014).

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MNCH Issues Highlighted During Week Of U.N. General Assembly

Maternal Health Task Force: UNGA week shows maternal and newborn health are central to development challenge
Amy Boldosser-Boesch, interim president of global advocacy at Family Care International, discusses the prominence of maternal, newborn, and child health issues during the week of the U.N. General Assembly meeting in September. She writes, “As the world works together to shape the post-2015 development goals, these experiences during UNGA show that the new agenda must prioritize continuing to address maternal, newborn, and child mortality which is linked to many of the world’s pressing development challenges, including poverty…” (10/22).

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