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Kaiser Daily Global Health Policy Report

In The News

Lack Of Global Response Contributing To Worsening Ebola Outbreak

News outlets report on the responses to and predictions for the Ebola outbreak in West Africa.

Wall Street Journal: Ebola Virus Crisis Worsens for Lack of Global Help
“…The rapid expansion of the Ebola epidemic sends a shrill wake-up call to the global health community and the governments that often provide aid in crises — because so far the nations with the funds and medical resources to help deal with this scourge have offered only a trickle of aid. The lackluster response has compounded the pain and suffering the countries and their people are going through…” (Hinshaw/McKay, 8/29).

Washington Post: Sense of urgency heightens over Ebola crisis
“The Ebola outbreak sweeping through West Africa will get significantly worse before it subsides, infecting as many as 20,000 people, the World Health Organization said Thursday, even as U.S. researchers announced plans to begin human safety trials next week in a race to develop an effective vaccine…” (Dennis, 8/28).

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Social Unrest In Liberia, Guinea, As Quarantines, Rumors Stir Controversy Amid Ebola Outbreak

News outlets report on social unrest in Liberia and Guinea, as quarantines are implemented and rumors spread about the Ebola virus outbreak.

New York Times: As Ebola Grips Liberia’s Capital, a Quarantine Sows Social Chaos
“…Isolating communities has succeeded in some rural areas in past [Ebola] outbreaks in Central Africa. But the quarantine of an entire urban neighborhood, where 60,000 to 120,000 people are crammed into crumbling shacks, has proved to be more than just porous. It has also led to deadly clashes with soldiers and may even be helping spread the disease, experts say, forcing people to crowd together for basic humanitarian aid, like food relief…” (Onishi, 8/28).

Reuters: Guinean security forces break up riot in Ebola-racked south
“Riots broke out in Guinea’s second-largest city Nzerekore over rumors that health workers had infected people with the deadly Ebola virus, a Red Cross official and residents said on Friday…” (Samb/Farge, 8/29).

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Ebola Genetic Analysis Shows How Virus Spread From Guinea To Sierra Leone

News outlets report on a study published in Science that describes the genetic mutations taking place in the Ebola virus as it spreads among humans in the West African outbreak.

Associated Press: Scientists dig into Ebola’s deadly genes for clues
“…Stephen Gire and other health researchers on the ground in Africa had some hope that the Ebola outbreak was coming under control or at least plateauing in late May. Then came the funeral of a healer in Guinea. More than a dozen of the mourners contracted the disease there, probably by washing or touching the body, and took it to Sierra Leone, according to a new genetic mapping of the Ebola virus that scientists hope will help them understand what makes this killer tick…” (Borenstein, 8/28).

New York Times: Outbreak in Sierra Leone Is Tied to Single Funeral Where 14 Women Were Infected
“Sierra Leone’s explosion of Ebola cases in early summer appears to stem from one traditional healer’s funeral at which 14 women were infected, according to scientists studying the blood of victims. The funeral, which took place in mid-May, constitutes a ‘super-spreader’ event comparable to one in 2003 in a Hong Kong hotel in which one doctor from China dying of SARS infected nine other guests who spread the virus throughout the city and to Vietnam and Canada…” (McNeil, 8/28).

NPR: Ebola Is Rapidly Mutating As It Spreads Across West Africa
“For the first time, scientists have been able to follow the spread of an Ebola outbreak almost in real time, by sequencing the virus’ genome from people in Sierra Leone. The findings, published Thursday in the journal Science, offer new insights into how the outbreak started in West Africa and how fast the virus is mutating…” (Doucleff, 8/28).

Reuters: Gene studies of Ebola in Sierra Leone show virus is mutating fast
“Genetic studies of some of the earliest Ebola cases in Sierra Leone reveal more than 300 genetic changes in the virus as it leapt from person to person, changes that could blunt the effectiveness of diagnostic tests and experimental treatments now in development, researchers said on Thursday…” (Steenhuysen, 8/29).

Scientific American: Patient Zero Believed to Be Sole Source of Ebola Outbreak
“One glaring fact from the latest report on the Ebola outbreak is that five of the many study authors are dead, killed by the disease that is roiling West Africa. The new analysis, published in the August 29 issue of Science, reveals that the current Ebola outbreak stemmed from an earlier initial leap from the wild into humans, rather than the virus repeatedly jumping from a natural reservoir — perhaps infected animals — to humans…” (Maron, 8/28).

Washington Post: Ebola virus has mutated during course of outbreak
“…The genomic sequencing also offers hints as to how the Ebola ‘Zaire’ strain at the heart of the current outbreak — one of five types of Ebola virus known to infect humans — likely ended up in West Africa in the first place. Researchers said the data suggests that the virus spread from an animal host, possibly bats, and that diverged around 2004 from an Ebola strain in Central Africa, where previous outbreaks have occurred…” (Dennis, 8/28).

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Dead Game Animal Linked To Ebola Outbreak In DRC, WHO Says

CIDRAP News: WHO: Dead game animal sparked DRC Ebola outbreak
“The Democratic Republic of Congo’s (DRC’s) Ebola outbreak started with a pregnant woman who butchered a game animal, leading to a total of 24 suspected cases and 13 deaths, the World Health Organization (WHO) announced [Wednesday]…” (Roos, 8/27).

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NIH To Begin Ebola Vaccine Safety Clinical Trial In Humans

News outlets report on an Ebola vaccine human clinical trial scheduled to begin next week.

ABC News: U.S. to Test Ebola Vaccine in Humans Amid Growing Outbreak in West Africa
“U.S. scientists will begin testing an Ebola vaccine in humans next week, health officials announced [Thursday]. But it could take 11 months to learn whether the vaccine is safe as the virus’ toll in West Africa continues to rise…” (Moisse, 8/28).

Associated Press: U.S. to begin safety testing Ebola vaccine next week
“The National Institutes of Health announced Thursday that it is launching the safety trial on a vaccine developed by the agency’s National Institute of Allergy and Infectious Diseases and GlaxoSmithKline. Beginning Tuesday, it will test 20 healthy adult volunteers to see if the virus is safe and triggers an adequate response in their immune systems…” (Borenstein, 8/28).

Politico: NIH Ebola vaccine trial to start next month
“…With the National Institute of Allergy and Infectious Diseases taking the lead in this multinational effort, the study will first enroll three healthy volunteers at the NIH campus in Maryland and then expand to 20 volunteers between the ages of 18 and 50. Later in September, 60 volunteers will be enrolled at the Oxford University in England and 120 volunteers in The Gambia and Mali…” (Villacorta, 8/28).

Washington Post: Ebola vaccine to be tested in humans at NIH Clinical Center in Maryland this fall
“…The vaccine is designed to deliver one part of Ebola’s genetic material to human cells, eventually triggering an immune response in the patient. The vaccine, however, does not allow Ebola genes to replicate…” (Dennis, 8/28).

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U.K. Advises Only Essential Travel To Ebola-Affected West African Nations

News outlets report on travel warnings made by the U.K. in response to the West African Ebola outbreak.

BBC News: Travel ban to Ebola affected countries, U.K. officials say
“The U.K. Foreign and Commonwealth Office says all travel to Sierra Leone, Guinea, and Liberia should be avoided — unless essential, due to the Ebola outbreak. British Airways has suspended flights to Sierra Leone and Liberia, and other airlines are taking similar measures…” (Mundasad, 8/28).

Reuters: Britain advises against all but essential travel to Ebola-hit nations
“Britain warned its citizens on Thursday to avoid all but essential travel to West African countries hit by the world’s worst outbreak of the deadly Ebola virus. The escalation in the travel advice issued by the foreign office in regards to Sierra Leone, Guinea, and Liberia came after a British volunteer nurse working in West Africa became the first British citizen to contract the disease…” (Goldsmith, 8/28).

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IMF, ECOWAS Comment On Ebola Outbreak; Sierra Leone Stops U.N.-Led Troop Rotations Into Somalia

Reuters reports on several issues surrounding the Ebola outbreak in West Africa.

Reuters: IMF says Ebola having ‘acute’ impact on West African economies
“The worst ever outbreak of the Ebola disease is likely to lead to ‘sharply’ lower growth in Guinea, Liberia, and Sierra Leone and raise financing needs in all three West African countries, an IMF spokesman said on Thursday…” (8/28).

Reuters: West African states call for end to border closures over Ebola
“West African states should re-open their borders and end flight bans put in place to halt the spread of Ebola, the Economic Community of West African States (ECOWAS) said on Thursday…” (8/28).

Reuters: Ebola fears halt rotations of Sierra Leone forces into Somalia
“Sierra Leone, which is battling to contain the deadly Ebola virus, will stop new rotations of its U.N.-led forces into Somalia for now as authorities move to establish safeguards, Somalia’s president said on Monday…” (8/29).

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2.5B People Lack Proper Sanitation, Creating Adverse Effects On Health

The Guardian discusses the issue of sanitation and its relevance to development and health outcomes globally.

The Guardian: Lack of toilets blights the lives of 2.5bn people, U.N. chief warns
“The world’s lack of progress in building toilets and ending open defecation is having a ‘staggering’ effect on the health, safety, education, prosperity, and dignity of 2.5 billion people, the U.N. deputy secretary general, Jan Eliasson, has warned…” (Jones, 8/28).

The Guardian: Ethiopians’ plight: ‘The toilets are unhealthy, but we don’t have a choice’
“Addis Ababa has more than three million people, but there are just 63 public toilets. … Government figures show that diarrheal diseases are among the 10 most prolific in the country…” (Smith, 8/28).

The Guardian: Lack of toilets puts India’s health and rural women’s safety at risk
“…India leads the world in open defecation. At least 636 million Indians lack toilets, according to the latest census data, a crisis that contributes to disease, childhood malnutrition, loss of economic output, and, as highlighted recently, violence against women…” (Anand, 8/28).

The Guardian: Toilets: 2.5bn people go without — a 99-second video animation
“More people have access to mobile phones than to bog-standard sanitation around the world. The numbers are actually quite close — both are around the 4.5bn mark. But the implications are clear: as a species, we value a text, a tweet, the incessant pulse of blinking pixels over one of our most basic sanitary needs: the loo…” (Henley et al., 8/28).

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Lack Of Sanitation Leads To Health Problems In Uganda, But Local Solutions Offer Progress

Al Jazeera America: Unclogging Uganda’s rural sanitation crisis
“…Poor sanitation and hygiene are contributing factors to three-quarters of the diseases found [in Uganda], according to Julian Kyomuhangi, assistant commissioner for environmental health at Uganda’s Ministry of Health. … Foreign aid officials working on sanitation in Uganda say the most effective model they’ve found is one that shifts the burden to local communities…” (Loewenberg, 8/28).

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More Than 3 Million Refugees Have Fled Syria, U.N. Says

News outlets report on the U.N.’s announcement that more than three million refugees have fled Syria due to the country’s civil war.

Agence France-Presse/The Guardian: Three million refugees have fled Syria, says U.N.
“More than three million Syrians have fled the civil war ravaging their country to become refugees — a million of them in the past year alone, the U.N. said on Friday…” (8/29).

New York Times: Syrian Refugees Surpass 3 Million, U.N. Says
“The number of refugees from the Syrian civil war has risen above three million, the United Nations refugee agency said Friday, calling the crisis ‘the biggest humanitarian emergency of our era’…” (Cumming-Bruce, 8/29).

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Security Concerns Preventing WFP From Determining Extent Of Food Insecurity In S. Sudan

Reuters: U.N. working to determine full scope of food crisis in South Sudan
“Security concerns are preventing the United Nations gathering data from some areas of South Sudan to determine the full scope of a food crisis that could lead to full-blown famine by the end of the year, a World Food Programme (WFP) official said…” (Odera, 8/28).

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Somalia Heading Towards Second Famine; Donors Must Act Now, U.N. Says

Reuters: Somalia donors must act now to avoid famine ‘catastrophe': U.N.
“War-ravaged Somalia is hurtling towards a second famine in three years that could be prevented if donors increased funding, Philippe Lazzarini, United Nations’ humanitarian coordinator for Somalia, said on Sunday…” (Jorgic, 8/29).

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Misunderstanding Of Sex Hinders Effective HIV Prevention Strategies, Experts Say

IRIN: Does the global HIV response understand sex?
“Stigma, squeamishness, and misunderstanding of anal sex is leading to research gaps and inaccurate information about the risks of this common sexual behavior, and hindering effective HIV/AIDS prevention strategies, experts say. A move towards ‘sex positive’ approaches could enhance social acceptance and increase protection…” (8/28).

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Antibiotic Overuse Leads To Drug Resistance In India

Inter Press Service: India: A Race to the Bottom with Antibiotic Overuse
“In 2011, the World Health Organization (WHO) warned: ‘Combat Drug Resistance — No Action Today, No Cure Tomorrow.’ The slogan was coined in honor of World Health Day, urging governments to ensure responsible use of antibiotics in order to prevent drug-resistant viruses and bacteria, or ‘super bugs.’ The warning is even more salient in 2014, particularly in India, a country of 1.2 billion people that recently earned the dubious distinction of being the worst country in terms of antibiotic overuse in the world…” (Biswas, 8/28).

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Awareness Should Be Raised On Climate Change's Impact On Human Health, WHO Official Says

Deutsche Welle: Climate change’s health toll: ‘We can save millions of lives, even now’
“While the effects of climate change on the environment are gaining wide attention, there’s a lack of awareness about the impact on human health. The WHO’s Diarmid Campbell-Lendrum tells DW how both can be addressed…” (Rasper, 8/28).

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Editorials and Opinions

Editorial, Opinion Piece Call For Additional Resources To Control Ebola, Strengthen Health Systems

The following editorial and opinion piece discuss the Ebola outbreak in West Africa.

New York Times: An Ominous Ebola Forecast
Editorial Board

“The World Health Organization warned on Thursday that the Ebola epidemic in West Africa, already the largest outbreak ever recorded, is going to get much worse over the next six months, the shortest window in which it might conceivably be brought under control. … It is a frightening prospect that requires an urgent infusion of aid from public and private donors around the world. The situation as described by the health agency is so dire and the resources needed so daunting that it is hard to see how they can be supplied anytime soon. The agency issued a road map listing tasks that must be carried out by countries with Ebola cases, nearby countries, the international community, and nongovernmental organizations if the epidemic is to be contained…” (8/28).

Devex: Lessons from Ebola: The urgent need to build resilient health systems
Michael Myers, managing director at the Rockefeller Foundation

“The tragic stories coming out of West Africa about Ebola shock our sensibilities. We have more advanced tools and greater capacity for communication and collaboration than ever before to ensure these types of outbreaks don’t grow into global health crises — yet inadequate and ill-resourced national health systems lacked the capacity to mobilize these interventions to keep up with the outbreak. … The Ebola epidemic will come to an end eventually, but the challenge will not end there. If we fail to invest in 21st century health systems that meet everyone’s basic health needs, we will not only repeat today’s experience in West Africa, but also upset all other progress” (8/28).

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Recent Releases

Issue Brief Discusses Integration Of WASH, Water Conservation, Climate Resilience

National Resources Defense Council’s “Switchboard”: USAID Needs to Bring Together Safe Drinking Water and Sanitation with Fresh Water Conservation and Climate Resilience in Development Assistance
Elizabeth Shope, an advocate with the NRDC, discusses an issue brief she authored, titled “Connecting Water, Sanitation, and Hygiene with Fresh Water Conservation and Climate Resilience: The Need to Facilitate Integration in Development Assistance.” The brief makes “the case that development projects intended to help these vulnerable populations need to be better integrated and take into account the potential impacts of climate change” and “suggests steps that [USAID], a key player in world efforts to reduce poverty, can take to improve integration in development assistance, which is critical to helping solve major humanitarian challenges,” she notes (8/28).

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Defeating Ebola 'Requires Commitment And Support' From Global Community

Global Health Governance: The Truth about Ebola: Global Health Leaders Try to Fight Panic with Information
Contributing blogger Tara Ornstein writes about the Ebola outbreak in West Africa, concluding, “…[T]his outbreak has provided a clear example that maintaining and protecting global health requires commitment and support from the international community” (8/28).

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Overcoming Malnutrition Key To Achieving MDGs 4, 5

Woodrow Wilson Center’s Environmental Change and Security Program’s “New Security Beat”: Overcoming Malnutrition Key to Maternal and Child Health Improvements, Says Dr. Ranu Dhillon
Sarah Meyerhoff, an intern at the Wilson Center, discusses a podcast by Ranu Dhillon, a global health expert from Columbia University and Harvard Medical School, in which he highlights nutrition and its importance on maternal and child health and achieving MDGs 4 and 5 (8/29).

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PLOS Discusses VL-HIV Co-Infection, Releases Collection Of Papers

PLOS “Speaking of Medicine”: Visceral leishmaniasis-HIV co-infection: Time for Concerted Action
Johan van Griensven, an internist and clinical epidemiologist at the Institute of Tropical Medicine in Antwerp-Belgium, announces the launch of the Visceral Leishmaniasis-HIV Collection, a set of papers published by PLOS on VL-HIV co-infection that will be expanded over time (8/28).

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special notice

The Kaiser Daily Global Health Policy Report will not be published on Monday, September 1, in recognition of Labor Day. The report will resume publication on Tuesday, September 2.

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