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Kaiser Daily Global Health Policy Report

In The News

Former U.S. President George W. Bush Says Support For Foreign Aid, PEPFAR In Nation's Moral, Security Interests

The Hill: George W. Bush: Foreign aid is in U.S. moral, national security interests
“Former President George W. Bush is defending foreign aid spending as a moral and security imperative in the face of massive cuts President Trump has proposed to State Department and U.N. agency budgets. In an interview with NPR aired Thursday, Bush said that the U.S. has an obligation to provide assistance to other countries faced with humanitarian crises. Failing to do so, he argued, only creates openings for extremists to spread an anti-American message…” (Greenwood, 4/13).

NPR: George W. Bush Calls Foreign Aid A Moral And Security Imperative
“…Bush dedicated billions to combating HIV/AIDS in Africa with a program called PEPFAR that still exists today. … He highlighted the program’s work and that of his post-presidency initiative to combat AIDS and cervical cancer during a recent trip to Africa. … He added, ‘I believe in this case that it’s in our national security interests as well as in our moral interest to continue funding this program’…” (Greene et al., 4/13).

POLITICO: George W. Bush makes case for foreign aid and immigration reform
“…Although Bush refrained from directly criticizing President Donald Trump in his comments, they contrast with the current Oval Office occupant’s call for dramatic cuts to the foreign aid budget and his hard-line rhetoric on immigration…” (Conway, 4/13).

U.S. News & World Report: Bush Offers Defense of Foreign Aid
“…President Donald Trump has proposed deep cuts to foreign aid as part of [his] ‘America First’ policy, including slashing [millions] from USAID and sharply reducing support for the United Nations, global development programs, and climate change initiatives. … Bush said [PEPFAR’s] success was proof that supporting global health initiatives is an important way to improve U.S. standing in the world — and thus make it more secure…” (Levy, 4/13).

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U.N. Members Vote Unanimously To End Haiti Peacekeeping Mission Blamed For Bringing Cholera To Country

New York Times: U.N. Votes Unanimously to End Peacekeeping Mission in Haiti
“The United Nations Security Council voted unanimously on Thursday to end its 13-year-long peacekeeping mission in Haiti, and replace its blue-helmeted soldiers with police officers. … [The mission] became arguably best known for introducing a deadly cholera strain to the country — and then refusing for years to take responsibility for it. … [In her remarks, U.S. Ambassador to the U.N. Nikki Haley] did not address the cholera outbreak, nor how the United Nations can compensate survivors…” (Sengupta, 4/13).

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Science Examines Vaccinemakers' Ideas On How To Use CEPI Funding, Better Respond To Emerging Infections

Science: Epidemic Insurance
“…A new organization, the Coalition for Epidemic Preparedness Innovations (CEPI), was launched and has raised half a billion dollars to work on three [vaccines for emerging infections]. GlaxoSmithKline, one of only four large vaccinemakers in the world, has proposed devoting one of its idle manufacturing plants to be a facility dedicated to making vaccines for emerging infections, and is seeking CEPI funding. But other vaccinemakers have different ideas about how best to improve the response. And many of the people at the front of reinventing the way the world responds to emerging infections stress that the problem in need of fixing is much larger than simply manufacturing novel vaccines…” (Cohen, 4/14).

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More Research Needed To Identify MERS Patients, Prevent Outbreaks, WHO Says

The Lancet: Research needed to prevent MERS coronavirus outbreaks
“After a recent outbreak of MERS coronavirus was contained in Saudi Arabia, WHO calls for more research for a better control of the disease…” (Devi, 4/15).

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India's Landmark New Legislation Banning Discrimination Against People With HIV Criticized For Loopholes On Treatment, Requirements For Enforcement

CNN: India to ban discrimination against people with HIV/AIDS
“India has passed a landmark bill which aims to ensure equal rights for those living with HIV/AIDS. The HIV and AIDS (Prevention and Control) Bill, passed by the country’s parliament on Tuesday, will make it illegal to discriminate against people living with and affected by HIV. It is the first of its kind in South Asia, and will make India the largest country in the world to ban this kind of discrimination…” (Suri, 4/12).

The Guardian: India takes flawed first step towards ending HIV and AIDS prejudice
“A landmark law banning discrimination against people living with HIV in India has sparked criticism, with one lawyer claiming the legislation could turn back the clock on tackling the virus to the mid-1990s. … [T]here has been opposition to a requirement that all state governments must establish an ombudsman to investigate violations of the new law, while a stipulation that the government must provide free treatment ‘as far as possible’ has also met with resistance…” (Dhillon, 4/13).

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Cholera Cases In Somalia Expected To Double To 50K By Summer, WHO Says, Warning Case Fatality Rate Above 2%

Associated Press: Somalia’s cholera outbreak at more than 25,000 cases: WHO
“The World Health Organization says a cholera outbreak in Somalia has grown to more than 25,000 cases this year alone and is expected to double by the end of June. WHO spokesman Tarik Jasarevic said Thursday that the outbreak has killed 524 people so far this year…” (4/14).

International Business Times: Cholera spreading in drought-hit Somalia as WHO projects 50,000 cases by summer
“…Somalia is already facing the ‘largest humanitarian crisis in history of the United Nations,’ as millions are at risk of starvation and famine across the Horn of Africa, Nigeria, and Yemen, due to lack of rain and prolonged insecurity…” (Buchanan, 4/13).

Reuters: Cholera spreading in Somalia, 50,000 cases foreseen: WHO
“…Already 25,424 infected people have been identified since the start of the year, WHO spokesman Tarik Jasarevic said by email, adding: ‘These numbers are projected to increase to 50,000 by summer.’ The case fatality rate for the disease, spread by contaminated food or water, is already 2.1 percent in Somalia, twice the emergency threshold, he said…” (Nebehay, 4/13).

VOA News: U.N.: Cholera Spreading in Drought-stricken Somalia
“…The United Nations reports 6.2 million people, more than half of Somalia’s population, urgently need humanitarian assistance. Of these, 2.9 million are suffering from extreme hunger…” (Schlein, 4/13).

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Vaccination Campaign Underway In Nigeria To Curb Meningitis Outbreak; 489 Reported Deaths So Far, WHO Says

CNN: Vaccinations underway as meningitis kills hundreds in Nigeria
“A meningitis outbreak has killed 489 people in Nigeria this year, the World Health Organization said Thursday. The country’s Center for Disease Control reported 4,637 suspected cases. … The WHO also said that a vaccination campaign organized by the International Coordinating Group on Vaccine Provision is underway in Nigeria…” (Busari, 4/13).

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Editorials and Opinions

Editorials Denounce U.S. Decision To Withhold UNFPA Funding

The Lancet: Defunding the UNFPA: sign of the times
Editorial Board

“…The removal of support [for UNFPA] is a blow to an agency that ensures access to contraception and maternal and child health services, and fights against gender violence, child marriage, and female genital mutilation in more than 150 countries worldwide. … But the current U.S. administration’s invocation of Kemp-Kasten and its broadening of the related global gag rule appear to be a more direct attack on women’s lives and rights. … In fact, the dismay over the UNFPA defunding masks the depressing reality of the low-level and priority of health funding for women. … To follow the U.S. lead would send a message that the world does not care for women. Other countries should stridently reject this misogyny and harken support for UNFPA to continue its essential work” (4/15).

Los Angeles Times: Stop playing political football with humanitarian funding for women and children
Editorial Board

“…[T]he U.S. decided recently to pull all of its funding for the [UNFPA] — a foolhardy and unnecessary move. The State Department invoked the Kemp-Kasten Amendment of 1985, which bars U.S. aid to any organization that the president determines supports or participates in coercive abortion or involuntary sterilization. … The U.S. rightly denounces China’s forced ‘family planning’ practices as violations of human rights. … Not only does the [UNFPA] decry such practices, it has called on China to dismantle its coercive family planning program. … Besides, none of the money the U.S. gives to the U.N. fund is allowed to be spent in China, for exactly this reason. Nor is any money from any contributor spent on elective abortions anywhere. … What’s happening is part of an ongoing battle in which the agency has been used as a political football. Since 1985, Republican administrations have invoked Kemp-Kasten to withdraw funding — or part of it — and then Democratic administrations have read the law differently and restored the funding. … There are plenty of ways for the U.S. to set funding restrictions on American dollars — without slashing away all funding from organizations working in desperately poor, badly underserved and conflict-torn areas of the world” (4/14).

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U.S. Congress Should Continue To Support, Fully Fund PEPFAR To Reach AIDS-Free Generation Goal

Minneapolis Star Tribune: Keep fighting AIDS ‘until the job is done’
Editorial Board

“…PEPFAR is now in the budget cross hairs of the young Trump administration. The president’s so-called ‘skinny budget’ proposal for [FY 2018] recommends dramatic cuts to medical research, health and human services programs, and the State Department, among other areas. While many observers initially thought the administration had spared PEPFAR, closer scrutiny of its ‘reduction options’ reveals a recommended cut of [around $300] million. The PEPFAR reductions have not been enacted because Congress has yet to pass a 2017 budget. But PEPFAR’s inclusion in the administration’s ‘reduction options’ suggests a potential retreat from the nation’s role in leading the global fight against AIDS. That’s deeply troubling. … Former President [George W.] Bush … recently wrote a commentary for the Washington Post urging Congress to fully fund the program. … Bush’s defense of this remarkable humanitarian program is welcome. He’s exactly right in saying that: ‘We are on the verge of an AIDS-free generation, but the people of Africa still need our help.’ Americans should take the former president’s advice and ‘keep going until the job is done'” (4/13).

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Cutting U.S. Foreign Aid 'Counterproductive' To U.S. Interests Overseas

Washington Post: The amorality and stupidity of eviscerating foreign-aid spending
Jennifer Rubin, columnist for the Washington Post

“…If [President Trump] is willing to use military power to achieve ends that enhance U.S. standing in the world, why not expend many fewer dollars to stem or prevent humanitarian disasters and political and economic collapse elsewhere? Perhaps he and his neophyte advisers are under the impression that government monies are unnecessary so long as there are private philanthropic sources. Well, take it from Melinda Gates, who along with her husband sits atop the world’s largest foundation and describes how aid has transformed one country by, among other things, expanding access to contraception. … Gates is particularly concerned with cuts in assistance to family planning under the recently restored Mexico City policy, but her point is a broader one. No private foundation can match the resources of the U.S. government. No military maneuver could have been as effective in developing a pro-Western, peaceful country [like Indonesia, which used foreign aid to implement a successful family planning program]. Since this seems to be the week in which Trump throws policy after policy overboard, perhaps he can dispense with cuts to foreign aid. No single action would be more counterproductive to U.S. international interests and security than cutting foreign aid” (4/13).

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U.S. System Of Public Health Emergency Response Is 'Highly Decentralized,' Needs Leadership

Washington Post: Letters to the Editor: In case of epidemic: Get organized
Allan R. Glass, physician in Bethesda, MD

“The April 9 news article ‘Trump team ill-prepared for pandemic’ focused on the impact of vacancies in the offices of high-level federal officials, but such federal officials have very limited real authority in pandemic situations because of our highly decentralized system of public health emergency response. Governors, acting through their state and local public health directors, have the real authority to take action during pandemics. The role of the federal government is primarily to offer advice and assistance when state and local health officials request it, and, not surprisingly, there is a widespread lack of uniformity of policies and procedures among state health departments. … When it comes to pandemic response, the key question is not so much who occupies a particular office but rather a more prosaic concern that has bedeviled us for decades: Who has the authority to take charge and direct others to take action?” (4/13).

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From the Global Health Policy Community

Proposed Cuts To U.S. Foreign Assistance For Global Health Requires Other Nations, NGOs, Private Sector To Take 'Leadership In International Aid'

PLOS Blogs’ “Your Say”: Trump wants deep cuts to international aid: the uncalculated costs of global health insecurity
Ana Rita Sequeira, lecturer and researcher at Murdoch University, discusses the potential implications of proposed cuts in the U.S. foreign aid budget for global health, writing, “If approved by the Congress, [President] Trump’s first budget proposal is a game-changer by lowering the global response to finance basic health care in the developing world, and reducing the global disease surveillance systems. These new changes demand a new architecture and leadership in international aid, whether that calls for an action from a block of countries (leading E.U. countries and South-South Cooperation), to charities and foundations like Bill & Melinda Gates, or public and private partnership, or all together” (4/12).

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FT Health Discusses U.N.'s Role In Haiti Cholera Epidemic, Interviews WHO DG Candidate Tedros Adhanom Ghebreyesus

FT Health: Taking responsibility
The latest issue of the Financial Times’ weekly global health newsletter discusses the U.N.’s role in spreading cholera in Haiti and speaks with Tedros Adhanom Ghebreyesus, candidate for WHO director general, about his qualifications to run the agency and priorities if elected. The newsletter also provides a roundup of global health-related news stories (Jack/Dodd, 4/13).

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