KFF Daily Global Health Policy Report

In The News

Number Of Ebola Deaths Reaches 1,350 In West Africa, WHO Says

News outlets report on new WHO estimates on the number of deaths recorded in the West African Ebola outbreak and ask researchers and aid workers about the potential for underestimating the case numbers.

Associated Press: WHO: West Africa Ebola death toll rises to 1,350
“The World Health Organization says the death toll from the Ebola outbreak in West Africa is now at least 1,350 people…” (8/20).

Reuters: Death toll from Ebola outbreak in West Africa rises to 1,350
“The death toll from the Ebola outbreak in West Africa has risen to 1,350, the World Health Organization said on Wednesday, with 106 new deaths reported between August 17-18 in three countries…” (Farge, 8/20).

NPR: How Much Bigger Is The Ebola Outbreak Than Official Reports Show?
“…[T]he WHO has previously warned that its official figures may ‘vastly underestimate the magnitude of the outbreak.’ … So how bad is it really? That’s the question NPR put to several people who have been carefully watching the outbreak…” (Greenfieldboyce, 8/21).

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U.N. Coordinator On Ebola Begins West Africa Trip To Address Outbreak Response

News outlets report on David Nabarro, the U.N. system coordinator on Ebola, who is traveling to West Africa this week to address issues surrounding the outbreak.

Agence France-Presse: U.N. Ebola czar visits West Africa after violent clashes
“The U.N.’s new pointman on Ebola was due to arrive in West Africa on Thursday for a visit aimed at shoring up health services in the region where at least 1,350 lives have been lost to the virus. … [David] Nabarro will travel to Monrovia, Freetown, Conakry, and Abuja as part of his overall mission to coordinate the global response to the worst-ever outbreak of Ebola…” (Dosso/Bah, 8/21).

U.N. News Centre: U.N. System Coordinator on Ebola dispels myths, pledges support for West Africa’s efforts to halt outbreak
“…Speaking to the U.N. News Centre before heading out on his first mission to West Africa, Dr. Nabarro, tasked with ensuring that the U.N. system makes an effective, coordinated contribution to the global effort to control the outbreak, touched on some critical issues — strengthening the health sectors in the affected countries, ensuring protection for frontline health workers, and tackling fear and stigma associated with Ebola — that the region’s governments, with the support of the United Nations family, will be grappling with in the coming days and weeks…” (8/20).

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Police, Soldiers Use Tear Gas, Live Rounds To Enforce Ebola Quarantine In Liberian Neighborhood

News outlets report on the situation in Liberia, where quarantines have been instituted to try to stem the spread of Ebola.

Associated Press: Liberian slums barricaded as Ebola sets new record
“Riot police and soldiers acting on their president’s orders used scrap wood and barbed wire to seal off 50,000 people inside their Liberian slum Wednesday, trying to contain the Ebola outbreak that has killed 1,350 people and counting across West Africa…” (Paye-Layleh/Williams, 8/20).

New York Times: Clashes Erupt as Liberia Sets an Ebola Quarantine
“…Fighting Ebola in an urban area — particularly in a neighborhood like this one, known as West Point, an extremely poor and often violent place that still bears deep scars from Liberia’s 14 years of civil war — presents challenges that the government and international aid organizations have only started grappling with…” (Onishi, 8/20).

NPR: Reporting On Ebola: An Abandoned 10-Year-Old, A Nervous Neighborhood
“…The neighborhood is called West Point and it’s where a holding center for patients suspected of having Ebola was attacked over the weekend. Patients fled, and looters carried off bloody mattresses and other possibly infected supplies. The NPR team in Liberia visited West Point on Tuesday. We spoke to correspondent Nurith Aizenman about the experience…” (Silver, 8/20).

Reuters: Liberia police fire on protesters as West Africa’s Ebola toll hits 1,350
“Police in the Liberian capital fired live rounds and tear gas on Wednesday to disperse a stone-throwing crowd trying to break an Ebola quarantine imposed on their neighborhood, as the death toll from the epidemic in West Africa hit 1,350…” (MacDougall/Harding Giahyue, 8/21).

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Experts Sent To Investigate Reports Of Ebola-Like Illnesses In Northern DRC Province

News outlets report on several reports of Ebola-like illness in Democratic Republic of Congo (DRC).

The Hill: Report: Potential signs of Ebola virus in Congo
“The Democratic Republic of Congo is investigating potential evidence of the Ebola virus there, a sign that the deadly illness may have spread to a fifth country…” (Viebeck, 8/20).

Reuters: Illness with Ebola-like symptoms kills several in Congo: locals
“Democratic Republic of Congo has sent its health minister and a team of experts to the remote northern Equateur province after several people died there from a disease with Ebola-like symptoms, a local official and a professor said on Wednesday…” (8/20).

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U.S. Records 68 Ebola Investigations; American Doctor Recovers From Disease, To Be Released From Hospital

News outlets report on how U.S. health care facilities are handling Ebola scares and the status of an American physician who recovered from the disease.

ABC News: U.S. Hospitals Have Had 68 Ebola Scares, CDC Says
“American hospitals and state labs have handled at least 68 Ebola scares over the last three weeks, according to the U.S. Centers for Disease Control and Prevention. Hospitals in 27 states alerted the CDC of the possible Ebola cases out of an abundance of caution amid the growing outbreak in Guinea, Liberia and Sierra Leone…” (Lupkin, 8/20).

Reuters: U.S. hospital to discharge doctor treated with experimental Ebola drug
“An American doctor who contracted Ebola treating victims of the deadly virus in Liberia has recovered and will be discharged on Thursday by the U.S. hospital that treated him with an experimental drug, his charity said. Kent Brantly was given ZMapp, a drug used on a handful of patients in the West African outbreak and produced by U.S.-based Mapp Biopharmaceutical…” (Bavier, 8/21).

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U.K., Wellcome Trust Offer $10.8M For Ebola Research, As Scientists Say 30K Would Need Treatment

News outlets report on treatment and prevention research issues surrounding Ebola.

Reuters: U.K. and Wellcome offer $10 million for emergency Ebola research
“An emergency research call has been launched to help fight the world’s worst Ebola outbreak in West Africa, with the British government and the Wellcome Trust medical charity pledging a combined 6.5 million pounds ($10.8 million)…” (Hirschler, 8/20).

Deutsche Welle: Ebola: researchers now know how many doses we need of a vaccine that’s yet to exist
“A team of researchers from the University of Oxford have calculated the amount of medicine needed to fight the current outbreak of the Ebola virus in Western Africa…” (Schmidt, 8/21).

The Hill: Researchers: 30K need Ebola drugs to contain outbreak
“British scientists say production of experimental Ebola drugs and vaccines must be ramped up, estimating that at least 30,000 people need access to medications to stop the current outbreak…” (Al-Faruque, 8/20).

Reuters: Experimental Ebola drugs needed for ‘up to 30,000 people’
“…The World Health Organization (WHO) is hoping for improved supplies of experimental treatments and progress with a vaccine by the end of the year, after last week backing the use of untested drugs and vaccines…” (Hirschler, 8/20).

New York Times: Experimental Drug Used for Ebola-Related Virus Shows Promise
“An experimental drug has completely protected monkeys from lethal doses of a virus related to Ebola, bolstering confidence that a similar medicine might be effective if deployed in the current outbreak in Africa, researchers reported on Wednesday…” (Pollack, 8/20).

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NPR Interviews MSF President About Ebola Outbreak, Response

NPR: Doctors Without Borders: What We Need To Contain Ebola
“…In an interview on All Things Considered, MSF’s international president, Dr. Joanne Liu, tells NPR’s Audie Cornish that they opened a new Ebola care center in Monrovia, Liberia, this weekend. It was equipped with 120 beds, and ‘all the beds got filled in one day.’ … Liu says that caring for patients is only one of the three ‘pillars’ for controlling the Ebola outbreak. The other two are tracing possible Ebola cases and educating the community…” (8/19).

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Humanitarian Airlift To Northern Iraq Begins, U.N. Agency Says

News outlets report on the U.N.’s humanitarian airlift to northern Iraq that began on Wednesday.

Reuters: Aid airlift to northern Iraq has started, U.N. says
“A humanitarian airlift to northern Iraq began on Wednesday, kicking off a 10-day operation to provide tents and other aid to half a million displaced people who are struggling for survival, the United Nations’ refugee agency UNHCR said…” (8/20).

U.N. News Centre: Iraq: major relief effort underway in north as U.N. envoy warns against targeting of Sunnis in south
“A United Nations refugee agency cargo jet carrying 100 tons of emergency relief supplies landed at Erbil in Iraq’s Kurdistan region [Wednesday] ‘in the largest single aid push’ in more than a decade, as the top U.N. official in the country warned against increased targeting of Sunni minorities in the south…” (8/20).

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G20 Countries Account For 'Lion's Share' Of NTDs, Expert Says

The Guardian: Wealthier countries home to ‘lion’s share’ of neglected tropical diseases
“The international community needs to stop looking at neglected tropical diseases (NTDs) as a sub-Saharan African problem and realize that the G20 countries are now home to the ‘lion’s share’ of the dangerous, debilitating, yet low-profile illnesses, a U.S. expert has warned…” (Jones, 8/21).

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Anti-Polio Campaign Faces Challenges As Conflict Escalates In Afghanistan

Reuters: Amid Afghanistan’s escalating war, a battle to beat polio
“Tens of thousands of volunteers fanned out across Afghanistan this week, braving deteriorating security and distrusting parents to administer two chilled drops of the oral polio vaccine each to millions of children…” (Mahr/Harooni, 8/21).

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Ethiopia Hosts Largest Number Of Refugees In Africa; U.N. Camp Conditions Inhumane, MSF Says

The Guardian reports on the refugee crisis due to conflict in South Sudan, including Ethiopia’s soaring refugee population and allegedly inhumane U.N. camp conditions.

The Guardian: Ethiopia hosts largest number of refugees in Africa
“Ethiopia has overtaken Kenya to become Africa’s largest refugee-hosting country after hundreds of thousands of South Sudanese arrived in the country this year. The total refugee population has reached almost 630,000, raising concerns that its capacity to help displaced people may be overstretched…” (Anderson, 8/20).

The Guardian: Conditions at U.N.’s South Sudan camp inhumane, says MSF
“The 40,000 people sheltering from South Sudan’s civil war in a flooded and crowded U.N. camp are enduring conditions ‘barely compatible with life and incompatible with human dignity,’ and must be helped before disease and danger force them back into the conflict zone, Médecins Sans Frontières (MSF) has warned…” (Jones, 8/21).

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Despite Anti-Child Marriage Law, India Home To One In Three Child Brides Globally

Inter Press Service: India: Home to One in Three Child Brides
“…A recent United Nations report entitled ‘Ending Child Marriage — Progress and Prospects’ found that, despite the existence of a stringent anti-child marriage law, India ranks sixth among countries with the highest prevalence of child marriages across the globe…” (Lal, 8/20).

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Seals Brought TB To Americas, Study Says

News outlets report on a study published in Nature that suggests seals and sea lions brought tuberculosis (TB) to the Americas.

Nature: Seals brought TB to Americas
“Ancient bacterial genome sequences collected from human remains in Peru suggest that seals first gave tuberculosis (TB) to humans in the Americas…” (Skinner, 8/20).

New York Times: Tuberculosis Is Newer Than Thought, Study Says
“After a remarkable analysis of bacterial DNA from 1,000-year-old mummies, scientists have proposed a new hypothesis for how tuberculosis arose and spread around the world. The disease originated less than 6,000 years ago in Africa, they say, and took a surprising route to reach the New World: It was carried across the Atlantic by seals…” (Zimmer, 8/20).

Washington Post: Tuberculosis first came to the Americas by jumping from seals to humans
“The origin of tuberculosis (TB) in the Americas is no longer a mystery — the seals and sea lions gave it to us. The oldest strains have since given way to our current variety, which comes from Europe. But until the Americas made contact with Europe, a study published Wednesday in Nature reports, our ancestors suffered from a fishier ailment…” (Feltman, 8/20).

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Editorials and Opinions

NEJM Perspective Pieces Discuss Responses To West African Ebola Outbreak

The New England Journal of Medicine (NEJM) on Wednesday published several perspective pieces discussing the ongoing Ebola outbreak.

NEJM: The International Ebola Emergency
Sylvie Briand, director of the pandemic and epidemic diseases department (PED) at the WHO, and WHO colleagues

“…These observations [about the Ebola outbreak] point to immediate priorities for control: early diagnosis with patient isolation, contact tracing, strict adherence to biosafety guidelines in laboratories, barrier nursing procedures and use of personal protective equipment by all health care workers, disinfection of contaminated objects and areas, and safe burials. … These recommended control methods are, of course, more easily recited than implemented. … Above all, we are looking for a sustained decrease in incidence, from week to week and district by district, with no sign of further geographic spread. In the coming days and weeks, that will be our primary measure of success in preventing infections and saving lives” (8/20).

NEJM: Ebola Virus Disease in West Africa — No Early End to the Outbreak
Margaret Chan, WHO director general

“Many people have asked me why the outbreak of Ebola virus disease in West Africa is so large, so severe, and so difficult to contain. These questions can be answered with a single word: poverty. … Experience tells us that Ebola outbreaks can be contained, even without a vaccine or cure. Nonetheless, with the formidable combination of poverty, dysfunctional health systems, and fear at work, no one is talking about an early end to the outbreak. The international community will need to gear up for many more months of massive, coordinated, and targeted assistance. A humane world cannot let the people of West Africa suffer on such an extraordinary scale” (8/20).

NEJM: Ebola 2014 — New Challenges, New Global Response and Responsibility
Thomas Frieden, CDC director, and CDC colleagues

“…The Centers for Disease Control and Prevention (CDC) is working intensively with partners to help stop the outbreak at its source in Africa. … In addition to acting to stop this outbreak, we should put systems in place to prevent another one. Earlier this year, the United States joined partner governments, the World Health Organization, and other multilateral organizations and nongovernmental actors to launch the Global Health Security Agenda, which aims to better protect all people from health threats. … The Global Health Security Agenda aims to strengthen public health systems in countries that need it most in order to stop outbreaks before they become emergencies…” (8/20).

NEJM: Studying ‘Secret Serums’ — Toward Safe, Effective Ebola Treatments
Jesse Goodman of Georgetown University and the Veterans Affairs Medical Center

“…As we move forward, quickly but cautiously, in using and testing new therapies, we have already learned some lessons from this outbreak — regarding the need to build trust, the need to enhance public understanding of experimental treatments and their safe evaluation, and the critical nature of the capacity both for public health intervention and to ethically field clinical studies under challenging conditions. When it comes to infectious diseases, we are increasingly one world and dependent on each other for knowledge, safety, and security” (8/20).

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Ebola Response Must Incorporate Gender Lens

Foreign Policy: Why Are So Many Women Dying From Ebola?
Lauren Wolfe, journalist and director of Women Under Siege

“Sitting in her house in Massachusetts, [Martha Anker, a former statistician in communicable disease surveillance and response at the WHO,] had a gut feeling: that Ebola, as it had in the past, would claim women as its primary victims. … It shouldn’t take so many deaths — more than 1,200 at the time of this writing — to realize how attention to gender dynamics might help save lives. … With so many dying in West Africa, there is an opportunity to go against the grain, to try to incorporate a much-needed gender lens into medical and social responses. Now is the time to do it — just like it was in the last crisis” (8/20).

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Ending Hunger Is 'Feasible Objective' In This Lifetime

Thomson Reuters Foundation: How to dramatically reduce hunger — even in very poor countries
José Graziano da Silva, director general of the U.N. Food and Agriculture Organization (FAO)

“…The international community has an important role to play in enabling and supporting national efforts — in the identification and evaluation of policy options, in the design of effective social protection, trade policy assessment, and vulnerability and resilience analysis, as well as in developing measures to improve agricultural productivity and sustainability. This seems like a demanding agenda, but as country after country has demonstrated, ending hunger in our lifetimes is no longer a dream, but a feasible objective for all countries…” (8/20).

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Commitment To Security Of Health Workers In Nigeria Needed To Deliver Necessary Care

Huffington Post: Health Care Workers Need Security in Northern Nigeria
Toyin Ojora-Saraki, founder-president of the Wellbeing Foundation Africa

“Access is already one of Africa’s biggest health care provision challenges, and the militant insurgency in the north of Nigeria is adding a layer of difficulty and hampering potential progress. … The insurgency is having massively detrimental effects on the lives of families in the northern states of Nigeria. There is no simple solution, but in order to deliver necessary health care, there needs to be a commitment to security for health professionals. Ensuring governance, rebuilding education systems, and resettling internally displaced peoples will take time. However, in the short term, we need to heighten security to get health care workers to the people that need access to health care…” (8/20).

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From the Global Health Policy Community

Indonesia Hosting Global Health Security Agenda Meeting

CDC’s “Our Global Voices”: Indonesia Takes a Leadership Position in the Global Health Security Agenda
William Hawley, country director for CDC-Indonesia, writes, “… As one of the early countries to take a leadership role in the Global Health Security (GHS) Agenda, the Government of Indonesia will welcome senior health and agricultural leaders from 36 countries and 12 international organizations for the next commitment meeting August 20-21. The meeting, ‘Building Global Commitment to Multisectoral Approaches to Manage Emerging Zoonotic Diseases in Support of the Global Health Security Agenda within the Framework of Public Health,’ demonstrates the progress and growing momentum of the GHS Agenda…” (8/20).

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Ebola Outbreak Highlights Gaps In Access To Care

Cognoscenti: Ebola And The Gap Between The Haves And Have-Nots In Global Health
Catherine Womack, a philosophy professor at Bridgewater State University, discusses how the Ebola outbreak shows the impact of access gaps in global health and the “need to help repair and build improved trust between the global health haves and have-nots through government aid to the stricken countries, and transparency in the ways that aid is determined and distributed” (8/20).

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Experts Discuss Use Of New TB Drug Bedaquiline

Global Health Technologies Coalition’s “Breakthroughs”: New TB drug bedaquiline: Weighing the benefits against the risks
The blog interviews Laia Ruiz Mingote and Dorothy Namutamba, co-chairs of the Community Research Advisors Group (CRAG), and Mike Watson Frick, the TB/HIV program officer at the Treatment Action Group, about the benefits and risks of using the new drug bedaquiline to treat TB (Chmiola, 8/20).

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