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Kaiser Daily Global Health Policy Report

In The News

Devex Examines USAID's 'Extreme Poverty Agenda'

“USAID is working to align its programs with President Barack Obama’s call to help eliminate extreme poverty by 2030. But some agency staff and partners are losing their patience over the administration’s ever-expanding list of development and health initiatives and the metrics that accompany them,” Devex reports. The news service examines whether the agency’s “‘extreme poverty agenda’ amount[s] to an entirely new initiative — or is rather a repackaging of work the agency is already doing.” Devex, which includes comments from Alex Thier, assistant to the administrator for policy, planning and learning at USAID, writes, “Officials have been trying to clarify — both internally and publicly — how the extreme poverty agenda fits in with other USAID priorities like Power Africa, food security, global health, climate change and resilience, and how they can ensure the various goals don’t take energy and resources away from each other” (Igoe, 12/12).

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IPS Looks At NGO Effort Urging Obama Administration To Clarify Helms Amendment In Cases Of Post-Rape Abortion

Inter Press Service reports on how a group of U.S. and African non-governmental organizations (NGOs) has launched a campaign, called “Break the Barriers,” “to step up pressure on the Obama administration to support and allow access to safe abortion services for the millions of women and girls who face sexual violence in areas plagued by conflict.” According to advocates, the Helms Amendment — which prohibits the use of foreign assistance to pay for the performance of abortion as a method of family planning or to motivate or coerce any person to practice abortion — “has been interpreted by U.S. government agencies, including [USAID], to include post-rape abortions, despite the fact that the text only refers to [abortions performed for] family planning purposes,” IPS notes (Srour, 12/12). The campaign is asking the administration to clarify the interpretation of the Helms Amendment with regard to “cases of rape, incest or life endangerment,” according to the Miami Herald (Charles, 12/12).

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Health Groups Launch Initiative To Stop Violence Against Aid Workers In Conflict Zones

“Several medical associations and non-governmental organizations have launched an initiative to tackle violence against aid workers in conflict zones,” The Lancet reports. The International Committee of the Red Cross (ICRC), “along with key players in global health such as the World Medical Association (WMA), the British Medical Association (BMA), and Médecins Sans Frontières (MSF), is spearheading a project called Healthcare in Danger to raise awareness of the way that medical workers in war zones are targeted,” the journal writes. “Providing health care in conflict zones is obviously inherently dangerous,” the journal notes. The Lancet examines underlying motivations behind the violence and what can be done to protect humanitarian workers in war zones (Shetty, 12/14).

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Tobacco Companies Using Legal Strategies To Block Regulation In Developing Countries

“Tobacco companies are pushing back against a worldwide rise in antismoking laws, using a little-noticed legal strategy to delay or block regulation,” the New York Times reports. The strategy “has gained momentum in recent years as smoking rates in rich countries have fallen and tobacco companies have sought to maintain access to fast-growing markets in developing countries,” the newspaper states. “The industry is warning countries that their tobacco laws violate an expanding web of trade and investment treaties, raising the prospect of costly, prolonged legal battles, health advocates and officials said,” the newspaper writes, adding, “Industry officials say that there are only a few cases of active litigation, and that giving a legal opinion to governments is routine for major players whose interests will be affected.”

“But tobacco opponents say the strategy is intimidating low- and middle-income countries from tackling one of the gravest health threats facing them: smoking,” according to the New York Times. “They also say the legal tactics are undermining the world’s largest global public health treaty, the WHO Framework Convention on Tobacco Control, which aims to reduce smoking by encouraging limits on advertising, packaging and sale of tobacco products,” the newspaper writes, discusses global smoking trends and examines how this legal strategy has affected a number of countries (Tavernise, 12/13).

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Proactive Health Care Model Reduces Child Mortality In Mali, Study Shows

“The mortality rate among children under age five living in Yirimadjo, Mali, southeast of the capital, Bamako, decreased by nearly tenfold over three years after the Malian Ministry of Health and NGOs Tostan and Muso introduced a new health care model: proactively seeking out patients and treating them early,” IRIN reports. “A study on the program, by researchers from Harvard Medical School and the University of California San Francisco (UCSF), published this week in PLOS ONE found under-five mortality dropped from 155 deaths per 1,000 children to 17 deaths per 1,000,” according to the news service. The program “focused the health care redesign on ‘ultra-rapid access’ to care and prevention services,” including education programs, and “involved removing user fees for those who cannot afford to pay,” IRIN notes.

“All parties involved in the intervention said it is important to note that there are limitations to the study,” IRIN writes. “Most notably, there was no control group, and without that, researchers say it is impossible to attribute the drop in child mortality solely to the intervention,” the news service states, adding, “Other factors, such as demographic changes, including immigration, could have affected the decrease.” According to IRIN, “Researchers say they are now planning a follow-up to further characterize the role of each element of the intervention in reducing child mortality” (12/13).

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Report Examines Philanthropic Aid For HIV/AIDS Initiatives In LMICs

“Philanthropic support for HIV/AIDS initiatives in low- and middle-income countries in 2012 totaled $500 million, or 5.4 percent of total international funding, a report from Funders Concerned About AIDS finds,” Philanthropy News Digest reports. “Produced with support from UNAIDS, the report [.pdf], ‘Global Philanthropic Support to Address HIV/AIDS in 2012,’ found that philanthropic funding to address HIV/AIDS was essentially flat — increasing less than one percent — on a year-over-year basis and has remained at roughly the same level since 2007,” the news service writes (12/12). This slight increase “is largely due to the addition of 40 funders, new to the report, based outside of the U.S. and Western & Central Europe,” according to the report summary (December 2013).

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Critics Question How Chinese Provinces Use One-Child Policy Fines

“Recent revelations about the huge amounts paid by families who violate China’s one-child policy have raised questions about just how the money is spent and spurred calls to ban the fines,” the New York Times’ “Sinosphere” blog reports. “Chinese provinces have begun disclosing the amounts they received last year in fines after a lawyer opposed to China’s family planning policies formally requested the tallies in July,” the blog writes, adding, “The 24 provinces, regions and provincial-level cities that have reported so far say they took in 20 billion renminbi, or about $3.29 billion, last year. Another seven provinces have yet to respond.” The blog examines how the money is spent and states, “The critics say that making public the amount collected in fines is an important first step, but that the fines must eventually be scrapped” (Ramzy/Li, 12/12).

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Aid Workers Warn Of Worsening Humanitarian Crisis In CAR

“Aid workers warned Thursday of a looming humanitarian crisis in the Central African capital as tens of thousands of residents desperate for protection slept rough near a French army base in Bangui,” Agence France-Presse reports. “But as some districts of the capital returned to a semblance of normality,” following the deployment of French troops “last week to prop up an African peacekeeping force and start disarming fighters,” “the focus shifted to conditions in insalubrious makeshift camps, with humanitarian workers raising fears of cholera and other diseases spreading,” the news agency writes. “To make matters worse, U.N. aid agencies have not delivered any food supplies to the camp for the last week, a humanitarian official said, speaking on condition of anonymity,” the news service notes, adding, “[Médecins Sans Frontières (MSF)] called on the United Nations to do more to address the crisis” (12/12).

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Mail & Guardian Highlights Mandela's Evolution As AIDS Activist

The Mail & Guardian examines Nelson Mandela’s evolution as an AIDS activist, writing, “After stepping down as president, Mandela openly regretted not doing more about the pandemic, but also about the lack of time to do so.” The newspaper adds, “The South African Press Agency reported that he said: ‘It’s no use crying over spilt milk … I had no time … I had to concern myself with nation-building.'” The newspaper examines Mandela’s public speeches on HIV/AIDS, and includes comments from Mark Heywood, head of the advocacy group Section27, and Constitutional Court judge and HIV advocate Edwin Cameron (Malan, 12/13).

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Cell Phones Helping To Track Malaria In Africa, Marketplace Reports

Noting the WHO on Wednesday released its 2013 World Malaria Report, Marketplace examines how an epidemiologist at Harvard is using cell phones to track the disease in Africa by “plotting malaria cases on a map and then overlaying data showing where people are moving, which helps make better predictions about where the disease might go next.” The news service writes, “‘The challenges are the very poorest populations, and that the density of cell towers determines how high a resolution you can get your estimates,’ Buckee says. ‘So, in some of the most rural and underserved populations, we have the hardest time'” (Johnson, 12/11).

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The Guardian Interviews 12 Girl Leaders About Health, Development Efforts

The Guardian’s “Adolescent Girls Hub” interviews 12 girl leaders under age 20 about their efforts “to campaign to reduce illiteracy, sexual harassment or teenage pregnancy in [their] own communit[ies] and why is it so important that the voices of girls are heard” (Leach/O’Neill, 12/12).

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Editorials and Opinions

Voices Of Women, Youth Must Be Included In Post-2015 Development Goals

Noting the Millennium Development Goals (MDGs) expire in 2015, Dawn Laguens, executive vice president of the Planned Parenthood Action Fund and the Planned Parenthood Federation of America, writes in the Huffington Post’s “Politics” blog that “leaders and advocates from across the [U.S. are speaking] up to ensure that the health and rights of women and young people take center stage in the setting of new goals.” She highlights comments made at several events nationwide during which people were able “to weigh in on what issues the U.N. and all nations should prioritize to improve the state of our health, lives, and planet.” She concludes, “We must [continue to] make our voices heard to ensure that the health and rights of women and young people get the focus they deserve, at home and abroad, as the global community decides how best to allocate attention and resources” (12/12).

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Break Down Foreign Assistance Myths To Build Local Capacity

“So much is written and said about foreign aid that it has become difficult to contribute meaningfully to the debate about whether it is effective. But if we are charting our fates as citizens of a crowded, fragile planet, then any honest assessment must conclude that progress has been made, whether in terms of child survival or literacy or access to basic sanitation,” anthropologist and physician Paul Farmer, a professor at Harvard University, writes in a Foreign Affairs opinion piece. However, “[m]yths and mystifications about aid persist. Whether we speak of feedback loops or best practices — or, perhaps, simply better practices — we have a long way to go,” he writes, continuing, “But the aspiration to improve the lives of those living in extreme poverty through better public health, public education, and public works by definition requires public-sector capacity.”

“Given how little aid is delivered in a manner that could durably build local capacity in fragile settings and extreme poverty — the raison d’être of official development assistance — we see the trap in which we’re stuck. In order to free ourselves from it, we must begin by confronting the myths surrounding foreign aid,” Farmer writes and presents several myths, including “that foreign aid doesn’t work.” He discusses aid programs in Haiti and Rwanda as examples, and he provides five recommendations “[t]o help other nations make … progress to reduce extreme poverty.” Farmer concludes, “Only the power of public systems can provide health care, clean drinking water, education, and the multitude of other services all societies require to reap the benefits of modernity and escape the shackles of entrenched poverty. None of these proposals is easy. But the rewards awaiting us at the end are well worth the arduous journey of getting there” (12/12).

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Mandela's Associations With Global Health 'Broad And Deep'

A Lancet editorial reflects on the legacy of Nelson Mandela, who died on December 5 at age 95. “Mandela was such an important figure in the history of the struggle, not only for justice and freedom, but also for the right to health,” the editorial writes. The Lancet quotes a speech Mandela delivered at the Rivonia Trial in April of 1964, in which he discussed the relationship between poverty and disease, and the editorial notes “Mandela’s associations with global health are broad and deep,” highlighting his AIDS work. “With characteristic insight, Mandela also saw that the impact of AIDS on Africa was simply the signal of a larger challenge: one of economic, educational, and political inequality. And he came to embody that challenge.” The editorial concludes, “It is unimaginable that any future history of the global struggle for human health and equity will not hold, in pride of place, the name, and the courage, of Nelson Mandela” (12/14).

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Recent Releases

Partnerships Responsible For Global Progress Against Malaria

Noting the release of the WHO’s 2013 World Malaria Report on Wednesday, retired U.S. Navy Rear Admiral Tim Ziemer, who serves as the U.S. Global Malaria Coordinator, writes in USAID’s “IMPACTblog,” “We celebrate the dramatic progress that has been made in reducing the burden of malaria in sub-Saharan Africa,” which “is due to partnership — of national governments, international donors including the U.S. and U.K., the Global Fund, the World Bank, the private sector, non-governmental and faith-based organizations, local leaders, civil society, philanthropists, and many others” — but “host country governments, the President’s Malaria Initiative (PMI), and the Global Fund deserve special praise for fueling this remarkable progress against malaria.” He continues, “While we celebrate the good news revealed in the WHO World Malaria Report which states that the risk of malaria is declining and more children are surviving, the gains are fragile and could be reversed without continued support” (12/12).

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Dybul Says Partnership Replacing Paternalism In Global Health

“Mark Dybul, executive director of the Global Fund, said the paternalism overshadowing relations between rich countries and poor in global health is giving way to an era of partnership that owes much to the vision of Nelson Mandela,” the Global Fund to Fight AIDS, Tuberculosis and Malaria states in a press release. The press release summarizes Dybul’s closing speech at the 17th International Conference on AIDS and STIs in Africa (ICASA), in which he “paid a rousing tribute to the late South African leader, saying Mandela ‘broke the silence on HIV in Africa and he broke the silence on HIV in the world.'” The press release also describes speeches delivered at the conference by South African Constitutional Court Justice Edwin Cameron and ICASA Chair Robert Soudré (12/11).

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Bill Gates Reflects On Polio Vaccination Efforts In Nigeria

Bill Gates, co-chair of the Bill & Melinda Gates Foundation, writing in a post in the foundation’s “Impatient Optimists” blog, reflects on a recent trip to Nigeria, where he “was able to learn firsthand about how work is going on polio eradication and immunizing kids against preventable diseases.” Gates writes, “There’s a tremendous opportunity now for Nigeria to eradicate polio and it was exciting to meet with many of the government and traditional leaders who are making this progress possible.” He details several meetings and events he attended while in country, writing, “I left Lagos more convinced than ever that Nigeria is on the right track” (12/12).

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Proactive Health Care System Can Save Lives

“What if, instead of waiting for patients to overcome the many obstacles they face to come in for care, health systems were proactive, and went searching for patients door-to-door?” Ari Johnson, a co-founder of Muso and a physician at the University of California San Francisco, asks in the Bill & Melinda Gates Foundation’s “Impatient Optimists” blog. Johnson co-authored a study published this week in PLOS ONE that describes the success of a “partnership between the Malian Ministry of Health and two NGOs, Muso and Tostan.” The model “brings health care proactively into the home and removes fees that patients often cannot afford,” and “includes education, community organizing, and employment opportunities so that community members can overcome conditions of poverty that cause disease,” he writes (12/12).

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'Collective Action' Benefits Nutrition Initiatives

“We are witnessing a pivotal moment for nutrition. Forty-two countries have committed to scaling-up nutrition through the SUN Movement, and this number continues to grow. Governments and donors have pledged billions — $4.15 billion at the Nutrition for Growth event in the U.K. this June,” Manfred Eggersdorfer, a professor at the University Medical Center Groningen and a senior vice president at DSM Nutritional Products, writes in the Global Agriculture Development Initiative’s “Global Food for Thought” blog, adding, “But perhaps the most important development has been a new spirit of collaboration.” He continues, “Collective action is vital because every sector touches nutrition, and nutrition touches every sector.” He discusses how collaborative projects are working to address chronic micronutrient deficiencies (12/12).

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New Issue of 'Global Fund News Flash' Available Online

The Global Fund to Fight AIDS, Tuberculosis and Malaria has published Issue 34 of its newsletter, the “Global Fund News Flash.” The issue focuses on health efforts in South Sudan, where the Global Fund and other partners are supporting the Juba National Health Training Institute “to train people to lead the fight against diseases in the country.” In addition, “the Global Fund and other partners like PSI and BRAC have launched extensive volunteer projects to deliver malaria drugs that protect children,” the issue writes, noting Marion Gleixner, the Global Fund Portfolio Manager for the Middle East and North Africa, “cited the strong spirit of service and broad partnerships as contributing factors to making progress against HIV, TB and malaria” (12/12).

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