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Kaiser Daily Global Health Policy Report

In The News

Two Policemen, Polio Worker Killed In Separate Incidents In Pakistan

“Two policemen and a polio worker were killed by gunmen in separate incidents in restive northwest Pakistan on Friday, officials said,” the Los Angeles Times reports (Ali/Magnier, 12/13). “In the first attack Friday, gunmen opened fire on two officers as they were riding on a motorcycle to the town of Swabi, where they were supposed to protect a polio team during a vaccination drive, according to police officer Khalid Iqbal,” the Associated Press writes, adding, “Hours later, a gunman killed a polio worker on his way home after vaccinating children in Jamrud, a tribal region located on the outskirts of Peshawar” (Khan, 12/13). “No group has claimed responsibility for the attack, but the Taliban oppose the polio vaccination schemes, which they see as a cover for international espionage,” BBC News notes (12/13). “Militants have targeted anti-polio campaigns in Pakistan since U.S. intelligence officials used a fake vaccination program to help in their hunt for Osama bin Laden in 2011,” CNN adds (12/13).

“Opposition party leader Imran Khan condemned the killings in a statement, calling on Khyber Pakhtunkwa leaders to take ‘strong action’ to arrest those responsible and to provide additional security for polio workers,” United Press International writes (12/13). “Pakistan is one of only three countries in the world where the polio virus is still endemic, but efforts to stamp out the crippling disease have been hit by repeated attacks on health teams,” according to DAWN.com (12/13). “The attacks come despite a recent fatwa by a prominent religious scholar, who urged parents to immunize their children against polio and other life-threatening diseases and said vaccinations were compliant with Sharia,” Agence France-Presse/Express Tribune notes (12/13).

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Activists In India React To Supreme Court's Decision To Reinstate Gay Sex Ban

“Human rights have taken a step back in India, activists say after the Supreme Court overturned a ruling of the High Court that had earlier lifted the ban on gay sex,” Inter Press Service reports. “Many people in India, not necessarily from the LGBT community, believe the upholding of Section 377 is a step to once again criminalize the LGBT community, and is a violation of human rights,” the news service writes, examining reactions in the country. “The Supreme Court has placed the onus of changing the existing law on parliament,” IPS notes, adding, “Activists do not hold much hope that parliament will move swiftly when only about five months are left [before] the next general election” (Biswas, 12/13).

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Guardian Examines Access To Abortion Services In Ethiopia

The Guardian examines access to abortion services in Ethiopia, noting, “In 2005, Ethiopia legalized abortion in cases of rape or incest, for all young women under the age of 18, and in a number of other situations. Guidelines from the ministry of health in 2006 went further, expanding the range of health facilities allowed to provide abortion services and instructing health workers that women seeking abortions do not have to provide proof of rape or incest, or of how old they are.” However, “despite having one of the most liberal abortion laws in Africa, progress on expanding access to services has been slow, particularly in rural areas,” the newspaper writes. The Guardian also examines how U.S. law affects foreign assistance for abortion, writing, “While reproductive health issues and efforts to end maternal deaths have risen up the agenda of aid donors, very few are willing to fund abortion” (Provost, 12/16).

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Honorees At USGLC Dinner Discuss U.S. Foreign Affairs Spending

Devex describes the U.S. Global Leadership Coalition’s tribute dinner that took place on December 12 in Washington, D.C. The group this year honored Vice President Joe Biden and Reps. Kay Granger (R-Texas) and Nita Lowey (D-N.Y.), “a Republican and a Democrat who as chairwomen of the House Appropriations Subcommittee on State and Foreign Operations have for years held the purse strings for the so-called 150 account, which covers U.S. foreign affairs spending,” the news service writes and includes comments from all three about “how to convince lawmakers to fund development cooperation” (Rosenkranz, 12/13).

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SciDev.Net Highlights 'Key Aid News Stories From 2013'

SciDev.Net highlights “some of the key aid news stories from 2013.” The selected stories cover a range of topics, “[f]rom measuring the impact of aid and showing its worth, through changing aid practices to boost effectiveness, to filling data gaps and including local knowledge” (12/16).

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Middle East's Snow, Cold Weather Exacerbate Humanitarian Situation For Displaced Syrians

“Already suffering from shortages of food aid, schooling, clean water, sanitation and employment, Syrians displaced inside the country and throughout the region — about nine million people — now must contend with bitter weather that, according to UNICEF, threatens more than 100,000 children living in temporary and often flimsy shelters in Lebanon alone,” the New York Times reports. “While snow is common in Lebanon and parts of Syria, some [in Egypt] saw snow for the first time in their lives and Jerusalem this week recorded the heaviest December snowfall since the 1950s,” the newspaper notes. The New York Times examines conditions at “one of the hundreds of informal, scattered camps that house most of the several hundred thousand Syrians who have fled to Lebanon” (Barnard/Saad/Ghannam, 12/13).

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Nigeria's Kano State Faces Cholera Outbreak

“Ten people in Nigeria’s Kano State have died from cholera and another 300 have been hospitalized with the disease, health officials said,” United Press International reports. “Tijjani Hussein, the deputy director of the state’s ministry of health, said the government is advising residents to rush their family members to the hospital if they are vomiting or have diarrhea,” the news service writes, adding, “He also urged people to practice personal hygiene to prevent the spread of the disease” (12/15).

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NPR Examines Efforts To Eradicate Polio In 2013

“The lowest number of polio cases ever recorded in the world was 223. And 2013 was on track for an even lower number, on the road to complete eradication of the virus,” NPR’s “Shots” blog reports, adding, “But this was a year when polio pushed back. Hard.” The blog examines how “[t]he number of cases in both Afghanistan and Nigeria fell significantly,” but outbreaks plagued Pakistan, the Horn of Africa, and Syria. “So far, billions of dollars have been spent in the eradication drive. The expectation is that it will take billions more to stomp out the last few cases and ensure that polio doesn’t stage a comeback. The challenge now is to sustain the political will for such a massive global campaign all the way to the end,” the blog writes. The blog includes comments from WHO spokesperson Sona Bari; Michael Klag, dean of the Johns Hopkins School of Public Health; and William Muraskin, professor of urban studies at City University of New York. An audio version of the story from “Weekend Edition Sunday” also is available (Beaubien, 12/15).

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Health Advocates Working To Lower Cost Of HCV Medicines In LMICs, Reuters Reports

“A new battle is looming over access to antiviral medicines in developing countries — this time for treating hepatitis C [HCV] — more than a decade after a global showdown over the price of AIDS drugs in Africa,” Reuters reports. “Modern pills being launched in western markets could cure the liver-destroying infection in tens of millions of people from China to Congo, or even eradicate the disease entirely. But that will only happen if the cost falls dramatically,” the news agency writes, adding, “Health care campaigners expect corporate schemes for poorer countries will focus on price discounts in middle- and low-income markets — but they argue this as a poor substitute for full generic competition, which could send prices tumbling” (Hirschler, 12/16).

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VOA Reports On World Bank, Global Fund Results-Based Financing Plan

VOA News reports on how the World Bank is working with the Global Fund to Fight AIDS, Tuberculosis and Malaria to help countries implement results-based financing health care programs, which “provid[e] incentives to direct medical care to patients or get the patient to the clinic.” According to the news agency, “Since 2007, the World Bank has funded results-based programs in 31 countries, enough to see that the program saves lives and stretches donor funds.” VOA adds, “Other major funding groups also are studying the plan. Similar programs might help keep girls in school where they can learn job skills and, at the same time, discourage child marriages and prevent teen pregnancy” (12/12).

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Editorials and Opinions

Mandela Would Approve Of Global AIDS Progress

In a post in the Huffington Post’s “Impact” blog, Michel Kazatchkine, the U.N. secretary general’s special envoy on HIV/AIDS in Eastern Europe and Central Asia, reflects on Nelson Mandela’s role in the global AIDS response. He recounts Mandela’s attendance at the July 2003 International Conference on HIV Pathogenesis, Treatment and Prevention in Paris, writing, “We all admired the great statesman, a man whose political vision was strongly and undefeatably based on a confidence in a long-term future that went beyond any short-term concerns.” He continues, “The following years, despite the many and enormous challenges the world faced in rolling out antiretroviral treatment to those who most needed it, would prove to us all that those confident in the future were indeed right.” Kazatchkine continues, “Today, 10 million people are accessing AIDS treatment which represents over sixty percent of all those in most urgent need of therapy and the number of new infections and AIDS-related mortality have decreased by 25 percent in the last five years.” He concludes, “What appeared to be utopian 10 years ago is now a reachable target. Mandela would undoubtedly approve” (12/15).

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Polio Resurgence In Syria Could Reinvigorate Global Campaign Against Disease

“As of November 26, WHO has confirmed a polio outbreak with a total of 17 cases caused by wild poliovirus type one in Syria, which had been polio-free since 1999,” a Lancet Infectious Diseases editorial states. “At present, polio is endemic in three countries — Afghanistan, Nigeria, and Pakistan,” the editorial notes, adding, “Until poliovirus transmission is interrupted in these strongholds, all countries remain at risk, as shown not only by the outbreak in Syria, but also in recurrent outbreaks across sub-Saharan Africa, including an ongoing outbreak in Somalia.”

“The outbreak in Syria could have major health consequences for other countries, and the government there must assist in providing health care workers and aid organizations with access to at-risk populations,” the editorial continues. “But the outbreak also serves as a reminder that high vaccination coverage is essential in countries where the disease is not currently circulating,” The Lancet writes. “Although it seems like a major setback to eradication efforts, the polio outbreak in Syria might be used as an opportunity to reinvigorate eradication campaigns in Afghanistan, Nigeria, Pakistan, and surrounding countries by reminding local political, religious, and community leaders that the persistence of poliovirus transmission there has global repercussions,” the editorial concludes (January 2014).

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Recent Releases

HHS Secretary Outlines U.S. Government Work To Achieve AIDS-Free Generation

“I believe — and President Obama believes — that an AIDS-free generation is within our reach,” HHS Secretary Kathleen Sebelius writes in the AIDS.gov blog. She summarizes U.S. government work addressing the virus domestically and abroad, adding, “The budgetary constraints our teams across the [HHS] have been working under have posed considerable challenges. We need to continue to be smart about how we target our investments to make sure we’re devoting every possible resource to bringing an end to this epidemic” (12/13).

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World Bank, Global Fund Results-Based Financing Partnership Can Improve Health Systems

Writing in the Center for Global Development’s (CGD) “Global Health Policy” blog, Victoria Fan, a research fellow and health economist at CGD, and Amanda Glassman, senior fellow and director of global health policy at the center, discuss the World Bank and Global Fund to Fight AIDS, Tuberculosis and Malaria’s recent announcement to establish “a stronger partnership for health centered around an innovative aid mechanism, results-based financing (RBF).” They continue, “This duo will arguably have far wider scale and uptake than the Health Systems Funding Platform, which intended to bring the bank, the fund, and GAVI together but has yet to achieve widespread buy-in or results. In short, this represents a serious venture for the fund to improve health systems” (12/13).

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G20 Should Take Action On Global Health, Development

“As the world gears up for the next G20 Summit in Brisbane, Australia, the Global Network is dialing down on the summit’s agenda in a push to get global health included as a key policy issue,” the Global Network for Neglected Tropical Diseases’ “End the Neglect” blog writes. The blog highlights a concept note submitted by the network to the Australian Civil Society Steering Committee (C20) on Friday, “which outlines why global health matters to the G20.” The blog continues, “We are looking to the G20 — the world’s leading economies — to take concrete, tangible actions on global health and development this year” (Cashwell, 12/13).

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Invest In Health Workers For Better Health Care Delivery

In a guest post in IntraHealth’s “Vital” blog, Vanessa Kerry, founder and CEO of Seed Global Health, examines the need to invest in health workers, writing, “For essential caregivers — whether they’re physicians, midwives, or skilled birth attendants — training can mean the difference between life and death.” She highlights the efforts of her organization “to help create a sustainable solution to the severe shortage of skilled health care providers worldwide,” focusing on a recent project “to prevent newborn asphyxiation in Uganda.” She concludes, “Investing in training 200 nurse educators today can lead to better health care delivery, result in a lower rate of neonatal mortality, and strengthen Uganda’s health system. Building a larger cadre of well-educated nurses is essential to the future of neonatal health in Uganda and around the world” (12/13).

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Global Health Community Must Spread Word About Vaccines' Successes

Noting “a full 84 percent of the world’s one-year-olds are vaccinated against measles,” Orin Levine, director of vaccine delivery at the Bill & Melinda Gates Foundation, writes in the foundation’s “Impatient Optimists” blog that “less than one in five Americans identified the correct level” in a recent Gapminder survey. The survey “provides a wakeup call that too many of us are unaware of the impact our contributions are having in expanding childhood vaccinations, fighting deadly disease and saving lives,” he writes, concluding, “We need to take the responsibility to share what we know so that others see those successes and ironically, their role in them. Without their support we risk successful programs going unsupported because of ignorance or misinformation” (12/14).

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Blog Post Examines Underlying Factors Behind Anti-Vaccination Movements

In a post in the PLOS “Speaking of Medicine” blog, Sara Gorman, an MPH candidate at Columbia University Mailman School of Public Health, examines “some of the factors behind anti-vaccination movements.” She notes “[a] few, but not many, studies have been done to begin to understand the demographics, spread, and circumstances behind various anti-vaccination movements or instances of vaccine non-compliance,” and she discusses some of this research (12/13).

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Arogya World Blog Post Summarizes 2013 NCD Work In India

The Arogya World blog reflects on their work in 2013 to address non-communicable diseases (NCDs), writing, “In 2013, we have made great progress on our advocacy goals and on-the-ground work in India, delivering on promises made and taking up new challenges.” The blog summarizes some of Arogya World’s initiatives, including mDiabetes and healthy workplace and schools programs (12/13).

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