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Kaiser Daily Global Health Policy Report

In The News

Two Studies Describe How HIV Destroys Cells, Leads To AIDS

“U.S. scientists have discovered the basic mechanisms that allow HIV to wipe out the body’s immune system and cause AIDS, which could lead to new approaches to treatment and research for a cure for the disease that affects 35 million people around the world,” Reuters reports (Steenhuysen, 12/19). “It turns out HIV, which infects only a small number of T cells at the start, destroys approximately 95 percent of immune cells through a process known as the bystander effect,” VOA News states, noting the virus “destroys the immune system by infecting a relatively few number of cells that create a fiery pathway that consumes nearby cells” (Berman, 12/19). “In the paper published in Science, the Gladstone team identified a mechanism that detects the damaged cells and triggers this cell death pathway,” according to Reuters. “In the paper published in Nature, the team explored the implications of blocking this cellular suicide with experiments using anti-inflammatory drugs that block the caspase-1 enzyme, including the Vertex drug VX-765,” which has been tested to treat epilepsy, the news agency notes (12/19).

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Two Reports Recognize Progress In Malaria Eradication, Call For Increased Funding

“Malaria eradication programs will fail in the face of rising drug resistance without increased funding in malaria research and development (R&D), according to two major reports published this month,” SciDev.net reports. “Over the next decade, malaria R&D will need as much as $8.3 billion to overcome increasing resistance of mosquitoes to insecticides and malaria parasites to drugs,” according to a report (.pdf) from the PATH Malaria Vaccine Initiative (MVI), the news service writes, adding, “But the report also hails the progress made towards achieving global malaria targets.” A separate report from the WHO “also recognizes progress in fighting malaria,” but “says much more needs to be done to win the fight against malaria, including greater funding investments from a more diverse pool of donors,” the news service continues. The article quotes Ashley Birkett, MVI program leader at PATH, and Nick Chapman, a senior analyst at the think-tank Policy Cures (Kennedy, 12/19).

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Lancet Examines Shortfall In Global Fund Pledges

“At a meeting in Washington, D.C., on Dec. 3, donors pledged $12 billion to the Global Fund to fight AIDS, Tuberculosis and Malaria for the next three years for activities to fight the three most deadly diseases in resource-poor settings. Although a record amount for the fund, the result falls short of the $15 billion the organization had hoped to raise,” The Lancet reports. “Donors restored their confidence in the Global Fund this month with substantial funding promises, but economic woes prevent some from increasing their contributions,” the journal writes, noting “in times of austerity, most donors did not increase their contributions to the extent the Global Fund had hoped.” The Lancet examines the pledges made by various donor countries, including the U.S., which “confirmed that it would provide $4 billion” and will add an additional $1 for every $2 committed in addition to the current pledges. “The final donor pledge is likely to increase somewhat from $12 billion in the coming months,” the journal adds (Usher, 12/21).

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IRIN Examines Key Lessons For Adapting Food Security Response To Urban Settings

“With the vast majority of population growth taking place in towns and cities, according to the U.N., aid agencies are adapting their food security responses to better fit into urban contexts,” IRIN reports. The news service provides a list of lessons that can be applied to this effort, including not overestimating “urban resilience”; distributing cash and vouchers, which “are often more appropriate than food distributions in urban settings”; coordinating with local authorities; using technologies to “assist in urban distributions”; designing and funding all new programs “with a strong monitoring and evaluation capacity”; allotting more time and resources “to tracking and targeting urban populations”; considering “alternatives to large-scale distribution”; and establishing “program boundaries” (12/18).

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News Outlets Examine Biggest Global Health, Development Stories Of 2013

News outlets look back at the biggest global health and development stories of 2013. Lancet correspondent Tim Dehnel highlights challenges that arose this year in the global polio response, the emergence of Middle East respiratory syndrome (MERS), the emergence of the H7N9 strain of bird flu in China, and advances in the fight against AIDS, among other stories (12/21). GlobalPost’s “Global Pulse” blog focuses on global child health developments in 2013, highlighting UNICEF’s annual report on child mortality published in September, which found “child deaths have declined by nearly 50 percent since 1990,” growing momentum in the global “Committing to Child Survival: A Promise Renewed” initiative, and the unveiling of “a low-cost vaccine against the most common and lethal form of diarrhea” in India, among other stories (Stuart, 12/20). And Devex discusses the global response to climate change, emerging trends and transitions in development aid, and reforms within the World Bank, among other developments (Rosenkranz, 12/19).

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Editorials and Opinions

NIH Researchers Make Progress In HIV Vaccine Development

“At the Vaccine Research Center at the [NIH], researchers have developed high-resolution images of the AIDS virus at the atomic level,” columnist Michael Gerson writes in a Washington Post opinion piece. He describes this research and the advances scientists have made in learning how to prevent HIV from infecting cells. “The goal is a vaccine that causes the body itself to produce the needed antibodies” to destroy the virus, he writes, adding, “All this matters directly to the 2.3 million people infected with [HIV] each year — including a quarter of a million children. But it is also a tribute to the tenacity and importance of the scientific enterprise.” Gerson concludes, “HIV/AIDS emerged in the early 1980s as a nameless fear, which some initially thought could be transmitted by casual contact. Scientists identified the disease’s true avenues of transmission, researched the antiretroviral drugs that have rendered it a chronic condition for many and have now identified its vulnerabilities at the atomic level — a development that may help understand and counter the next nameless fear” (12/19).

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U.S. Must Act Decisively To Address Unfolding HIV Epidemic In Russia, Passage Of Controversial Anti-Gay Legislation

“Bravely crusading against Vladimir Putin’s anti-gay law, the U.S. head of state has picked two openly gay athletes as part of a team of U.S. delegates travelling to the Sochi Winter Olympics in 2014,” Joseph Charlton writes in an editorial in The Independent’s “Independent Voices” blog. “Sadly, it is a gesture of defiance laughably incommensurate with the human rights crisis currently unfolding in Russia,” he states, noting, “The country elected to host the next Olympic Games is quietly spiraling into a country-wide HIV crisis and its president’s recently passed anti-gay legislation has just made things exponentially worse.” He adds, “To make matters even worse, Putin’s controversial anti-NGO law has made it increasingly difficult for charities working within Russia to fight HIV.”

Noting “HIV is spreading five times faster in Russia than the global average,” Charlton continues, “In a country where HIV is already rampant, and predicted to get worse, the Putin administration has ensured that it is considerably harder for Russian citizens to know how to protect themselves from the virus, or indeed how to seek treatment.” He writes, “Russia is facing a human rights catastrophe with the potential of becoming a quiet genocide as a result of government indifference … which renders the United States’ boast of a homosexual envoy to next year’s Olympics the soft power swindle of the year.” He concludes, “In 1964 South Africa was banned from the competition for apartheid and the country did not compete again until the 1992 Barcelona Games. Now is the time for similar decisive action” (12/18).

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Effective Healthcare Requires Universal Access, Delivery In Addition To Research

In a SciDev.net opinion piece, Roger Williamson, an independent consultant and visiting fellow at the Institute of Development Studies at the University of Sussex, examines what “the poorest billion need to improve ‘poor health.’” He highlights an article published by SciDev.net last week, which “reported that the WHO will decide on research projects to fund in the area of neglected tropical diseases that have funding gaps due to market failures,” and writes, “This is good news. But we should remember that, although delivering healthcare for the poorest cannot work without science at its core, this alone is not enough — to be effective, healthcare also needs universal access and delivery.”

“Recent decades have seen huge innovation in funding and delivery for effective health systems, for example, the creation of the Global Fund to Fight AIDS, Tuberculosis and Malaria,” Williamson continues. “Yet research and innovation on their own have not solved global health problems,” he notes, adding, “Tackling poor health requires both science — health research, for example — and financing, in this case a proper market for research outputs. The drugs may exist but someone has to pay for them.” He adds, “For healthcare to be effective and economical, this market also has to be large scale.” Williamson concludes, “So let us remember that we need both effective health systems and grassroots demand to ensure that health innovations make a difference” (12/20).

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Opinion Pieces Examine Health Needs Of Children During Holiday Season

The following is a summary of opinion pieces examining the needs of children around the world this holiday season.

  • Marion Roche, Huffington Post’s “Impact” blog: Noting “[d]iarrhea remains the second leading cause of death in children under five years old” and “is also the leading cause of malnutrition in children under five,” Roche, a technical adviser for the Micronutrient Initiative, writes, “Looking to the New Year, I have many wishes for moving forward.” She lists her “top five wishes to end diarrheal disease for 2014,” including “better access to safe drinking water,” “adequate sanitation and hygiene,” “easy access to health facilities,” “encouragement and clarity from health providers,” and “consistent treatment for children” (12/19).
  •  Lynn Croneberger, Huffington Post’s “Global Motherhood” blog: “During the holiday season, people always ask me what these children really need to thrive. And I wish it were something we could find at a toy store,” Croneberger, chief executive officer of SOS Children’s Villages-USA, writes. “For too many children around the world, we need to go all the way back to basics,” she states, adding, “Children need a loving family … Children who grow up without the stability of a family are at higher risk of exploitation, abuse and disease.” She concludes, “Toys are a great start, but this holiday season, let’s do our part to ensure all children receive the building blocks to a successful life. Love, food, shelter, education, and health care allow vulnerable children to survive and thrive” (12/19).

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Women Living In Poor Communities Most Powerful Resource For Health, Development

In a POLITICO opinion piece, published as part of “a series in which dozens of women will reveal what women they most admire … part of ‘Women Rule,’ a unique effort this fall by POLITICO, Google and The Tory Burch Foundation exploring how women are leading change in politics, policy and their communities,” Melinda Gates, co-chair of the Bill & Melinda Gates Foundation, reflects on her friendship with Jane Otai, whom she first met during a visit to Kenya, where Otai “is a senior program adviser for Jhpiego,” a partner organization to the Gates Foundation “that bring[s] quality health care to women and their families.” Gates writes, “When POLITICO asked me to write about a woman who inspires me, I realized she’s also one of my heroes.”

“Over the years, she has taught me that the most powerful resource in poor communities around the world is the women who live there,” Gates continues. She writes about Jane’s life having grown up in a slum in Kenya, and notes, “She, in fact, believes access to family planning helped her succeed.” Gates continues, “Family planning is my top priority and my passion. I spend my time learning about it.” She concludes, “My friendship with Jane constantly reminds me that, while I can do a lot to help, the solutions come from the bravery and resilience and talent of millions of women in communities around the world” (12/19).

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Recent Releases

Examining Prospects For U.S. Family Planning Funding In FY 2014

“While it is too early to tell what the specific implications may be for international family planning and reproductive health (FP/RH) funding and policy, [Wednesday's] Senate passage of a two-year, bipartisan budget agreement (H.J. Res. 59) sets the stage for the negotiation of final fiscal year 2014 appropriations legislation,” Population Action International reports in its newsletter. “The relaxation of sequestration and the inclusion of additional funding for non-defense discretionary programs could bode well for international affairs programs, including overseas family planning,” the newsletter states, adding, “Assuming that the amount of overall funding allotted to the State Department foreign operations appropriations bill is closer to that used by the Senate committee in approving its version back in July, the likelihood that FP/RH funding will stay at about current levels and remain under existing policy restrictions increases” (12/19).

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Examining Pathway To Improve Survival Of Preterm Infants In Low-, Middle-Income Settings

“It is heartbreaking to know that there are low-cost interventions to manage preterm birth and care for preterm infants, but without enough frontline health workers and without implementation of known interventions, more than a million preterm babies die every year,” Sarah Alexander, the director of external relations at the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS), an initiative of Seattle Children’s, writes in the Bill & Melinda Gates Foundation’s “Impatient Optimists” blog. “In a global call to action, scientific experts from the Bill & Melinda Gates Foundation, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, GAPPS, and the March of Dimes Foundation published in Lancet Global Health ‘A solution pathway for preterm birth: accelerating a priority research agenda,’” she notes, adding, “The solution pathway includes critical steps in development and delivery science that can help scale up interventions to improve the survival of preterm infants in low- and middle-income settings” (12/19).

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Science Speaks Selects Top 10 HIV, TB Stories Of 2013

The Center for Global Health Policy’s “Science Speaks” blog provides a list of key news stories on HIV and tuberculosis in 2013. The blog notes the passage of the PEPFAR Stewardship and Oversight Act, Global Fund to Fight AIDS, Tuberculosis and Malaria replenishment efforts, “[t]he Supreme Court’s upholding [of] the reversal of the anti-prostitution oath requirement tied to the disbursal of PEPFAR funds,” and Ambassador Eric Goosby’s decision to step down as global AIDS coordinator, among other stories (12/19).

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special notice

The Kaiser Daily Global Health Policy Report will not publish December 23 through January 3. The report will resume publication on Monday, January 6, 2014.

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