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Kaiser Daily Global Health Policy Report

In The News

First Global Health Service Partnership Volunteers Sworn In

“Thirty U.S. doctors and nurses from across the country were sworn in at the White House July 18 as the first class of Peace Corps Global Health Service Partnership volunteers,” IIP Digital reports, adding, “The new volunteers will leave July 20-21 for one-year assignments as medical or nursing educators in Tanzania, Malawi and Uganda, where they will work alongside local faculty to train the next generation of health care professionals” (7/19). The partnership, — “a collaboration of the Peace Corps, [PEPFAR], and the non-profit SEED Global Health — presents an opportunity for American physicians and nurses to make a real difference in communities abroad by helping to address the known shortage of skilled physicians, nurses and clinical faculty in resource-limited countries,” Africa Science News writes (Chuki, July 2013). According to a Peace Corps press release, the partnership “represents the first organized effort by the Peace Corps to send U.S. healthcare professionals abroad with a focus on teaching and expanding clinical capacity” (7/18). MSNBC provides video footage of an interview with Vanessa Kerry, CEO of SEED Global Health, and two program volunteers (7/17). In addition, the Sacramento Bee provides a transcript of an interview with another program volunteer (Searles, 7/22).

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H7N9 Virus May Be Highly Transmissible Among Ferrets, Study Says; Researchers Examine Implications For Human Transmission

“The H7N9 bird flu virus may be highly transmissible among ferrets, a common animal model for studying how flu might spread in humans, Chinese researchers reported Thursday,” Xinhua reports. “Though H7N9 appears to have been brought under control, the researchers warned in a study published online in the U.S. journal Science that the character of the virus, including its pandemic potential, ‘remains largely unknown’ and that it’s possible the virus can efficiently spread between humans eventually,” the news service writes (7/19). “Led by Chen Hualan, one of China’s top virologists, researchers tested the ability of multiple strains of the virus to spread by placing three healthy ferrets in one cage next to three infected ferrets in another cage,” the Wall Street Journal’s “China Real Time Report” notes, adding, “In most cases, only one of the healthy ferrets became infected, but in the case of the Anhui strain, all three of the healthy ferrets became infected with the virus” (Chin, 7/19). “Moreover, testing in ferrets — widely considered to be the best proxy for humans in flu testing — finds that one lethal strain of the virus that killed the first H7N9 victim in China is transmissible via respiratory droplet, meaning that it could conceivably be spread by coughing and sneezing,” Scientific American writes (Maron, 7/18).

“Although the ferret model has its limitations, Chen and co-workers conclude that their findings portend future problems,” according to Science Now, which notes two similar studies — one from the CDC and one by Yoshihiro Kawaoka, a virologist at the University of Wisconsin, Madison, and the University of Tokyo — “reach different conclusions about the severity of the threat” (Cohen, 7/18). “So far, there have been no reports of sustained human-to-human transmission with H7N9 bird flu. But the new findings add to growing evidence that the virus likely needs to undergo just a few genetic mutations to gain the ability to spread between people, said Dr. Richard Webby, a bird flu expert at St. Jude Children’s Research Hospital in Memphis, Tenn., who was not involved in the new study,” LiveScience writes (Rettner, 7/18). In related news, “A 61-year-old woman from northern China was confirmed Saturday as having contracted the deadly H7N9 bird flu virus, state media reported,” Agence France-Presse notes (7/21).

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U.N. Agencies Continue To Deliver Humanitarian Aid In Syria Despite Violence

“While violence continues unabated in many parts of Syria, United Nations agencies are working to deliver humanitarian assistance, in spite of difficult security conditions and restricted access to various areas, a spokesperson for the world body said [Friday],” the U.N. News Centre reports. According to the news service, “the World Food Programme (WFP) is planning to increase its distributions to reach three million people, up from the current 2.5 million” by the end of the year; “the U.N. Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) has reached more than 58,000 people with food assistance and 59,000 people with cash assistance in the past two weeks”; and the WHO “has also continued its work inside the country, supporting the ministry of health in Damascus with essential and communicable disease medicines to treat more than 90,000 people” (7/19).

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NPR Reports On Resurgence Of Polio In Somalia; New York Times Examines Polio Response In Pakistan

NPR’s “Shots” blog reports on a resurgence of polio in Somalia, noting the country “hadn’t had a case of polio for nearly six years. But in the past few months, the virus has come back.” According to the blog, “Twenty new cases of polio were reported this week in Somalia by the Global Polio Eradication Initiative. That brings the total number of cases in the Horn of Africa to 73. The rest of the world combined has tallied only 59 cases so far this year.” The blog continues, “The number of polio cases in Somalia is increasing by the day, says Dr. Nasir Yusuf, who leads UNICEF’s immunization efforts in eastern and southern Africa,” adding, “Part of the problem, he says, is that the majority of children in Somalia have never been immunized against polio.” NPR notes, “In response to the current outbreak, there have been five emergency polio immunization campaigns in Somalia since May” (Beaubien, 7/20).

In related news, the New York Times examines efforts to eradicate the virus in Pakistan, where “[a]nger … over American foreign policy” — specifically a fake vaccination campaign staged by the CIA in its hunt for Osama bin Laden and the continued use of drone strikes in the country — “has led to a disastrous setback for the global effort against polio.” The newspaper notes a number of recent killings of polio vaccination workers in the country and writes, “While some experts fear the killings will devastate the effort here, Pakistan’s government insists that they will not, and has taken steps to ensure that” (McNeil, 7/21).

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Wall Street Journal Examines India's School Lunch Program

Noting the deaths of 23 children in India last week “after eating a meal under the program at their school in Bihar, one of India’s poorest states,” the Wall Street Journal’s “India Real Time” blog examines the program, quoting a number of experts, and provides “a list of ways to ensure that it doesn’t endanger the children it is designed to help.” According to the blog, recommendations include revamping the infrastructure for providing the cooked meals in most schools, improving hygienic practices at the community level, implementing wider monitoring of the program, and providing “a clear system for registering grievances,” among others (Sugden/Rana, 7/19).

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NPR Examines Reemergence Of Tuberculosis

NPR’s Shots blog examines the reemergence of tuberculosis in some parts of the world as well as the history of the disease, including in the U.S., as part of its continued coverage on the disease. “TB is not at all treated with the diligence that it should be,” Mel Spigelman, president and CEO of the Global Alliance for TB Drug Development (TB Alliance), tells the blog (Doucleff, 7/19).

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Editorials and Opinions

Continued Partnership, Resources Needed To Achieve AIDS-Free Generation

In a Forbes opinion piece, Barbara Pierce Bush, CEO and co-founder of Global Health Corps and a board member of Friends of the Global Fight Against AIDS, Tuberculosis and Malaria, reflects on the global AIDS response over the last decade, writing, “Very rarely, a crisis occurs that is so urgent it galvanizes the unlikeliest partners and brings out the best in all of them. A decade ago, the global AIDS epidemic did just that.” She states, “Americans from across ideologies and interests — concerned citizens young and old, Republicans and Democrats, the faithful and the agnostic, celebrities, doctors and scientists — joined forces to support incredible progress in the fight against HIV and AIDS on the continent,” prompting “other countries to contribute whatever resources they could — both bilaterally, though programs like PEPFAR, and through multilateral partnerships like the Global Fund to Fight AIDS, Tuberculosis and Malaria.”

“The U.S. is the largest supporter of the Global Fund, which partners with PEPFAR to strengthen and expand the work of both initiatives,” Bush notes, adding, “This funding and support have seen returns that could not have been imagined 10 years ago.” She states, “In addition to marking PEPFAR’s 10th anniversary, 2013 is a replenishment year for the Global Fund. … Support for the Global Fund is critical to reaching our goals and making the most of U.S. leadership and investment.” She concludes, “Despite our differences, in the spirit of partnership and camaraderie, there is no limit to what we can do. … It’s going to take continued partnership, support and resources to get from one million babies to every baby — an entire generation born HIV-free” (7/21).

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Laws Aimed At Criminalizing Sex Trade Hindering HIV/AIDS Response In India

Writing in the Huffington Post’s “World” blog, journalist Michelle Chen examines efforts to combat HIV/AIDS among sex workers in India, highlighting “various laws aimed at criminalizing the sex trade, supposedly to protect women from exploitation,” which she says reflect “a deeper culture of oppression that sex workers face around the world at all levels of society, not just in the streets but in the social institutions that are supposed to protect them.” She notes, “India has not outlawed sex work itself, but sex workers face various restrictions on related activities such as soliciting in public or pimping,” and highlights a “directive embedded in PEPFAR, the White House’s keystone global HIV/AIDS program, [that] has for years explicitly barred U.S. support for any organization that aids sex workers.”

“Fortunately, the Supreme Court recently dealt a potentially lethal blow to the so-called ‘anti-prostitution loyalty oath’ by ruling that the mandatory pledge violates the free speech rights of U.S. organizations,” she writes, adding, “But there’s a catch: The court’s ruling applies only to U.S.-based groups.” She notes, “When aid comes with political strings attached, poor governments are pressured to mirror Washington’s culture wars,” adding, “Across the Global South, the politics of PEPFAR ironically feeds into the same structural barriers that put sex workers at risk of AIDS and other social threats.” She states, “In India’s heated politics of sex, violence and public health, the treatment of sex workers represents deep blind spots in even the best-intentioned social policies” (7/21).

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Recent Releases

U.S. Congressional Subcommittee Approves FY 2014 State And Foreign Operations Appropriations Bill

“[On Friday] the House State-Foreign Operations Appropriations Subcommittee approved its FY14 State-Foreign Operations Appropriations Bill by voice vote, with no amendments offered. The $40.6 billion measure, comprise[s] of $34.1 billion in base funding and $6.5 billion in Overseas Contingency Operations (OCO) funds,” according to a post on the U.S. Global Leadership Coalition’s (USGLC) website. “The Subcommittee faced the difficult task of writing a bill with an appropriations allocation 19 percent below current levels and the Administration’s request,” the USGLC post writes, adding, “The result is a bill that prioritizes security assistance and some global health programs but imposes deep cuts to many development and multilateral accounts” (Preston, 7/19).

The appropriations bill includes funding for U.S. global health programs at USAID and the State Department, which comprises a significant portion of U.S. funding for global health, according to the Kaiser Family Foundation’s “Policy Tracker,” which also includes details about the bill’s proposed spending for certain global health programs (7/19). In addition, the bill reinstates the Mexico City Policy, also known as the “Global Gag Rule,” and prohibits funding for the United Nations Population Fund (UNFPA), according to a subcommittee press release (7/18). The bill will be further addressed in Congress this week, USGLC notes ( 7/19). The Center for Global Health Policy’s “ScienceSpeaks” blog also writes about the bill (7/19).

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Blog Examines Need For Global Health Governance

Writing in the Global Health Governance journal’s “Young Voices” blog, contributor Anand Bhopal examines the need for governance in the global health field and why the WHO should lead the effort. Bhopal discusses how the WHO is funded, addresses the WHO budget deficit, and examines the future of the health agency (7/19).

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