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Kaiser Daily Global Health Policy Report

In The News

PEPFAR Marks 10th Anniversary, Celebrates Milestone Of 1M Babies Born Without HIV

“At a ceremony lauding the 10th anniversary of the anti-AIDS initiative PEPFAR, Secretary of State John Kerry announced the program had achieved a remarkable milestone: one million babies born to HIV-positive mothers had been born free of the disease,” UPI.com reports (Levy, 6/18). “Our commitment has only been strengthened by the progress we’ve made and the lives we’ve saved, and this is the story we are able to tell today. … This story compels us to continue,” Kerry said, the Center for Global Health Policy’s “Science Speaks” blog writes (Barton, 6/18). “The chances of a mother infecting her baby once stood at around 30 percent, but now, with [combination antiretroviral therapy], that has dropped to only about two percent, [U.S. Global AIDS Coordinator Ambassador Eric Goosby] said,” Agence France-Presse notes (Biddle, 6/18). “Secretary Kerry also stated that, according to an updated analysis by PEPFAR, 13 countries are at the programmatic tipping point in their AIDS epidemic — the point where the annual increase in adults on treatment is greater than the number of annual new adult HIV infections,” according to a press release from the Global Fund to Fight AIDS, Tuberculosis and Malaria, congratulating the program’s success (6/18).

Speaking at the event, “Namibian Health Minister Richard Nehabi Kamwi said his government would always be ‘eternally grateful’ for PEPFAR’s assistance, which has helped turn the tide against the disease in his country,” according to AFP (6/18). “PEPFAR has embodied the spirit of shared responsibility and global solidarity through its commitment to helping the most vulnerable in society,” UNAIDS Executive Director Michel Sidibé said in a UNAIDS press statement (6/18). A VOA News “Policy Brief” video report examines the PEPFAR initiative over the past decade (6/18). The U.S. State Department provides a PEPFAR fact sheet on its webpage (6/18).

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Senate Subcommittee Approves Agriculture Draft Spending Bill Without Food Aid Reform Changes

On Tuesday, “[t]he Senate Agriculture Appropriations Subcommittee approved, without objection, a [$20.9 billion draft spending] bill that would increase funding for the Agriculture Department, the Food and Drug Administration and related programs by $420 million more than the fiscal 2013-enacted level, not including cuts triggered by sequestration,” CQ Roll Call reports, noting, “The full committee is set to consider the measure Thursday.” According to the news service, “The measure would provide roughly $1.5 billion for foreign food assistance under the Food for Peace program, $33 million above the fiscal 2013 level” (Marcos, 6/18). However, the “bill rejects a proposal by President Obama to give the administration greater flexibility when purchasing food for international food aid,” The Hill’s “On The Money” blog reports, noting, “Obama wants to reduce the purchases of U.S. farm goods and allow [USAID] to buy food abroad.” According to the blog, “Ranking member Roy Blunt (R-Mo.) said he was pleased that the ‘core integrity’ of the existing Food for Peace program had been preserved” (Wasson, 6/18). VOA News examines the debate over U.S. food aid, the agricultural industry’s opposition to reform, and some non-governmental organizations’ preference for cash over food aid (Baragona/Farabaugh/Loomis, 6/18).

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World Bank Warns Climate Change Will Affect Development, Worsen Poverty Unless Action Taken

“In fewer than 20 years, climate change impacts — from flooded major cities to crashing food production — threaten to fundamentally reshape the world economy and dramatically worsen human lives, the World Bank’s president warned on Wednesday,” Thomson Reuters Foundation reports (Goering, 6/19). “It is time to stop arguing about whether (climate change) is real or not,” World Bank President Jim Yong Kim said at a Thomson Reuters newsmaker event in London, according to Reuters. The news agency notes he “said there was 97 to 98 percent agreement among scientists that global warming was real and caused by human activity” (Chestney, 6/19). “In sub-Saharan Africa, food shortages will become more common. … In South Asia, shifting rain patterns will leave some areas underwater and others without enough water for power generation, irrigation or drinking,” Rachel Kyte, a bank vice president for sustainable development, said, Bloomberg Businessweek reports (Morales/Rastello, 6/19).

A new World Bank report released this week details the potentially devastating effects, the Washington Post notes (Schneider, 6/18). “The bank said it was concerned that unless the world took bold action now, a disastrously warming planet threatened to put economic prosperity out of reach of millions and roll back decades of development,” Deutsche Welle writes (6/19). “The development bank is stepping up its funding for countries to adapt to the effects of climate change, and is calling for rich countries to make greater efforts at cutting greenhouse gas emissions,” The Guardian notes (Harvey, 6/19). “The World Bank doubled its investment in climate adjustment to $4.6 billion in fiscal year 2012 ending June 30 from $2.3 billion the prior year, [Kyte] said,” according to Agence France-Presse (Smith, 6/19).

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World Facing Worst Refugee Crisis Since 1994, Report Says; Obama Pledges More Aid For Syria

“The world is in the throes of its most serious refugee crisis for almost 20 years, as conflicts in Syria, Democratic Republic of the Congo and Mali have forced tens of thousands of people to flee their homes, the U.N.’s refugee agency has said,” The Guardian reports (Tran, 6/19). According to the UNHCR’s annual Global Trends report, “as of the end of 2012, more than 45.2 million people were in situations of displacement compared to 42.5 million at the end of 2011,” and that number “includes 15.4 million refugees, 937,000 asylum seekers, and 28.8 million people forced to flee within the borders of their own countries,” a UNHCR press release states, noting, “The report does not include the rise in those forced from their homes in Syria during the current year” (6/19). “Those are the highest numbers since 1994, when people fled genocide in Rwanda and bloodshed in former Yugoslavia,” the Associated Press/Washington Post adds (6/19).

“The report says war is the main reason for displacement with more than 55 percent of all refugees coming from five war-affected countries — Afghanistan, Somalia, Iraq, Syria and Sudan,” VOA News writes (6/19). “Earlier this month, the United Nations and partner agencies began an appeal for $4.4 billion, the largest in history, for urgent humanitarian aid to help Syrians,” the New York Times notes. “President Obama announced during his meeting with [G8] leaders on Monday that his administration would give an additional $300 million in humanitarian assistance to help feed, shelter and provide medical care for Syrians,” the newspaper writes, adding, “The United States remains the single largest contributor of humanitarian aid for the Syrian people, with the promise of the new assistance bringing the total United States commitment for the Syrian crisis to nearly $815 million” (Banco, 6/18). The Guardian’s “DataBlog” breaks down the statistics of the report (Sedghi, 6/19).

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BBC Radio Show Examines Child Undernutrition

BBC World Service’s “More Or Less” radio show “examines the claim that every 15 seconds a child dies of hunger,” which “is a popular statistic used by celebrities and charity campaigners in support of the Enough Food for Everyone IF campaign.” However, the show summary states, “According to the experts behind these figures, the answer is no. The real problem is undernutrition, which leaves children more susceptible to infectious diseases.” Ruth Alexander, the show’s host, “takes a detailed look at the problem of child malnutrition — which countries are worst affected, and what is being done to try to ease the problem,” according to the show summary, which adds, “She is joined by Jack Lundie, IF campaign; Professor Robert Black, Johns Hopkins Bloomberg School of Public Health and Jane Howard from the U.N. World Food Programme” (6/16).

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WHO Calls For Tighter Controls On Marketing Of Unhealthy Foods To Children

“The marketing of unhealthy foods to children has proven ‘disastrously effective,’ driving obesity by using cheap social media channels to promote fat-, salt- and sugar-laden foods, the [WHO's] Europe office said on Tuesday,” Reuters reports. The WHO “called for tighter controls on such marketing, saying tougher regulations were crucial to winning the fight against childhood obesity,” the news service adds (Kelland, 6/18). “‘Children are surrounded by adverts urging them to consume high-fat, high-sugar, high-salt foods,’ said Zsuzsanna Jakab, WHO regional director for Europe,” The Hill’s “Healthwatch” blog writes, noting, “She added that food marketing is commonly present in places where children should be ‘protected, such as schools and sports facilities’” (Viebeck, 6/18). “Television remains the dominant form of advertising and a large majority of children and adolescents watch TV on average for more than two hours a day,” the health agency said in a report on food marketing, according to Reuters, which adds, “WHO Europe said that, while all 53 member states of its European region have signed up to restrictions on the marketing of unhealthy foods to children, most rely on general advertising regulations that do not specifically address the promotion of high-fat, high-salt or high-sugar products” (6/18).

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Devex Interviews Director Of USAID's Development Credit Authority

In an interview with Ben Hubbard, director of USAID’s Development Credit Authority, the office that partners with banks and other finance institutions to guarantee loans, Devex examines how the office “is now working behind the scenes to change the way USAID regional bureaus and country missions finance development projects by alleviating investment risks and putting finance officers in the field.” According to Devex, “Hubbard sees his office playing a larger role in helping USAID link its country strategies to commercial banks and microfinance institutions which might be able to direct private capital to nearby development projects, instead of relying on foreign aid grants. … This shift from donors funding projects directly to using foreign assistance to leverage private funds, he says, is indicative of a changing global development climate” (Igoe, 6/18).

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Editorials and Opinions

Opinion Piece, Editorial Address Efforts To Reform U.S. Food Aid Program

The following opinion piece and editorial address the Obama administration’s proposal to reform the Food for Peace program, as well as congressional debate over the proposed changes.

  • Reps. Ed Royce (R-Calif.) and Eliot Engel (D-N.Y.), The Hill: “Regrettably, the Food for Peace program, which has its roots in the Eisenhower years, is badly showing its age, and is best described as slow, inefficient and wasteful,” Royce and Engel write, adding, “We believe reform of our international food aid is long overdue, and we commend President Obama for proposing substantial reforms as part of his 2014 budget.” They continue, “Food aid reform is not and should not be a partisan issue. Proposals to feed more desperate people faster, and at a lower cost to taxpayers, are simply common sense.” Royce and Engel outline several benefits of a reformed program, writing, “Still, this reform effort faces an uphill fight, being opposed by those with a stake in the current system, including some farmers — despite the fact that food aid accounts for less than one percent of total U.S. food exports.” They conclude, “As we continue to debate food aid reform, we hope that good policy will trump politics, and that the interests of U.S. taxpayers will prevail” (6/18).
  • Miami Herald: The proposed changes to the food aid program “would translate into more people getting fed at no extra cost to American taxpayers,” the editorial writes, adding, “More food for the buck is a win-win — except for entrenched special interests that prefer the inefficient and expensive status quo.” The editorial notes, “In fact, the United States is the only industrialized donor nation that refuses to buy food in bulk from local farmers in crisis areas.” An amendment to the House Farm Bill, offered by House Foreign Affairs Committee Chairman Ed Royce (R-Calif.), “would allow USAID to use up to 45 percent of its food-aid money to purchase food abroad, closer to where the need resides or allow vouchers or debit cards to get to those in need to buy the food where they live,” the editorial states, adding, “The effort is expected to deliver $215 million in savings. And the Royce amendment, cosponsored by Rep. Eliot Engel (D-N.Y.) also would apply about $150 million to deficit reduction.” The editorial concludes, “Loosening the rules would deliver more food, more quickly to those most in need at less cost to U.S. taxpayers” (6/18).

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AIDS-Free Generation Within Reach 10 Years After Inception Of PEPFAR

Noting U.S. Secretary of State John Kerry’s announcement on Tuesday “that a cumulative total of one million babies will have been born HIV-free … due to direct PEPFAR support” over the last decade, Ambassador Eric Goosby, U.S. global AIDS coordinator and head of the State Department’s Office of Global Health Diplomacy, writes in the Huffington Post’s “The Big Push” blog, “This achievement would have been unimaginable 10 years ago when the U.S. Congress passed the legislation that created PEPFAR, yet today, we can celebrate this momentous milestone.” He states, “We have gained real momentum now — driven by political commitment and leadership, and enhanced by science — now we must continue to join forces in pushing toward the finish line.” He discusses advancements in antiretroviral treatment (ART), describing a prevention of mother-to-child transmission (PMTCT) intervention for pregnant women called Option B+, which “offers all pregnant women — regardless of their CD4 count or clinical staging — lifelong ART.”

“Success in implementing Option B+ across countries with high HIV burdens will help us meet the targets set by President Obama on World AIDS Day in 2011 for the United States, through PEPFAR, to support six million people on ART and provide antiretroviral drugs to prevent mother-to-child transmission of HIV for 1.5 million pregnant women living with HIV by the end of 2013,” Goosby continues. “With PEPFAR directly supporting ART for more than 5.1 million people worldwide, as of the end of September 2012, we are on track to meet that goal,” he writes, concluding, “Our unwavering commitment and continued focus on making smart investments in strong evidenced-based interventions will help future generations by protecting infants from HIV infection while bringing sustainable, lifesaving treatment to mothers. It has been 10 years since the inception of PEPFAR, and we have more hope than ever that an AIDS-free generation is within our reach” (6/18).

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Global Community Must Continue Investing In Proven Interventions To End AIDS, TB, Malaria

“Over the past decade — and with the U.S. government leading the way with investments in [PEPFAR], the President’s Malaria Initiative (PMI), and the Global Fund to Fight AIDS, Tuberculosis and Malaria — the world has reduced HIV incidence by more than 20 percent, tuberculosis deaths by more than 40 percent and malaria deaths in Africa by 33 percent,” Deborah Derrick, president of Friends of the Global Fight Against AIDS, Tuberculosis and Malaria, writes in the Huffington Post’s “The Big Push” blog. “The Global Fund — the world’s largest global health financier — has worked with the U.S. government and other partners for the past 10 years to fight the scourges of AIDS, tuberculosis [TB] and malaria,” she states, noting, “This year, the Global Fund seeks to replenish its resources by mobilizing pledges from donors to continue and expand this work, especially in regions with the greatest disease burden and fewest resources.”

“In its recently published Needs Assessment, the Global Fund estimates that $15 billion will be required over the next three years to maintain the programs it funds today; allow new programs to be added; and renew and scale up existing, effective programs,” Derrick continues, adding, “The Global Fund has identified four primary ‘pillars’ of support to get to that $15 billion goal, noting that the fights against these diseases ‘cannot be the sole responsibility of external donors.’” She identifies these pillars as current donor countries, the private sector, domestic co-investment and emerging economies, and expands on each. “The world currently stands at a tipping point,” she states, and writes, “But this opportunity will slip away — and the gains we’ve made will be put at significant risk — unless we continue investing in proven interventions and leverage recent global health breakthroughs, including falling costs, growing scientific knowledge and improved implementation” (6/18).

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Opinion Pieces Address Issue Of Malnutrition At G8 Summit

The following is a summary of opinion pieces addressing the issue of malnutrition at the G8 summit that took place in Lough Erne, Northern Ireland, on Monday and Tuesday.

  • Jamie Cooper-Hohn and Jim O’Neill, Globe and Mail: “One item hidden away on paragraph 55 of the joint communique is undernutrition, traditionally seen as a development challenge, and one in which Canada has shown great leadership,” Cooper-Hohn, chief executive officer of the Children’s Investment Fund Foundation, and O’Neill, former chair of Goldman Sachs Asset Management, write, noting, “A historic shift has taken place in recent weeks: large-scale undernutrition is now rightly seen as dampening growth in developing countries, with profound consequences for the global economy.” They state, “British Prime Minister David Cameron, chair of the G8, was therefore right to hold a high-level meeting on nutrition last weekend, alongside the Children’s Investment Fund Foundation and the government of Brazil,” and they continue, “Breaking the cycle of deprivation would add $125 billion a year to the global economy by 2030. With a $10 billion price tag, it could be among the best money we have ever spent” (6/18).
  • Stuart Gillespie and Marie Ruel, The Guardian’s “Global Development Professionals Network” blog: “The G8 countries are being asked to make firm financial and strategic commitments to fight malnutrition on a scale never before imagined. Can they do it?” Gillespie, a senior research fellow at the International Food Policy Research Institute (IFPRI) and CEO of the Transform Nutrition research program consortium, and Ruel, division director of the IFPRI’s poverty, health, and nutrition division, write. “If not, we can point to a lack of political will, but not lack of information and viable solutions,” they state. “Nutrition researchers, economists, and other champions in the fight against undernutrition have worked hard over the past five years to come up with tools and strategies that, when used together, can improve the lives of millions around the world,” they continue, adding, “For real impact, policymakers must tackle malnutrition on all fronts and at all levels. This means making broader programs — such as agriculture, social protection, early child development, education, water and sanitation, and other development programs — nutrition sensitive” (6/18).
  • Marwin Meier, Huffington Post’s “Global Motherhood” blog: “At the 2009 G8 Summit held in the ruins of the heavily earthquake-affected Italian town of l’Aquila, the G8 and partners promised to spend $22 billion on food security by the end of 2012,” Meier, health and advocacy manager for World Vision in Germany, writes, adding, “Yet they have disbursed less than three quarters of that amount.” He continues, “We have had much G8 rhetoric around nutrition and food security over the last several years and the renewed interest in this quintessential intervention for human development is good, but needs to be backed up by a transparent accountability framework that can trace every promised dollar.” He adds, “Whether to report on progress made cannot be left to the gusto of a given G8 host, it must become part and parcel of every G8 accountability report” (6/16).

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U.S. Must Continue Leadership In Efforts To Eradicate Polio

“Twenty-five years after we set out to achieve one of the most ambitious public health goals ever, we are within reach of the finish line: polio eradication,” Alan Hinman, director for programs at the Center for Vaccine Equity at the Task Force for Global Health, writes in the Huffington Post’s “Impact” blog. He reviews the history of polio immunization and says the Global Polio Eradication Initiative (GPEI) has made an “extraordinary” impact. Hinman also outlines the roles played by the CDC, USAID, the Bill & Melinda Gates Foundation, and Rotary International. He continues, “We are closer than ever to ending polio. Insufficient human and financial resources now could compromise our chance of success — and the longer it takes, the more expensive it will be. The U.S. must continue its leadership and commit additional funding to achieve the goal” (6/17).

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Recent Releases

Congressional Briefing Focuses On NTDs

Writing in the Global Health Technologies Coalition’s (GHTC) “Breakthroughs” blog, GHTC Communications Officer Kim Lufkin summarizes a congressional briefing focusing on neglected tropical diseases (NTDs). The briefing, held Monday, “focused on how the U.S. government has played a significant role in combatting NTDs globally through programs like those at [USAID], which has helped deliver more than half a billion treatments in six years to more than 250 million people,” Lufkin notes, adding, “At the same time, [Rachel Cohen of the Drugs for Neglected Diseases initiative (DNDi)] and other panelists stressed that significant changes are needed to make U.S. NTD programs even more successful.” She continues, “[A]ll the panelists urged U.S. policymakers to become increasingly involved in an ongoing global discussion about how to redefine NTD research and product development efforts. All three of these changes — investing in NTD product development, expanded support for all 17 NTDs, and engaging in global discussions about NTD research — will help ensure that the U.S. makes the greatest impact possible against NTDs worldwide” (6/18).

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Saving Mothers, Giving Life Recognizes First Anniversary

“This month marks the first anniversary of Saving Mothers, Giving Life, a partnership intended to aggressively reduce the number of women in the developing world who die during pregnancy and childbirth,” Celina Schocken, director of Saving Mothers, Giving Life, notes in the ONE blog. She outlines some of the program’s success over the past year, writing, “We are making progress. But we have a long way to go. Millennium Development Goal 5, which calls for a 75 percent reduction in the maternal mortality ratio by 2015, lags furthest behind all eight goals.” Schocken concludes, “Working together, with strong leadership at all levels of the health care system, we can ensure that more sons and daughters will be delivered safely and more mothers survive childbirth” (6/18).

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Association Of Southeast Asian Nations Recognizes Dengue Day

“Last week the Association of Southeast Asian Nations (ASEAN), a regional organization comprising 10 countries, celebrated Dengue Day …, an excellent way to raise awareness about the burden of dengue which infects [up to] 100 million people worldwide every year, three-quarters of them living in Asia and the Pacific,” Anupama Tantri and Anna Johnston with the Global Network for Neglected Tropical Diseases write in the Global Network’s “End the Neglect” blog. “Just last week, corresponding with ASEAN’s Dengue Day, the Global Network released a new report [.pdf] titled, ‘Regional Health Cooperation to Achieve Equity and End the Burden of NTDs among ASEAN Member States,’” they continue, noting, “The report outlines recommendations and potential opportunities for ASEAN countries to work together and with the support of ASEAN partners such as Australia, China, Japan, Korea and the United States” (6/18).

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