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Kaiser Daily Global Health Policy Report

In The News

U.S. Sen. Shaheen Speaks With Devex About Effort To Permanently Repeal Mexico City Policy With HER Act

Devex: Q&A: Senator Shaheen on her fight to repeal the ‘global gag rule’ permanently
“Senator Jeanne Shaheen is challenging U.S. President Donald Trump’s ‘global gag rule’ in Congress with the Global Health, Empowerment and Rights (HER) Act, which seeks to permanently repeal the order, as NGOs and activists warn of the severe impact of the rule. The bill, introduced in January by Shaheen, a democratic senator from New Hampshire, and Democratic Rep. Nita Lowey from New York, has garnered bipartisan support, including from Republican Senators Susan Collins and Lisa Murkowski. … However, it faces an uphill battle in the Republican-controlled Congress. … Shaheen spoke to Devex about the implications of the [Mexico City] policy, the progress of the HER Act, and what the development community can do to safeguard health care services…” (Edwards, 3/13).

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U.S. Delegation To U.N. Commission On The Status Of Women Might Support Stances Of Conservative Nations, Including Those Listed On Trump's Travel Ban

The Guardian: U.S. may go cheek by jowl with women’s rights abusers at U.N. gender talks
“U.S. negotiators at this week’s U.N. Commission on the Status of Women could find themselves standing shoulder to shoulder with some of the world’s worst violators of women’s rights, activists have warned. … In the first real test of the Trump administration’s stance on women’s rights on the international stage, the U.S. delegation may find itself firmly aligned with conservative countries including Iran, Sudan, and Syria — among the six countries targeted in Trump’s revised travel ban. These countries are notorious in their attempts to water down language on women’s rights — not least on sexual and reproductive health, what constitutes a family, and the protection of female activists — during the annual CSW discussions, which begin on Monday…” (Ford, 3/13).

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U.S. Sen. Bernie Sanders Urges President Trump To Disallow Army To Exclusively License Experimental Zika Vaccine To Sanofi Without Guarantee Of Fair Pricing

The Hill: Sanders: Trump must stop French company’s exclusive Zika vaccine deal
“Sen. Bernie Sanders (I-Vt.) is pressuring President Trump to stop the Army from giving a French company the exclusive license to a vaccine against the Zika virus. In a New York Times op-ed published Saturday, Sanders criticized French pharmaceutical company Sanofi, noting the firm has already gotten $43 million from the Department of Health and Human Services to develop a vaccine with the Army and is expected to receive $130 million more in federal funding. ‘If Mr. Trump allows this deal, Sanofi will be able to charge whatever astronomical price it wants for its vaccine,’ Sanders wrote…” (Smilowitz, 3/11).

The Hill: Chelsea Clinton praises Sanders for Zika op-ed
“Former first daughter Chelsea Clinton on Saturday praised Sen. Bernie Sanders (I-Vt.) for his op-ed pressuring President Trump to stop the Army from giving a French company an exclusive license to a Zika virus vaccine. ‘Thank you Sen. Sanders — we need to ensure equitable access to the Zika vaccine & all vaccines,’ Clinton tweeted alongside his op-ed…” (Seipel, 3/11).

Washington Examiner: Sanders slams Zika vaccine deal
“…[Sanders] was worried that Sanofi could gouge ‘American consumers, Medicare and Medicaid, or our military when it sells the vaccine.’ … Sanofi said that it was far too early to discuss pricing now for any vaccine. ‘Much remains to be done to get to a point where appropriate information is available and reasoned decisions can be made,’ the company said. ‘In addition, pricing is a totally separate issue from the license’…” (King, 3/11).

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U.N. Humanitarian Chief Warns World Facing Worst Humanitarian Crisis Since WWII With 20M People At Risk Of Starvation, Famine In 4 Nations

Agence France-Presse: World faces worst humanitarian crisis since WWII: U.N.
“The United Nations is warning that the world is facing its worst humanitarian crisis since the end of World War II, with more than 20 million people facing starvation and famine in four countries. The world body’s humanitarian chief Stephen O’Brien called Friday for an urgent mobilization of funds — $4.4 billion by July — for northeastern Nigeria, Somalia, South Sudan, and Yemen to ‘avert a catastrophe’…” (3/11).

U.N. News Centre: U.N. aid chief urges global action as starvation, famine loom for 20 million across four countries
“…Without collective and coordinated global efforts, he warned, people risk starving to death and succumbing to disease, stunted children and lost futures, and mass displacements and reversed development gains. … ‘I continue to reiterate the same message to all: only a political solution will ultimately end human suffering and bring stability to the region,’ [O’Brien] said, noting that with access and funding, humanitarians will do more, but cautioned that relief workers were ‘not the long-term solution to the growing crisis’…” (3/10).

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WHO Releases New Data On Zika, Says Vigilance Must 'Remain High'

U.N. News Centre: Vigilance against Zika virus should ‘remain high,’ U.N. health agency says in new guidance
“Although a decline in cases of Zika virus infection has been reported in some countries, there is still a need for heightened vigilance, the World Health Organization (WHO) reported [Friday], issuing fresh guidance on the virus that has been linked to birth defects and neurological complications. The new WHO data also lists countries where the Aedes aegypti mosquito is present, but where there is no sign of the Zika virus…” (3/10).

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New York Times Features Articles, Video Profiling Struggles Of Brazilian Families Impacted By Zika

New York Times: For Brazil’s Zika Families, a Life of Struggle and Scares
“…Thirteen months after the World Health Organization declared Zika a global health emergency, some of the public alarm over the mosquito-borne virus that swept through Latin America is receding. In November, the WHO lifted its emergency designation, but Zika has hardly disappeared. Thousands of new Zika infections continue to be reported throughout Latin America, and WHO officials said that their action simply signals that, like malaria or yellow fever, Zika is a continuing threat in the region rather than an urgent pandemic. For families of Zika babies, however, the disastrous effects are only deepening. That is especially true in the impoverished cities and villages of northeastern Brazil, where the connection between the mysterious virus and infants born with tiny misshapen heads was first detected and where hundreds of families are struggling to give these babies the best lives possible…” (Belluck/Franco/Zehbrauskas, 3/11).

New York Times: A Zika Tale in a Favela
“At night, rats often scurry on top of the thin gray mattress where Maria de Fátima dos Santos and Paulo Rogério Cavalcanti de Araújo sleep with their two small children in a one-room house with a floor of dirt and concrete, and a green plastic basin for a toilet. In this achingly poor section of the Brazilian city of Recife, … the couple is struggling to raise a baby with disabilities caused by the Zika virus…” A video accompanies the article (Belluck/Franco, 3/11).

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Editorials and Opinions

President Trump Should Demand Fair Prices For Zika Vaccine From Sanofi

New York Times: Bernie Sanders: Trump Should Avoid a Bad Zika Deal
Bernie Sanders, independent senator from Vermont

“…[The Trump] administration, through the Army, is on the brink of making a bad deal, giving a French pharmaceutical company, Sanofi, the exclusive license to patents and thus a monopoly to sell a vaccine against the Zika virus. If Mr. Trump allows this deal, Sanofi will be able to charge whatever astronomical price it wants for its vaccine. … Before President Trump makes this deal, he must guarantee that Sanofi will not turn around and gouge American consumers, Medicare and Medicaid, or our military when it sells the vaccine. … American consumers should not be forced to pay the highest price in the world for a vaccine we paid to help develop. A failure by the government to demand fair prices from Sanofi in exchange for giving the company a monopoly would be only one more example of the broader insanity around American drug prices. … Our government must stop being pushovers for the pharmaceutical industry and its 1,400 lobbyists. We must not hand this gift to a French drug company without making it pledge not to overcharge American consumers. Will the president negotiate a better deal for the taxpayers of this country and our soldiers? Or was the president lying when he claimed he would make only the best deals on behalf of the American people? We will soon find out” (3/10).

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Opinion Pieces Discuss Implications Of Reinstatement, Expansion Of Mexico City Policy

The Lancet Global Health: Trump’s “global gag rule”: implications for human rights and global health
Jerome A. Singh, head of ethics and law at the Centre for the AIDS Programme of Research in South Africa (CAPRISA) and adjunct professor at the Dalla Lana School of Public Health Sciences and the Joint Centre for Bioethics at the University of Toronto, and Salim S. Abdool Karim, director of CAPRISA and professor at the Mailman School of Public Health at Columbia University

“The USA has engaged in international health activities for more than a century. … Given this proud history, it is deeply concerning that newly elected President Donald J. Trump, has, through an executive order in his fourth day in office, reinstated a Reagan-era prohibition on the disbursement of federal funding to [foreign] non-governmental organizations (NGOs) and agencies that provide, promote, or make referrals to abortion services, or give information about abortions. … [T]he version of this policy that President Trump reinstated will apply not only to recipients of family planning funding, but also to recipients of all global health assistance furnished by all U.S. government departments or agencies. The implications are profound. U.S. federal-funded [foreign] NGOs and agencies focusing on diseases such as Zika virus, Ebola virus, tuberculosis, and AIDS but also providing family planning-related services that even so much as mention abortion, could now be barred from receiving U.S. federal funds. This executive order could have great human rights and ethics implications. South Africa is an example of a country that stands to be adversely affected. … Compliance with Trump’s order will potentially require clinicians in NGOs and international agencies that operate in South Africa and receive U.S. federal funding to violate their professional codes of ethics, the country’s abortion laws, and the country’s bill of rights. … Seen in this light and the scale of US federal funding for global health initiatives, the Trump administration’s expanded ambit of the Mexico City Policy is a direct threat to global health…” (April 2017).

The Guardian: How women’s health advocates can win in 2017
Ruth Landy, consultant and advocate for women’s and children’s health and nutrition

“…The health of women and children are at risk in this shifting global environment, but how can advocates and newly enraged activists turn this crisis into opportunity? Research helps us to understand why some global health campaigns succeed while others fail. Progress in combating HIV/AIDS, advancing tobacco control, and reducing women’s deaths in pregnancy and childbirth, for example, would not have been possible without influential action. … Now that health is more political than ever and gender is central, reproductive health advocates can make the most of this as an opportunity to make headlines. … That requires powerful voices, independent accountability, making the business case, and sustained citizen engagement. Women Deliver is an inclusive platform to build on, alongside a revitalized Every Women, Every Child initiative. It’s also about politics — further sharpening political engagement, from high-level forums to NGOs and civil society movements. Leadership at all levels is critical. It will be the determining factor in advancing the Global Strategy for Women’s, Children’s and Adolescents’ Health (2016-2030) in this new era…” (3/11).

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Opinion Pieces Highlight Benefits, Role Of U.S. Foreign Aid

Boston Globe: The ethics and practicalities of foreign aid
Jeffrey D. Sachs, professor and director of the Center for Sustainable Development at Columbia University

“…[F]oreign aid works — when we put in the honest effort and thinking to make it work. … Aid works when its main purpose is to finance supplies such as medicines and solar panels, and the staffing by local workers in public health, agronomy, hydrology, ecology, energy, and transport. U.S. government aid should be pooled with finances from other governments to support critical investments in health, education, agriculture, and infrastructure, based on professional best practices. … There is a lot of negative propaganda about foreign aid … We certainly hear an earful: Aid is wasted; aid is a huge budgetary burden; aid demeans the recipients; aid is no longer needed in the 21st century. … The simple fact is that some aid is wasted and other aid is used brilliantly. The main issue is whether the aid directly supports the work of local professionals saving lives, growing food, installing rural electricity, and teaching children, or whether the aid goes instead to foreign warlords or overpriced American companies. Our responsibility is to fund the aid that works, and when aid has been demonstrated to work, as in public health and education, to expand the assistance as it’s needed by the poorest of the poor. … [T]his is not aid at all, but justice…” (3/13).

Foreign Policy: Trump’s Cuts to USAID Would Imperil the United States
Mona Yacoubian, deputy assistant administrator in the Middle East bureau at USAID from 2014 to 2017

“President Donald Trump’s proposal to slash the U.S. foreign aid budget by 37 percent threatens to undermine U.S. national security. While touting his budget as critical ‘to keep Americans safe,’ the president’s strategy is shortsighted and fails to recognize the critical role international development assistance plays in addressing complex global security challenges. … While the soft power aspect of U.S. development assistance is important, increasingly the work performed by the U.S. Agency for International Development (USAID) and others must be recognized as a strategic asset that is no less powerful than the military in confronting multifaceted challenges … The protection and promotion of U.S. national security interests has traditionally rested on the three-legged stool of defense, diplomacy, and development. In this era of complicated security challenges, development, alongside diplomacy, must retain equal footing with defense. Cutting any of these legs will severely compromise U.S. national security. As the purported master of the deal, Trump should recognize the significant value versus dollar spent on development assistance. Deep reductions in the development budget will do little to reduce the overall budget, while greatly imperiling the United States” (3/10).

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Opinion Pieces Discuss WHO's Exclusion Of TB From Its Priority List Of Antibiotic-Resistant Bacteria

STAT: The World Health Organization made a big mistake on TB. It must fix it
José Luis Castro, executive director of the International Union Against Tuberculosis and Lung Disease

“…[The WHO’s global priority list of antibiotic-resistant bacteria] contains an enormous flaw that requires immediate correction. The experts compiling the list failed to include Mycobacterium tuberculosis, the bacteria that cause tuberculosis (TB), even though TB kills more people than any other infectious disease and has developed such extensive resistance to antibiotics that WHO itself labels it ‘a crisis.’ WHO’s rationale for excluding TB from consideration is that ‘it is already a globally established priority for which innovative new treatments are urgently needed.’ In other words, TB was not considered for inclusion in a list of global priorities because it is a global priority. This explanation defies reason. … [T]he exclusion of TB from the global priority list is a sudden broadside to the TB effort. … Rather than arbitrarily limiting the scope of the list, the WHO should evaluate a broader range of pathogens — including viruses, fungi, and other microbes — that are increasingly drug-resistant, and revise the list to portray a more evidence-based picture of public health research priorities” (3/13).

STAT: WHO’s new priority list of antibiotic-resistant bacteria looks beyond the scourge of tuberculosis
Marie-Paule Kieny, assistant director general for health systems and innovation at the WHO

“…The absence of M. tuberculosis from the [WHO global priority list of antibiotic-resistant pathogens] sparked considerable criticism from the TB community. Some saw it as an oversight, others as an attempt to take funding and attention away from this important disease. It was neither. The WHO global priority list of antibiotic-resistant pathogens clearly states that TB ‘is already a globally established priority for which innovative new treatments are urgently needed.’ The goal of this report is to highlight research and development needs in addition to, and beyond, those directed toward antibiotic-resistant TB. … I urge researchers to turn their attention to antibiotic-resistant pathogens, such as Mycobacterium tuberculosis and those highlighted on the new priority list, so we can begin to curb alarming trends in antibiotic resistance in our hospitals and our communities. Moving forward, the WHO will continue to consult with the scientific community on the value of prioritizing other groups of pathogens using the same approach [it used to develop its priority bacteria list]. TB and other major infectious diseases, such as HIV and malaria, will remain global priorities and continue to be the focus of increased incentives for research and development. But we must also pay attention to other looming threats, so science can deliver effective treatments to all patients” (3/13).

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Governments, Investors Should Act Now To Mitigate Risk Of Infectious Disease Threats

Project Syndicate: The Mispriced Risk of Infectious Diseases
Dambisa Moyo, economist, author, and member of the board of directors of a number of global corporations

“…[P]rotection from public health threats is one vital area where markets do not deliver efficiently. As a result, it is governments that usually bear the costs of prevention and treatment. With government budgets already overstretched, coping with the intensifying health burden from [antimicrobial resistance (AMR)] will be difficult, to say the least. Yet governments are unlikely to move fast to mitigate this risk. On the contrary, experience indicates that governments often struggle to align public spending with underlying or mounting problems, such as public health threats, until they reach a crisis point. … Though the threat [of infectious diseases and AMR] is substantial, it is not immediate, so governments continue to pursue other priorities, allowing the threat to grow, largely out of sight. As a result, it is not adequately priced into the markets. When the crisis finally erupts, the true scale of the threat will become clear. But by that point, it will be much more difficult and expensive to contain, resulting in far more casualties. Unfortunately, that point may be closer than anyone — government or investor — expects” (3/10).

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From the Global Health Policy Community

FT Health Examines WHO Director General Election, Features Interview With Dutch Minister Who Launched She Decides Initiative

Financial Times: FT Health: Who for the WHO?
The latest issue of the Financial Times’ weekly global health newsletter features an article discussing the WHO director general election and an interview with Lilianne Ploumen, Dutch minister for foreign trade and development co-operation who launched the She Decides initiative (Jack, 3/10).

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Use Of Various Communication Mechanisms Would Improve Aid Programs Targeting Smallholder Farmers

Chicago Council on Global Affairs: Guest Commentary — Elevating the Smallholder Voice and Making Aid more Accountable for Improved Food and Nutrition Security
Anne Wanlund, country director at Gardens for Health International, discusses how “having high-quality, context-specific information is critical to designing successful food and nutrition security activities.” She encourages the use of feedback mechanisms and multi-directional communication structures to ensure accurate data, accountability, and transparency among programs affecting smallholder farmers (3/10).

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El Salvador Considers Legislation To Relax Country's Total Abortion Ban

Rewire: Momentum Builds for Reforming El Salvador’s Abortion Ban
Kathy Bougher, an educator, social justice activist, and writer, discusses El Salvador’s ban on abortion in all cases and highlights legislation under consideration “that would decriminalize abortion in cases of rape or human trafficking, fetal non-viability, or to preserve the pregnant person’s health or life. It would also legalize abortion when the pregnancy results from rape or statutory rape of a minor, with the consent of the minor’s parent or guardian…” (3/10).

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