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Kaiser Daily Global Health Policy Report

In The News

Merck, GlaxoSmithKline To Offer HPV Vaccine To Developing Countries At Discounted Price

“Drugmakers Merck and GlaxoSmithKline are working with the [GAVI Alliance] to provide hugely discounted cervical cancer vaccines to millions of girls in poor countries,” the Associated Press/Washington Post reports (5/9). “The two companies that make [the] [human papillomavirus (HPV)] vaccine … will drop their prices to $4.50 and $4.60 per dose respectively in developing countries for the period 2013-2017,” the Globe and Mail writes, noting “prices will drop further as demand grows” (Picard, 5/9). Noting women need three shots in the immunization series, so the cost will be approximately $13.50 per woman, Guardian health editor Sarah Boseley states in her “Global Health Blog,” “It is a small price to pay for preventing a disease that is a scourge of Africa and Asia — but the bill for immunizing whole populations of schoolgirls will be huge” (5/9). “The same vaccines can cost more than $100 in developed countries and the previous lowest public sector price was $13 per dose, said GAVI,” Xinhua notes (5/9).

“The new record low price for [HPV] vaccines should mean millions of girls in developing countries can be protected against the disease, [GAVI] said on Thursday,” according to Reuters (Kelland, 5/9). “Starting with pilot programs in eight Asian and African nations, the ambitious project ultimately is intended to inoculate more than 30 million girls in more than 40 countries by 2020,” the Associated Press writes (Johnson, 5/9). “The low price will initially apply to a few million doses for demonstration projects in Kenya, Ghana, Laos, Madagascar and elsewhere,” the New York Times notes (McNeil, 5/9). “Until now, there have been very few efforts to get the inoculations that protect against the sexually transmitted [virus] to women in low-income countries where there is little testing or treatment for cervical cancer,” Bloomberg Businessweek writes, adding, “More than 80 percent of deaths from cervical cancer are in developing countries, where it is the leading cause of cancer deaths in women” (Pettypiece, 5/9).

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GlaxoSmithKline, Save The Children Form Partnership To Save Children's Lives

“GlaxoSmithKline [GSK] is giving Save the Children $23 million and entering into a five-year partnership with the charity to try to save the lives of one million children,” the Associated Press/Bloomberg Businessweek reports (Straziuso, 5/9). “The initiative launched by the two organizations on Thursday in Kenya will see Save the Children with a seat on the R&D board, advising on new products for the poorest countries, while GSK also pays for the training of more health care workers who will dispense medicines and give vaccines,” The Guardian writes, adding, “Save the Children’s Chief Executive Justin Forsyth, at the launch in Kenya with GSK’s Chief Executive Sir Andrew Witty, described it as ‘a ground breaking partnership’ which ‘involves both organizations working in genuinely new ways to save the lives of a million children'” (Boseley, 5/9).

GSK “said the partnership would set a new standard for how companies and charities could work together,” according to BBC News (5/10). “GSK said it would give at least £15 million ($23.25 million) over the course of the partnership, partly in donations from its 104,000 staff worldwide, as well as contributions through research and development (R&D) programs,” Thomson Reuters Foundation writes. The companies “have agreed to work together for an initial five-year period, but this could be extended if the initiative proves successful, a GSK spokeswoman told Thomson Reuters Foundation,” the news service states, adding, “Both Witty and Forsyth said they saw the partnership as a long-term collaboration” (Rowling, 5/9).

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France Investigates 3 Suspected Cases Of Coronavirus

“French health officials said Friday they are investigating three suspected cases of a deadly new respiratory virus related to SARS, while a man confirmed to have the virus remains hospitalized,” the Associated Press reports (Keller, 5/10). “A nurse in a hospital that held France’s only confirmed case of the SARS-like coronavirus that has killed 18 people has been admitted to hospital in northern France on suspicion of being infected herself, French health officials said,” Reuters writes (Savary et al., 5/10). “A doctor and a former hospital roommate who had each been in contact with the first patient also remain hospitalized. Test results are expected later Friday,” the AP adds (5/10). “The ARS local health authority said the two other men were in individual rooms in separate hospitals, one in Lille and the other in the nearby town of Tourcoing, and that tests had been carried out on both of them,” Reuters notes in a separate article (Savary/Bremer, 5/9).

“The 13 recently reported patients have all been linked to a hospital in Hofuf, in Saudi Arabia’s Eastern Province; but how they became infected, or whether there is human-to-human transmission, remains unclear,” Science reports (Enserink, 5/10). “The Saudi government is reportedly conducting ongoing investigation into the outbreak linked to [the] health care facility,” Nature World News notes, adding, “Based on the information it’s received regarding the current situation, the WHO encourages countries to keep a watchful eye out for severe acute respiratory infections in the case of any unusual patterns” (Kemsley, 5/9).

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World Food Prices Rise For Second Month, FAO Reports

“World food prices rose for a second straight month, the United Nations Food and Agriculture Organization (FAO) today said, while global production of coarse grains could set a new record this year with strong growth also projected for global wheat and rice production,” the U.N. News Centre reports. “The slight boost was driven mainly by a spike in dairy prices,” according to the news service (5/9). The price index, “which measures monthly price changes for a basket of cereals, oilseeds, dairy, meat and sugar, averaged 215.5 points in April, up two percent from a revised 213.2 in March,” Reuters notes (5/9).

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WFP Regional Coordinator Examines Solutions To Sahel Food Crises

“Those working to combat food insecurity in the Sahel need to ‘get their thinking together’ and realize that it could take several years for the poorest families to recover from three successive regional droughts and hunger crises, says the new regional coordinator of the World Food Programme (WFP),” The Guardian reports. “Denise Brown, who took up the post in early April after two years as WFP head of office in Niger, says an integrated approach between agencies is needed,” the newspaper writes, adding, “Brown is hoping her experience in Niger — the worst affected country in the 2012 crisis, when about five million people went hungry and many thousands of children suffered severe malnutrition — will stand her in good stead to help WFP coordinate better regionally with other bodies such as the U.N. children’s agency, UNICEF, and the Food and Agriculture Organization.”

“In Niger, WFP has been looking for overlaps in several areas in which it works, such as food distribution and cash for work programs,” The Guardian writes and highlights a program, called Nigeriens Feed Nigeriens, or “Trois Ns,” which The Guardian says has influenced Brown’s interest in better coordination. “Led by the Nigerien president Mahamadou Issoufou, the initiative aims to tackle Niger’s chronic food insecurity using homegrown methods,” the newspaper writes, adding, “Brown believes that the Trois Ns’ focus on building local capacity to deal with what seems to be becoming a permanent pattern of unpredictable rainy seasons and harvests should be translated to the regional level” (Hicks, 5/9).

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Science Magazine Examines Recent HIV Vaccine Clinical Trial Results

Science magazine reviews the disappointing results of two recent HIV vaccine clinical trials, which “sugges[t] that a successful vaccine, the most effective way to slow if not end the epidemic, lies far in the future.” The news service focuses on the experimental vaccines’ use of adenovirus vectors, which “are widely used in experimental vaccines and gene therapy studies” and show some evidence of increasing the risk of HIV infection. “Other than a large-scale trial of a new and improved version of RV144 set to start in South Africa in 2015, all HIV trials currently in the works are at very early stages,” Science notes (Cohen, 5/10).

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Editorials and Opinions

Vigilance Over Disease Outbreaks Must Continue, Opinion Pieces, Editorial State

The following summarize an editorial and opinion pieces on recent disease outbreaks, including H7N9 avian flu in China and a novel coronavirus in Saudi Arabia, and the global public health response.

  • Washington Post: The outbreak of a new bird flu strain in China, known as H7N9, “has not reached U.S. shores, but it is a reminder of the unpredictable nature of influenza,” the editorial states. “The uncertainty ought to remind us of past lessons about infectious disease and globalization, which remain as urgent as ever,” the editorial continues, adding, “One of those lessons is the vital role of rapid communication about an emerging outbreak.” Noting China’s failure to report early cases of severe acute respiratory syndrome, or SARS, as the virus spread a decade ago, the editorial says, “This time, China has reacted differently.” The editorial continues, “The critical tripwire that could lead to a pandemic would be sustained human-to-human transmission of the virus. Until now, there have been small clusters of people infected but not sustained transmission.” But “[g]erms do not stop at passport control. … Bird flu is everyone’s problem, and we can only hope that China continues to fight it effectively and with transparency,” the editorial concludes (5/8).
  • Michael Osterholm, New York Times: Noting the news of H7N9 avian flu and novel coronavirus outbreaks in China and Saudi Arabia, respectively, Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, writes, “While the number of human cases from these two pathogens has so far been limited, the death rates for each are notably high.” But, “[a]larmingly, we face a third, and far more widespread, ailment that has gotten little attention: call it ‘contagion exhaustion,'” Osterholm states, noting coverage of many new and emerging diseases over the years. While “the number of infected people is small, and the infections are occurring thousands of miles away from the United States … we should be seriously concerned about both,” he says, because diseases like H7N9 and coronaviruses “can kill large numbers of people quickly and simultaneously around the world” and “[o]ur public health tools to fight these viruses are limited.” He adds, “The world as whole must invest in a new generation of effective influenza and coronavirus vaccines” (5/9).
  • David Quammen, New York Times: Also noting the news of H7N9 avian flu and novel coronavirus outbreaks, Quammen, an author and National Geographic contributing writer, states, “Every new disease outbreak starts as a mystery, and among the first things to be solved is the question of source.” He adds, “In most cases, the answer is wildlife,” and discusses how the source of the severe acute respiratory syndrome virus was bats, also being investigated as a source for novel coronavirus. “One emergent virus, sooner or later, will be the Next Big One. It may show up first in China, in Congo or Bangladesh, or maybe on the Arabian Peninsula; but it will globalize,” he writes, concluding, “We can’t detach ourselves from emerging pathogens either by distance or lack of interest. The planet is too small” (5/9).

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Lack Of Discussion On Health Implications Of U.K. Withdrawal Of Aid To South Africa 'Disappointing'

Noting “the U.K.’s International Development Secretary, Justine Greening, [in April] announced that Britain’s bilateral development program in South Africa would end in 2015, on the grounds of South Africa’s enormous political and economic progress,” a Lancet editorial writes, “The withdrawal decision … was regarded as ‘unilateral’ by South Africa’s government, who claimed it would have ‘far-reaching implications’ and would be ‘tantamount to redefining’ the two countries’ relationship. In response, the U.K. Foreign Secretary William Hague said that the U.K. would clear up any confusion with the South African government.” The editorial continues, “Disappointingly, the essential issue of health has not been part of the discussion.”

“This bilateral development program, currently worth £19 million [$29.2 million] annually, will focus in its final two years on finishing projects that will help reduce the number of women dying in childbirth by more than 10 percent and also that support businesses,” the editorial notes, and asks, “Considering the current maternal health status in South Africa, can the £19 million per year package help achieve the target in reducing maternal death by 2015?” The Lancet continues, “Health is without doubt a key part of the U.K.-South African bilateral partnership,” concluding, “While the U.K. and South Africa are trying to resolve this misunderstanding, it is crucial for both sides to assess how important the U.K.’s aid is to health care in South Africa and the implications for global health from stopping aid” (5/11).

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Recent Releases

Sustain Global Fund Investment To Continue Progress In Africa

“I’m hopeful about the potential of the World Economic Forum on Africa, where business minds will meet political leaders in Cape Town, South Africa, to discuss the economic future of Africa,” but “I worry those gathered will focus narrowly on discussions of economic statistics or trade rules and ignore the only way we can ensure Africa delivers on its promise — by investing in the health of its people,” Yvonne Chaka Chaka, president of Princess of Africa Foundation and a Roll Back Malaria goodwill ambassador, writes in the World Economic Forum blog. “We have come to a critical crossroads,” she continues, adding, “Without $15 billion mobilized this year, the Global Fund [to Fight AIDS, Tuberculosis and Malaria] will not be able to continue [its] historic progress for the next three years, and Africa will fall backwards in its fight against AIDS, TB and malaria at great economic and human cost to our continent.” She states, “International donors such as the United Kingdom and Australia must come forward to fund the Global Fund, and African countries must follow through on their health promises” (5/9).

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Examining The Need For Transmission-Blocking Malaria Vaccine

The WHO “has undertaken an update of the 2006 Malaria Vaccine Technology Roadmap — a document developed through a consultative process to align the malaria vaccine development community toward common goals,” David Kaslow, director of the PATH Malaria Vaccine Initiative, writes in USAID’s “IMPACTblog” as part of a May series examining the agency’s global health work. He notes “the long-term goal will be updated to better reflect the global health community’s desire to eradicate malaria altogether and targets vaccines that interrupt malaria transmission (VIMTs) and that support the elimination/eradication agenda, including transmission-blocking vaccines (TBV).” Kaslow writes, “When used in conjunction with other technologies, a transmission-blocking vaccine could help a country push across the threshold from control to elimination and ultimately help achieve global eradication” (5/9).

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Examining Food Aid Reform Debate

Noting the proposed reform to the U.S. food aid program contained in President Obama’s FY 2014 budget request, Hannah Laufer-Rottman, executive director of Palms for Life Fund, a non-profit that promotes a global alliance to end poverty and hunger, writes in the Chicago Council on Global Affair’s “Global Food For Thought” blog, “While the goal of reducing hunger in the world continues to be a key strategic goal of this country, the effectiveness of the policy will hinge on the application of a global, regional and country-by-country understanding of how complexities can work for or against the issue.” She lists six “complexities” the key elements of the policy will have to address, notes several questions that arise “when we look at the underlying context of the discussion on international food aid,” and states, “All the above opens another level of discussion that policy makers and the Obama administration cannot ignore if we intend to further the debate into a workable proposal. Such discussion takes into account the realities of international trade, fair trade among nations, and regulation of global food markets and food prices” (5/9).

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Panel Welcomes 3 New NTD Special Envoys

“On Tuesday, the Global Network [for Neglected Tropical Diseases (NTDs)] and the Center for Strategic and International Studies (CSIS) hosted a panel to welcome three new neglected tropical disease special envoys,” the network’s “End the Neglect” blog writes. Former President Alvaro Arzú Irigoyen of Guatemala, former Chile President Ricardo Lagos Escobar, and former Pan American Health Organization (PAHO) Director Mirta Roses Periago “have joined the effort to eliminate NTDs in the Americas and in other regions of the world where these diseases cause suffering and promote the cycle of poverty,” according to the blog (Alabaster, 5/9). “The new NTD Special Envoys will focus primarily on the Latin America and Caribbean (LAC) region,” a press release from the Sabin Vaccine Institute states, noting they will “provide the political voice and the technical expertise needed to reach the [WHO's] goal to control or eliminate the most common NTDs by 2020” and “will work with key G8/G20 countries, such as Brazil, Canada and Japan, to increase their support for the prevention and treatment of NTDs through expanded technical assistance and increased investments across the region” (5/7).

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