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Kaiser Daily Global Health Policy Report

In The News

House Passes PEPFAR Stewardship And Oversight Act; President Expected To Sign Bill

“The House on Tuesday cleared legislation that would extend for five years certain authorities related to federal efforts to combat HIV and AIDS around the world, sending the bill to the president’s desk,” CQ Roll Call reports (Kim/Tomkin, 11/19). “Members passed S. 1545, the PEPFAR Stewardship and Oversight Act, in a voice vote,” The Hill’s “Floor Action” blog notes, adding, “President Obama is likely to be in a position to sign the bill into law as early as this week, as the Senate passed the same bill on Monday” (Kasperowicz, 11/19). “In the House, Foreign Affairs Committee Chairman Ed Royce and ranking Democrat Eliot Engel both backed the bill,” the Associated Press/ABC News writes (Jackson, 11/20). Additional information on the bill is available from the Kaiser Family Foundation’s “Policy Tracker” (11/18).

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Shah Says Philippines Will Not Have Aid Problems Similar To Haiti

“The Philippine government is strong enough to ensure long-term reconstruction in the wake of devastating Typhoon Haiyan is effective and avoid the aid problems seen after the Haiti earthquake three years ago, the [USAID administrator] said on Tuesday,” the Thomson Reuters Foundation reports. “One thousand U.S. marines were arriving on Tuesday to help clear rubble and create access for aid workers at the heart of the disaster zone, Rajiv Shah said” in an interview with the news agency. “The international community has already provided $182 million in aid for the Philippines, Shah said, adding that the United States has committed $37 million,” Reuters writes. “Reconstruction plans in the Philippines are already in focus, with the head of U.N. disaster relief Valerie Amos stressing on Tuesday the need for long-term planning to ensure farmers and fishermen can resume their livelihoods,” the news agency adds (Scrutton, 11/19). “The typhoon that hit the Philippines has caused crop losses worth $110 million and inflicted damage to the agriculture sector of more than twice that figure, preliminary estimates from the [U.N. Food and Agriculture Organization] showed on Tuesday,” Reuters notes (11/19).

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UNAIDS Report Highlights Progress, Challenges In Asia-Pacific AIDS Response

“A new U.N. report [.pdf] warns the HIV epidemic in Asia and the Pacific is at a pivotal juncture with little progress in reducing new infections,” VOA News reports, adding, “AIDS researchers and activists are calling for more political will by governments to address related issues” (Corben, 11/19). “Significant legal and policy barriers still remain for Asia-Pacific countries’ fight against AIDS, a report released on Tuesday by [UNAIDS] showed,” Xinhua/Global Times states. “Currently, all countries in the region have at least one law that hinders the AIDS response, according to the report disclosed at the opening of the 11th International Congress on AIDS in Asia and the Pacific (ICAAP11) in Bangkok,” the news service writes (11/19). The report “warned of high HIV prevalence in key populations in Asia and the Pacific such as intravenous drug users and men who have sex with men,” China Daily notes (Juan, 11/20).

However, “[n]ew HIV infections were down in 2012 by 26 percent since 2001 in the Asia-Pacific region, to an estimated 350,000, clinching the region’s reputation as an AIDS-response success story,” Deutsche Presse Agentur/The Nation reports (11/19). “This reduction, while welcome, falls far short of global targets aimed at reducing new infections in every country by 90 percent,” according to the Bangkok Post (11/19). “Voicing deep concern over high HIV/AIDS infection among children and teenagers in Asia-Pacific, the United Nations Children’s Fund (UNICEF) [on Tuesday] called for accelerated actions to address the specific needs of this vulnerable group and wipe out the pandemic,” the U.N. News Centre writes, noting, “A UNICEF-backed report titled ‘Lost in Transitions: Current issues faced by adolescents living with HIV in Asia Pacific’ will be launched on the closing day of ICAAP” (11/19).

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Talks At U.N. Climate Change Meeting Continue; Ban Urges Attendees To Act

“Poor countries have thrown down the gauntlet as the U.N. climate talks under the U.N. Framework Convention on Climate Change (UNFCCC) entered their final week, when government ministers take over the negotiations in Poland,” IRIN reports. “Recognition of the impact climate change is having on food security, a mechanism to address loss and damage as the climate changes and finance to help countries adapt are the major issues for poor countries,” the news agency writes. IRIN summarizes “the positions of some negotiators on the main issues at present” (Kindra, 11/19). U.N. Secretary-General Ban Ki-moon told conference attendees on Tuesday “that the deadly devastation wrought by Typhoon Haiyan proves that the world must act now to counter the wrath of a warming planet,” according to the U.N. News Centre. “‘The science is clear. Human activities are the dominant cause of climate change. We cannot blame nature,’ he told the conference,” the news service writes (11/19).

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U.N. Officials Speak About Sanitation, Hygiene On World Toilet Day

“With its first official observance of World Toilet Day, the United Nations [on Tuesday] called on the international community to help break taboos around toilets, which are still out of reach to more than one-third of the global population, and make sanitation a global development priority,” the U.N. News Centre reports. “Of the eight anti-poverty targets known as the Millennium Development Goals (MDGs), the sanitation target is the most off-track with more than 80 percent of countries behind in the national targets that they set,” the news service adds. The article includes quotes from U.N. Secretary-General Ban Ki-moon; Catarina de Albuquerque, the U.N. special rapporteur on the human right to safe drinking water and sanitation; and Theresa Dooley, senior adviser for sanitation and hygiene at UNICEF (11/19). In a separate article, the U.N. News Centre interviews U.N. Deputy Secretary-General Jan Eliasson, who talks “about why it is vitally necessary to make progress to improve hygiene, change social norms, better manage human waste and waste-water systems, and, ultimately, eliminate open-air defecation, which perpetuates a vicious cycle of disease and entrenched poverty” (11/19).

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Merck To Expand Its Maternal Health Program Begun In Developing Countries To U.S.

“Merck & Co on Tuesday said it is expanding its ‘Merck for Mothers’ program, which aims to reduce pregnancy-related deaths from impoverished countries such as Senegal and Zambia, to the United States — a stark reminder of how far the country lags other wealthy nations on key measures of health,” Reuters reports. “‘As Americans, we simply should not accept that 46 countries have lower rates’ of reported maternal mortality, said Merck Chief Executive Ken Frazier,” the news agency writes, adding, “The fact that U.S. pregnancy-related deaths have nearly doubled since 1990 is ‘appalling’ and ‘something we ought to be ashamed of,’ he said.” Merck “launched the $500 million global program in 2011 to reduce pregnancy-related deaths, focusing on India, Uganda and other poor countries with only rudimentary health care systems,” Reuters notes, adding, “‘Merck for Mothers’ will provide $6 million to U.S. programs in 10 states and three cities aimed at decreasing the number of women who die as a result of being pregnant or giving birth” (Begley, 11/19).

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Kuwait, Saudi Arabia, Qatar Report MERS Cases, Deaths

The WHO on Monday “confirmed the first two Middle East respiratory syndrome coronavirus (MERS-CoV) cases in Kuwait, while a media report said Spain now has its second probable case in a woman who participated in the recent hajj in Saudi Arabia,” CIDRAP News reports (Roos, 11/18). In addition, “Saudi health authorities on Wednesday announced a new MERS death,” according to Agence France-Presse, which adds, “It also reported a new infection of a 65-year-old Saudi man in the northern Al-Jawf province, currently receiving treatment at a Riyadh hospital” (11/20). And “[a]n expatriate living in Qatar had died after he contracted MERS, bringing to three the number of deaths from the coronavirus in the Gulf state, health authorities said Tuesday,” AFP writes in a separate article, noting Qatar in September reported “two other deaths from MERS of a man and a woman” (11/19).

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Zimbabwe Capital Risks Cholera Outbreak, Human Rights Watch Warns

“Human Rights Watch on Tuesday warned that Zimbabwe’s capital Harare was at risk of repeating a cholera outbreak five years ago that killed over 4,200 people,” Agence France-Presse/France 24 reports (11/19). According to the group, “residents in Harare’s poorest townships have little access to clean piped water and often resort to drinking water from wells contaminated with feces,” the Associated Press writes (11/19). “In a report [titled] ‘Troubled Water: Burst Pipes, Contaminated Wells, and Open Defecation in Zimbabwe’s Capital,’ Human Rights Watch said residents face an increased threat from cholera, dysentery and similar diseases unless the water and sanitation situation was fixed,” according to VOA News (Mhofu, 11/19). “Residents must often drink from shallow, unprotected wells befouled by sewage, according to the report, which was based on research conducted over the last two years,” the New York Times adds (Gladstone, 11/19). “The government should take a number of steps to improve Harare’s water and sanitation crisis, including investing in low-cost sanitation and water strategies,” Human Rights Watch states in an article on its website (11/19).

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Southern Afghanistan Marks 1 Year With No Recorded Polio Cases

“No new cases of wild poliovirus have been reported in southern Afghanistan in the last year, UNICEF said Tuesday, marking a crucial milestone in the country’s battle against the debilitating disease,” TIME reports, noting “Afghanistan is one of the three remaining countries (along with Pakistan and Nigeria) where polio is still endemic” (Katz, 11/19). “At the same time, many areas of the country still have low levels of routine immunization coverage and it is now more important than ever that we all redouble our efforts to build the immunity of children across the country with polio vaccine to stop transmission of the virus,” according to a UNICEF press release. “Efforts also continue across Afghanistan to strengthen the routine immunization system so that children are better protected from all vaccine-preventable diseases and to sustain achievements in polio eradication in the long term,” the press release adds (11/19).

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NPR Examines U.S. Project Employing Traditional Healers To Track Plague In Uganda

NPR’s “Shots” blog examines a project through which traditional “healers and herbalists are helping to track down the plague in Uganda for scientists” at the CDC. “Many villages in rural Uganda don’t have medical doctors or nurses to diagnose or treat the plague,” but “many patients do go see their village’s herbalist or healer,” the blog writes, noting medical anthropologist Mary Hayden and her team “trained them to spot potential cases of the plague and other severe diseases and then refer the people for modern medical care.” The blog adds, “The CDC’s network of traditional healers in northwestern Uganda has now referred more than 150 patients to local hospitals, Hayden says. The system even helped the CDC stop a case of pneumonic plague, the airborne form, from spreading through a community” (Doucleff, 11/19).

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China's One-Child Policy Relaxation Could Impact Food Security, Public Services

“China’s relaxation of its one-child policy, announced last week, is unlikely to spark a baby boom,” ScienceInsider reports, adding, “But it may be a steppingstone to a bigger change that influences when the nation’s population peaks — a milestone with major ramifications for food security.” According to the news service, “Many demographers consider the relaxation a prelude to eventually allowing all families to have two children. But many government planners are not sold on abolishing the one-child policy” (Ouyang, 11/19). Chinese Communist Party “conservatives still fear two things about loosening population controls,” The Economist writes. “The first is that without proper controls the population may grow beyond the country’s planned capacity to feed itself (1.5 billion people by the year 2033). The second is that loosening too quickly may spur a baby boom that would strain public services,” the news magazine continues (11/19). “The new policy could affect millions of lives, but demographers and policymakers believe it won’t have a significant impact on China’s current demographic reality,” ScienceInsider notes. “With China’s food security planning aiming to feed as many as 1.5 billion people by 2033, says Wang Feng, a demographer at the University of California, Irvine, a two-child policy would not overstress the system,” according to the news service (11/19).

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Southern African Organizations Sign Food Security MoU; SciDev.Net Presents Food Security Spotlight

The Centre for Coordination of Agricultural Research and Development for Southern Africa (CCARDESA) in Botswana and the Regional Agricultural and Environmental Innovations Network Africa (RAEIN-Africa) in South Africa “have signed a Memorandum of Understanding (MoU) to collaborate to improve food security and people’s livelihoods in the Southern African Development Community (SADC),” SciDev.Net reports. “The collaboration is expected to enhance their common interest in training, future development of agriculture, and research [on the] development, application and transfer of technologies,” and “[o]ther key areas of the collaboration include research and development that focus on food security and livelihoods, natural resources management, practices that enhance the relationship between research and industry and the promotion of sustainable agriculture through capacity building initiatives,” the news service adds (Kavahematui, 11/19). In a Food Security Spotlight, SciDev.Net presents several other articles and opinion pieces on the issue (Pirozzi, 11/20).

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LiveScience Series Examines Impacts Of Population Growth

Noting the U.N. estimates the global population could grow to 11 million people by the end of the century, LiveScience in a weeklong series “is taking a look at the impacts a population of 11 billion people might have on our home planet.” On Tuesday, the news service examined the issue of food security, including challenges to and strategies for feeding the growing population (Rettner, 11/19). A second article highlights six possible strategies for feeding 11 million people (Rettner, 11/19). An infographic looks at food waste, food production and the effects of climate change on crop yields (Toro, 11/12). The series also plans to examine how the growing population will affect water security, climate change, animal populations, disease outbreaks, sanitation, and space travel (11/19).

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Editorials and Opinions

Saudi Arabia Must Remain Vigilent, Transparent On MERS

Citing two conflicting studies on Middle East respiratory syndrome coronavirus (MERS-CoV) — one showing “a slowly growing epidemic” and the other not — a Washington Post editorial states, “The behavior of this virus is a matter of concern to the world. Much is unknown, and much will depend on Saudi Arabia, which has reported a steady stream of cases, including 53 of the deaths so far.” The editorial continues, “There are rumblings of worry among public health experts about the lack of good research coming from Saudi Arabia, with its traditions of isolation and opacity.” The editorial writes, “A decade ago, the SARS epidemic shocked Chinese leaders into realizing that transparency was essential for battling a public health crisis,” adding, “The MERS coronavirus could mutate and pose a threat far beyond the Middle East.” The Washington Post concludes, “Before that moment, Saudi Arabia ought to learn a lesson from China and do everything it can to make sure the world’s wisdom and experience are brought to bear on [MERS]” (11/19).

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China's Relaxation Of One-Child Policy 'Could Significantly Improve Lives'

Noting China last week relaxed its one-child policy to allow couples “to have two children if one parent is an only child,” as well as several other announced reforms, a New York Times editorial writes, “Set against the government’s authoritarian record, the announcements on family size … are genuinely surprising. China’s one-child policy in particular has defined the state’s power to control individual lives.” The editorial continues, “From time to time, the policy has been relaxed in some parts of the country and for certain ethnic minorities. But it has often been brutally applied to force women into abortions. The policy has been criticized not only by human rights advocates but by economists because it contributes to the aging of China’s population and its shrinking labor force.” The New York Times concludes, “But if carried through, some of the initiatives outlined in the latest meeting [of China's Central Committee] could significantly improve the lives of Chinese people” (11/16).

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More Must Be Done In South Africa's AIDS Response, But Progress Should Be Celebrated

In a Project Syndicate opinion piece, Tochukwu Akunyili, a graduate student at the University of Erfurt’s Willy Brandt School of Public Policy, examines the AIDS response in South Africa. “Until recently, the government’s response to the epidemic, which threatened the country’s very lifeblood, was lackluster and foolish. But rising pressure over the past two decades — from civil-society groups, the media, and more enlightened politicians — is finally showing results,” he writes. He provides a brief of the country’s response to the epidemic, and notes “annual AIDS-related deaths have fallen by around 100,000 since 2005.” However, “a new U.N. report [.pdf] suggests that South Africa’s battle against the virus is far from over,” he writes, providing statistics from the report. “More can and must be done,” Akunyili continues, adding, “But progress to date should be acknowledged, if not celebrated.” He concludes, “The recent successes demonstrate that with political will and sufficient resources, even the greatest of scourges can be beaten — a lesson not only for South Africa but also for countries elsewhere in Africa and the developing world” (11/20).

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As International Family Planning Conference Concludes, Focus On Youth Should Continue

“This year’s International Conference on Family Planning (ICFP) saw the largest youth delegation in its history,” Ward Cates, president emeritus with FHI 360, Joy Cunningham, a technical adviser with FHI 360, and Kate Plourde, a technical officer with the organization, write in the Huffington Post’s “Impact” blog. “At the conference, youth participants developed a call for action on young people and family planning, highlighting the importance of comprehensive sexuality education, improving accessibility and reducing barriers, increasing meaningful engagement and youth participation, and ensuring the provision of youth-friendly services,” they note, adding, “This landmark document not only highlights the importance of renewed energy and commitment to reducing adolescent pregnancy, but also demonstrates the importance of involving young people as catalysts for change.” They conclude, “Now that the conference has drawn to a close, let’s work to ensure that the international attention on youth remains strong and results in real action to improve the lives of young people” (11/19).

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Climate Change, Population Growth Threaten Population In Low-Lying Areas

“Unfortunately, catastrophes like [Super Typhoon Haiyan in the Philippines] are likely to become more common in the coming years” as a result of climate change and population growth, John Seager, president of Population Connection, writes in the Huffington Post’s “World” blog. He notes that as sea levels rise as a result of climate change, “so does the threat to populations in low-lying areas such as the Philippines,” and asks, “What can we do about it?” He states, “We can’t move everyone [away from these areas]. But those of us in the developed world can move to lower-carbon living — and stop doing our part to make climate change worse.”

“And we can help the world’s most vulnerable people become more resilient,” he continues. “One simple tool — birth control — can play an important role in accomplishing both these goals,” he states, noting, “Right now, more than 222 million women in the developing world — many in areas at high risk of climate change-related effects — want to avoid pregnancy but lack the modern birth control they need to do so.” He adds, “It’s easy to feel hopeless in the face of the devastation in the Philippines. But there is plenty we can do,” such as giving to charitable organizations, reducing carbon emissions, and “ensur[ing] every woman around the world who wants it has access to contraception” (11/18).

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Recent Releases

USAID's Shah To Deliver Speech On Ending Global Poverty

“On Thursday, USAID Administrator Rajiv Shah is set to give a speech at Brookings on the goal of ending extreme poverty, planned to put a bit more policy oomph behind the president’s call in the State of the Union earlier this year for America to join with its allies to end $1.25 poverty in two decades,” Charles Kenny, a senior fellow at the Center for Global Development (CGD), writes in the center’s “Rethinking U.S. Development Policy” blog. He highlights a number of issues he hopes will be raised in the speech, and states, “If [Shah] can use the drive to end global extreme poverty as a means to further improve and target U.S. aid so it can make the most difference, here’s hoping Thursday’s speech is a blockbuster” (11/19).

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On International Men's Day, Continue Working To Protect Men, Boys From HIV

On November 19, “as we celebrate International Men’s Day, we need to ‘step up’ for every man and boy, keeping them safe as they continue the battle against HIV,” Robert Ferris, chief of the Technical Leadership & Research Division in USAID’s Office of HIV/AIDS, writes in the agency’s “IMPACTblog.” He continues, “This means prioritizing access to HIV prevention services like voluntary medical male circumcision (VMMC)”; “scaling up evidence-based structural and behavioral interventions to remove barriers to HIV services”; “identifying more men and boys who are HIV-positive and enrolling them in quality HIV care and treatment services”; and “continuing the search for a safe and effective HIV vaccine and possibly even a cure.” Ferris concludes, “On this International Men’s Day, let’s continue our work to keep men and boys safe from HIV” (11/19).

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Blogs Address World Toilet Day

The following is a summary of blog posts addressing World Toilet Day, which was observed November 19.

  • Alex Gordon, Global Network for Neglected Tropical Diseases’ “End The Neglect” blog: “Without a toilet, people are forced to defecate outside — an act that compromises a person’s dignity, privacy and safety, and leaves billions susceptible to neglected tropical diseases (NTDs),” Gordon, a contributor to the blog, writes. “By combining NTD treatment, hygiene education and creative solutions for the 2.5 billion people without access to toilets, we can tackle this problem,” he states (11/19).
  • Carl Hensman, Bill & Melinda Gates Foundation’s “Impatient Optimists” blog: Noting “40 percent of the planet’s population does not have access to safe sanitation, impacting their health and prosperity,” Hensman, a program officer in the water, sanitation, and hygiene program at the foundation, writes, “So on November 19th, while you perch on your porcelain pedestal, as we all do, please celebrate the luxury under you, a luxury that is regarded as one of the greatest health benefits in history and only costs the average household $40-50 per month.” He adds, “Then ask yourself, what makes us so special that we should have a functioning sanitation system while 40 percent of the planet is forced to make do with something completely inadequate and completely dangerous?” (11/19).
  • Shankar Narayanan, PSI’s “Impact” blog: “Over 60 percent of India’s population does not have access to a toilet, meaning they are forced to defecate outside, a practice which causes the spread of diarrheal disease and contamination of the environment,” Narayanan, director of programs at PSI India, writes. “PSI partnered with the [non-governmental organizations (NGOs)] Monitor Group, PATH and Water For People to answer the question: ‘Why don’t households have toilets?'” he notes, adding, “We found that the supply chain is fragmented.” He writes, “To address these issues, PSI is applying its expertise in social franchising, the use of commercial franchising strategies in the non-profit sector to expand access to products and services for underserved communities” (11/19).
  • Jaehyang So, Huffington Post’s “Global Motherhood” blog: “In any given country, when we talk about securing food, water and health, as a development community we need to look the problem square in the eye and ask ourselves, have we at least covered basic human sanitation and hygiene?” So, manager of the World Bank’s Water and Sanitation Program, writes. She highlights “three things we can do differently,” including ensuring various ministries within governments “work together to fix sanitation in countries where it is needed most,” “talk[ing] about sanitation on a global scale,” and “innovat[ing] ways to ensure basic water and sanitation services reach the poorest people” (11/19).

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Washington's Global Health Organizations Making Worldwide Impact

Writing in the Bill & Melinda Gates Foundation’s “Impatient Optimists” blog, Bill Gates, Sr., who guides the vision and strategic direction of the foundation, discusses the state of Washington’s “positive influence on the global health and development landscape.” In particular, he describes the activities of Global Washington and the Infectious Disease Research Institute (IDRI). “Global Washington and IDRI aren’t the only catalytic health and development organizations in our neck of the woods — several of our partners, including local universities and colleges, PATH, Landesa, and Seattle BioMed, also work on behalf of the globe’s poorest people,” he writes, concluding, “It is the strength of local organizations like these — with their global reach and influence — that has helped Washington be an important player in global health and development” (11/19).

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