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Kaiser Daily Global Health Policy Report

In The News

U.N. Appeals For Polio Funding For Horn Of Africa; Disease Detected In Cameroon

“Two U.N. agencies on Friday called on countries in the Horn of Africa region to remain watchful as [a] polio outbreak has significantly slowed down,” Xinhua reports. “The [WHO] and UNICEF also appealed for $88 million to support [regional] governments’ polio eradication efforts in 2014 and maintain the momentum built over the last six months,” the news agency writes, noting, “The agencies said about one million children in the Horn of Africa, most of them in Somalia, have never been immunized or have not received the required number of doses.” Xinhua adds, “The outbreak had affected some 200 children and adults in Somalia, Kenya and Ethiopia” (Mutai, 11/22). In related news, CIDRAP News notes “the disease has been detected in Cameroon.” However, “both Pakistan and Afghanistan reported overall decreases in wild poliovirus (WPV) cases from January through September, compared with the same time period in 2012, the [CDC] said [Thursday] in a press release,” the news service adds (Schnirring, 11/21).

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Climate Talks Close With Last-Minute Compromise

“Developed countries and fast-growing economies have reached a last-minute compromise to avert a breakdown of climate talks in Warsaw, working towards the outline of a new United Nations pact in 2015 to slow down global warming,” Al Jazeera America reports (11/24). “Under the agreement, settled in the early hours of Sunday morning after more than 36 hours of non-stop negotiations, countries have until the first quarter of 2015 to publish their plans,” The Guardian writes, adding, “This process is seen as essential to achieving a new global deal on emissions at a crunch conference in Paris in late 2015, for which the fortnight-long Warsaw conference was supposed to lay the groundwork” (Harvey, 11/24). “But negotiators in Warsaw failed to agree on key details, such as what the plans should include and how they should be evaluated,” Politico Pro notes. “Delegates hope to reach agreement on a major climate pact in Paris that would take effect in 2020,” the news service writes, adding, “The negotiations are part of a broader, two-decade-old United Nations process that led to the 1997 Kyoto Protocol, which the United States never ratified” (Restuccia, 11/25).

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India Leads Efforts To Negotiate 'Peace Clause' In WTO Agriculture Agreement

“India and some other developing nations are trying to negotiate a cease-fire in a heated battle over food subsidies for the poor that is threatening to derail global trade talks, officials involved in the talks said,” the Wall Street Journal reports (Mukherji/Dalton, 11/24). “The G33 nations, a group of emerging countries including India, are demanding amendment in the WTO’s Agreement on Agriculture (AoA) in order to implement the [country's] food security plan without attracting any penalty even after breaching the minimum subsidy cap,” the Economic Times writes, noting that under current WTO regulations, “a developing nation can provide food subsidy of up to 10 percent of the total farm output.”

According to the Economic Times, “India is likely to agree for a four-year ‘peace clause,’ which will provide immunity against penalty for breaching the food subsidy cap” (11/23). “The U.S. and some other WTO members have argued that India’s program and others like it could lead to an artificial lowering of food prices on world markets, especially if India exported subsidized rice and wheat,” the Wall Street Journal writes, adding, “The standoff has threatened to stymie progress in broader talks set for next month in Bali aimed at reviving long-moribund multilateral trade negotiations” (11/24). On Friday, Ertharin Cousin, executive director of the U.N. World Food Programme, “wrapped up a two-day visit to India by lauding the government for [its Food Security Act] that has made the right to food legally enforceable in a country that is home to about a quarter of the world’s undernourished,” the U.N. News Centre writes (11/22).

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Indian Health Activists Take Legal Action To Stop Patenting Of Gilead Hepatitis C Drug

“Indian health activists are seeking to prevent Gilead from patenting its new treatment for Hepatitis C in the country in a fresh battle over affordable access to medicine,” the Financial Times reports. “The Initiative for Medicines, Access & Knowledge in India said it had filed a ‘pre-grant’ application in Calcutta to block” Gilead’s patent application, a legal action that “follows previous spats in India over intellectual property on medicines including those for HIV and cancer [and] could open the way for local generic drug manufacturers to sell low-cost versions of the product domestically and export it to other low-income countries without strong patent protection laws,” the newspaper writes. “The legal action could stall for several years the granting of patents in India, which one generic drug manufacturer said could permit the production of low-cost equivalents over several years,” the Financial Times notes (Jack, 11/24).

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UNFPA Launches Appeal To Focus Humanitarian Efforts In Philippines On Women, Children

“Two weeks after Typhoon Haiyan devastated the Philippines, more than 3.2 million women and girls of reproductive age are still in need of urgent care and protection, the United Nations population agency said [Saturday], launching an appeal for $30 million to provide services and aid during the next six months,” the U.N. News Centre reports. “An estimated 230,000 pregnant women are currently in affected areas, while 835 women are giving birth every day with very limited access to emergency obstetric care, according to the U.N. Population Fund (UNFPA),” the news service adds (11/23). In addition, “[h]ealth authorities aim to immunize 500,000 children most at risk of contracting measles in the wake of Typhoon Haiyan, but they face challenges in keeping the vaccines cold amid electricity shortages and in reaching some stranded areas,” the Wall Street Journal writes. “The health focus on children and also pregnant women comes as the number of deaths caused by the storm reached 5,235 people, making Haiyan the Southeast Asian country’s deadliest storm in recorded modern history,” the newspaper adds (Larano, 11/23).

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UNAIDS Calls For End To Gender-Based Violence, Highlighting Association With HIV Risk

UNAIDS “is calling for an end to gender-based violence, which is not only a serious human rights violation but also increases the risk of HIV infection,” the U.N. News Centre reports. “Recent research has established a clear association between intimate partner violence and HIV, with women experiencing such violence facing a 50 percent increased risk of acquiring the virus, according to” the agency, the news service writes. “About one in three women globally experience physical and/or sexual violence by a partner or sexual violence by a non-partner, the [WHO] has said,” according to the news service, which adds, “Responding to gender-based violence and HIV is ‘a matter of shared global responsibility for social justice,’ UNAIDS said in its news release” (11/22).

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Humanitarian Crisis Worsening In CAR

IRIN examines the worsening crisis the Central African Republic (CAR) “has faced since a rebel alliance known as Seleka took power by force in March 2013,” writing, “Humanitarian and development indicators were dire before the coup, but now, amid increasing violence by armed groups and between communities and religious faiths, they are even worse: almost the entire population of 4.5 million has been affected; 1.1 million people outside the capital, Bangui, are estimated to be severely or moderately food-insecure; and there are almost 400,000 internally displaced people (IDPs), double the figure of just a few months ago” (McNeish, 11/22). “Thousands of people are dying at the hands of soldiers and militia gangs or from untreated diseases such as malaria,” The Guardian adds (Smith, 11/22).

“The number of child soldiers in [CAR] has more than doubled to as many as 6,000 in recent months, as self-defense militia have sprung up to counter waves of attacks by former rebels, the United Nations said on Friday,” Reuters notes (Nebehay, 11/22). “The United Nations said a ‘pre-genocide’ situation may exist as the conflict takes on a religious aspect, pitting Christians against Seleka, which is mostly Muslim,” United Press International writes (11/22). “Samantha Power, the U.S. ambassador to the U.N., noted recently that the situation in the CAR has been referred to as ‘the worst crisis most people have never heard of,’” according to The Guardian (11/22).

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Militants Kidnap 11 Pakistani Teachers Involved In Polio Vaccination Campaign

“Militants kidnapped 11 Pakistani teachers involved in a polio vaccination campaign for school children on Saturday, officials said, the latest in a string of attacks on health workers trying to eradicate the deadly disease,” Reuters reports (Ahmad, 11/23). “Authorities said the workers were kidnapped on Thursday from the Bara area by Lashkar-e-Islam, the militant group in the country’s Khyber tribal district,” Agence France-Presse writes (11/24). “Tribal elders in the region are reportedly negotiating with suspected militants to release the kidnapped polio workers,” according to BBC News (11/23). “Militants frequently attack polio vaccination workers in Pakistan, accusing them of being Western spies or part of a plot to sterilize Muslims,” VOA News notes (11/23). “The kidnappings came as Imran Khan, the opposition politician whose party controls Khyber Pakhtunkhwa province, gave Nawaz Sharif, Pakistan’s prime minister, until November 23 to stop the U.S. drone program or he would order the closure of NATO supply routes in the province,” Reuters/Al Jazeera adds (11/23).

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Gates Foundation Recommits To Coordinating Malaria Eradication Efforts

“Malaria researchers believe that better coordination and new technologies, such as the use of vaccines and sophisticated disease mapping, can inject new life into the ambitious goal of eradicating the deadly illness,” AllAfrica reports in an article discussing the Bill & Melinda Gates Foundation’s “plan to synchronize the efforts of the malaria community worldwide towards the goal of global eradication, building on the foundation’s original eradication call of six years ago.” The news service summarizes recent developments and includes comments from Alan Magill, director of the Gates Foundation’s malaria program, and others who “spoke on the sidelines of the American Society of Tropical Medicine and Hygiene (ASTMH) conference held [earlier this month] in Washington, D.C., where the Gates Foundation made its announcement” (Strupp, 11/22). ASTMH provides a blog listing news from the conference (11/17).

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Cambodia Launches Investigation Into Corruption Allegations In Handling Of Global Fund Money

“Cambodia’s government anticorruption agency has launched an investigation into allegations of corruption involving the handling of money from an international fund to fight infectious diseases, a senior official of the watchdog agency said,” Kyodo News International/GlobalPost reports. The Global Fund to Fight AIDS, Tuberculosis and Malaria suspended contracts with two international suppliers of mosquito nets after discovering the companies had paid bribes to health officials in Cambodia, the news service notes, adding, “The Global Fund said it began investigating allegations of corrupt practices among Cambodian fund recipients in 2011.” According to the news agency, “Phay Siphan, a spokesman of the Council of Ministers, said the government will conduct a full investigation” (11/23).

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Qatar Reports 4th MERS Death; WHO Says Case-Fatality Rate At 39%

“An expatriate living in Qatar has died of [Middle East respiratory syndrome coronavirus (MERS-CoV)], bringing to four the number of deaths in the Gulf state from the coronavirus, health authorities said on Friday,” Agence France-Presse reports. “Experts are struggling to understand the disease, for which there is no vaccine,” the news agency writes (11/22). In a report released on Friday, the WHO “said … the continuing outbreak of [MERS-CoV] cases is probably being sustained, as some researchers have suggested, by a combination of human-to-human transmission and spillover from animals or other non-human sources — not one or the other,” CIDRAP News reports. “The agency’s current MERS-CoV count is 157 confirmed and 19 probable cases, for a total of 176. With 69 deaths, the case-fatality ratio is 39.2 percent,” the news service writes (Roos, 11/22).

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Singapore's Dengue Fever Outbreak May Continue To Worsen, Authorities Warn

“Authorities in Singapore are warning that Singapore’s most deadly outbreak of dengue fever since 2005 could get worse, after the disease claimed its seventh victim despite a vigorous effort by the government to control the epidemic,” the Wall Street Journal’s “Southeast Asia Real Time” blog reports. “More than 20,000 cases of the tropical, mosquito-borne disease have been identified in Singapore so far in 2013,” the blog writes, adding, “In recent months the National Environment Agency, or NEA, has continued to boost measures to bring the rate of infection down by asking for public suggestions about how to make the fight against dengue more fun and engaging, particularly for children.” The blog notes “Singapore is not alone in battling the latest outbreak. Thailand, Malaysia, Laos, Hong Kong, Japan and South Korea have all reported a wider incidence of the disease this year” (Watts, 11/23).

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Editorials and Opinions

Opinion Pieces Published Ahead Of Global Fund Replenishment Conference

The following is a summary of opinion pieces published ahead of the Global Fund to Fight AIDS, Tuberculosis and Malaria’s replenishment conference scheduled to take place in Washington, D.C., on December 3.

  • Phyllis AlRoy, Times of Trenton: “The choice is clear: invest in efforts to end these pandemics or allow them to fester and kill for decades to come,” AlRoy, a RESULTS volunteer, writes. “Because every $1 the U.S. gives to the fund has been historically matched by $2 from other donor nations, a $5 billion U.S. pledge could lead to the global replenishment goal of $15 billion,” she writes, concluding, “Continued U.S. leadership will set the stage for the defeat of AIDS, TB and malaria” (11/25).
  • Deborah Derrick, Huffington Post’s “Global Motherhood” blog: “The United States’ and others’ investments in the Global Fund and bilateral programs have led the way to stunning results in the past decade,” Derrick, president of the Friends of the Global Fight Against AIDS, Tuberculosis and Malaria, writes. “We are at a unique moment in history when scientific advances, greater knowledge of how to target the diseases, and better implementation strategies mean that controlling HIV/AIDS, tuberculosis and malaria is within our reach,” she states, adding, “Now is the time to come together as a global community to rev up support and ensure long-term, sustainable solutions in the fight against these deadly, yet treatable, diseases” (11/22).
  • DeVon Hale, Salt Lake Tribune: “Since people with HIV are able to live longer, healthier lives, HIV/AIDS doesn’t seem as threatening as in the past, making it easy for people and governments to decrease their monetary support of programs supplying medication to those infected,” Hale, assistant dean for international medical education at the University of Utah School of Medicine, writes. However, “[t]o support an accelerated attack on [the global AIDS, TB and malaria] pandemics requires $15 billion over three years,” he notes, adding, “[As] Mark Dybul, President George W. Bush’s global AIDS coordinator and now executive director of the Global Fund, said, ‘We have a choice: we can invest now, or pay forever’” (11/23).
  • Ashley Harvin and Braveen Ragunanthan, Richmond Times-Dispatch: “With a combination of recent advances in science, massive scale-up of services, and improved epidemiological tools, control of [HIV, TB, and malaria] is now within reach,” Harvin and Ragunanthan, both medical students at Virginia Commonwealth University, write. “The battle against these diseases is no longer in the laboratory; instead the challenge now lies in effective resource allocation,” they note, adding, “We as citizens can contribute to this unique effort by encouraging U.S. leaders to make a bold pledge of $5 billion over the next three years when the U.S. convenes the Global Fund replenishment conference” in December. They state, “Cutting these investments will not dent our national debt, but it will result in the deaths of millions of people” (11/25).

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Senate Should Ratify U.N. Convention On Rights Of Persons With Disabilities

“Senator Robert Menendez, a New Jersey Democrat and chairman of the Senate Foreign Relations Committee, has revived … the United Nations Convention on the Rights of Persons With Disabilities,” a New York Times editorial states, noting the Senate last year “fell five votes short of ratifying [the] international treaty that would improve protections for the disabled.” The newspaper notes, “He has held two hearings and plans a committee vote perhaps next month,” and writes, “Unanimous approval leading to quick Senate ratification is warranted; 138 other countries have ratified the treaty.” The editorial continues, “The United States is the leader in promoting the rights of people with disabilities because of the Americans With Disabilities Act of 1990. But projecting that globally has been hampered by the failure to ratify the U.N. convention in the four years since President Obama signed it.” However, “with a growing number of veterans groups and corporations backing the treaty, perhaps the Senate naysayers can be persuaded to do what’s right,” the editorial concludes (11/24).

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Recent Releases

USAID Working To Eradicate Extreme Poverty

Alex Thier, assistant to the USAID administrator for policy, planning, and learning, writes in USAID’s “IMPACTblog” about a recent panel held “at the Brookings Institution to discuss a bold vision of a world without extreme poverty by 2030.” He continues, “At USAID, we recognize that — for the first time in history — a world without extreme poverty is possible. … Major initiatives are underway in areas like food security and energy to promote economic growth, and have begun to address the fundamental pathways out of poverty.” Thier concludes, “It will only be through continued global partnership and determination that we will be able to truly lift one billion people out of the most abject poverty in the next two decades — and eradicate extreme poverty entirely. But it is possible” (11/22).

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Blog Highlights Recent Global Health News, Including Kerry Testimony On Disability Treaty

In a news summary, the Center for Global Health Policy’s “Science Speaks” blog notes U.S. Secretary of State John Kerry testified last week before the Senate Foreign Relations Committee regarding the Convention of the Rights of People With Disabilities. The blog also highlights a statement from UNAIDS Executive Director Michel Sidibé on a recently released UNAIDS report and a statement from the Treatment Action Campaign decrying delays surrounding a clinical trial of bedaquiline to treat multidrug-resistant tuberculosis (Barton, 11/22).

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USAID Blog Recognizes 10 Years Of PEPFAR Ahead Of World AIDS Day

USAID is observing World AIDS Day on December 1 “by celebrating 10 years of our HIV and AIDS work under PEPFAR,” the agency’s “IMPACTblog” notes in two separate posts. In the first post, Goli Fassihian, senior public affairs adviser for the Global Health Bureau’s Office of HIV/AIDS, writes, “PEPFAR was, and continues to be, ambitious, visionary, and far-reaching,” adding, “[W]e can confidently say that the program has saved millions of lives and delivered hope to communities where it was so desperately needed” (11/22). In a separate post, Elizabeth Walsh of Management Sciences for Health (MSH), and Lourdes de la Peza, a senior technical adviser for the Leadership, Management & Governance (LMG) Project, examine how the LMG Project has “helped support the PLAN-Health Nigeria project, funded by PEPFAR through USAID and managed by [MSH], to pilot Leadership Development Program Plus (LDP+), which focuses on empowering teams to improve [prevention of mother-to-child transmission of HIV (PMTCT)] results” (11/23).

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Obama Signs HIV Organ Policy Equity Act

The AIDS.gov blog features a statement by U.S. President Barack Obama on the event of his signing into law the HIV Organ Policy Equity (HOPE) Act, “a bipartisan piece of legislation that allows scientists to carry out research into organ donations from one person with HIV to another.” Obama said, “The HOPE Act lifts the research ban, and, in time, it could lead to life-saving organ donations for people living with HIV while ensuring the safety of the organ transplant process and strengthening the national supply of organs for all who need them” (11/22).

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IntraHealth, Countries Make Commitments To Global Health Human Resources

Judith Winkler, senior adviser for strategy and planning at IntraHealth International, writes in IntraHealth’s “Vital” blog about the recently concluded Third Global Forum on Human Resources, which took place earlier this month in Recife, Brazil. She highlights three themes from the conference — universal health coverage, system complexity and multisectoral engagement; lists several countries’ commitments to the Global Health Workforce Alliance; and summarizes IntraHealth’s commitment (11/22).

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