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Kaiser Daily Global Health Policy Report

In The News

Cleaner Cookstoves, Cutting Pollution Could Save Millions Of Lives Annually, World Bank Report Says

“Cleaner cookstoves could save a million lives every year, but costs need to decrease sharply for poor households in developing countries to be able to afford them, according to a World Bank report,” The Guardian reports. “‘On thin ice: how cutting pollution can slow warming and save lives,’ published on Sunday evening, calls for action to reduce common pollutants such as soot, known as black carbon, to not only slow global warming, but prevent millions of deaths,” the newspaper writes (Tran, 11/4). “‘The damage from indoor cooking smoke alone is horrendous — every year, four million people die from exposure to the smoke,’ World Bank President Jim Yong Kim said in a statement,” Reuters notes, adding, “‘If more clean cookstoves — stoves that use less or cleaner fuel — would be used it could save one million lives,’ the report said of the annual benefits.” According to the news service, “Almost 200 nations will meet in Warsaw from November 11-22 to consider ways to combat global warming” (Doyle, 11/3).

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Leaked Panel Report On Climate Change Warns Of Risks To Global Food Supply

“Climate change will pose sharp risks to the world’s food supply in coming decades, potentially undermining crop production and driving up prices at a time when the demand for food is expected to soar, scientists have found,” the New York Times reports. “The warnings come in a leaked draft of a report under development by a United Nations panel, the Intergovernmental Panel on Climate Change. The document is not final and could change before it is released in March,” the newspaper adds. “The warning on the food supply is the sharpest in tone the panel has issued. Its previous report, in 2007, was more hopeful,” the newspaper writes. “On the food supply, the new report finds that benefits from global warming may be seen in some areas, like northern lands that are now marginal for food production,” the New York Times notes, continuing, “But it adds that overall, global warming could reduce agricultural production by as much as two percent each decade for the rest of this century” (Gillis, 11/1).

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U.N. Feeds Record Number In Syria, Warns Many Still Without Food In Areas Cut Off Due To Conflict

“The United Nations World Food Programme (WFP) said that it is reaching close to 3.3 million people in Syria — a record for its operations — but many are still without food in areas cut off by fighting, particularly in Damascus and the capital’s besieged suburbs,” the U.N. News Centre reports (11/1). Those areas, “where fighting has intensified, have not been reached for many months and the nutritional state of those trapped is believed to have deteriorated significantly, the [WFP] said,” Reuters writes (Nebehay, 11/1). “Large swathes of territory near Aleppo and Hassekeh remain inaccessible to aid agencies, and WFP spokeswoman Elizabeth Byrs says other areas are becoming inaccessible due to the intensification of the conflict,” VOA News adds (Schlein, 11/1).

The WFP said “it feared a rise in malnutrition among children trapped in besieged communities in Syria where fighting has halted supply convoys,” Agence France-Presse/GlobalPost notes (11/1). “Millions are going hungry to varying degrees, and there is growing evidence that acute malnutrition is contributing to relatively small but increasing numbers of deaths, especially among small children, the wounded and the sick, aid workers and nutrition experts say,” according to the New York Times (Barnard, 11/2). “More children are being admitted to hospitals in Damascus and other parts of the country for treatment of malnutrition, a condition that leaves them weakened and more susceptible to other diseases, the U.N. Children’s Fund (UNICEF) said,” Reuters adds (11/1).

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Health Officials Implementing Efforts To Stop Polio's Spread In Syria, Neighboring Countries

Following the WHO’s confirmation of polio cases in Syria, “[t]here is worry that the highly infectious disease will spread farther, as people move in and out of the area to other parts of the country and across borders to refugee camps and nearby countries,” National Geographic reports. “To prevent that, response to the outbreak has already begun,” the news service writes and asks, “Why has the end [of polio] remained elusive, and what is being done to protect against future setbacks?” (Cole, 11/1). NPR’s “Weekend Edition Saturday” examined efforts in Syria to stop the disease, as well as efforts in Lebanon, where Syrian refugees arrive daily. “[H]ealth officials are sending out 5,000 workers for door-to-door immunizations,” and “a center is opening at the airport and at the border to immunize young children as they arrive,” NPR writes (Amos/Marrouch, 11/2).

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U.N. Special Envoy Warns Of Growing HIV Epidemics Among Marginalized Groups In Eastern Europe

“Health care systems in Eastern Europe and Central Asia remain woefully unable to cope with HIV/AIDS as the region’s raging epidemic — the fastest growing in the world – takes on a new dimension, a senior U.N. official has told [Inter Press Service],” the news service reports (Stracansky, 11/4). “HIV epidemics are becoming more concentrated in marginalized groups such as sex workers, drug users and gay men, and could defy global attempts to combat AIDS if attitudes do not change, [Michel Kazatchkine, U.N. Special Envoy for HIV/AIDS in Eastern Europe,] said,” Reuters writes, noting “he would like to be able to celebrate without reservation global progress made in the past decade, but stubborn infection rates and alarming growth of outbreaks in hard-to-reach populations make that difficult” (Kelland, 11/4).

“Until now the Eastern Europe and Central Asia (EECA) epidemic had been driven by injection drug use. But data and anecdotal evidence has shown a strong rise in the spread of the disease through heterosexual transmission as well as via men who have sex with men — potentially throwing up a new set of challenges for governments and health care ministers,” according to IPS. However, Kazatchkine “says … until a new approach to treating the disease is taken in countries worst affected by it, the response to the epidemic will continue to be poor and largely ineffective,” the news service writes, adding, “International bodies have urged countries in the region to adopt harm reduction programs, including needle exchanges and drug substitution therapy, which are recommended best practice in the West as a front-line measure to help prevent the spread of the disease” (11/4). “Kazatchkine called for a ‘shift in the collective mindset’ to put equity and human rights at the center of the battle against HIV in these groups,” according to Reuters (11/4).

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Devex Interviews Afghanistan's Public Health Minister

“The U.S. Special Inspector General for Afghan Reconstruction [SIGAR] is not sure the country’s ministries are ready to receive direct U.S. government funding,” Devex reports. “But Dr. Suraya Dalil, Afghanistan’s public health minister, says SIGAR should recognize their progress and be more open to the idea, after the watchdog released a report claiming alleged ‘risk of waste, fraud, and abuse’ of funds for its public health programs in the country,” the news service writes. Devex provides “some highlights from [a] conversation with the Afghan health minister.” According to the transcript, Dalil talks about improvements made in the health sector, examines the “readiness of Afghan ministries to receive U.S. government funding,” and discusses security issues in the country (Igoe, 10/31).

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Expert Cautious Over Global Fund's New TB/HIV Funding Strategy, Devex Reports

“Groups advocating for [tuberculosis (TB)] elimination are hailing a new Global Fund proposed strategy that could raise coverage of the disease’s treatment, but an [unnamed] expert warns it entails some risks,” Devex reports. The recommendation — “that countries with high TB and HIV co-infection applying for Global Fund support only put forward a single, joint proposal for both diseases” — could “allow a country to tackle both diseases on the same level … and can lead to savings,” according to the expert, Devex states. However, the expert “said if the proposal is not properly implemented and not taken seriously, or some institutions and organizations resist it, there will be no progress in significantly scaling up TB and HIV services,” which “could lead to co-infected patients continuing to struggle to access care from two ‘vertical’ structures, as it is in many situations currently,” the news service writes. “The strategy is expected to be part of the Global Fund’s new funding model, which is scheduled for full implementation by March next year,” according to Devex (Ravelo, 11/4).

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Editorials and Opinions

U.S. Must Push For Inclusion Of Reproductive Health In Post-2015 Development Agenda

“It’s a true testament to how far we have come over the last decade that reproductive health and rights are now an essential piece of the United Nations’ efforts to improve the lives of millions of people around the world,” Rep. Mike Quigley (D-Ill.) writes in the Huffington Post’s “World” blog. “Still, as we approach the expiration of the [Millennium Development Goals (MDGs)] in 2015, the fight for reproductive rights is far from over,” he states, adding, “We must continue to make our voices heard and push to ensure comprehensive reproductive health services are a cornerstone of any plan to replace the MDGs.”

“Although things have changed a great deal here in the U.S., we still have to fight for women’s rights every day. And the fight is even more robust in developing nations where women are marginalized, abused and discriminated against on a daily basis,” Quigley continues. “As the largest contributor to the United Nations and funder of international family planning, the U.S. is in a unique position to continue to lead the global agenda and place reproductive health at its core,” he writes, noting, “Sadly, there is a contingent of Congress bent on slashing all government investments and particularly those aimed at family planning.” He adds, “It is due to this obstructionism that we must make our voices heard and stand up for reproductive rights of women around the world” (11/1).

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Opinion Pieces, Editorial Address Spread Of Polio In Syria

The following is a summary of two opinion pieces and an editorial addressing a polio outbreak in Syria.

  • Joel Brinkley, Kansas City Star: “With little health care to speak of, infectious diseases are devastating the nation — including a new outbreak of polio, not seen in Syria since the late 1990s,” Brinkley, a former New York Times columnist and the Hearst professional in residence at Stanford University, writes. “Polio is a highly contagious disease with no cure, and remember that more than two million Syrians are refugees in neighboring states,” he continues, adding, “All of this presents a humanitarian disaster for Syria — and potentially the region and the world.” He states, “The United Nations is correct: [Syrian President Bashar al-Assad] absolutely must allow health and humanitarian workers free and protected access to the affected areas of his country” (11/1).
  • Ahmed Rashid, Financial Times’ “The A-List” blog: “It is a frightening indictment of the civilized world’s utter failure at peacemaking in Syria that a disease the WHO and organizations such as the [Bill & Melinda Gates Foundation] have, in a global campaign, been so close to eliminating has returned with a vengeance,” Rashid, an author of several books about Afghanistan, Pakistan and Central Asia, writes. “If the U.N. Security Council is not able to put to rest its squabbles and stand-off over Syria, and if China and Russia are not able to agree with the west on a common strategy to fight a potential polio epidemic, then how on earth can we expect a peace conference by the end of the year or anything even approaching an end to the conflict?” he asks, adding, “Surely the lives of children and averting a polio epidemic is a cause that should unite the world rather than divide it, or worse still, be ignored by the world’s leaders” (11/1).
  • Washington Post: “The outbreak is a sign of what happens when health care systems collapse. Most ominous, about half a million Syrian children have not been immunized,” the editorial states. “Vaccination is the most critical tool in the battle against polio, and a large-scale effort is being mounted to reach the unvaccinated children,” the newspaper writes, adding, “The United Nations and Syria’s neighbors ought to demand that all sides — government forces and the opposition — guarantee that volunteers immunizing children do not become targets or victims.” The editorial concludes, “Roadblocks can stop fighters, but they will not stop poliovirus, which threatens all in its path, the children of rebel fighters and army generals alike” (11/2).

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Three Steps GAVI Can Take To Vaccinate More Children

“As GAVI concludes its ‘mid-term review’ meeting — where it reflected on its accomplishments over the last few years and looked ahead to how it will position itself in the future — we think it’s a good time to suggest several short- and long-term changes that could help reach more of the children who are missing out on life-saving vaccination,” Manica Balasegaram, executive director of Médecins Sans Frontières’ Access Campaign, writes in the Huffington Post’s “Impact” blog. “First, humanitarian actors vaccinating in emergencies must be able to buy vaccines at the lowest global prices that have currently been negotiated by GAVI,” he states. “Second, GAVI needs to play a more active role in shaping the development of vaccine products that are easier to use in places with weak health systems,” Balasegaram writes. “Third, GAVI needs to negotiate even lower vaccine prices with pharmaceutical companies,” he continues. “[N]ow is the best time for GAVI to take a closer look at how it can improve its policies, push for easier-to-use products, and negotiate lower prices for vaccines to fulfill this potential,” he writes, concluding, “This is the urgent booster that the world’s children are waiting for” (10/31).

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Governments, Advocacy Groups Must Continue Efforts To Improve Treatment For, Rights Of Mentally Ill

“In many poor and developing countries, thousands of mentally ill people are warehoused in dirty and dangerous institutions,” freelance writer John Rudolf writes in a New York Times opinion piece. “Institutionalization is just one facet of the broader catastrophe of mental health care in the developing world,” he adds. “Government and humanitarian funding to treat the most severely afflicted is almost nonexistent … [b]ut governments that have put their minds and money to the task can make a difference,” he states. “Recent developments suggest that a turning point on institutionalization may be at hand,” Rudolf writes, and he uses Guatemala as an example of one country making progress. “[A] global effort will be required to expose abuses and shame governments into enacting serious reforms. If and when that fails, international human rights law can and should be used to compel action. Governments and international advocacy groups must also elevate public awareness and dispel myths and prejudices about the mentally ill,” he concludes (11/1).

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Recent Releases

Ambassador Goosby Pens Last Blog Post As U.S. Global AIDS Coordinator

“It is with a degree of sadness but also an enormous debt of gratitude that I post my final blog as U.S. Global AIDS Coordinator and head of the Office of Global Health Diplomacy,” Ambassador Eric Goosby writes in the State Department’s “DipNote” blog. The success of PEPFAR and “arriv[ing] at a moment in which creating an AIDS-free generation is truly within our reach … has only been possible because thousands of committed and compassionate individuals wake up each day and go to bed each night thinking about how we can all do more and do it better,” he writes. “This epidemic has wrought untold harm on our world, stolen millions of lives, destroyed families and entire communities, and very nearly entire nations. But it also brought out the best in people — in the United States and around the planet,” he states, adding, “We can find no better way to honor those we have lost than to keep pushing forward, and to complete the task that we began more than 30 years ago” (11/1). The Center for Global Health Policy’s “Science Speaks” features excerpts from an interview with Goosby (Barton, 11/1).

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GAVI Making Progress On Promises, But 'Much Left To Do'

“[W]ith two years to go” to reach the GAVI Alliance’s goal of “help[ing] developing countries immunize an additional quarter of a billion children by 2015, and prevent[ing] four million future deaths in the process,” Dagfinn Høybråten, chair of the GAVI Alliance Board, writes in the Bill & Melinda Gates Foundation’s “Impatient Optimists” blog, “[T]here is indeed much left to do if we are to fulfill our promises.” He summarizes progress made and reported in GAVI’s Mid-Term Review, and he notes some of the organization’s success stories “have now been captured in a series of impact stories showing the extraordinary efforts being made by implementing countries and GAVI partners to ensure that vaccines reach the children who need them, wherever they are” (10/31).

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