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Kaiser Daily Global Health Policy Report

In The News

U.N. Warns Humanitarian Situation In Syria Deteriorating 'Rapidly And Inexorably'

“The humanitarian crisis inside Syria is escalating rapidly with more than nine million people — about 40 percent of the population — in dire need as winter approaches and agencies find it increasingly difficult to deliver aid inside the war-ravaged nation, the United Nations warns,” the Los Angeles Times reports. “After more than 2 1/2 years of brutal conflict, Syria is facing a kind of humanitarian breakdown, aid workers say, with shortages of essential medicines, power, shelter, clean water and even food,” the newspaper states (McDonnell, 11/5). “‘The humanitarian situation in Syria continues to deteriorate rapidly and inexorably,’ U.N. humanitarian chief Valerie Amos told the U.N. Security Council behind closed doors, according to her spokeswoman Amanda Pitt,” Reuters writes (Charbonneau, 11/4). “Amos told the council that 9.3 million people now need outside help to survive, up from 6.8 million in September, and 6.5 million are now homeless inside the country, up from 4.25 million,” Agence France-Presse notes.

Amos “handed the council a letter which set out a call for greater pressure to back a statement agreed by the Security Council on October 2 calling on the government and opposition rebels to make it easier to provide food and medicines, diplomats said,” AFP reports. “The 15-nation council is divided over the 32-month-old war which the U.N. says has left well over 100,000 dead,” the news agency notes (11/4). “The United States and Russia failed on Tuesday to agree on a date for a Syrian peace conference, remaining divided over what role Iran might play in talks to end the civil war and over who would represent Syria’s opposition,” Reuters reports in another article (Nebehay/Miles, 11/5).

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PBS NewsHour Examines HIV Epidemic Among 'Key Populations'

PBS NewsHour examines a rebound in HIV infection among sex workers and other marginalized “key populations” — including “injecting drug users, men who have sex with men, inmates and other groups in which HIV rates have moved against the global trend.” The news service writes, “[E]xperts with organizations as diverse as the [WHO] and Human Rights Watch agree that government officials must do more to support these ‘key populations’ — no matter how illegal their activities may be — if they want to see an AIDS-free generation within their borders anytime soon.” The news service adds, “Halting the spread of HIV among these key populations comes down to a series of calculated risks for both governments and the individuals themselves,” and PBS provides in-depth examples of efforts to prevent and treat HIV/AIDS among these groups in Tanzania (Kane, 11/5).

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Carter, Pfizer Commemorate 15th Anniversary Of International Trachoma Initiative

“As [former President] Jimmy Carter approaches 90, he is reaching for victory in a 15-year war against an infection spread by houseflies that blinds millions in developing countries and posed a threat to his own family and neighbors as a child on a Georgia farm,” Reuters reports (Pierson, 11/5). “Carter joined Pfizer [Tuesday] to commemorate the 15th anniversary of the International Trachoma Initiative (ITI), an independent, not-for-profit program dedicated to the elimination of blinding trachoma as a public health concern,” an ITI press release states (11/5). “Largely through the combined efforts of the Carter Center and [the ITI], co-founded by Pfizer in 1998, blindness associated with the disease may have been eradicated in Morocco and Ghana,” Reuters writes. “But blinding trachoma remains a threat in other developing nations, especially Ethiopia, where almost a third of the population is considered at risk,” Reuters continues. “Trachoma, the world’s leading cause of preventable blindness, affects more than 20 million people worldwide, of whom about 2.2 million are visually impaired and 1.2 million are blind, according to the [WHO],” the news service notes (11/5).

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Pollution Threatening Health Of Up To 200M People Globally, Report Says

A new report — published Tuesday by two independent environmental organizations, Green Cross Switzerland and the U.S.-based Blacksmith Institute — “has found that the health of up to 200 million people worldwide is threatened by pollution,” VOA News reports. “The top 10 most polluted places are spread over eight countries located in Africa, Asia, Eastern Europe, and Latin America,” which “are cited for threatening the lives of the millions of people who live there by exposing them to dangerous environmental toxins,” the news service writes. “The report noted that pollutants in these places affect people through direct inhalation, food intake and skin contact,” VOA notes (Schlein, 11/5). “The Top Ten Toxic Threats report is the latest in a series of annual reports documenting global pollution issues,” according to Inter Press Service, which notes, “The list is based on the severity of the health risk and the number of people exposed.” The news service writes, “The Blacksmith Institute has conducted more than 3,000 initial risk assessments in 49 countries since the last list of polluted sites released by the two groups in 2007,” and IPS provides details of the report (11/5).

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UNAIDS Supplement Examines AIDS Epidemic Among People Age 50 And Older

“The shifting demographics of the AIDS epidemic demands a new focus to reach people aged 50 and over who are currently underserved by HIV services,” UNAIDS said on Friday, the U.N. News Centre reports. “Out of the estimated global total of 35.3 million people living with HIV, an average 3.6 million are people aged 50 years or older, according to a new supplement [.pdf] to the 2013 UNAIDS report on the global AIDS epidemic focused on the issue HIV and aging,” the news service writes. “The supplement revealed that in high-income countries almost one-third of people living with HIV are 50 years or older,” the news service notes, adding, “The majority of the population where the percentage of adults living with HIV is 50 years or older, is in low-and middle-income countries, however.”

“The ‘aging’ of the HIV epidemic is due to three main factors: the success of antiretroviral therapy in prolonging the lives of people living with HIV, decreasing HIV incidence among younger adults shifting the disease burden to older ages, and that people aged 50 and above are engaging in risk taking behavior such as unprotected sex and injecting drug use which are leading to new HIV infections,” according to the U.N. News Centre. “The supplement highlights that HIV prevention services, including HIV testing, tailored to the needs of people aged 50 and above, are essential and that these services should also reflect the needs of key populations in this age group,” the news service adds (11/1).

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Myanmar Clinic Operations Threatened As Australia Plans To Withdraw Funding, Devex Reports

Devex examines how “the Australian government’s decision to cut the foreign aid budget and integrate AusAID into the Department of Foreign Affairs and Trade” is threatening to close “the award-winning Mae Tao Clinic on the Myanmar-Thailand border, established in 1989 to provide health services to thousands of refugees … if it doesn’t find new sources of funding.” According to Devex, “The clinic received AU$500,000 every year since 2010, comprising almost a quarter of its average donation coffers. But that money will dry up in December of this year.” Devex continues, “The Australian government’s decision to cut the clinic’s funding is based on two main reasons: failure to meet renewal requirements and the decision to support the refugee return policy of the Myanmar government.” The clinic is seeking additional funding from other sources, the news service notes (Santos, 11/5).

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Bangladeshi Government Working To Rid Markets Of Fake, Substandard Medicines

“Despite a backlash to its recent crackdown on the sale of counterfeit medicines in Bangladesh’s capital, Dhaka, the government has vowed to continue fighting the growing industry of illicit, substandard, counterfeit and life-endangering medicines,” IRIN reports. The article describes a September government seizure of “fake, substandard and unauthorized medicine” in the country’s medicine market and other government efforts to evaluate pharmaceutical companies and prevent such medicines from reaching the market (11/4).

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Editorials and Opinions

Donor Organizations, Nations Must Improve Transparency

“[W]hile it is important to root out corruption in developing countries it is also worth remembering that by definition transparency should work both ways; that it is equally about holding [developing countries,] wealthy nations and aid organizations to account,” Dagfinn Høybråten, chair of the GAVI Alliance Board and secretary general for the Nordic Council of Ministers, and Richard Sezibera, member of the GAVI Alliance Board and secretary general of the East African Community, write in the Huffington Post’s “Impact” blog. To increase the number of agencies receiving a “very good” mark on Publish What You Fund’s Aid Transparency Index, organizations should be “proactive about publishing information on aid, making it comprehensive, timely, accessible and comparable. Moreover, donor organizations should not only ensure that everyone can access this information, but they should also actively promote this right,” they state. “[T]hese principles are also equally at home in the South” among developing countries, they write, concluding, “To create the trust necessary for lasting change, we first need to create more windows of transparency” (11/5).

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To Improve Women's Access To Health, Improve Women's Education

“When talking about improving health care, it is paramount that local traditions and customs are taken into account,” Edna Adan Ismail, a nurse-midwife, U.N. diplomat, and former Foreign Minister of Somaliland, writes in a Thomson Reuters Foundation opinion piece. “In some cultures, including mine, women — for example — cannot make their own decisions in regards to medical care, even in emergency situations,” she states, adding, “Improving women’s access to health care will involve much more than lowering costs, improving transportation, or opening more clinics. It is a matter of changing people’s outlook on life.” Ismail continues, “One of the first steps is to raise awareness that health care is both a right and a necessity. … Women should recognize health care as a priority and demand greater access … from their countries, from their communities, and from their families.” She states, “Only by opening the minds of women through education in the health sciences will we help them understand the value of prenatal checkups, breastfeeding, immunizations and other health care that women in the developed world take for granted.” She concludes, “The problem can be solved only through dedicated and systematic efforts to empower women, to change the way they see themselves, and to train more midwives” (11/5).

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Recent Releases

Kazatchkine Calls For Increased Efforts To Prevent HIV/AIDS Among 'Key Affected Populations'

Writing in the BMJ blog, Michel Kazatchkine, the U.N. special envoy for HIV/AIDS in Eastern Europe and Central Asia, reflects on progress made against the AIDS epidemic in the last decade, noting, “The response to AIDS has generated extraordinary hope … that it may indeed be possible to end major epidemics in poor countries.” However, he continues, “This progress contrasts with the failure to respond effectively to HIV among so-called ‘key affected populations’ — people who inject drugs (PWID), sex workers, men who have sex with men (MSM), and prisoners, as well as migrant and transgender populations, among whom the response to AIDS has often been a story of indifference and neglect.” He adds, “The response to the AIDS epidemic has certainly come a long way in the past three decades, but we urgently need a shift in the collective mindset to change the course of the epidemic for those key affected populations” (11/5).

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GHTC Releases Fact Sheet On U.S. Government Investment In Global Health R&D

On Tuesday, the Global Health Technologies Coalition (GHTC) published “a new fact sheet [.pdf] outlining the important contributions the U.S. government has made to global health [research and development (R&D)] and why it’s critical the United States continues to robustly support the global health research pipeline,” Nick Taylor, GHTC’s senior program assistant, writes in the group’s “Breakthroughs” blog. “Increased investments in global health research by the United States have the potential to increase the amount of tools combating global diseases,” he writes and summarizes some of the fact sheet’s data. “U.S. leaders should seize upon the recent successes in global health R&D and pass a long-term budget that ensures America’s legacy as a leader in innovation and science is not forgotten,” he concludes (11/5).

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Exchange Of Ideas, Youth, Frontline Health Workers Essential To Global Health

Writing in IntraHealth’s “Vital” blog, IntraHealth International President and CEO Papa Amadou Gaye discusses his participation last month in the annual meeting of the Partners for Population and Development (PPD) in Beijing, China. “I spoke to the assembled ministers of health and finance about the vital role of the health workforce. Investing in frontline health workers, I explained, may help us finally traverse the last mile in providing health care services to those who are in desperate need of them,” he writes. To reach collective global health goals, “we must have three things,” he writes, adding, “The first is a platform such as PPD that provides a voice for its members and allows countries in the global South to exchange experience and ideas. The second is a focus on the world’s young people, including embracing all the technologies available to us to reach them. And third, we must ensure that health workers remain at the center of all of our efforts to tackle global health challenges” (11/5).

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Two Global Health Meetings Examine Need For UHC, Improved Access To Reproductive Health Services

“In a week and a half, as a team of our colleagues arrive in Ethiopia for this year’s International Conference on Family Planning, others will already be in Brazil for the Third Global Forum on Human Resources for Health [HRH],” Fabio Castaño, who works with Management Sciences for Health (MSH) as the global technical lead for family planning and reproductive health, and Jonathan Jay, a senior writer for MSH, write in the Bill & Melinda Gates Foundation’s “Impatient Optimists” blog, noting “[t]his year’s HRH Forum addresses universal health coverage (UHC).” They state, “It’s symbolic that these two meetings are happening half a world apart: as movements around family planning, health workforce and UHC have advanced, there has been too little dialogue and collaboration across these communities.” They examine the merits of UHC, specifically with respect to family planning and reproductive health (11/4).

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Public Health Policies Are Meant To 'Protect The Population'

In the PLOS “Translational Global Health” blog, Jo Jewell of the World Cancer Research Fund discusses “health policy and its role in global health,” the blog notes. He primarily addresses policy in relation to non-communicable diseases (NCDs), writing, “Through policy it will be possible to create new social norms over time, where people grow up valuing health and seek out opportunities to lead healthy lifestyles.” He says “accusations of ‘nanny state’ need to be reconsidered” when policies are implemented to improve public health, because “[i]t is the duty of the state to protect the population and we all need to do a better job at communicating this so that people are better able to judge for themselves whether the government is actually taking away freedoms or simply trying to re-empower its citizens” (11/4).

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Good Governance Africa Publishes Several Stories About Health In Africa

Good Governance Africa last week published several stories relating to health in Africa (11/1). Among others, the stories include an article examining the dangers of vaccine defiance (Vegter, 11/1). The publication also includes a “review of Africa’s progress in reducing deaths from HIV/AIDS-related illnesses, malaria and tuberculosis” (Nkomo, 11/1). A third article looks at food and nutrition insecurity in Burundi (Jobson, 11/1). Yet another article examines the issue of counterfeit drugs across the continent (Whitehead, 11/1).

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PLOS Blog Highlights Articles Published In PLOS Medicine

The PLOS “Speaking of Medicine” blog highlights several new articles published this week in PLOS Medicine. One article examines “the most recent and comprehensive estimates on how much death and disability is attributable to depression, both worldwide and in individual countries and regions,” and another “evaluate[s] the cost-effectiveness and budget impact of antenatal syphilis screening for 43 countries in sub-Saharan Africa and estimate[s] the impact of universal screening on averted stillbirths, neonatal deaths, congenital syphilis, and disability-adjusted life years (DALYs),” according to the blog. A “Policy Forum” piece “compare[s] measles outbreak responses from the Democratic Republic of the Congo (DRC) and Malawi, and argue[s] that outbreak response strategies should be tailored to local measles epidemiology,” and an essay “argues that applying human rights frameworks and approaches to maternal health offers strategies and tools to address the root causes of maternal morbidity and mortality within and beyond health systems, in addition to addressing other violations of women’s sexual and reproductive health and rights” (11/5).

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