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Kaiser Daily Global Health Policy Report

In The News

TPP Will Not Hinder Access To Essential Medicines, U.S. Commerce Secretary Says

“A wide-ranging Asia-Pacific free trade agreement will not hinder access to affordable medication, the U.S. commerce secretary said on the sidelines of an Asia-Pacific Economic Cooperation (APEC) summit that concluded on October 8 in Bali, Indonesia,” IRIN reports. “But activists remain concerned after the closed-door trade talks concluded among” the countries involved in talks surrounding the Trans-Pacific Partnership (TPP), the news service notes. Médecins Sans Frontières (MSF) “says U.S. proposals in the TPP negotiations create ways for multinational pharmaceutical companies to extend their patents on medicines through a common pharmaceutical industry practice known as ‘evergreening’ — which would guarantee these companies’ continued stranglehold on the market,” IRIN writes.

According to the news service, U.S. Commerce Secretary Penny Pritzker said, “Obviously the United States wants the world population to have access to good medicines, so we’re not trying to stand in the way of that.” “Intellectual property is one of several areas TPP countries are still debating,” the news service notes, adding, “Negotiators are expected to meet in November to address remaining contentious issues” (10/9).

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Committee On World Food Security Meets In Rome

The Guardian reports on the 40th session of the Committee on World Food Security (CFS), meeting in Rome this week. “Once a relatively mechanistic, high-level event, today the CFS stands alone among big U.N. meetings for bringing everyone to the table and is often hailed the most inclusive global governance forum,” the newspaper writes, noting representatives from civil society, government, philanthropy, and the private sector all have “space at the CFS table.” The Guardian writes, “This week, negotiators hope to find a consensus on the particularly prickly debate about how to balance biofuels and food security concerns. Other issues on the table include how to deal with food insecurity in protracted crises, and what principles for responsible investment in agriculture should look like” (Provost, 10/10).

In a separate article, The Guardian writes about a new report (.pdf) on hunger and nutrition from civil society, titled “Alternatives and Resistance to Policies That Generate Hunger,” which “argues that particular attention must be paid to the social and political structures that constrain women’s choices and limit their ability to participate in decision-making.” According to the newspaper, “The report also warns that the growing number of public-private partnerships around food, nutrition and agriculture — including the G8’s new alliance for food security and nutrition and the Scaling Up Nutrition initiative — must be coherent with international human rights obligations and that it must be made clearer how they will manage conflicts of interest” (Provost, 10/9). Devex features a video interview with Benoît Miribel, director-general at Fondation Merieux and honorary president at Action Against Hunger, who “call[s] for better organization, more cooperation to ‘break the wall’ between health and agriculture ministries, and a move beyond announcements toward concrete progress on an international framework for food security and nutrition” (Jones, 10/10).

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RBM, South African Health Department Release Report On Reduced Malaria Mortality In South Africa

“South Africa has turned the tide on malaria, cutting mortality rates by 85 percent over the last 12 years, and hopes to soon eliminate the disease, a report [(.pdf) released by the Roll Back Malaria partnership (RBM) and the South African Department of Health] stated Wednesday amid controversy over the use of highly controversial DDT,” Agence France-Presse reports. “‘South Africa is well on its way to being a malaria-free country,’ Health Minister Aaron Motsoaledi said,” the news agency notes (10/9). “Nationwide, malaria morbidity and mortality decreased 89 percent and 85 percent respectively between 2000 and 2012, from 64,500 to 6,847 malaria cases, and from 460 to 70 deaths,” according to an RBM statement (10/9). “Malaria, which was once common in urban centers such as Durban, has now been pushed back to the border regions with Mozambique and Zimbabwe thanks to sustained investment in the program,” a South African Department of Health media advisory states (10/9).

“At the [center] of the fight to eliminate infections is the use of the highly contentious insecticide dichlorodiphenyltrichloroethane, better known by its acronym DDT,” which was reintroduced in South Africa in 2000, AFP writes, noting DDT “is linked to genital birth defects, infertility and cancer and is banned in many parts of the world.” According to the news agency, Tiaan de Jager, professor and head of environmental and occupational health at the University of Pretoria, said, “We are not saying that people should rather die than using DDT,” but “we should also look at safer methods that can lead to elimination,” including improved housing and sanitation (10/9).

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Caribbean Reduces Rate Of Mother-To-Child HIV Transmission; Officials Express Concern Over Possible Funding Reductions

“[T]he Caribbean is on the verge of becoming the first region in the world to eliminate” mother-to-child HIV transmission by 2015, the Christian Science Monitor reports, noting that “thanks to an influx of foreign funding, [the region] has led the world in the reduction of deaths from the disease and in cutting the spread of infection.” According to the newspaper, “The Caribbean’s success has been achieved through an expansion of treatment to patients, who are now offered universal access to antiretroviral drugs in some countries. The islands have also made testing free and easy for much of the population.”

However, “[s]ome are concerned that the success is set to be challenged as international funding dries up and nations reduce foreign aid amid global economic uncertainty,” though “[a] few major donors, including [PEPFAR] and the Global Fund to Fight AIDS, Tuberculosis and Malaria, remain committed to the Caribbean, officials said,” the newspaper writes. The article includes comments from Luis Ernesto Feliz Báez, who oversees the Dominican Republic’s response to HIV/AIDS; Michel de Groulard, regional program adviser for UNAIDS in the Caribbean; Ruth Ayarza, Latin America and Caribbean regional manager for the International HIV/AIDS Alliance; and Dereck Springer, director of the Pan Caribbean Partnership Against HIV/AIDS coordinating unit in Guyana (Fieser, 10/9).

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Editorials and Opinions

International Community Should Better Integrate Mental Health Care Into Humanitarian Responses

“October 10 commemorates World Mental Health Day and is observed, in part, to raise public awareness about mental health issues. One matter that deserves critical attention is better integrating mental health care into global humanitarian responses,” Curt Goering, executive director of the Center for Victims of Torture, writes in the Huffington Post’s “Impact” blog. “For refugee torture and war trauma survivors, especially in places with few or no mental health resources, the consequences of neglecting their mental health needs can be severe and long lasting,” because the symptoms can “make it difficult for the survivor to care for themselves and their families,” he states, noting the Syrian crisis alone is predicted to produce more than five million refugees by the end of 2014 if not resolved.

“Yet, even after such terrible experiences, torture survivor rehabilitation programs are effective in helping survivors heal from their trauma and rebuild meaningful lives of dignity,” Goering writes. “The international community should use World Mental Health Day as an opportunity to demonstrate their support for torture survivor rehabilitation by increasing their contributions to the United Nations Voluntary Fund for Victims of Torture,” he states, adding, “Let us begin today, and continue every day, bringing knowledge, awareness, and advocacy to better integrating mental health care into global humanitarian responses” (10/9).

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Improving Health Systems Must Go Hand-In-Hand With Increased HIV Treatment Access

Noting price reductions for HIV treatments over the past decade have helped increase access for millions of patients in Africa, Jeffrey Misomali, an Aspen New Voices fellow, writes in the Huffington Post’s “Aspen Institute” blog, “However, these new patients used HIV treatment and care services within an ailing health system that could not cope with the increased workload.” He uses Malawi as an example, saying health care workers “have to provide HIV treatment and care services with minimum infrastructure, equipment and limited incentives despite the increase in their daily workload.” He continues, “The reduction of antiretroviral pricing, changes in treatment guidelines outlined by the [WHO], and other major global shifts … [has] opened [the door] to millions more patients without proper development of the existing health systems to handle these numbers.”

“Global decisions on increasing treatment access are a step in the right direction, but the absence of effective health systems could easily undermine the progress made so far,” Misomali writes. Though health care workers are “cop[ing] with the surge in demand,” “the responsibility is on governments and the donor community to quickly strengthen health systems to cope with the next expected increase in patient numbers,” he states. Misomali concludes, “Global decisions have helped developing nations make important steps in the fight against HIV, but it is in understanding and finding solutions to local challenges … that will finally end the HIV epidemic” (10/9).

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Three Initiatives To Help Africa Meet Health, Development Goals

Writing in New York Times columnist Nicholas Kristof’s “On the Ground” blog, Shawn Baker, Helen Keller International’s vice president and regional director for Africa, discusses three initiatives “that are poised for the kind of success at scale that will help us keep our promises” for health and development in Africa. “Breastfeeding is one of the easiest ways to deliver the essential nutrition that has been shown to increase IQ and brain development,” but “the development community hasn’t invested enough in promoting sound breastfeeding practices,” he states. However, “Malawi has reached a rate of 72 percent and the Alive and Thrive initiative has seen spectacular improvements in Bangladesh and Vietnam,” he notes.

“The last decade has seen a veritable revolution in treatment of severe acute malnutrition,” Baker states, adding, “There is a moral imperative to identify and treat severely malnourished children, but even more so, we need to double down on efforts to prevent any child from becoming malnourished.” Finally, “[t]here remains an urgent need to address the end stage of trachoma, the leading infectious cause of blindness, trichiasis,” he writes, concluding, “It is important that programs address both the immediate and long-term prevention of blindness from this forgotten disease” (10/9).

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Recent Releases

Innovation, Partnership Necessary To Bring Vaccines To The Poor

Noting the WHO this week endorsed a new Chinese-produced Japanese encephalitis vaccine, Bill Gates, co-chair of the Bill & Melinda Gates Foundation writes in the organization’s “Impatient Optimists” blog, “[T]here’s a powerful story here about the tremendous progress the world is making to save and improve the lives of the world’s poorest.” He discusses the partnership between PATH and the China National Biotec Group (CNBG) that helped make the vaccine available to millions. “What’s especially exciting about the announcement is the opportunity it creates for China to become a leader in creating great vaccines for the world,” Gates writes, adding the announcement “serves as a reminder that there’s still more work to be done to protect the poorest against other neglected diseases.” He continues, “We need more innovative manufacturers like CNBG, creative partners like PATH, and more generous donors to join this cause” to “bring the world closer to the day when all children, no matter where they live, will have access to lifesaving vaccines” (10/8).

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American Journal Of Tropical Medicine And Hygiene Special Section Focuses On Cholera In Haiti

A special section published this month in the American Journal of Tropical Medicine and Hygiene “document[s] the public health response to the largest national cholera outbreak in modern history,” which followed the 2010 earthquake in Haiti, a press release from the American Society of Tropical Medicine and Hygiene (ASTMH) states. Jon Andrus, deputy director of the Pan American Health Organization (PAHO), states, “Now we arrive at a critical juncture where from the depths of a terrible epidemic there is an opportunity for Haiti to rise up to a new level of protection against infectious diseases,” according to the press release. The special section features articles on water, sanitation and hygiene (WASH), as well as vaccines, the press release adds (10/9).

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