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Kaiser Daily Global Health Policy Report

In The News

Asia-Pacific Countries Form Alliance To Reduce Malaria

“Asia-Pacific leaders gathered in Brunei for the East Asia Summit on Friday endorsed the creation of an alliance to combat malaria” focused on reducing deaths and infections and preventing the spread of drug-resistant malaria, the Wall Street Journal’s “Southeast Asia Real Time” blog reports. “The Asia-Pacific Leaders Malaria Alliance, or APLMA, will initially include Australia, Cambodia, China, Laos, Myanmar, Thailand and Vietnam,” with the Asian Development Bank (ADB) acting as secretariat, the blog notes. “Malaria — particularly the emergence of artemisinin-resistant malaria — is a major development challenge, requiring strengthened regional collaboration, sustainable solutions and predictable financing,” ADB President Takehiko Nakao said in a statement, according to the blog.

Though “the number of reported deaths in the region has actually declined over the past decade, compared to Africa, where they remain elevated,” “increased population movements, low quality and counterfeit anti-malarial medicine, and climate change exacerbate the region’s vulnerability, noted the ADB,” the blog reports. ADB “estimates that at least $400 million is needed between 2013 and 2015 to step up efforts to contain artemisinin-resistant forms of malaria,” the blog adds (Larano, 10/11). ABC Radio Australia reports that Patricia Moser, lead health specialist for the Regional Sustainable Development Department at ADB, said, “[A]s programs are successful … sometimes it’s easy for countries to start looking at other priorities or to move the attention away from malaria. We think it’s really important that attention be maintained on malaria,” according to a transcript (10/11).

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U.N. Security Council Votes To Continue Haiti Peacekeeping Mission With Reduced Force Level

The U.N. Security Council on Thursday “voted unanimously to extend the United Nations peacekeeping mission in Haiti until mid-October 2014 so it can continue contributing to stability and development in the small Caribbean nation,” the U.N. News Centre reports. The “resolution decided that [the U.N. Stabilization Mission in Haiti (MINUSTAH)] overall force levels will consist of up to 5,021 troops and of a police component composed of up to 2,601 personnel. Currently, the mission consists of 6,233 troops and 2,457 police,” the news service notes (10/10). The resolution “noted government efforts to ‘control and eliminate'” the cholera epidemic that began in October 2010 following a devastating earthquake in the country, Agence France-Presse reports.

The resolution “urged ‘United Nations entities in coordination with other relevant actors to continue to support the government of Haiti in addressing the structural weaknesses, in particular in the water and sanitation systems’ in the impoverished Caribbean nation,” the news agency writes, adding, “It said there should be support for ‘rapid and targeted medical responses to outbreaks designed to reduce the threat’ from the cholera” (10/10). In response to a question about a “class action lawsuit filed [Wednesday] in a United States Federal Court in New York in connection with the cholera outbreak,” U.N. spokesperson Farhan Haq told a news conference, “The United Nations is working on the ground with the government and people of Haiti both to provide immediate and practical assistance to those affected, and to put in place better infrastructure and services for all,” another U.N. News Centre article reports (10/9).

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Experts Say Rabies Kills 24,000 People Annually In Africa

“Rabies kills 24,000 people a year in Africa, most of them children, because many on the world’s poorest continent cannot afford the cost of the vaccine, experts said on Thursday” at a conference of rabies experts held in Dakar, Reuters reports. “Africa is home to nearly half the 55,000 people around the world who die each year from rabies, caused mainly by bites from dogs contaminated with the virus,” the news agency adds. Herve Bourhy, a doctor with the Pasteur Institute in France, told reporters, “This is the disease of the poorest of the poor who can’t afford the vaccine,” according to the news agency. Because the cost of the vaccine is “prohibitively expensive” for many in African rural areas, “rabies experts from 15 sub-Saharan and north African countries who took part in the conference said the most effective way of avoiding the spread of the disease in many parts of Africa was simply to tie up dogs,” Reuters notes (Ba, 10/10).

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Editorials and Opinions

U.S. Should Maintain Funding For Successful Public Health Programs In Afghanistan

“[F]inanced largely by American foreign aid, [Afghanistan's public health care system] has produced the most rapid increase in life expectancy observed anywhere on the planet,” Justin Sandefur, a research fellow at the Center for Global Development, writes in an Atlantic opinion piece. “In terms of lives saved, it is as if the entire Syrian tragedy were averted thanks to a U.S. aid program few Americans had ever heard of,” he states and reviews some of the program’s successes. “Despite these successes, the health program has met resistance from an unexpected source: auditors,” Sandefur writes, noting “the Special Inspector General for Afghanistan Reconstruction, or SIGAR [in September] issued a report [.pdf] calling for the suspension of USAID’s $236 million in aid for basic health care in Afghanistan.”

“While the U.S. military can produce receipts for bombs and bullets bought in America, the Afghan government struggles to do the same for vaccines dispensed in remote rural clinics. Thus, from a government auditor’s perspective, it is riskier to give Afghan citizens health care than to shoot their insurgents,” Sandefur continues. “Aid will never be a substitute for a military strategy. Aid is not a counter-terrorism policy. But the lesson of USAID in Afghanistan is not that help is futile; on the contrary,” he writes, concluding, “Beyond hunting Osama Bin Laden to make America safer, American leaders have sold the war in Afghanistan in lofty terms, as an altruistic fight for the benefit of Afghan women and children terrorized under Taliban rule. When presented with the means and the opportunity to save the lives of thousands of those very same mothers and infants, if America retreats on the grounds of procurement rules and auditing queries, this narrative becomes hard to maintain” (10/10).

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To Maximize Aid Efficiency, International Community Needs 'Better Information And Clear Understanding'

In a CNN opinion piece, Charles Lwanga Ntale, director for Africa for Development Initiatives, questions “the value and impact of international aid,” writing, “The truth is, it is actually quite hard to measure. But there are important questions about both the quantity and quality of aid that must be answered.” He reviews the findings of the Investments to End Poverty report, “a major new report that analyzes aid in all of its complexity.” He continues, “At Development Initiatives we reviewed each individual record of foreign aid from OECD donors over the period 2006-2011 — over a million rows of data. Now, for the first time ever, we can see just how much aid flows between specific countries and, crucially, what that aid consists of.” Ntale adds, “If we want to maximize the impact and reach of international aid, we need to ensure that every dollar is spent as efficiently as possible. We can only do this with better information and a clear understanding” (10/9).

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Opinion Pieces Address International Day Of The Girl Child

October 11 marks the International Day of the Girl Child “to recognize girls’ rights and the unique challenges girls face around the world,” according to the day’s website. The following summarizes several opinion pieces written in recognition of the day.

  • Victoria Dunning, Huffington Post’s “Global Motherhood” blog: “[T]oo many girls are out of school, are living in poverty, are married young and are not safe from harassment, discrimination and violence. It is not only a matter of injustice, but also of economics and opportunities,” Dunning, executive vice president of the Global Fund for Children, writes. She discusses the activities of the fund and concludes, “We trust these girls to lead us just as they trust us to understand their potential to lift themselves and others out of poverty. As nations look to the future, let’s ensure that not only are girls included, but that they are leading the way” (10/10).
  • John Kluge, Huffington Post’s “Social Entrepreneurship” blog: “Today, the large majority of microloans go to women, for very pragmatic reasons” — such as “women tend to make financial decisions that benefit their children and extended families,” Kluge, co-founder and chief disruption officer of Toilet Hackers, writes, adding, “As we mark the second International Day of the Girl on October 11, I’m calling for a similar recognition of the power and potential of girls, enlisting them in our mission to bring safe, sustainable sanitation to the billions who live without it.” He discusses several Toilet Hackers initiatives meant to empower girls, and he concludes, “At Toilet Hackers, we want all girls, and all women, to have a chance to live and thrive, to change the world for those around them” (10/10).
  • James Whiting, Huffington Post U.K.’s “Women” blog: “Although there are more obvious girl-specific barriers, in much of Africa malaria is one of the greatest single obstacles to the fulfillment of a girl’s potential — and one of the cheapest to remedy,” Whiting, executive director of Malaria No More U.K., writes. He discusses the importance of education and the success of the campaign to end malaria. “If we can defeat malaria, it will have such a knock-on effect on education, on the economy of the family — and entire countries,” he states, concluding, “[T]he drive to defeat malaria has positive knock-on effects. For mums, for girls, for everyone” (10/11).

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Recent Releases

NEJM Publishes Two Perspective Pieces Discussing PEPFAR

The October 10 issue of the New England Journal of Medicine includes two perspective pieces discussing PEPFAR. One piece, from Palav Babaria of the University of California, San Francisco, discusses the successes of PEPFAR, adding, “Now PEPFAR is at risk, as investments in AIDS give way to other global health priorities — a shift supported by some in the global health community who fail to recognize that the systems delivering [antiretroviral therapy (ART)] also permit expansion of primary care, chronic disease treatment, and maternal and child health care services” (10/10). In another piece, Ingrid Katz of Brigham and Women’s Hospital and colleagues discuss the implications for HIV care in South Africa as “South Africa [becomes] the first PEPFAR-funded country to transition to full ownership of — and financial responsibility for — its HIV program” (Katz et al., 10/10). An audio interview of Katz by Stephen Morrissey, NEJM managing editor, also is available online (10/10).

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'Science Speaks' Features Several Posts On AIDS Vaccine 2013 Conference

The Center for Global Health Policy’s “Science Speaks” blog features a series of blog posts on issues discussed at the AIDS Vaccine 2013 conference that recently concluded in Barcelona. The blog includes a post discussing the need to include married or cohabitating couples in HIV prevention trials; a post discussing next steps after a 2009 clinical trial in Thailand showed the risk of HIV infection could be reduced by a vaccine; and a post discussing “questions lingering over the results of three halted clinical research trials for which follow-up studies continue” (Barton, October 2013).

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