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Kaiser Daily Global Health Policy Report

In The News

WHO Investigates Possible Polio Outbreak In Syria; Virus Continues To Spread In Pakistan, Afghanistan, Horn Of Africa

“The [WHO] said Saturday it is investigating a possible outbreak of polio in Syria, where an ongoing civil war has decimated the public health infrastructure,” CNN reports. “The organization said it received reports Thursday of ‘a cluster of acute flaccid paralysis (AFP) cases’ … detected early in the month in the eastern province of Deir Ezzor,” the news agency writes (Watkins, 10/20). “The WHO is still waiting for final test results from its regional reference laboratory,” according to Reuters, which adds, “Wild poliovirus was last reported in Syria in 1999” (Kelland, 10/19). “Syria’s Ministry of Public Health is launching an urgent response, but experts fear the disease will be hard to control amid civil unrest,” BBC News writes, noting “vaccination rates have been waning,” “[a]t least a third of the country’s public hospitals are out of service,” and the risk of an outbreak is increased due to “overcrowding, poor sanitation and deterioration in water supply” (10/21).

In related news, Reuters in a separate article examines how “[a] Taliban ban on vaccination is exacerbating a serious polio outbreak in Pakistan, threatening to derail dramatic progress made this year towards wiping out the disease worldwide,” according to health officials. “Health teams in Pakistan have been attacked repeatedly since the Taliban denounced vaccines as a Western plot to sterilize Muslims and imposed bans on inoculation in June 2012,” the news service notes (10/18). In similar news, the Global Dispatch reports “[t]he number of polio cases in the Horn of Africa outbreak has risen by six as both Somalia and Ethiopia recorded new cases,” “Afghanistan reported one new wild poliovirus-1 (WPV1) case in the past week,” and “Pakistan reported four new WPV1 cases in the past week” (10/18). Scientific American on Friday introduced “a special e-publication called ‘Polio: Pushed to the Brink,’” which draws articles from the magazine’s archives (De Quadros, 10/18).

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Uganda Launches First-Ever 'Adolescent Girls Vulnerability Index'

“Uganda has become the first country in the world to institute an Adolescent Girls Vulnerability Index [.pdf], thus recognizing the unique challenges that teenage girls face and their effect on society as a whole,” VOA News reports. The index, released earlier this month by the Ugandan government and UNICEF, “could help with policy making,” the news service notes. The index “measured things like education and rates of early marriage and pregnancy, as well as poverty levels” among girls ages 10 to 19, and “found that more than 20 percent of Uganda’s adolescent girls had ‘extreme vulnerability,’” the news service writes. “For the moment, UNICEF has no plans to extend the index to the rest of the world,” VOA notes (Heuler, 10/18).

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Report Shows Increase In Number Of New HIV Cases In Australia

Australia’s Kirby Institute on Monday published a report showing “new cases of HIV last year rose at their fastest rate in 20 years, with a dramatic increase among young men and indigenous people,” The Guardian reports (Davidson, 10/20). David Wilson, a professor at the institute who wrote the report, said, “It’s very alarming what’s happening with HIV at the moment. We’ve had over 1,250 cases of HIV recorded, that’s those that have been diagnosed. … There are about 25 percent of cases that are undiagnosed in Australia as well,” according to ABC News. “The Australian Federation of AIDS Organisations [AFAO] says there has been a significant rise in gay men with casual partners having unprotected sex, particularly among men aged under 25,” the news service writes (10/20). “Bill Whittaker of the National Association of People With HIV Australia (NAPWHA), believes Australia has reached ‘one of the critical moments in 30 years of AIDS’ and warns that not enough is being done to combat the disease,” The Guardian notes (10/20). AFAO Executive Director Rob Lake “says there is a need for a new strategy to encourage condom use and HIV testing,” ABC writes (10/20).

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Two Studies Show Oral Cholera Vaccine Effective In India, Guinea

“A study released [Friday in The Lancet] shows that an oral cholera vaccine made in India is the first such vaccine to offer significant protection for five years, while another new report says the vaccine was well-accepted in an immunization campaign last year in the African country of Guinea,” CIDRAP News reports. “The vaccine, Shanchol, is made by Shantha Biotechnics and was endorsed by the [WHO] in 2011,” the news service notes, adding, “The cumulative protective efficacy of the vaccine was 65 percent … , and year-by-year estimates showed no evidence of a decline in efficacy, the report says.” The other study, published in PLOS Neglected Tropical Diseases, “focused on a mass cholera vaccination campaign launched by Guinea’s Ministry of Health in 2012, with support from Médecins Sans Frontières, to help battle the country’s ongoing cholera epidemic,” CIDRAP states, noting the report authors said “that although oral cholera vaccines should not be viewed as a long-term solution for global cholera control, they should be integrated as an additional tool into the response” (Roos, 10/18).

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FDA Advisory Panel Recommends Experimental Drug To Treat Leishmaniasis For Approval

“Paladin Labs Inc.’s experimental drug to treat a rare parasitic disease is effective and safe enough to be approved, an advisory panel to the [FDA] said on Friday,” Reuters reports. “The drug, Impavido, is designed to treat three forms of leishmaniasis, a disease caused by a group of parasites known as Leishmania, which are spread by the bite of a female sand fly,” the news service notes. “Impavido was granted priority review by the FDA, a status that cuts the review time to six months from the standard 10,” Reuters notes, adding, “The FDA is not bound to follow its advisory panel’s advice but typically does so” (Clarke, 10/18).

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Devex Profiles Head Of Global Fund's Critical Enablers And Civil Society Group

Devex profiles Kate Thomson, “an HIV-positive individual who used to work for the [Global Fund to Fight AIDS, Tuberculosis and Malaria] back in its early days as manager of civil society relations,” noting she is returning to the organization “to lead a group of specialists whose role is to ensure Global Fund grants ‘support and expand gender equality, human rights, and [the] scaling up of community-led services and policy dialogue,’” according to Ibon Villalebeitia, a spokesperson for the fund. “The group is called the Critical Enablers and Civil Society hub,” according to the news service. “To take on the role, Thomson will be temporarily leaving her position as chief of community mobilizations at UNAIDS,” Devex writes, and discusses Thomson’s views of society engagement in development (Ravelo, 10/18).

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Editorials and Opinions

Adequate Response To Post-2015 Agenda Will Require Greater Cooperation Among U.S. Agencies

In an opinion piece in The Guardian’s “Global Development Professionals Network,” John Norris, executive director of the Sustainable Security and Peacebuilding Initiative at the Center for American Progress (CAP), and Annie Malknecht, a research associate at the center, write about U.S. efforts to balance “defense, diplomacy and development,” and the work of the CAP initiative, which aims “to develop solutions for these complex scenarios and better balance the three legs of America’s international engagement.” They continue, “The project aims to reform the U.S. approach by spending lean foreign assistance funds more effectively and efficiently, building institutional capacity in weak states and strengthening U.S. engagement with the international community and institutions. While these reforms will not erase the need for traditional hard power, they will help decrease the need for military action.”

Norris and Malknecht discuss the quadrennial diplomacy and development report (.pdf) and several reforms proposed by the Obama administration. “While these reforms are commendable, there is more to be done,” they write, noting international discussion of the post-2015 development agenda. “Whatever the details of the post-2015 development agenda, the U.S. and other developed countries must establish another 15-year commitment to cooperate on complex and far-reaching issues — the stakes are too high for inaction,” they write, adding, “Without government commitment reaching beyond aid agencies, poverty reduction efforts will flounder and the world will face increasingly complex problems in decades to come.” They continue, “For the U.S., this will require greater co-operation between the departments of state and defense and USAID” (10/18).

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U.S. Needs To More Directly Address Antibiotic Resistance

Noting recent warnings from the CDC and WHO about the increasing rate of antibiotic resistance, David Hoffman, a contributing editor at the Washington Post, writes in an opinion piece in the newspaper, “[M]y reporting for the documentary ‘Hunting the Nightmare Bacteria,’ which is to air Tuesday on PBS’s ‘Frontline,’ suggests that past warnings about antimicrobial resistance were largely discarded.” He adds, “We ought to snap out of our long complacency.” “I found smart people at the CDC, NIH, the Food and Drug Administration and elsewhere all working on the resistance crisis, … [b]ut politically, there is no active constituency — no patient groups marching in the streets,” he writes, adding, “President Obama ought to shake us out of this lethargy and appoint someone to tackle antimicrobial resistance across all fronts.”

“The goals are clear: far more detailed, national data reporting; improved stewardship of existing antibiotics; and a major antibiotic drug discovery and development effort,” Hoffman states. “This crisis will require truly broad collaboration, including scientists, clinicians, hospitals, regulators and the pharmaceutical industry,” he adds, concluding, “But government can light a spark and galvanize people toward a result that each could not achieve acting alone in the face of a real threat” (10/20).

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Report Explores Strategies To Better Address NCDs

“Over the past year I have been involved with the Oxford Martin Commission for Future Generations, a group of international leaders working to identify how progress can be delivered on critical challenges such as addressing the global burden of chronic disease and the risks (and opportunities) associated with our hyper-connected world,” Peter Piot, director of the London School of Hygiene and Tropical Medicine, writes in the Huffington Post’s “Impact” blog. “Our report, ‘Now for the Long Term,’ highlights the deep global inequalities which persist in access to food, adequate sanitation, vaccines and health care, and aims to shift government and business priorities towards longer-term challenges that will shape our futures,” he adds.

“[W]e believe the threat of non-communicable diseases [NCDs], such as stroke, cancer, diabetes and dementia, cannot be ignored,” Piot writes. “To better respond to the threat of NCDs, the Oxford Martin Commission recommends the creation of an action-focused global network centered on cities and dedicated to fighting the rise of NCDs,” he states, adding, “This would require engaging with the food, beverage and alcohol industries, as well as developing and enforcing healthy food and drinking regulation beyond total smoking bans, and creating incentives for the production and marketing of healthy, tasty and affordable food” (10/18).

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Women's Full Participation Critical To International Peace, Security

In a Thomson Reuters Foundation opinion piece, U.N. Women Executive Director Phumzile Mlambo-Ngcuka examines the role of women’s empowerment in building international peace and security, noting “[a] resolution adopted [Friday] by the U.N. Security Council moves us one step closer to the full participation of women as leaders for peace and security.” She writes, “By unanimous vote, the council adopted a resolution that sets in place stronger measures to enable women to participate in conflict resolution and recovery, and puts the onus on the Security Council, the United Nations, regional organizations and Member States to dismantle the barriers, create the space, and provide seats at the table for women.”

“U.N. Women hopes that this new Security Council resolution will trigger opportunities for women’s direct engagement, setting priorities for recovery in their countries,” Mlambo-Ngcuka states, writing, “There can be few better investments in building a sustainable peace than involving women. They connect the talks to the lives of those affected by conflict. They help generate broad social buy-in to the peace.” She concludes, “With [the] resolution, the Security Council is recognizing something very important: that gender-based inequality, just like poverty, is an injustice that fuels conflict and undermines peace, and that gender equality and women’s full participation are critical to international peace and security” (10/18).

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Recent Releases

Blog Reports On Pending Departure Of U.S. Global AIDS Coordinator Goosby

The Center for Global Health Policy’s “Science Speaks” blog reports on the pending departure of Ambassador Eric Goosby, head of the U.S. State Department’s Office of Global Health Diplomacy and the U.S. global AIDS coordinator, noting “his departure date is set for as early as October 26.” The blog states, “After four years of leading the U.S. Office of the Global AIDS Coordinator and its [PEPFAR program] with an unprecedented acceleration of treatment roll out, scale up of evidence-based action, and efforts to reach those hardest hit by the epidemic, Goosby will leave a lasting and significant legacy, HIV response advocates say.” The blog adds, “They are urging that his replacement be named swiftly to ensure work that has expanded in scope and ambition under his watch continues uninterrupted” (Barton, 10/18).

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GAVI Alliance Board Chair Reflects On 2013 Mid-Term Review

Writing in the ONE blog, Dagfinn Høybråten, chair of the GAVI Alliance Board, reflects on the organization’s 2013 Mid-Term Review, released last week, which found the alliance is on track to “immunize an additional quarter of a billion children by 2015, and prevent four million future deaths in the process.” He states, “While we may not be there yet, it is nevertheless a huge accomplishment and one that is not just measured in lives saved,” adding, “But now with two years to go, there is indeed much left to do if we are to fulfill our promises” (10/18).

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PPPs 'Critical To Deliver Messages To New Mothers'

“Lifebuoy joined forces with [USAID] and its Maternal and Child Health Integrated Program (MCHIP) to create a neonatal program to raise awareness of the link between newborn survival and handwashing with soap,” Anila Gopal, global social mission manager at Unilever-Lifebuoy, writes in USAID’s “IMPACTblog.” She continues, “Public-private partnerships are critical to deliver messages to new mothers. Health organizations and governments have on-the-ground expertise to ensure health workers deliver the messages to new mothers in a scalable and sustainable way.” This program “will help fulfill Lifebuoy’s vision of bringing health and hygiene to one billion people,” Gopal concludes (10/18).

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