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Kaiser Daily Global Health Policy Report

In The News

Humanitarian Situation Deteriorating In Syria As Winter Months Approach

“With more than five million people internally displaced, a suspected polio outbreak, and starvation threatening, the United Nations and aid agencies say that just a trickle of the required assistance is getting into war-ravaged Syria as the harsh winter months loom,” the Washington Post reports. “The U.N. humanitarian chief, Valerie Amos, on Friday chastised both sides for failing to improve access along the lines laid out in an October 2 U.N. statement and described the situation as a ‘race against time,’” the newspaper writes, adding, “The United States has accused the Syrian government of deliberately preventing the delivery of lifesaving relief, describing it as ‘unconscionable.’” According to the Washington Post, “Western diplomats say that improving humanitarian relief access, also a key demand of the Syrian opposition ahead of a planned peace conference in Geneva this month, is now their key focus.”

“Although more than 100,000 people have been killed in the war, according to U.N. and activist estimates, there are no figures on how many thousands more may have died from treatable conditions due to a lack of supplies and Syria’s devastated health care system,” the Washington Post adds. Médecins Sans Frontières, “which says it has confirmed cases of malnutrition, expects cases to spread in northern Syria during the winter months as food supplies run low and inflated prices mean that many struggle to feed their families,” the newspaper writes, noting, “More than two million Syrians, 10 percent of the population, have fled the country” (Morris, 10/26).

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U.N., Syria Launch Campaign To Vaccinate 2.5 Children Against Polio

“The United Nations has announced that it will vaccinate 2.5 million children and eight million others in Syria to prevent a widespread outbreak of polio,” GlobalPost reports (Stainburn, 10/26). “As Syria awaits confirmation of suspected polio cases in the east of the country, UNICEF has joined the [WHO] and other partners in mounting a large-scale immunization effort aimed at protecting as many children as possible both in the country and across the region against polio, as well as other vaccine-preventable diseases,” UNICEF states in a press release (10/25). “At least 22 people — most of them babies and toddlers — are now believed to have contracted polio in Syria, the [WHO] has reported,” according to BBC News, which notes, “If confirmed, it would be the first outbreak of the disease there in 14 years” (10/25).

“Inside Syria, a campaign led by the Ministry of Health began on October 24,” CNN notes (Watkins/Alkhshali, 10/25). “The [WHO], working with UNICEF and other aid groups, has organized a plan to administer repeated oral doses of polio vaccine in concentric geographical circles, starting with children in Deir al-Zour and eventually reaching western Iraq, southern Turkey, Jordan, Israel, the Palestinian territories and Egypt,” according to the New York Times (Gladstone, 10/25). In addition, “Lebanon, which hosts more than 700,000 Syrian refugees, said on Friday it would vaccinate all children under five against polio after suspected cases of the crippling viral disease were found in neighboring Syria,” Reuters adds (Solomon, 10/25).

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Syrian Crisis Overshadowing Humanitarian Situations In CAR, DRC, U.N. Official Says

UNICEF Emergencies Director Ted Chaiban “says the dire humanitarian situations in the Central African Republic and the Democratic Republic of Congo are being overshadowed by the crisis in Syria,” VOA News reports. He “was part of an assessment mission to both African countries by the directors of emergencies for seven major U.N. agencies and two private organizations,” the news agency notes. Chaiban said 2.5 million people are internally displaced in DRC and in need of food and health care assistance, and “1.6 million [people in CAR] are estimated to be in dire need of food, protection, health care, water and sanitation and shelter,” according to VOA. He said the World Food Programme lacks resources to address the situations in Syria and central Africa, the news agency adds, writing Chaiban “says no one questions the need to support the millions of victims of Syria’s conflict.  At the same time, he says the mission is beginning to see how funding for Syria is impacting other crises” (Schlein, 10/25).

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Devex Examines Global Efforts To Achieve Health MDGs

“[W]ith 800 days to go before the 2015 deadline, the Millennium Development Goals [MDGs] of reducing deaths for children under five by two-thirds and the maternal mortality ratio by three-quarters are unlikely to be met,” Devex reports. The news service “spoke to thought leaders in these sectors to determine the status of these goals and the latest strategies being employed by the development community to address the existing challenges,” it states. “The solution may lie in achieving universal access to reproductive health, another MDG,” Devex writes, noting, “Over 200 million women worldwide would like to delay or avoid pregnancy but do not have access to voluntary family planning methods, said Dr. Timothy Mastro, global health for population and nutrition manager at FHI 360.” The news service notes “that if this need were met, maternal mortality would be reduced by a third and infant mortality by 10-20 percent.” Devex examines the international aid community’s efforts and discusses the need to include these issues on the post-2015 agenda (Parmanand, 10/25).

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Malaria Deaths In Chad Nearly Double This Year, Aid Groups Say

“Malaria deaths have nearly doubled in Chad this year, with 2,057 fatalities registered so far and around 780,000 cases diagnosed, aid groups say,” IRIN reports. “Erratic rainfall with intermittent dry spells may have encouraged the breeding of mosquitoes and the development of larvae into adult insects,” but [h]ealth experts are conducting studies to confirm the exact causes of this year’s high rates of infection,” the news service notes. “Experts say that reported cases are beginning to stabilize, at around 40,000 cases per week,” according to IRIN. “In the worst-affected districts, the government of Chad, UNICEF and the [WHO] have launched a broad response comprising the distribution of bed nets, medicines, malnutrition treatment for children under five, and the boosting of prenatal services such as vaccination and preventive malaria treatment,” the news service adds (10/25).

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Thailand Records Record Number Of Dengue Cases

“Thailand is experiencing its largest dengue epidemic in more than two decades, with a record number of people infected by the mosquito-borne disease and 126 fatalities so far this year, health experts said on Thursday, pointing to climate change as a factor behind the spike in cases,” Thomson Reuters Foundation reports. “More than 136,000 cases of dengue fever … have been confirmed so far this year” — “a more than 50 percent increase in infections compared to 2012” — but health officials say fewer deaths from the disease have occurred because of improved response, according to the news service. “Thailand’s Public Health Ministry says it is trying to contain the outbreak through nationwide fumigation campaigns to eradicate the mosquito breeding grounds, public awareness campaigns in rural communities, and newly set-up operation centers around the country to coordinate with provincial health offices,” Reuters writes (Lefevre, 10/24).

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New Installation Of Al Jazeera's 'Lifelines' Examines Efforts Against River Blindness in South Sudan

In a recent installation of “Lifelines: The Quest For Global Health,” Al Jazeera’s “new cross-platform project profiling the extraordinary work of global health workers as they tackle eight deadly diseases and conditions that afflict poor people,” the news agency examines efforts prevent and treat river blindness in South Sudan, where infection is endemic “but treatment and education is being delivered to the most afflicted regions” (Green, 10/24). Additional coverage and information about Lifelines is available on the program’s website (10/28).

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Researchers Discover Protein In Breast Milk That Can Disable HIV

In a study published in the Proceedings of the National Academy of Sciences, Genevieve Fouda of Duke University and colleagues describe the isolation of a “single protein called tenascin-C” in human breast milk that is believed to “disabl[e] HIV by locking onto a protein on the virus’s surface, and … is as effective at doing so as antibodies generated by the immune system for that specific purpose,” The Economist reports. “Whether tenascin-C, or something derived from it, can be deployed against HIV by doctors, rather than just by nature, remains to be seen,” the magazine notes (10/26).

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Editorials and Opinions

International Community 'Must Act Quickly' To Deliver Life-Saving Assistance To Syrians

“The world already knows that [Syria's] Bashar al-Assad has used chemical weapons, indiscriminate bombing, arbitrary detentions, rape, and torture against his own citizens,” U.S. Secretary of State John Kerry writes in a Foreign Policy opinion piece. “What is far less well known, and equally intolerable, is the systematic denial of medical assistance, food supplies, and other humanitarian aid to huge portions of the population,” he adds, noting, “Reports of severe malnutrition across vast swaths of Syria suffering under regime blockades prompted the United Nations Security Council to issue a presidential statement calling for immediate access to humanitarian assistance.” He states, “To bolster the U.N.’s position, every nation needs to demand action on the ground — right now.”

“Simply put, the world must act quickly and decisively to get life-saving assistance to the innocent civilians who are bearing the brunt of the civil war,” Kerry continues, adding, “To do anything less risks a ‘lost generation’ of Syrian children traumatized, orphaned, and starved by this barbaric war.” He notes a “U.N. statement [issued] earlier this month calls on all parties to respect obligations under international humanitarian law,” and he writes, “Convoys carrying aid need to be expedited. Efforts to provide medical care to the wounded and the sick must be granted safe passage. And attacks against medical facilities and personnel must stop.” Kerry concludes, “With winter approaching quickly, and the rolls of the starving and sick growing daily, we can waste no time. Aid workers must have full access to do their jobs now. The world cannot sit by watching innocents die” (10/25).

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USAID's Disaster Assistance Helps India Avoid More Deaths After Cyclone

Noting a cyclone killed at least 10,000 people on the east coast of India in 1999, and a similar cyclone last week hit the same area, resulting in about 50 fatalities, Jeremy Konyndyk, director of the Office of U.S. Foreign Disaster Assistance at USAID, writes in the Huffington Post’s “World” section, “This reduction in fatality levels from the tens of thousands down to the tens is no accident — it is a powerful example of how good disaster risk reduction efforts can save lives on a massive scale.” The Indian government’s efforts to issue storm warnings and evacuate nearly one million people are well documented, “[b]ut the untold story behind those headlines is how a U.S. government partnership helped India to develop that capacity,” he writes. Konyndyk describes USAID’s work with India in disaster response and mitigation, concluding, “The Indian government deserves enormous credit for its investment in these systems, and the U.S. can take pride in knowing that our investment in this partnership with India has now paid off in a big way” (10/25).

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Progress Against Diseases In Africa Must Continue

“One of the leading impediments to freedom and prosperity in Africa has been disease, particularly HIV, tuberculosis and malaria,” a Deseret News editorial states. “The good news is that the world now has th[ese] and other diseases on the run,” the newspaper continues. “Political turmoil, poor education and improper sanitation practices have long been impediments to the fight against diseases in Africa,” the editorial notes, adding, “Some of these problems remain, but the progress against disease in recent years has been remarkable and must be continued.” The newspaper adds, “Americans should remember that extreme poverty and its attendant problems seldom are isolated and contained, no matter how far from home they exist,” concluding, “By eradicating diseases and helping to educate people, the United States can build goodwill and influence the spread of liberty and the development of new trading partners” (10/27).

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'Novel Paradigms' Needed To Increase R&D Funding For Neglected Diseases

Describing two recent articles criticizing the pharmaceutical industry for not spending more for research and development (R&D) into neglected diseases, John LaMattina, former president of Pfizer Global Research and Development, writes in a Forbes opinion piece, “People have the view that Big Pharma is a cash generating machine. But, the biopharmaceutical industry is being squeezed by patent expirations, higher regulatory hurdles for their experimental drugs, and ever increasing demands for showing the value of new medicines, … causing companies to slash R&D budgets.” He continues, “I think that the private sector could be doing more,” and he describes a model for neglected disease R&D involving academic institutions and private donor funding. LaMattina concludes, “[T]o expect Big Pharma to do a significant amount more R&D in neglected diseases is not economically feasible in the current environment. It is going to take novel paradigms to generate greater progress in this field” (10/26).

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Recent Releases

Brookings Institution Hosts Public Release Of 2013 Aid Transparency Index

The Brookings Institution on Thursday hosted the public release of the 2013 Aid Transparency Index — “the only global measure of donors’ aid transparency,” George Ingram, a senior fellow in the Global Economy and Development program, reports in the Brookings “Up Front” blog. Ingram examines the importance of making such data available to the public and provides details of data related to various U.S. agencies (10/24).

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Global Health Workers Need Comprehensive Training Rather Than 'Quick Interventions'

“As governments from all corners of the world are desperately trying to improve their health systems and achieve the [Millennium Development Goals (MDGs)] by 2015, they promise to increase the workforce of health workers manifold,” Frances Day-Stirk, president of the International Confederation of Midwives (ICM), writes in the Bill & Melinda Gates Foundation’s “Impatient Optimists” blog. “The question is, do we want to cover the tip of the iceberg and train health workers in emergency skills, or do we want to do our job right and educate a cadre of health workers — including midwives — who all have the essential competencies to do every part of the job instead of only a few quick interventions,” she writes, concluding, “It is time to address all the issues properly and let the midwives and other health workers develop all of the skills that people need so desperately” (10/24).

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'Integration And Resource-Sharing' Necessary To Address Both Infectious, Chronic Diseases

Writing in the PLOS “Speaking of Medicine” blog, Sara Gorman, an MPH candidate at Columbia University Mailman School of Public Health, “explores the interconnectedness of infectious and chronic diseases,” asking, “In a world of global health systems that tend to focus on one disease or one category of disease at a time, should we be shifting our focus from HIV, tuberculosis, and malaria to asthma, heart disease, and diabetes?” She continues, “To avoid [excessively vertical health programs], the constant interplay between infectious and non-communicable diseases needs to be recognized and acknowledged and greater integration and resource-sharing in health systems must be pursued” (10/25).

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