KFF Daily Global Health Policy Report

In The News

Global Funding For TB R&D Declined Last Year, Report Says

“Funding for research and development [R&D] of new drugs, vaccines and rapid diagnostic methods for [tuberculosis (TB)] declined 4.6 percent in 2012 to $627.4 million after rising annually every year from 2005 to 2011, said [a report from] the Treatment Action Group, a New York-based AIDS research and policy think tank that also focuses on TB issues,” the Wall Street Journal reports. “Most of last year’s cuts came from private-sector donors, the group said, warning that reductions are likely this year as well, because major public-sector donors such as the U.S. government have been hit with budget cuts and across-the-board spending reductions called sequestration,” the newspaper writes, outlining some of the specific cuts and TB research efforts. “While the drop in funding wasn’t huge, it comes at a time of a worsening epidemic of drug-resistant TB, which public health authorities say can’t be confronted effectively without new tools,” the Wall Street Journal notes, adding, “The decline in investment for R&D is part of an uncertain picture overall for funding against TB, which killed an estimated 1.3 million people in 2012, but draws far less overall investment than HIV/AIDS, which was linked to the deaths of 1.6 million people that year” (McKay/Shah, 10/28).

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Study Finds Gaps Persist In Efforts To Prevent, Treat Neglected Diseases

“Despite much progress in the last 35 years, a new study, [conducted by the Drugs for Neglected Diseases Initiative, Doctors Without Borders, the WHO’s tropical disease research branch and others, and published last week in Lancet Global Health,] has found that major gaps persist in the effort to prevent and treat the ‘neglected diseases’ of the poor,” the New York Times reports. “The study, a survey of the 850 new drugs and vaccines approved in the last 12 years, found that only four percent were for the 49 diseases the authors consider neglected, including obscure worm and diarrheal diseases and well-known killers like malaria and tuberculosis,” the newspaper writes, adding, “Another four percent of newly approved products were for AIDS, which the authors do not consider neglected.” Noting the study “is a follow-up to a 2002 survey by the same group covering the years 1975 to 1999,” the New York Times writes, “While four percent may seem small, the earlier findings were far more bleak: only one percent of all pharmaceutical research focused on neglected diseases.” In addition, “[o]f the 150,000 trials registered as of December 2011, only one percent were for neglected diseases,” the newspaper states (McNeil, 10/28).

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Food Aid Cash Vouchers Allow More Aid To Reach Recipients, But Programs Need Flexibility, Study Says

“Cash can be more effective than food aid when it comes to reaching hungry people,” according to a study by the International Food Policy Research Institute (IFPRI) and the World Food Programme, but “the study authors find there is no right way to deliver aid, and say flexibility is key,” VOA News reports. Researchers examined “aid projects in four very different countries: Ecuador, Uganda, Niger, and Yemen,” finding “cash was cheaper to provide than food,” and “[i]f the projects used only cash or vouchers, an additional 32,000 people could have been fed, approximately 15 percent of the total,” according to the news service. “However, [John Hoddinott of IFPRI] stressed, ‘We want to be very clear: the results of our study do not say that you should always provide cash,'” VOA writes. The U.S. “Congress is considering legislation that would allow slightly more flexibility” in food aid policies to provide more assistance in the form of cash vouchers, the news service notes, adding, “The legislation is part of the much larger Farm Bill,” which House and Senate negotiators begin discussing this week (Baragona, 10/28).

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Devex Examines Food Rapporteur's Report; NPR Interviews Buffett Family About New Book On Food Security

“[I]n the past decade, an empowered civil society has been a driving factor of the significant progress made in several countries in ensuring food security and combating malnutrition,” Devex reports. Civil society organization (CSO) “participation has helped shape government policies and improve service delivery, particularly for the most vulnerable populations, according to a U.N. General Assembly report filed on Friday by outgoing Special Rapporteur on the Right to Food Olivier De Schutter, whose mandate ends April next year,” the news service adds. Other factors positively influencing food security “include getting the highest levels of government to put food and nutrition security as a priority, establishing institutions to monitor progress and policy implementations, and a continuous flow of investments,” according to the report, Devex notes and includes comments from De Schutter (Ravelo, 10/28).

In related news, NPR’s “The Salt” blog features an interview with Warren Buffett, Howard G. Buffett, and Howard W. Buffett, who co-authored a book on food security, titled “40 Chances: Finding Hope in a Hungry World.” They discuss advocacy, biofuels, genetically modified organisms (GMOs), U.S. food aid policies, and other issues (Aubrey/Charles, 10/28).

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Brazil To Produce Measles, Rubella Vaccine For Developing Countries

“Brazil’s top biomedical research and development center announced plans on Monday to produce a combined measles and rubella vaccine for developing countries, mainly in Africa,” Reuters reports. “The first Brazilian vaccine developed specifically for export will be made by Bio-Manguinhos, a unit of the Oswaldo Cruz Foundation (Fiocruz), in partnership with the Bill & Melinda Gates Foundation,” the news service writes, adding, “Brazilian Health Minister Alexandre Padilha announced the vaccine plan at a medical science conference that the Gates Foundation organized in Rio de Janeiro” (Boadle, 10/28). “The vaccine is expected to be the most affordable on the market and will be the first made for export by Brazil,” according to BBC News, which notes, “Currently, only India produces such vaccines.” The news service adds, “The Brazilian government says it will build a brand new production plant in Rio de Janeiro, creating jobs and boosting expertise” (10/28).

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New Report Examines District-Level Health Data In South Africa

South Africa’s Health-e on Tuesday published six articles highlighting Health Systems Trust’s annual District Health Barometer, which provides district-level data on a wide range of health issues. The first article examines maternal and infant mortality in various provinces and districts (Cullinan, 10/29). A second article lists “some of the worst districts in South Africa to be a woman or mother” based on different health indicators (Gonzalez, 10/29). A third article looks at child malnutrition in various districts (Cullinan, 10/29). A fourth article examines various health indicators for the Western Cape province (Cullinan, 10/29). A fifth article reports on Gauteng’s HIV treatment program (Cullinan, 10/29). The final article looks at HIV gains despite high numbers of patients in KwaZulu-Natal (10/29).

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NPR's 'Shots' Presents Timeline Of Global Polio Response

NPR’s “Shots” blog examines global efforts against polio in an interactive timeline. “Just a few decades ago, polio was crippling more than a thousand children each day. Now the paralyzing virus is endemic to only three countries — Afghanistan, Pakistan and Nigeria. And there were just 223 cases globally last year,” the blog writes. “Until the transmission of poliovirus is stopped in endemic countries, the threat of outbreaks in other areas of the world remains,” NPR notes, adding, “Nevertheless, health leaders are aiming to eradicate polio completely by 2018” (Oshinsky, 10/27).

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IRIN Examines Use Of Goodwill Ambassadors To Raise Awareness Of Development Issues

IRIN examines the use of Goodwill Ambassadors to champion development-related causes. “[T]here is no denying the global attention and resources that well-known personalities can bring to their chosen causes, … [b]ut using actors, musicians and sports stars to convey messages about potentially complex development issues has its pitfalls,” the news service writes. The article includes comments from London Metropolitan University’s Mark Wheeler; Marissa Buckanoff, head of UNICEF’s celebrity relations and partnerships division in New York; Marie-Vincente Pasdeloup, manager of Oxfam’s Global Ambassador program; Sisonke Msimang, a South Africa-based social commentator and civil society insider; and Aziyadé Poltier-Mutal, communications partnerships manager with the U.N. Development Program (Siegfried, 10/28).

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Editorials and Opinions

Uganda's Breast Cancer Treatment Lagging But Women Beginning To Organize To Bring About Changes

Following a New York Times feature story on breast cancer in Uganda, journalist Denise Grady writes about the issue in the newspaper’s “Reporters Notebook.” “There’s a lot of hand-wringing in Uganda about the fact that most breast cancer here is diagnosed late, after it has begun to spread, when there is little or no chance of curing it,” she states. “Much of the problem is chalked up to women’s failure to see a doctor soon enough, because of ignorance, shame or being too poor to afford treatment or even bus fare to the clinic,” she continues, but one of the clinics she visited in Mulago “is daunting and demoralizing, emblematic of a deeper problem: when women do seek help, Uganda’s sluggish, inefficient health system throws up one obstacle after another — endless waits, drug shortages, lost lab tests, unexpected fees.” She notes, “The survival rates for women with breast cancer in poor countries like Uganda are far lower than those in developed countries, according to the [WHO].” Grady writes about how women are beginning to organize into support and advocacy groups to push for better treatment (10/28).

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Better Data On Global Food Waste Needed

“Food waste is an issue of global significance, affecting food security and environmental sustainability, yet basic information is lacking on the types and quantities wasted,” Julian Parfitt, principal resource analyst at the Centre for Remanufacturing and Reuse, writes in The Guardian’s “Global Development Professionals Network” blog. “Global food waste estimates are mainly based on old statistics recycled into ‘new’ estimates,” with “[s]ome of these estimates dat[ing] back decades,” he states. “The uncertainty relates to the cost and level of difficulty of conducting primary fieldwork, particularly in relation to post-harvest losses in developing economies,” he writes, adding, “There are also significant gaps in understanding food wasted at the consumer level in different parts of the world.” He continues, “Better measurement and monitoring through a global benchmarking network is urgently needed,” and “[p]riority should be given to developing countries and those undergoing rapid dietary shifts.” Parfitt concludes, “Producing more food only for it to be wasted a few days later through lack of investment in post-harvest losses is not part of the ‘ecological intensification’ model posited by [the U.N. Conference on Trade and Development (UNCTAD)]. So let’s wake up before it is too late and look at the global food waste issue with greater urgency” (10/28).

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Global Community Should Recognize Road Deaths As Growing Public Health Issue

“Car crashes and motorcycle accidents are symptoms of a disease, and it’s high time we started looking at killer roads as a public health crisis — or ‘pandemic,’ as the Pulitzer Center put it recently,” John Sutter, a columnist for CNN Opinion and head of CNN’s Change the List project, writes in a CNN opinion piece. He cites an ongoing Pulitzer Center project called “Roads Kill,” noting, “Roads kill 1.24 million people each year, and by 2030, that annual number is expected to jump to 3.6 million.” He provides statistics for various developing countries, including South Africa, the Dominican Republic, and China. “If road deaths are part of a disease, we know the cure,” Sutter continues, writing, “Countries like the United States and Australia have greatly lowered their rates of road deaths, in part with smart safety laws and levels of traffic enforcement that don’t exist in some other nations.” He encourages readers to “look at the Pulitzer report — it has a map where you can look up your country — and tweet about what you want to change, or what you’ve experienced on the roads in the place where you live.” He states, “No one anecdote will solve this problem, but the more we talk about it the closer we’ll get” (10/28).

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War, Conflict Hinders Global Polio Eradication Efforts

In an opinion piece in The Conversation, John Rhodes, a fellow at the Royal College of Pathologists, examines how war, conflict and distrust in Syria are hindering global polio eradication efforts. “War in the country has seriously affected health services and immunization programs, and suspected polio in 22 children has led to the urgent vaccination of 2.4 million more,” he notes, adding, “Despite the huge push to get rid of polio, its eradication is judged to be at a tipping point between success and failure, with some estimating that failure could lead to a widespread resurgence within a decade. And the cases amid the Syrian crisis and another new epidemic in Somalia show eradication of this dreadful disease, which can lead to paralysis, is far from an easy task.” However, he continues, “eradication was achieved in Somalia in 2007 and the [Global Polio Eradication Initiative] believes it can be achieved again.” He writes, “[I]t is clear that polio doesn’t remain isolated if outbreaks aren’t tackled and that war and conflict have the power to disrupt plans to rid us of the disease,” concluding, “If 2015 remains the target for the global defeat of polio, we will need to think about the children also caught up in conflict zones” (10/28).

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Ethiopia Addressing Elephantiatis With Help From Mapping Partnership

Noting Ethiopia “recently launched its national master plan (2013-2015) for neglected tropical diseases,” Kebede Deribe, a research training fellow at the Wellcome Trust, writes in The Guardian’s “Global Development Professionals Network” blog about the importance of mapping cases of the “two principal causes of elephantiasis, or lymphedema”: lymphatic filariasis (LF) and podoconiosis. “A new initiative to map LF and podoconiosis in Ethiopia is underway, through a collaboration between several organizations,” he writes, adding, “Supported by the Wellcome Trust, DfID and End Fund, the Ethiopian Health and Nutrition Research Institute (Ehnri) is working with Brighton and Sussex Medical School (BSMS), the Centre for Neglected Tropical Diseases, and the Global Atlas of Helminth Infections at the London School of Hygiene & Tropical Medicine to map 1,384 communities in 692 districts, covering more than 130,000 individuals.” Deribe describes the methods used to track cases and the program’s challenges. The resulting maps, which will be available to decision makers, “will allow the Ethiopian health ministry and partners working on LF and podoconiosis to plan properly and better target their interventions to eliminate the disease,” he concludes (10/28). The newspaper also features a photo gallery related to the mapping work (10/28).

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From the Global Health Policy Community

Blogs Examine U.S. Agency, Initiative Rankings In Aid Transparency Index

Writing in the Center for Global Development’s (CGD) “Rethinking U.S. Foreign Assistance Blog,” CGD’s Ben Leo, Charles Kenny and Will McKitterick discuss Publish What You Fund’s (PWYF) recently released Aid Transparency Index rankings and present “our own extremely modest scheme for classifying U.S. agencies’ performance into the good, the bad, and the ugly.” They examine the Millennium Challenge Corporation, USAID, the Departments of Treasury, Defense and State, as well as PEPFAR. “As the Obama Administration pauses to assess its progress so far, there is a lot to be proud of. Yet, there remains a lot of terrain to traverse and a broad chasm separating individual agencies’ efforts that must be closed,” they write (10/24). The Center for Global Health Policy’s “Science Speaks” blog examines how PEPFAR ranked and includes comments from Nicole Valentinuzzi of PWYF and Erin Hohlfelder, global health policy director at ONE (Barton, 10/28).

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MSF Calls On GAVI To Make 'Four Key' Changes

“Several key policy changes are urgently needed at the GAVI Alliance to help reduce the number of children not benefiting from vaccination globally (22.6 million in 2012),” Médecins Sans Frontières (MSF) writes in a press release describing “four key areas where changes at GAVI could make an important difference.” Manica Balasegaram, executive director of MSF’s Access Campaign, said, “Humanitarian actors are still not able to access vaccines at the GAVI price so they can act swiftly in emergencies, vaccine prices overall are still too expensive for countries to afford long term, and GAVI’s not doing enough to support the vaccination needs of older children,” according to the press release. In addition, “GAVI must play a more active role in incentivizing [research] efforts so that easier-to-use vaccines can become available,” the press release states. Kate Elder, vaccines policy adviser at the Access Campaign, said, “We think GAVI should be commended for many of its accomplishments over the last decade, but we also think it’s very important for GAVI to take a close and critical look at what it can improve going forward,” the press release adds (10/28).

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Mobile Technology Can Help Achieve MDGs 4, 5

Writing in the United Nations Foundation blog, Tara Morazzini, an intern at the Mobile Alliance for Maternal Health (MAMA), notes the observance of United Nations Day last week and reflects on progress made toward achieving the Millennium Development Goals (MDGs). “Mobile technologies offer significant promise to advance sustainable development now and in the future,” she writes, noting MAMA “focuses on MDGs 4 and 5 (which aim to reduce child and maternal deaths, respectively), utilizing mobile technology to improve the health of pregnant women, babies, and young children.” She adds, “As we look toward the 2015 and 2030 benchmarks, we will continue to champion mobile technology as a powerful tool to take on the global challenges at a global scale” (10/28).

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