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Kaiser Daily Global Health Policy Report

In The News

USAID, Walmart Sign MOU To Work Together On Development Programs

USAID, Walmart and the Walmart Foundation “signed on Monday a Memorandum of Understanding expected to integrate the world’s largest retailer’s supply chains with the Feed the Future program,” Devex reports. “While it remains unclear whether the MOU establishes any binding commitments for either party, the partnership is expected to focus on President Barack Obama’s global hunger and food security initiative taking advantage of Walmart’s resources to better distribute food around the world,” the news service writes (Igoe, 9/10). The MOU aims to “improve livelihoods around the world by promoting women’s economic empowerment, sustainable agriculture, environmental sustainability and vocational and life skills training for youth,” a USAID press release states. “We are excited about this latest landmark in our relationship with Walmart. Our global partnership is emblematic of USAID’s new model of development and our commitment to work with private sector companies to end extreme poverty around the world,” USAID Administrator Rajiv Shah said at a ceremony held at Walmart’s Bentonville, Arkansas, headquarters on Monday, the press release notes (9/9). According to Devex, “The partnership is likely to come under intense scrutiny in light of concerns over Walmart’s failure to pay decent wages in Latin America or retailers sourcing from a garment factory in Bangladesh where 112 people died in a fire in November 2012” (9/10).

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Independent Audit Critical Of USAID Funds For Afghan Health Projects

“An independent audit released Thursday accused [USAID] of ‘reckless disregard toward the management of U.S. taxpayer dollars,’ prompting an angry rebuttal from the agency leading American reconstruction efforts in Afghanistan,” the Los Angeles Times reports (Bengali, 9/5). “In its latest report [.pdf] sharply criticizing U.S. government aid programs, the Office of the Special Inspector General for Afghanistan Reconstruction [SIGAR] charged Thursday that millions of U.S. dollars being spent on public health programs is ‘at risk of waste, fraud and abuse’ and that there is ‘little assurance’ the funds are being used as intended,” the Washington Post writes, noting the report “recommended that no further U.S. funding be provided to Afghanistan’s Public Health Ministry for basic services ‘until program costs are validated as legitimate'” and “called for aid officials to address 55 ‘deficiencies’ found in a previous review of the ministry’s financial practices before spending any more money” (Constable, 9/5). “The auditor suggested ‘returning the excess obligations to the U.S. Treasury for better use,'” according to the Fiscal Times (Ehley, 9/5).

“The program at the heart of SIGAR’s audit is the Partnership Contracts for Health, designed to help deliver health services to local Afghan hospitals and clinics,” Stars and Stripes notes, adding, “The USAID funds are used to pay for contracts with non-governmental organizations that provide health care in various provinces around Afghanistan” (Smith, 9/5). “An official with [USAID] however struck back and defended their work,” according to Devex, which adds, “The official, who declined to be named in order to avoid the agency’s clearance process, told Devex the report published by [SIGAR] glosses over the success the programs have achieved in the country, and barely mentions the significant risk mitigation processes USAID has put in place to ensure better accountability in reconstruction spending” (Igoe, 9/6). “USAID has promised to review its funding and determine whether the Afghan health agency could be misusing taxpayer funds,” the Washington Free Beacon notes (Kredo, 9/5).

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NPR Examines How U.S. Military Strikes In Syria Could Hinder Humanitarian Efforts

Noting the WHO “says the Syrian civil war is currently the worst ongoing humanitarian crisis on earth,” labeling “the situation a ‘Grade 3’ emergency, which is its highest alert level — reserved for an event ‘with substantial public health consequences that requires a substantial international response,'” NPR’s “Shots” blog and “Morning Edition” program examine how U.S. military strikes in the country could hinder humanitarian efforts. “Aid groups have been scrambling to provide shelter, food, water and health care to the huge numbers of people who’ve been uprooted by the fighting,” the news service writes, adding, “The big question now is whether U.S. military action could spark another wave of refugees and make the situation worse.” The news service provides quotes from Oxfam America President Raymond Offenheiser, “who spent last week touring refugee camps,” as well as World Food Programme (WFP) spokesperson Abeer Etefa, about how U.S. strikes may impact their respective organizations’ ongoing efforts (Beaubien, 9/9).

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U.N.-Backed Report Examines Rape, Sexual Violence Against Women In 6 Asia-Pacific Countries

“Nearly a quarter of men surveyed in six Asia-Pacific countries admit to committing rape, often against their own partners, according to a U.N. report published Tuesday that exposes widespread violence against women,” Agence France-Presse reports (9/10). “The findings, published in The Lancet [Global Health] …, are part of the first-ever survey on rape and sexual violence to be conducted across several countries,” TIME writes, adding, “Researchers surveyed more than 10,000 men from Bangladesh, China, Cambodia, Indonesia, Papua New Guinea, and Sri Lanka” (Brown, 9/10). “Rape was particularly common within relationships. However, one in 10 men admitted raping a woman who was not their partner,” BBC News notes (Mazumdar, 9/9). “Nearly 75 percent of those who had committed rape said they did so because they felt sexually entitled; more than half said they did it for entertainment,” according to The Guardian (Hodal, 9/9). “The word ‘rape’ was not used in the questions, but the men were asked if they had ever forced a woman to have sex when she wasn’t willing or if they had ever forced sex on someone who was too drunk or drugged to consent,” the Associated Press writes, noting, “The lowest rates were in Bangladesh and Indonesia and the highest were in Papua New Guinea.”

“International researchers said their startling findings should change perceptions about how common violence against women is and prompt major campaigns to prevent it,” the AP reports. “Still, the results were based on a survey of only six Asian countries and the authors said it was uncertain what rates were like elsewhere in the region and beyond,” the news agency writes, adding, “They said engrained sexist attitudes contributed, but that other factors like poverty or being emotionally and physically abused as children were major risk factors for men’s violent behavior” (Cheng, 9/10). “The huge variation of prevalence of rape and violence across countries shows that rape and violence is not inevitable. … While violence exists in every country, the fact that there is such variation highlights that it isn’t inevitable and that there are things we can do to prevent it,” Emma Fulu of Partners for Prevention, the joint-U.N. program that coordinated the study, said, according to The Guardian (9/9).

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African Health Ministers Agree On Several Priorities At WHO Regional Meeting

“With 44 percent of deaths among women worldwide occurring in the [WHO] African Region, African health ministers have agreed on measures aimed at addressing the issue as well as HIV, eHealth, traditional medicine and the health of elderly people,” PANA/AfriqueJet reports. The health ministers from 47 African countries, “who ended their 63rd session in Brazzaville, Congo, over the weekend, also adopted resolutions endorsing the report on the Rules of Procedure of the Regional Committee and a regional strategy on neglected tropical diseases (NTDs),” the news agency writes. “They … urged countries to, among others, give priority to women in their development agendas, remove barriers to women’s access to financial resources, property and health care and empower women through girl education,” according to PANA, which outlines other agreements arising from the meeting. “The 64th session of the Regional Committee is expected to be held in Cotonou, Benin, in 2014,” the news agency notes (9/10).

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South Africa Publishes Draft Intellectual Property Policy With Potential Effects For Pharma Patents

“South Africa’s government has published a draft intellectual property policy with potential far-reaching effects for pharmaceutical patents, which rights groups hailed Monday as a move towards lower medicine costs,” Agence France-Presse reports. “If accepted, the reforms will facilitate the production of cheaper, generic medicines, according to Doctors Without Borders (MSF) and local AIDS-activist group Treatment Action Campaign,” AFP writes, adding, “The policies ‘set the stage for changes that promise to increase competition in the pharmaceutical sector and lower the price of medicines in South Africa,’ the groups said in a statement.” The news service notes, “South Africa’s current laws allow firms to renew patents indefinitely by changing minute elements in a medicine’s composition,” while “[t]he new patent policies will allow the production of generic medicines and grant over five million South Africans living with AIDS or multidrug-resistant (MDR) tuberculosis access to treatments” (9/9).

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Agencies, Health Care Workers Continue To Vaccinate Against Polio In Somalia, Pakistan

VOA News examines the polio outbreak in Somalia and the Horn of Africa in a video feature. “Earlier in 2013, polio was confined to three so-called ‘endemic countries’ — Nigeria, Afghanistan and Pakistan — where the virus has never been snuffed out,” the news service writes in an accompanying article, adding, “Combined there were fewer than 100 cases in those three countries.” However, “[s]ince the virus re-emerged in the Horn of Africa, there have been at least 160 polio cases in Somalia alone, and the virus has spread to Kenya and Ethiopia,” the news service notes and describes an ongoing vaccination campaign in the country (Salinas, 9/9). In related news, The Independent profiles the work of female polio vaccinators working in Pakistan, where attacks on vaccination teams are common. “[O]n the frontline, where teams go door-to-door persuading often reluctant families to administer drops of vaccine to their children, it is women who are leading the fight. Frequently they risk their lives to do so,” the newspaper writes (Buncombe, 9/9).

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IPS Examines High Abortion Rate Among Teenagers In Cuba

Inter Press Service examines abortion in Cuba, where the procedure is legal, noting, “Three times as many teenagers terminate their pregnancies than carry them to term” in the country. “Having 76 percent of pregnant teenagers electing to abort ‘is a public health problem,’ said Dr. Jorge Peláez, vice president of the Cuban Society of Obstetrics and Gynecology,” IPS writes. “The difficulty is the rising rate of underage pregnancy in this Caribbean island nation,” according to the news service, which adds, “In this country with a very low birth rate, teenagers account for 16 percent of total fertility.” The news service provides a brief history of the decriminalization of abortion in the country, noting “[o]ver time, abortions became a means of regulating personal fertility.” IPS adds, “In July, the United Nations Committee on the Elimination of Discrimination against Women (CEDAW) expressed concern at Cuba’s ‘high rate of abortion, especially among girls as young as 12 years old,’ and urged it to ‘increase access, as well as use of effective and high quality methods of contraception towards reducing the practice of abortion as a method of family planning'” (González, 9/6).

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Israel Announces Polio Virus Found In Jerusalem Sewers

In the midst of a nationwide polio vaccination campaign, Israel’s health ministry on Monday announced “[p]olio virus has been found in Jerusalem’s sewers for the first time since Israel eliminated the disease,” the New York Times reports. “In June, the virus was found in sewage in Rahat, a small city in the Negev desert inhabited mostly by Bedouins,” the newspaper writes, adding, “The strain originated in Pakistan but appeared in Cairo’s sewers in January.” This is the first time the polio virus has appeared in Israeli sewage samples since 2002, and no one has been paralyzed by the virus in the country since 1988, the newspaper notes (McNeil, 9/9).

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Researchers Continue Trials On Vitamin A-Fortified Rice Strain

The Wall Street Journal examines golden rice, a new strain of vitamin A-fortified rice developed by researchers at the International Rice Research Institute meant to address deficiencies of the micronutrient among children. “A lack of the vitamin is a leading cause of preventable blindness and is linked to death due to infections in many poor countries,” the newspaper writes. “The golden rice program has received the backing of such groups as the Bill & Melinda Gates Foundation, Helen Keller International, the Rockefeller Foundation and [USAID],” which “provided $10.3 million in 2010 that is paying for research on golden rice’s safety and field trials in the Philippines and Bangladesh,” the newspaper notes. However, “opponents, such as Greenpeace International, … war[n] that genetically modified organisms could unleash serious, long-lasting problems in the environment,” according to the Wall Street Journal. The newspaper summarizes clinical trial results on the rice and includes comments from several experts (Larano, 9/9).

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Editorials and Opinions

Supporting Global Health For Women Will Bring More Prosperous, Safer World

“Access to life-saving maternal health care is one of the biggest challenges for women in the developing world,” Rep. Kay Granger (R-Texas) writes in the Huffington Post’s “Global Motherhood” blog. She notes “pregnancy is the leading cause of death for women ages 15 to 19 worldwide,” and “[w]hen a mother dies, her children are less likely to eat well, go to school and get immunized against diseases.” Granger highlights a community in the Ayacucho region in Peru, where “women often deliver their children without clean delivery rooms or trained professionals,” and she discusses how the non-governmental organization “CARE strengthened the community’s capacity to address maternal health risks by convening a broad spectrum of health workers to develop practical emergency obstetric protocols and provide training and resources to implement them.”

Noting “CARE also works with women and men to help them plan their families,” Granger continues, “As a result of these changes, women’s lives in Peru were saved.” She writes, “Some may wonder why the issue of global women’s health, particularly maternal health, should matter,” adding, “The answer is simple. We live in a global community and are global citizens.” She states, “Providing an opportunity for women to be educated about maternal and reproductive health is the first step. Improvements in the lives of these women and countries help everyone because progress and prosperity anywhere mean a more peaceful and stable world for us all.” Granger concludes, “Let’s stand together with mothers around the world by lending our support for better global health services for women” (9/9).

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Post-2015 Development Agenda Should Address Empowerment For Girls, Women

“Since beginning my work with the U.N. Foundation in February, I’ve been struck by startling statistics showing the harsh reality of life for many of the world’s girls and women,” Julie Smolyansky, CEO of Lifeway Foods, writes in the Huffington Post’s “Global Motherhood” blog. She notes “[o]ne out of every three women around the globe will be raped, beaten, or murdered”; “222 million women lack access to the reproductive health and voluntary family planning services they need to be informed and ready for pregnancy and childbirth”; and “33 million fewer girls than boys atten[d] primary school.” She continues, “Organizations such as the U.N. Foundation are working with community leaders, governments, businesses, and a host of other partners to turn such gender-based hardships into a thing of the past.” Smolyansky highlights the foundation’s Universal Access Project, the Shot@Life campaign, and the Girl Up initiative as examples, and she writes, “But a great deal of work still lies ahead.”

“Countries such as Russia, India, and Brazil must act faster and more vigorously to establish laws, institutions, and social norms that allow girls and women to live healthy, safe, and empowered lives,” Smolyansky continues. She notes a meeting in Russia, at which the U.N. Foundation’s board members “met with a host of Russian dignitaries, civil society leaders, and U.N. experts to discuss global development problems and priorities,” and states, “It was evident from the dialogues that emerged that while Russia faces numerous challenges on the road to gender equity, there are many people ready to take on those challenges.” She concludes, “As leaders in Russia and around the world turn increasing attention to establishing the post-2015 development agenda, let’s raise our voices to make sure that safety, equality, and empowerment for girls and women are at the top of that agenda” (9/9).

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Recent Releases

Addressing Gender Inequalities To Save Lives In LAC

In a post in USAID’s “IMPACTblog,” published as part of “a series to coincide with A Promise Renewed in the Americas: ‘Reducing Inequalities in Reproductive, Maternal and Child Health Summit’ during September 10-12 in Panama,” USAID Assistant Administrator for Global Health Ariel Pablos-Mendez highlights the Latin America and Caribbean (LAC) region’s success in “reaching their Millennium Development Goals (MDGs) 4 and 5, which address child and maternal health respectively.” He notes “[a]lmost all LAC countries have reached or are close to reaching” their goals. “Despite two decades of development gains and recent economic growth in LAC countries, a large health disparity remains among and within countries with regard to access and quality of health services,” he states, adding “more than 180,000 children under five years old and nearly 9,000 mothers still die annually, most of them poor, indigenous and marginalized groups.” Pablos-Mendez examines possible solutions to address the disparities, and states, “I’m looking forward to the outcomes of this summit over the next few days and look to continue USAID’s deep and successful relationship with the LAC region, understanding full well that success means our eventual departure” (9/9).

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Walmart, USAID Partnership To Help Farmers, Women, Youth

In a post in the U.S. Global Leadership Coalition blog, Sarah Thorn, senior director of federal government relations for Walmart and vice president of the Board of Directors for the U.S. Global Leadership Coalition, writes about the recent signing of a Memorandum of Understanding between Walmart and USAID to work together “on women’s economic empowerment, farmer training and sustainable agriculture, and vocational and youth skill training.” She writes, “We look forward to strengthening our partnerships with U.S. development programs as we continue to invest in emerging markets. We believe there will be new opportunities to leverage the Feed the Future initiative to assist more African farmers in providing for their families, serving as another effective example of just how much a difference public-private partnerships can make” (9/9).

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CFR Blog Examines Debate Over TPP Tobacco Regulation Proposals

In a Council on Foreign Relations (CFR) “Expert Brief,” Thomas Bollyky, a CFR senior fellow for global health, economics, and development, examines debate over the treatment of tobacco under the Trans-Pacific Partnership (TPP), “the pending trade deal between the United States and eleven other countries.” He continues, “The White House has tried to finesse the issue, recently proposing that the TPP agreement acknowledge tobacco as a health concern but otherwise treat it no differently from other products. That compromise has satisfied no one.” Bollyky writes, “Health advocates are furious that the White House dropped its previous proposal for a stronger tobacco control exception in the TPP agreement,” adding the “controversy over tobacco has backed U.S. trade officials into a corner.” He offers three ways in which “the administration should exempt tobacco control measures from legal challenge under the TPP” (9/5).

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Focus On MICs For Greatest Impact On Disease

In the Center for Global Development’s (CGD) “Global Health Policy” blog, Amanda Glassman, director of global health policy and senior fellow at CGD, and CGD Research Assistant Yuna Sakuma compare new data from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington with a paper Glassman co-authored in 2011 using 2004 data, saying both sets of data show “[t]he majority of the world’s sick live in middle-income countries (MIC).” They summarize the data and write, “While these new data don’t necessarily tell a new story, they still herald important implications for the way global health donors allocate resources and focus efforts moving forward. If global health funders care about having the greatest possible impact on disease at the lowest possible cost, a new, tailored MIC strategy needs to be developed.” Glassman and Sakuma provide several recommendations (9/9).

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President Carter, NYT Columnist Kristof To Host Google+ Health Conversation

Today at 3 p.m. ET, “former U.S. President Jimmy Carter, New York Times Op-Ed Columnist Nicholas D. Kristof, and Carter Center disease eradication expert Dr. Donald R. Hopkins will hold a special video chat, ‘Global Health: How We Can Make a Difference,’ to kick off a new series called ‘Conversations on Google+’ launching later this fall,” a Carter Center press release states. According to the press release, anyone on Google+ can access the conversation and share their health-related comments by joining the American Public Health Association’s Google+ Public Health Community. “The ‘Conversations on Google+’ series will continue with other high profile speakers later in the year,” the press release notes (9/4).

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