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Kaiser Daily Global Health Policy Report

In The News

U.N. Report Finds Early Childhood Deaths Halved Since 1990, But 18,000 Under 5 Die Each Day

“Early childhood deaths around the world have been cut in half since 1990 but some 18,000 children under five still die every day, according to a new report [.pdf]” released by UNICEF, the World Bank and the WHO on Friday, Agence France-Presse reports (9/13). “Nearly half of all children who die are in five countries: Nigeria, Congo, India, Pakistan and China,” according to the report, the Associated Presse notes, adding, “The top killers are malaria, pneumonia and diarrhea, the report said, taking the lives of about 6,000 children under age five daily,” and “[a] lack of nutrition contributes to almost half of these deaths, the U.N. said” (Petesch, 9/13). “While all the top killers have taken fewer and fewer children over the past two decades, the most marked progress has been against diarrhea, which killed 50 percent fewer children in 2012 than it did in 1990,” GlobalPost writes, noting, “The battle against pneumonia and malaria has been slower, dropping by a third between 1990 and 2012.”

However, “[a]s the numbers of children who die from infectious disease has dropped, the proportion of children who die from birth-related complications and infections during the first month of life has ballooned,” GlobalPost adds (Stuart, 9/12). In addition, the “researchers say the improvements are encouraging  but there are still challenges in reaching the group’s Millennium Development Goal [MDG] of lowering mortality among children under five by two-thirds by 2015,” and, “[i]f current trends continue, that target won’t be reached,” according to TIME (Sifferlin, 9/13). “The cost of inaction is alarmingly high: as many as 35 million more children could die mostly from preventable causes between 2015 and 2028, if the global community does not take immediate action to accelerate progress,” a UNICEF press release writes (9/13). “The lives of most of these babies could be saved if they had access to some basic health-care services,” a WHO press release states, adding, “These include skilled care during and after childbirth; inexpensive medicines such as antibiotics; and practices such as skin-to-skin contact between mothers and their newborn babies and exclusive breastfeeding for the first six months of life” (9/13).

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Global Fund Seeks $15B For Efforts Against AIDS, TB, Malaria

The Global Fund to Fight AIDS, Tuberculosis and Malaria “said on Thursday it needs $15 billion over the next three years to begin bringing ‘the three big global pandemics’ under control,” Reuters reports. “In a report released ahead of a pledging conference later this year, the [Global Fund] said timely investments could avert $47 billion in extra treatment costs and save millions of lives, but warned that acting too late would mean missing important opportunities,” the news service notes. “If international donors fail to stump up the at least $15 billion needed, [Global Fund Executive Director Mark Dybul] said this could lead to millions of avoidable cases of HIV during the funding period of 2014 to 2016,” the news service continues (Kelland, 9/12). “In addition, three million less people would be treated for TB and one million unnecessarily killed without treatment,” the U.N. News Centre writes, noting, “The report points to the cost of $30 per patient to start TB treatment, which can rise to 1,000 times the cost for multi-drug resistant TB in the future.” The news service adds, “The report also notes that the consequences for inadequate funding for malaria would be 196,000 lives lost per year and 430 million instances of people having malaria at a cost of $20 billion in lost gross domestic product (GDP)” (9/12).

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U.N. Agencies Appeal For Support For More Than 10 Million Facing Hunger In Yemen

“The United Nations on Thursday urged the international community, especially Gulf states, to increase aid to impoverished Yemen, saying that more than 10 million people in the country go hungry,” Agence France-Presse reports. “A Sanaa news conference by U.N. humanitarian chief Valerie Amos and World Food Programme [WFP] executive director Ertharin Cousin heard that ‘the humanitarian situation in Yemen remains critical,’ despite ‘positive’ political developments,” the news service writes, adding, “According to the U.N., child malnutrition rates are among the highest in the world with close to half of Yemen’s children under five years — around two million children — stunted” (9/12). “This year, WFP aims to provide almost five million people in 16 governorates with food assistance and is working to build community resilience,” the U.N. News Centre notes (9/12). “‘Yemen is a country wracked by chronic poverty and underdevelopment, and millions of Yemenis are struggling to cope,’ said Amos. ‘People need food, water, education and health care. But they also want to know that there is investment to secure their future. We urgently need more funding to help those in need,'” according to a WFP press release (9/12).

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Guardian Examines Barriers To Prescribing ART To All Children Under 5 As Recommended By WHO

Noting the WHO in June “published new guidelines on the prescription of anti-retroviral therapy (ART) for the treatment of HIV positive patients,” which included “a recommendation to prescribe ART to all children under five, whatever their CD4 count (a measure of the strength of the immune system),” The Guardian’s “Global Development Professionals Network” blog examines whether the new guidelines can “help break down the barriers to access to treatment.” The newspaper writes, “Most health professionals think so, simply by virtue of not requiring a CD4 count before putting a child on treatment,” but “extending ART to millions more children presents challenges, chief among them identifying HIV positive children.” The Guardian quotes a number of experts — including Allan Mayi, senior technical adviser at the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) in Turkana, Kenya; Jennifer Cohn, medical director of the [Médecins Sans Frontières (MSF)] Access Campaign; Laura Guay, vice president for research at EGPAF; and Kay Mahomed, an HIV consultant — who highlight additional challenges, such as a lack of trained health workers, availability of drugs, and “a growing cohort of HIV positive teenagers” (Filou, 9/12).

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PRI Interview Examines Family Planning in Africa

In this edition of The Takeaway — a co-production of WNYC Radio and Public Radio International (PRI), in collaboration with New York Times Radio and WGBH Boston — correspondent John Hockenberry interviews Anders Kelto, Africa correspondent for PRI’s “The World,” about “the issues Ethiopia, Kenya, and South Africa face when it comes to family planning.” According to the program description, Kelto joins the program “to discuss his findings and why the family planning concerns of the continent vary widely by region,” highlighting issues “rang[ing] from getting men to participate in the conversation to tackling infertility” (9/12).

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Devex Publishes Slideshow Examining History Of USAID-Walmart Partnerships

Noting USAID, Walmart, and the Walmart Foundation on Monday signed a Memorandum of Understanding to work together on development programs, Devex provides a slideshow on the history of USAID-Walmart partnerships. According to the description, the slide show examines “how and where USAID and Wal-Mart have cooperated on global development projects,” and describes the various projects (9/12).

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VOA Examines New World Bank, IHME Reports On Regional Health Challenges

The World Bank, in conjunction with the Institute for Health Metrics and Evaluation (IHME), recently “released new reports outlining the health challenges facing six major regions,” Voice of America reports. “The bank says the reports will help policymakers develop evidence-based health programs after the Millennium Development Goals expire,” the news service writes. Timothy Evans, director for health, nutrition and population at the World Bank, “said the world is too diverse to have a one-size-fits-all health plan,” VOA notes, and highlights the ongoing health challenges in the various regions (DeCapua, 9/13).

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Editorials and Opinions

Global Fund At Turning Point In Eliminating 'Big 3' Diseases, But Continued Support Needed

“Over the past decade, the resources provided through the [Global Fund to Fight AIDS, Tuberculosis and Malaria] have saved an estimated nine million lives and turned the tide against these terrible diseases in Africa and across the developing world,” Ngozi Okonjo-Iweala, the coordinating minister of the Nigerian economy and minister of finance, writes in The Guardian’s “Poverty Matters” blog. The fund “has provided the overwhelming majority of international funding for tackling TB, more than half of international funding for malaria, and is the second largest supporter of the global AIDS effort,” she notes, adding, “HIV treatment for more than 4.2 million people, TB treatment for 9.7 million people, and 310 million bednets to prevent malaria have been funded.” She states, “Importantly, all this has been achieved in a way that has strengthened the health systems of individual countries in Africa and the developing world, while proving very cost-effective.”

“Despite great progress, there is no room for complacency,” Okonjo-Iweala continues, writing, “The battle against these diseases has reached a critical moment, which makes the Global Fund as important as ever.” She states, “Scientific advances combined with our growing knowledge of what works offer a golden opportunity to save millions more lives and improve health, thereby removing the greatest barrier to increased global prosperity and stability,” adding, “If this opportunity is wasted, there is a real danger that the hard-won gains of the past decade will be reversed.” She writes, “The Global Fund has proved one of the smartest and most effective investments in improving public health and development,” and concludes, “By ensuring the Global Fund has the resources to step up its work, we can lift the shadow from millions more people and move our world decisively to a healthier, more stable and prosperous future” (9/12).

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International Community Must Address Gap In Children's Health Inequality

“Globally, the pervasive disparities in the health and wellbeing of children are detrimental not only to the poorest and most vulnerable children and their families and communities, but also to the whole of society,” a Lancet editorial states, and writes, “To eliminate such disparities, three major questions need to be answered. How wide is the health gap? What are the underlying and driving factors? What can be done?” The editorial highlights a report (.pdf), “The Killer Gap: A Global Index of Health Inequality for Children,” released by World Vision last week, which “tries to provide the answers,” noting “176 countries around the world are ranked according to the size of the gap between those who have greatest access to health education, awareness, prevention, and treatment, and those who have the most barriers to good health, using the four indicators of life expectancy, personal cost of using health services, adolescent fertility rate, and coverage of health services.”

“The index shows that the greatest gaps persist in the poorest and most fragile contexts and countries, but that a country’s wealth alone does not necessarily guarantee a small health gap, given that the USA, for example, sits only at 46 on the index,” the editorial continues. “There are many other factors beyond poverty — above all, that health systems fail to reach those who suffer most from health inequalities, including children unregistered at birth, children living with disabilities, orphaned children, indigenous children and ethnic minorities, refugees and displaced children, and child laborers and trafficked children,” the editorial states, adding, “The report rightly calls for greater attention to health inequalities at the highest political level, prioritization of child and maternal health in the post-2015 development agenda, and improvement of data collection.” The editorial concludes, “Ahead of the U.N. General Assembly, where the post-2015 development agenda will be discussed, it is timely to remind advocates of child health, together with health professionals (particularly pediatricians), of these remaining inequalities, and to urge collective efforts to close the gap” (9/14).

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Recent Releases

Briefing Paper Examines Funding For Global Health Product Development

Noting “the development of medicines, vaccines and diagnostic tools to stop preventable illnesses and deaths from treatable illnesses  has relied on significant investments from a handful of governments and philanthropic organizations,” the Center for Global Health Policy’s “Science Speaks” blog highlights a new briefing paper (.pdf) from the Global Health Technologies Coalition called “Financing,” which “examin[es] approaches, challenges and opportunities confronting nonprofit organizations developing products to target neglected and poverty related disease.” The blog states, “While the coalition’s first report in the series focused on challenges to identifying, developing and introducing products in settings of limited infrastructure and scientific capacity, the latest brief explores the roles that innovation, coordination and collaboration must play in continuing global health research and development” (Barton, 9/12).

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