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Kaiser Daily Global Health Policy Report

In The News

U.N. General Assembly Opens; Members To Discuss Post-2015 Development Agenda

“The United Nations General Assembly opened its annual session [on Tuesday] with its gaze firmly fixed on the decades ahead as its new president outlined the need to lay the groundwork for global sustainable development in the years following the end of the current development cycle in 2015,” the U.N. News Centre reports. “‘The upcoming year will be pivotal for this Assembly as we seek to identify the parameters of the post-2015 development agenda,’ 68th General Assembly President John W. Ashe said in his opening address,” the news service writes (9/17). Earlier on Tuesday, U.N. Secretary-General Ban Ki-moon “stressed the need for global cooperation to tackle the world’s most pressing issues including the crises in Syria and elsewhere [and] accelerating achievement of the Millennium Development Goals (MDGs),” a separate U.N. News Centre article reports. “Ban said that issues that will require urgent attention include climate change, boosting efforts to accelerate the achievement of the MDGs and the shaping of the post-2015 development agenda,” the news service notes, adding, “In addition, the General Assembly will this year hold a high-level session on disabilities and development” (9/17).

“Empowering women is the single most important factor for reducing poverty and must be central in the new set of global development goals from 2015, a top United Nations official said on Monday,” Thomson Reuters Foundation reports. “All the studies not only suggest but demonstrate that if you tackle gender equality, you empower women, then you will be much more effective in fighting poverty and hunger. There is no question about it,” Rebeca Grynspan, U.N. under-secretary-general and associate administrator of the U.N. Development Programme (UNDP), said during an interview with Thomson Reuters Foundation, the news service notes (Dawson, 9/17). In an interview with EurActiv, Eva Joly, the French Green MEP and chair of the European parliament’s development committee, said countries’ inability to meet MDG 5, to reduce maternal mortality, “is a failure of the fight against poverty,” EurActiv reports. “For Hafsat Abiola, a Nigerian state minister with responsibility for MDGs, funding is closely linked to other key issues such as power and gender relations,” the news service adds (Neslen, 9/17).

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Rajiv Shah Discusses Diversifying USAID Partners In Scientific American Interview

In an interview with Scientific American, USAID Administrator Rajiv Shah discusses modernizing and diversifying foreign assistance. He says his agency has “moved more than $730 million to more than 1,200 small-scale, diversified, local partners,” including small businesses and small non-governmental organizations (NGOs). “We have the same high standards of accountability for everybody, but we have dramatically diversified our partner base through this effort we call USAID Forward,” Shah says, adding, “We do it because we think more competition reduces cost and improves outcomes. And because at the end of the day, our goal is to exit these settings and have strong, capable local institutions take our place.” Asked about other countries’ concerns over genetically modified organisms in U.S. food aid, Shah says, “Our commitment is to ending hunger through business, science and partnership. … But it will always be the country’s decision as to how to regulate and make decisions about the use of different kinds of technology” (Maron, October 2013).

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IRIN Analysis Examines Success Rates Of WASH Aid Programs

“The success in achieving the Millennium Development Goals’ (MDGs) water target and massive growth in water, sanitation and hygiene (WASH) programs have masked a little-discussed secret: WASH interventions frequently fail,” IRIN reports. The news service examines the pressures aid organizations face to produce results; problems associated with not involving local communities in the planning and implementation processes; complications when addressing WASH issues during or following humanitarian disasters; and challenges in maintaining the long-term sustainability of WASH projects. “Few, if any, countries can claim to have a large-scale WASH system thanks to international [non-governmental organizations (NGOs)],” the news service writes. The article includes quotes from George De Gooijer, a water expert for the Netherlands Ministry of Foreign Affairs, Embassy Cotonou, Benin; Sasha Kramer, co-founder and executive director of Sustainable Organic Integrated Livelihoods; Arno Rosemarin, senior research fellow at the Stockholm Environment Institute; Prakash Jumar, chief executive officer of the WASH Institute in India; Katarina Runeberg, an environmental adviser with the Swedish Civil Contingencies Agency; Patrick Fox, an adviser to the disaster unit at the Swedish Red Cross; and Peter Morgan, a WASH inventor and scientist (James, 9/17).

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Australian Plan To Combine Aid Agency, Foreign Affairs Department Draws Criticism

“Tony Abbott, the new Australian prime minister, is recommending that AusAid, the government’s aid agency, be merged into the Department of Foreign Affairs and Trade (DFAT), after similar moves in Canada and New Zealand,” The Guardian reports, adding, “But aid experts expressed concerns about the proposed changes to the respected development agency.” According to the newspaper, “In 2012, Australia was the eighth-largest aid donor in the Organisation for Economic Co-operation and Development group of rich countries, just ahead of Sweden.” The Guardian includes comments from former AusAid Deputy Director-General Annemaree O’Keefe; ActionAid Australia Executive Director Archie Law; and World Vision Australia Chief Executive Tim Costello. “Charities point out that foreign aid accounts for just 1.4 percent of the federal budget and has suffered disproportionately from cuts and deferrals,” the newspaper writes (Tran, 9/18).

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Editorials and Opinions

TPP Should Address U.S. Business Concerns But Address Health Risks Of Tobacco

“Tobacco sickens and, eventually, can kill if consumed as intended. Every country, the United States included, should be taking every effective step to prevent smoking,” a Washington Post editorial states. The U.S. “has wisely pursued pacts to expand free trade with partners around the world,” but “[w]hat to do … when free trade and tobacco control seem to be in tension?” the editorial asks, noting “[t]he question arises in the context of the Trans-Pacific Partnership (TPP).” First, “the Obama administration favored a TPP provision exempting individual nations’ tobacco regulations — such as those banning advertising or requiring warning labels — from legal attack as ‘non-tariff barriers’ to the free flow of goods,” but a “new proposal simply specifies that tobacco is included in an existing exemption for policies necessary to protect human life or health, and requires governments to consult before challenging each other’s tobacco rules,” the editorial states.

The Washington Post notes the change likely was in response “to pushback from farm-state legislators, farm lobbies and other interest groups that feared a tobacco exception would expand to a health-related excuse for protectionism against many other products.” The editorial notes, “Though Asian countries have, in the past, discriminated against U.S. beef on trumped-up health grounds, U.S. agriculture’s fears this time are overblown. Tobacco is unique, and everyone knows it.” Citing a recently published brief by the Council on Foreign Relations’ Thomas Bollyky, the editorial concludes, “All concerned should strive for a TPP that addresses legitimate concerns of U.S. business — but reflects the unique dangers of smoking both here and abroad” (9/17).

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Congress Should Reconsider Budget Cuts For Biomedical Research

“Besides the prospect of a government shutdown or a default on the national debt, the most destructive aspect of the federal budget impasse is the sequester’s damage to basic scientific research, especially biomedical research,” Roll Call columnist Morton Kondracke writes in the news service’s “Beltway Insiders” blog. “The sequester demand[ed] a five percent cut across the board at every one of the NIH’s 27 institutes and research centers, including the one concentrating on infectious diseases,” he states, adding the cuts are slowing “work on a universal flu vaccine that could prevent a pandemic killing millions.” He notes cancer research “has slowed, too, because of cuts at the National Cancer Institute and the National Human Genome Research Institute.”

NIH Director Francis Collins “told me he has met with more than 100 members of Congress to plead for an undoing of the sequester,” Kondracke writes, noting, “The Senate Democratic budget does it.” He adds, “Collins said that most House Republicans tell him, ‘You’re right, but there’s not much I can do.’ They certainly ought to try.” He concludes, “As Collins says, this could be ‘the century of biology,’ leading to the conquest of major diseases and the development of new energy and food sources. But it won’t be America’s century if the government keeps slashing research” (9/17).

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U.S. Should Address Water Shortages That Contributed To Syrian Conflict

“The agreement forged by Russia and the United States over the weekend on Syria’s chemical weapons is good news for diplomacy … But the short-term focus on chemical weapons use risks undermining some much-needed long-term thinking on the issue,” Michael Shank, director of foreign policy at the Friends Committee on National Legislation (FCNL), and Emily Wirzba, program assistant for Sustainable Energy and the Environment at FCNL, write in an opinion piece on CNN’s “Global Public Square” blog. “[T]he Obama administration should belatedly be willing to address a surprising source of the current tensions — water shortages,” they state, adding, “Indeed, the sad fact is that the United States could have helped prevent tensions in Syria from escalating into civil breakdown if it had worked with the international community to tackle a growing problem with this most basic of resources.”

When Syria’s agriculture minister stated in a 2008 cable that “the economic and social fallout from the drought was beyond the country’s capacity to cope with” and the U.N. Food and Agriculture Organization representative in Damascus directly appealed to the U.S., “the U.S. government appears to have balked at the appeal for greater assistance,” the authors write. “As a result of lackluster U.S. leadership, the global response was weak,” Shank and Wirzba state, noting continuing water scarcity issues in Syria and Yemen. “If the [U.S.] wants to do something constructive to address potential flashpoints in the Middle East it would do well to address the root causes of tensions. And it will find ensuring that local populations have access to adequate resources far more effective — and less costly — than firing off more missiles,” they conclude (9/17).

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U.K. Should 'Seize The Moment' And Increase Donation To Global Fund

British Secretary of State for Development Justine Greening, along with Prime Minister David Cameron, “faces one of the most important decisions she will make as secretary of state: how much to allocate to the Global Fund to Fight AIDS, Tuberculosis and Malaria,” Adrian Lovett, Europe director of ONE, writes in the Huffington Post U.K.’s “Politics” blog. “Ministers have promised that the U.K.’s aid budget will be allocated with a ruthless focus on efficiency and results. By that measure, the Global Fund is one of the best possible ways to spend it,” he states, adding, “In any fight against infectious diseases there is a window of opportunity that must not be missed; that moment is now.”

Lovett outlines the positive impact a U.K. “contribution of at least £1 billion [$1.6 billion] over the next three years” could have in terms of treatment, prevention, and care, and he notes, “U.K. money will unlock more for the Global Fund from other countries.” He concludes, “Do we hold back, preserve the status quo with a modest contribution and increase the risk that these diseases rebound and spread again, wasting more than a decade of investment and putting lives on the line? Or do we seize this moment, be bold, back a proven success and help set a path to achieving what once seemed impossible — the defeat of AIDS, tuberculosis and malaria in our lifetime?” (9/17).

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Recent Releases

Journal Article Examines Migration And Disease Spread

In the Fall issue of the World Policy Journal, journalist Amy Lieberman examines migration and disease spread. “With today’s large-scale movement of vast populations, disease spreads quickly, and it is increasingly urgent for governments to claim responsibility for a threat that is not contained within their borders,” she writes, adding, “Political leaders need to collaborate and pledge, on national and regional levels, to include non-citizens like labor migrants as inclusive recipients of the same health services and basic rights their own citizens enjoy.” She continues, “Yet the issue of health — access to education, services, treatment, and a quality of life that can prevent migrants from getting sick with a transmittable illness — remains largely absent from regional and international agreements and discussions on migration.” She examines national policies in several regions, international agreements on the issue, and the spread of diseases including HIV and sexually transmitted infections, as well as influenza (Fall 2013).

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World Vision Report Examines Health Inequality For Children

The Center for Global Health Policy’s “Science Speaks” blog examines the World Vision report (.pdf) titled “The Killer Gap: A Global Index of Health Inequality For Children,” which examines “the gap between those who have and don’t have access to health” information, education, treatment and care. According to the blog, factors widening the gap include “discrimination, socio-economic patterns, and policies directing how health money is spent,” the blog notes, adding, “World Vision’s Global Health Gap Index is based on four indicators that result from those factors: life expectancy, personal cost of using health services, adolescent fertility rate, and number of doctors, nurses and midwives for every 10,000 people in a country.” The blog adds, “Prioritizing attention to health access for women and children, filling in data on uncounted populations, [and] working within communities to plan and evaluate health services are among the measures to close the gap” (Barton, 9/17).

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Frontline HCWs Essential To Achieve Development Goals

“As world leaders gather this week to discuss the achievement of the Millennium Development Goals and the Post-2015 Framework, no subject of conversation will be more important than the need for more frontline health care workers,” Carolyn Miles, president and CEO of Save the Children, writes in the Skoll World Forum blog. She notes the role of local health care workers in helping to reduce maternal and child mortality, using Pakistan as an example. “By some estimates, there is a shortage of at least one million frontline health workers in the developing world,” Miles states, adding, “The challenge for all of us in the business of saving mothers’ and children’s lives is to ensure that every person, no matter where they live in the world, is within reach of a health worker. We can — and should — start at the U.N. General Assembly, and continue the drumbeat at the Third Global Forum on Human Resources for Health in Recife, Brazil, in November” (9/18).

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Global Health Governance Posts New Articles To Summer 2013 Archive

Global Health Governance posted several new articles in its Summer 2013 Archive on Tuesday. The archive includes articles on setting global and national agendas for universal health coverage; no-cost maternal care in sub-Saharan Africa; medicine and health supply distribution in Uganda; China’s role in global health diplomacy; the WHO’s leadership role in global health; and stakeholder views on a health impact fund, among other articles (9/17).

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New Issue of 'Global Fund News Flash' Available Online

The Global Fund to Fight AIDS, Tuberculosis and Malaria has published Issue 25 of its newsletter, the “Global Fund News Flash.” The issue focuses on a recent Global Fund report setting a target of raising $15 billion over the next three years, highlights investment in a treatment to fight hepatitis C in the Ukraine, mentions a (RED) auction in New York, profiles a couple in Jakarta who work with partner agencies of the Global Fund, and analyzes Eritrea’s success in reducing malaria incidence and HIV prevalence (9/17).

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