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Kaiser Daily Global Health Policy Report

In The News

Annual UNAIDS Report Details Progress, Challenges In Global HIV/AIDS Response

The number of new HIV infections “and the number of AIDS-related deaths have been dramatically reduced [worldwide], thanks to expanding access to treatment, the United Nations said in a report issued on Monday,” Reuters reports (9/23). “Worldwide, 2.3 million people were newly infected with the AIDS-causing virus last year, compared with 3.4 million in 2001,” according to the report, Bloomberg notes, adding, “AIDS-related deaths fell 30 percent to 1.6 million last year from the peak in 2005, the Geneva-based agency said” (Bennett, 9/23). “There has been an impressive 34 percent drop in new infections [among adults] in sub-Saharan Africa since 2001, although the biggest drop is in the Caribbean, where it has been 49 percent,” The Guardian’s health editor Sarah Boseley writes in her “Global Health” blog, adding, “New infections are still on the rise in Eastern Europe, however, and in Central Asia, North Africa and the Middle East” (9/23).

“The report says the most striking results in combating HIV … are to be found among children, for which the number of new HIV infections has been cut by 52 percent since 2001,” according to VOA News. In addition, “[t]he report notes that some 9.7 million people in low and middle-income countries were accessing antiretroviral therapy by the end of 2012,” the news service notes (Schlein, 9/23). “Significant results have also been achieved toward meeting the needs of tuberculosis (TB) patients living with HIV, as TB-related deaths among people living with HIV have declined by 36 percent since 2004, the report said,” Xinhua reports. “However, the report noted slow progress was made in ensuring the respect of human rights, securing access to HIV services for people most at risk of HIV infection, particularly people who use drugs, and in preventing violence against women and girls,” the news service adds (9/23). “Gender inequality, punitive laws and discriminatory actions are continuing to hamper national responses to HIV and concerted efforts are needed to address these persistent obstacles to the scale up of HIV services for people most in need,” a UNAIDS press release states (9/23).

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JPMorgan Chase & Co., Gates Foundation Form Investment Fund To Back Development Of Global Health Technologies

“JPMorgan Chase & Co. (JPM) and the Bill & Melinda Gates Foundation formed an investment fund that will back late-stage development of technologies to fight killer diseases in low-income countries,” Bloomberg reports (Kitamura, 9/23). “The Global Health Investment Fund aims to offer investors a modest return on their capital over 10 years while supporting innovations to tackle diseases that struggle to attract sufficient support from private investors or aid agencies,” the Financial Times writes. “The hybrid mechanism taps new sources of funding for late-stage testing and approval of drugs, vaccines, diagnostics and other products designed to tackle infectious diseases such as HIV, malaria, tuberculosis and diarrhea in low-income countries,” the newspaper notes, adding, “The launch comes at a time of growing concern over a ‘product pile-up’ of experimental products given seed funding by philanthropists and governments, but unable to raise sufficient support to complete testing and regulatory approval” (Jack, 9/23).

“The Canadian and German governments and the Children’s Investment Fund Foundation committed $94 million to the fund, whose investors include the International Finance Corp., GlaxoSmithKline Plc (GSK), Merck & Co. (MRK), Pfizer Inc. (PFE)’s foundation, Storebrand ASA, JPMorgan Chase and qualified individuals,” Bloomberg writes (9/23). “To help mitigate the risk of investing in the clinical development of new technologies, the Gates Foundation and the Swedish International Development Cooperation Agency have committed to partially offset potential losses in the fund, which will seek a financial return for investors by targeting high-impact technologies with public health applications in both developed and emerging markets,” according to a JPM press release. “The GHIF will invest in new drugs and vaccines, emerging diagnostic tools, child-friendly formulations of existing products, expanding manufacturing capacity and other applications that will help bring affordable technologies to those most in need,” the press release adds (9/23).

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Gender Equality, Reproductive Health Essential For Sustainable Development, Asian-Pacific Conference Participants Agree

“Gender equality and reproductive health are indispensable to sustainable development, and must be a key part of the post-2015 development agenda, participants said at” the Sixth Asian and Pacific Population Conference (APPC) in Bangkok, supported by the U.N. United Nations Economic and Social Commission for Asia and the Pacific (ESCAP), in cooperation with the U.N. Population Fund (UNFPA), the U.N. News Centre reports. “After days of intense discussions, nearly 500 delegates, including ministers and senior officials from 47 countries, adopted a comprehensive Asian and Pacific Ministerial Declaration on Population and Development,” the news service writes. “‘Addressing one of the most important parts of our unfinished business, it affirms the importance of non-discrimination, of ending violence against women and girls, and of universal sexual and reproductive health, services, and rights,’ U.N. Under-Secretary-General and Executive Secretary of ESCAP Noeleen Heyzer said at the closing of the week-long conference on Friday,” according to the news service. “The document will be the region’s input to next year’s U.N. General Assembly review of the 20-year action plan on sexual and reproductive health rights, which was agreed on in 1994 in Cairo at the U.N. International Conference on Population and Development (ICPD),” the U.N. News Centre notes (9/22).

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Devex Examines Private Sector Involvement In Post-2015 Planning Process

“Planning for the post-2015 development agenda — which will officially kick off [this] week in New York during the U.N. General Assembly meetings — is expected to feature an aspect the expiring Millennium Development Goals [MDGs] did not in their infancy: vocal leadership from the private sector,” Devex reports. “Still, some business leaders are wondering, as the post-2015 planning process moves forward from public discussions to inter-governmental decisions — when, how and where will the private sector be asked to participate?” the news service writes. “Currently, there is no clear post-2015 planning roadmap that identifies the specific moments, meetings, or high-level panels where business representatives will play a role in formulating policy, even though many — including key U.N. officials — agree that several of the dozen or so post-2015 goals will ‘speak directly to business and the private sector,’” the news service notes.

“Macharia Kamau, Kenya’s permanent representative to the world body and co-chair of the open working group on sustainable development goals, said the distinction between development and business communities presents a false dichotomy,” according to Devex. “Kamau added that ‘we need to see each other as one,’ and noted that deliberation on the MDGs led to a primarily ‘social agenda,’ defined by development actors from a North-South and official development assistance framework,” the news service writes. However, “[s]ome [U.N. Global Compact (UNGC)] participants” — a group of business leaders who met on Thursday with a pre-assembly conference — “warned that [this] week some country representatives will likely voice concerns over the high degree of business involvement in setting the stage for the next development agenda, and business leaders agreed that in some cases of corporate short-sightedness, those concerns are well-founded” (Igoe, 9/20).

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UNFPA Adviser Discusses Faith-Based Organizations' Role In Development

In an interview with Inter Press Service U.N. Bureau Chief Thalif Deen, UNFPA Senior Adviser Azza Karam discusses the role of faith-based organizations (FBOs) in development. “The U.N. Population Fund (UNFPA) is perhaps the only U.N. agency that has invested — heavily and systematically since 2002 — in setting up a Global Interfaith Network of over 500 non-governmental organizations (NGOs) reaching out to disenfranchised communities worldwide,” IPS notes. In the interview, Karam discusses the effectiveness and sustainability of FBOs’ reproductive and basic health services, as well as FBOs’ contribution to and role in the post-2015 development agenda (9/20).

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Integrate Technology Solutions Into Future Development Goals, Sachs Says

“Access to, and the use of, technology should not be a standalone goal in any future development agenda because it will be the tool by which the targets will be achieved, according to Jeffrey Sachs,” director of the Earth Institute at Columbia University, who spoke “at a roundtable event at the Social Good Summit in New York on Sunday,” The Guardian reports. “As part of his work with the U.N. Sustainable Development Solutions Network, which mobilizes scientific and technical expertise to find solutions to global challenges, Sachs is leading a campaign to get one million community health workers mobilized in Africa by 2015, to help meet the health-related [Millennium Development Goals (MDGs)],” and he “wants all of them to have access to a mobile phone,” the newspaper writes. “His comments coincide with the publication on Saturday of a U.N. report that says although nearly 40 percent of people worldwide will be online by the end of the year, more than two-thirds of people in developing countries will remain unconnected,” The Guardian notes. “It’s no different from 13 years ago to get people (access) to antiretrovirals. In 2000 there wasn’t one (antiretroviral therapy) official development program. These things can be done, but they require a lot of organization and industry support,” Sachs said, according to the newspaper (Ford, 9/23).

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Indian States Using Technology To Improve Public Distribution Systems For Food Delivery

“After approving the food security bill, India’s challenge is to get all that heavily subsidized food grain to the 800 million or so people eligible to the program,” the Wall Street Journal’s “India Real Time” blog reports. “The bill expands an existing program that uses a five-decade-old public distribution system to deliver food subsidies to the poor and hungry. Experts say the system is highly inefficient, with more than half the food siphoned off and sold in the open market for higher prices,” according to the blog, which examines in depth how “[s]tates like Chhattisgarh and Orissa … are using technology to clean up their delivery systems and ensure that food reaches the right people” (Patel, 9/23).

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Editorials and Opinions

Health Care Workers, Patients In Syria Need Protection

Despite the diminishing threat of a U.S. military strike on Syria and a plan to remove chemical weapons from the country, Syrian President Bashar al-Assad “still poses a significant risk to civilians, doctors, the injured and those seeking medical attention, largely in areas lost to the regime’s control,” Saleyha Ahsan, a physician working in the country with Hand in Hand for Syria, writes in a Guardian opinion piece. “In this current climate of diplomacy, attention is turning to another international standard, enshrined in humanitarian law, and yet recurrently breached in the Syrian crisis — the access to humanitarian relief and safe access to health care,” she writes. “The U.N. has acknowledged that humanitarian aid, in particular health care, is being hampered,” she states, adding, “Health care workers and the injured are protected entities within international humanitarian law but here they are deemed high value targets.” Ahsan concludes, “What they need is protection, as promised, through international humanitarian law, to be able to do their job safely and to be supported by the international community instead of hampered by its bureaucracy” (9/21).

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Much Progress Made Against HIV/AIDS, But Continued Support Needed To Save Lives

Singer and songwriter Annie Lennox and Mitchell Besser, an obstetrician and gynecologist who founded mothers2mothers, a South African-based HIV care and support organization, write about their involvement with HIV/AIDS in the Huffington Post’s “Big Push” blog. “The Global Fund to Fight AIDS, Tuberculosis and Malaria launched in 2002 and the U.S. government’s PEPFAR program, launched in 2003 and renewed in 2008, pumped billions of dollars into Ministries of Health and non-governmental organizations across Africa to build health systems and provide HIV/AIDS care,” Besser writes, adding, “Organizations like the Clinton Foundation worked with pharmaceutical companies to make antiretroviral treatment affordable. Civil society groups like South Africa’s Treatment Action Campaign fought for access to care. And in small steps and then big, care was delivered.”

He discusses progress made over the past decade, writing, “We’ve done so much but there’s so much more that needs to be done.” He continues, “With the clock ticking towards the end of the Millennium Development Goals, we need to raise awareness. We need to ensure that nations continue to contribute generously to the Global Fund. We need to encourage the U.S. people to continue their humanitarian support for PEPFAR funding. Without sustained resources, all progress stops. The tragedy of each life lost is immeasurable; the tragedy of not completing what we’ve started is inconceivable” (9/20).

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Huffington Post Opinion Pieces Address Maternal, Child Health Ahead Of U.N. General Assembly Session

Ahead of the U.N. General Assembly’s 68th session and its general debate on the Millennium Development Goals (MDGs) — “Post-2015 Development Agenda: Setting the Stage” (September 24-October 2, 2013) — the Huffington Post’s “Global Motherhood” and “Impact” blogs posted separate series of opinion pieces addressing maternal and child health. The following is a summary of pieces published as part of the series over the weekend.

  • Anne Goddard, “Impact” blog: “While more women are receiving prenatal care [globally] — up by almost 20 percent since 1990 — only one out of every two women in developing countries are getting proper levels of health care,” Goddard, president and CEO of ChildFund International, writes, adding, “If progress is to continue, we must enhance access to care, especially for women in rural areas who often live long distances from the nearest medical facility or professional health care worker” (9/20).
  • Lucy Martinez Sullivan, “Impact” blog: “When we talk about ways the world can help end preventable child deaths, we have to pay greater attention to malnutrition — the cause of almost half of all deaths of children under age five. But as we think about how to tackle the pervasive and deadly problem of child malnutrition, we have to put greater focus on the nutrition of mothers,” Sullivan, executive director of the 1,000 Days initiative, writes (9/20).
  • Carole Presern, “Global Motherhood” blog: Noting “almost seven million women and children die each year — largely from preventable causes and at shockingly high levels in many parts of the world where poverty, conflict and gender disparities remain firmly entrenched,” Presern, executive director of the Partnership for Maternal, Newborn & Child Health (PMNCH), highlights a new report from [PMNCH] — “The PMNCH 2013 Report: Analyzing Progress on Commitments to the Global Strategy for Women’s and Children’s Health” — which she says “shows that more organizations, governments and the private sector are making commitments to improve women’s and children’s health every year, and that those commitments are being followed up with real action” (9/22).
  • Caroline Shakwei Sawe Mbindyo, “Global Motherhood” blog: Mbindyo, program manager of eHealth at AMREF, examines how eLearning — “electronic learning” through the use of electronic media/technology — and mobile learning “are transforming health delivery in developing countries, offering new skills to so many more health workers, mostly female, in remote, hard-to-reach places where the majority of African populations reside.” She highlights a program supported by AMREF, Accenture, Kenya’s Ministry of Health, the Nursing Council of Kenya, Kenya Medical Training Colleges, and a handful of private and faith-based nursing schools in Kenya, which aims to address health workforce shortages in the country (9/20).

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Recent Releases

Kaiser Family Foundation, UNAIDS Release Annual Funding Analysis On Global AIDS Response

“As world leaders prepare to meet to review progress towards the Millennium Development Goals, a report from the Kaiser Family Foundation and [UNAIDS] evaluates international efforts to finance the response to the AIDS epidemic,” a joint press release from the organizations states. “The annual funding analysis finds donor governments disbursed $7.86 billion toward the AIDS response in low-and middle-income countries in 2012, essentially unchanged from the $7.63 billion level in 2011 after adjusting for inflation,” the press release says, noting, “Overall, donor government funding for HIV has stayed at about the same level since 2008 — a plateau that followed a period of dramatic growth that saw donor nation support increase more than six-fold between 2002 and 2008.” The report, titled “Financing the Response to AIDS in Low- and Middle-Income Countries: International Assistance from Donor Governments in 2012,” “produced as a partnership between the Kaiser Family Foundation and UNAIDS, provides the latest data available on donor funding based on data provided by governments,” the press release adds (9/23).

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Global Fund Releases New Results Data Showing Significant Gains

“The Global Fund to Fight AIDS, Tuberculosis and Malaria announced new results [on Friday] that show significant gains in the treatment of people living with HIV and in the prevention of mother-to-child transmission of the virus,” the Global Fund reports in a press release. “The results show that 5.3 million people living with HIV are receiving antiretroviral therapy under programs supported by the Global Fund, as of July 1, 2013, up from 4.2 million at the end of 2012,” according to the press release, which adds, “The results also show a 21 percent increase in the number of women treated to prevent mother-to-child transmission of HIV, in the first half of 2013. The number of cases of malaria treated grew by 13 percent in the same half-year.” In addition, “Global Fund financing has cumulatively supported detection and treatment of 11 million smear-positive cases of TB, up from 9.7 million at the end of 2012,” the press release notes (9/20).

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Rep. Lee Introduces Bill Aimed At Ending HIV/AIDS Globally

Rep. Barbara Lee (D-Calif.) last week introduced a bill — HR 3117 — aimed at “bring[ing] an end to the spread of HIV/AIDS in the United States and around the world,” according to the bill’s summary on the OpenCongress webpage. According to the text of the bill, it addresses the Global HIV/AIDS-Free Generation Strategy, the strategic use of funds to maximize results, as well as legal and policy barriers to accessing health care (9/17).

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Global Leaders Must Address Health Care Worker Shortages

Writing in the Bill & Melinda Gates Foundation’s “Impatient Optimists” blog, Population Services International (PSI) Ambassador Mandy Moore recounts a trip to rural Cameroon, where she saw “firsthand a program that could change … reality for thousands of Cameroonians, allowing them to receive care in their communities by a trusted health worker.” Noting world leaders are meeting this week in New York City “to discuss progress on the Millennium Development Goals, and in November they will travel to Brazil for the 3rd Global Forum on Human Resources for Health,” she states, “The world has made incredible progress since these targets were set in 2000, but we have a bold vision, and to achieve it we need to address the critical shortage of health workers.” Moore concludes, “Now is the time for the United States and other governments to make firm commitments to build the health workforce and ensure access to health care for millions of people around the world” (9/19).

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Blog Post Examines Future Of Global Development Agenda

Noting “world leaders and advocates [will] gather at the United Nations on September 25 to kick into high gear what is expected to be a highly contentious, two-year process of negotiations to set international development priorities for a 15-year period starting in 2015,” Jay Winsten, an associate dean and director of the Center for Health Communication at Harvard School of Public Health, and Wendy Woods, a senior partner and managing director at Boston Consulting Group, write in the Bill & Melinda Gates Foundation’s “Impatient Optimists” blog, “The danger in the upcoming talks is that an expansive, intellectually coherent but politically unachievable agenda will emerge, fueled by advocates for competing causes, that will undercut current efforts to tackle extreme poverty, hunger, and disease that enjoy widespread political and public support.” They discuss the Millennium Development Goals (MDGs), “an ambitious set of non-binding milestones set in 2000 by international consensus for achievement by 2015,” and examine the “idea of folding the MDGs into an expansive set of Sustainable Development Goals designed to ‘overcome the interconnected crises of extreme poverty, economic instability, social inequality, and environmental degradation’” (9/20).

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