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Kaiser Daily Global Health Policy Report

In The News

House, Senate Lawmakers Introduce Legislation To Extend PEPFAR

“Senior U.S. lawmakers introduced legislation in the Senate and House of Representatives on Wednesday to extend … a successful and popular program to combat AIDS worldwide launched 10 years ago by former President George W. Bush,” Reuters reports. Sen. Robert Menendez (D-N.J.), chair of the Senate Foreign Relations Committee, and Sen. Bob Corker (R-Tenn.), the committee’s ranking member, introduced the legislation in the Senate, and Rep. Ed Royce (R-Calif.), chair of the House Foreign Affairs Committee, and Rep. Eliot Engel (D-N.Y.), the committee’s ranking Democrat, presented a companion bill in the House, the news agency notes (Zengerle, 9/25). According to a press release from Rep. Barbara Lee (D-Calif.), an original PEPFAR co-author who joined Engel, Royce, as well as Rep. Ileana Ros-Lehtinen (R-Fla.), in introducing the measure, “The bill requires coordination by the Inspectors General to develop oversight and audit plans; extends reporting requirements for cost studies; caps U.S. participation in the Global Fund; requires a robust annual report; and protects funding for treatment for orphans and vulnerable children” (9/25).

PEPFAR “is credited with saving millions of lives, predominantly in Africa, by helping to provide antiretroviral drugs” and other services, CQ HealthBeat notes. “‘This legislation seeks to reinforce these gains through improved oversight and reporting requirements while also extending provisions that promote greater country ownership and expanded international donor support,’ Corker said in a written statement,” the news service writes. Chris Collins, vice president and director of public policy at amfAR, The Foundation for AIDS Research, said, “I think this bill does some important things. First of all, it reaffirms Congress’ broad-based support. … I think the accountability features are important to success and a valuable part of this bill,” according to CQ (Cadei, 9/25). The Center for Global Health Policy’s “Science Speaks” blog notes Catherine Connor, senior director of public policy and advocacy for the Elizabeth Glaser Pediatric AIDS Foundation, said, “Having bipartisan and bicameral committee leadership introduce this legislation is a strong signal of support for the program. If it passes, it will be an even stronger signal to appropriators that this program remains a priority for the Congress” (Barton, 9/25). A fact sheet (.pdf) on the “PEPFAR Stewardship and Oversight Act” is available from Lee’s office (9/25).

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Leaders At U.N. Adopt Outcome Document On MDGs

“World leaders meeting at United Nations Headquarters today agreed to take bolder action against extreme poverty, hunger and disease, and called for a summit to take place in 2015 to adopt the next set of anti-poverty goals, which will heavily focus on achieving sustainable development,” the U.N. News Centre reports. “During a special event on the Millennium Development Goals (MDGs), countries adopted an outcome document [.pdf] which acknowledges the progress made since the eight global targets were set in 2000, while also committing to do more to tackle many remaining challenges and accelerate progress,” the news service writes (9/25). “The document — whose purpose is to ‘review progress made towards the achievement of the MDGs and chart the way forward’ — has taken into account the concerns and priorities of the people via the U.N. My World Survey to start crafting the next set of goals, balancing the three key elements of sustainable development — providing economic transformation and opportunity to lift people out of poverty, advancing social justice and protecting the environment — already included in the report of the U.N. High-Level Panel on Post-2015 presented to Secretary-General Ban Ki-moon last May,” Devex reports (Santamaria, 9/26).

U.N. General Assembly President John Ashe said, “This new agenda must not only tackle the unfinished business of the MDGs, it must go further — leading to a great overhaul in how we approach the planet and its people. On many levels, for many people, the new agenda’s composition will be a matter of survival,” according to the news service. At the event, U.N. Secretary-General Ban Ki-moon “presented to countries his report ‘A Life of Dignity for All,’ which outlines his vision for bold action to achieve the MDGs and for a new and responsive sustainable development framework that meets the needs of both people and planet,” the U.N. News Centre reports. Ban said, “It needs to be rights-based, with particular emphasis on women, young people and marginalized groups. And it must protect the planet’s resources, emphasize sustainable consumption and production and support action to address climate change,” according to the news service (9/25). At several General Assembly side events this week, some U.N., government, and non-governmental organization leaders questioned economic benchmarks used to measure poverty, saying the levels were too low or needed to be more “multidimensional” if the international community “is serious about ending extreme poverty,” The Guardian reports (Ford, 9/25). In a “Global Development Podcast,” The Guardian examines the MDGs and the post-2015 development agenda (Muir/Hill, 9/25).

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WHO Committee Calls For Increased MERS-CoV Surveillance During Hajj, Stops Short Of Declaring 'Public Health Emergency'

“A [WHO] emergency committee on Wednesday asked countries to step up monitoring for [the Middle East Respiratory Syndrome coronavirus (MERS-CoV)] as Muslim pilgrims from around the world return home from the annual hajj in Saudi Arabia, home to most of the victims so far,” the Wall Street Journal reports. “[T]he hajj draws more than three million pilgrims from dozens of countries for worship in the Muslim holy cities of Mecca and Medina,” the newspaper notes (Knickmeyer, 9/25). Despite the concerns over MERS-CoV addressed during the meeting, “the committee decided against calling the outbreak a ‘Public Health Emergency of International Concern’: a situation that requires a certain level of immediate, coordinated international action,” the Los Angeles Times writes (Brown, 9/25). This decision by the committee “reaffirmed its earlier finding that the status of [MERS-CoV] does not currently represent a global public health emergency,” according to CIDRAP News (Roos, 9/25).

“Health officials have yet to determine how MERS, which typically causes respiratory infections, and sometimes kidney problems, infects humans,” the Wall Street Journal writes (9/25). “We’re still early in our understanding of how to put this together,” Keiji Fukuda, WHO assistant director general for health security and environment, said during a conference call with reporters, the Los Angeles Times reports (9/25). In another article, the Wall Street Journal examines the response to MERS-CoV in Saudi Arabia (Knickmeyer/McKay, 9/24).

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Italy's Prime Minister Calls For Increased Cooperation On Food Security; E.U., FAO Announce New Efforts Against Hunger

In an address to the 68th U.N. General Assembly on Wednesday, Italian Prime Minister Enrico Letta “called for greater local and global action to overcome food insecurity,” the U.N. News Centre reports. He “noted that the eight anti-poverty targets known as the Millennium Development Goals (MDGs) have made ‘tangible improvements’ but that one in eight people worldwide still suffer from malnutrition,” the news service writes (9/25). “Letta said that the 2015 Expo, or world’s fair, in Milan should be a springboard for global initiatives, floating the idea that a multilateral pact might be reached there,” the Wall Street Journal notes. “The Milan Expo, whose slogan is ‘Feeding the Planet, Energy for Life,’ aims to draw 20 million visitors interested in issues linked to sustainability,” the newspaper writes, adding, “The event should be seized upon to create a Milan Protocol, modeled on the Kyoto Protocol of the late 1990s that covers environmental issues, with nutritional education, sustainable farming practices and food waste as its cardinal points, according to the Barilla Center for Food and Nutrition, a think tank backed by Barilla SpA, the pasta maker” (Emsden, 9/25). “In addition, the U.N. Food and Agricultural Organization (FAO) and the U.N. World Food Programme (WFP) are based in Rome,” the U.N. News Centre notes (9/25).

Also on Wednesday, “the European Union and the [FAO] announced they would step up efforts to reduce hunger in six countries before 2015 through agricultural development activities worth nearly €60 million [$81 million],” the U.N. News Centre reports in another article. “Some two million people will be reached through the joint initiative in Burundi, Burkina Faso, the Gambia, Haiti, Madagascar, and Mozambique,” the news service notes (9/25). “The funding comes from a €1 billion E.U. initiative that aims to foster speedier progress towards the [MDGs],” an FAO press release adds (9/25).

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Canada's Prime Minister Announces $200M Over 5 Years For Maternal, Child Health Projects

At a U.N. panel on maternal and child health on Wednesday, Canadian Prime Minister Stephen Harper announced the country would spend $200 million over five years to fund nine maternal and child health projects in developing countries “that will help to pay for more immunizations, provide basic health care and set up community services to ease the dangers of childbirth and pregnancy,” the Canadian Press/GlobalPost reports. “The money detailed Wednesday is part of Canada’s commitment of nearly $3 billion over five years to the issue of maternal and child health, part of the Muskoka Initiative on Maternal, Newborn and Child Health launched by G8 partners at the Muskoka Summit in 2010,” the news agency writes (9/25). “Harper highlighted that the initiative started at the Muskoka meeting involved not just promises of funding, but also new standards of accountability for delivering them,” the Globe and Mail reports, adding, “Canada has already distributed two-thirds of the money it committed, he said, and is on track to fulfill its pledges by 2015” (Slater, 9/25). “Before the maternal health panel, Harper met privately with computer billionaire and philanthropist Bill Gates and his wife Melinda Gates,” the CP/GlobalPost notes, adding, “Harper said their international charitable foundation is a great partner for Canada” (9/25).

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Editorials and Opinions

Global Commitment From Public, Private Sectors Can End Extreme Poverty

Noting the “proportion of households in developing countries below the extreme-poverty line (now measured as $1.25 per person per day at international prices) has declined sharply” since 1980, Jeffrey Sachs, special adviser to the U.N. Secretary General on the Millennium Development Goals (MDGs) and director of Columbia University’s Earth Institute, writes in a New York Times opinion piece, “While the recent gains are undoubted, the question is how to ensure that progress on incomes, health and other dimensions of poverty eradication (including access to schooling, safe water, electricity, sewerage) continues until extreme poverty is vanquished.” He adds, “Debates rage on this question and often shed more heat than light.”

In Africa, Sachs says the introduction of cellphones and a reduction in malaria incidence through proven control strategies have “played a vital role in reducing poverty in Africa.” He continues, “In both cases, the private sector has been essential, not only in developing breakthrough technologies but also enabling them to spread in a short time,” but “the public sector is also critical.” He notes “[p]ublic funds finance crucial scientific and technological breakthroughs,” citing the Global Fund to Fight AIDS, Tuberculosis and Malaria as an example. Sachs concludes, “One can say that the fight to end poverty is helping to forge a new kind of mixed capitalism. Old debates of public versus private are being superseded by new strategies that involve both the public and private sectors. … A global commitment to ending extreme poverty will spur creativity and action” (9/24).

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Coordination Essential To Success In Reducing Child Mortality

“Efforts to end … preventable child deaths will only be successful when integrated packages of interventions are available to the population most at risk,” Yehuda Benguigui, child health team leader for USAID’s Maternal and Child Health Integrated Program (MCHIP), writes in the Huffington Post’s “Impact” blog. “USAID’s [MCHIP] supports two well-established and relatively simple strategies to address the most common causes of child deaths: Integrated Management of Child Health Illnesses (IMCI) as a means to treat children at basic health facilities and Integrated Community Case Management (iCCM), which extends case management of childhood illnesses beyond health facilities so that more children have access to life saving treatments,” he states, adding, “Many countries have adopted one or both of these interventions; however, their successful implementation in health facilities and communities has been challenging.”

“These challenges,” such as having well-trained health care workers but a lack of medical supplies or vice versa, “are well understood by national governments, donor agencies and implementing partners,” Benguigui writes, adding, “And yet, as an international community, we have not established systematic ways to address or improve these situations.” He continues, “At the heart of these problems is coordination — we could avoid programmatic and funding overlap, and have adequate allocation of resources by improving coordination (or at least complement the available resources to support the strategic plan of the Ministry of Health). In this way, we could achieve a suitable operational plan for each country, subdivided by geographical areas, with the participation of all institutions and with proper coordination with national health authorities.” Benguigui uses the Latin America and Caribbean Newborn Health Alliance as an example of coordination, and he concludes, “With initiative and leadership, this structure can be replicated elsewhere. And with the current levels of attention on and funding for reducing child deaths, there is no reason why other regions and technical areas cannot adopt a similar approach” (9/25).

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Recent Releases

U.S. To Host December Global Fund Replenishment Conference

The Global Fund to Fight AIDS, Tuberculosis and Malaria’s “Fourth Replenishment Conference will be hosted by the United States in Washington, D.C., in early December 2013, Secretary of State John F. Kerry announced [Wednesday],” a Global Fund press release reports. “Convened once every three years, the conference will secure funding for 2014-2016, enabling the Global Fund to support programs in countries that fight AIDS, TB and malaria effectively, and to save the lives of millions of people,” the press release states, adding, “Nafsiah Mboi, chair of the Board of the Global Fund, said the decision by the U.S. demonstrates an exceedingly strong commitment to global health, willingness to invest and a determination to lead others toward the same goal” (9/25).

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USAID Committed To Improving Access To Voluntary Family Planning Options

Ellen Starbird, director of the USAID Office of Population and Reproductive Health, writes in the agency’s “IMPACTblog” about World Contraception Day, recognized on September 26, which “draws attention to the fact that more than 222 million women in the developing world say they want to delay or avoid pregnancy but are not using a modern method of contraception.” She adds, “USAID works across the globe to enable individuals to access and use affordable, high-quality family planning information, commodities, and services as a means to improve their health and quality of life. … As the world’s largest bilateral donor of family planning, USAID is committed to expanding choice and access to a variety of contraceptive options.” Starbird concludes, “Improving access to voluntary family planning information, products, and services is a necessary ingredient to helping women care for their families, participate in their communities, and build their countries” (9/26).

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USAID Blog Summarizes Events At U.N. General Assembly Meeting

USAID’s “IMPACTblog” includes daily highlights from the U.N. General Assembly meeting. In the first day’s summary, the blog includes links to an interview with USAID Administrator Rajiv Shah and a press release announcing a $1.15 billion commitment from the World Bank, UNICEF, the Government of Norway, and USAID for maternal and child health, among others (9/24). The second day’s summary includes links to a transcript of President Obama’s U.N. General Assembly address and summarizes an event on women and girls held with the U.K. Department for International Development, among others (9/25).

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Collaboration Launches New Report On Maternal Health

“As part of the [Wilson Center's 'Advancing Dialogue on Maternal Health'] 2012-2013 series, the Wilson Center and the Population Foundation of India convened a workshop on neglected maternal health issues which brought together participants in New Delhi with audiences at the Wilson Center and the Harvard School of Public Health,” an event summary notes. The event, held on Monday, launched “Delivering Success: Scaling Up Solutions for Maternal Health,” “a new report which captures, analyzes, and synthesizes the strategies and recommendations that emerged from the series,” the summary states (9/23). “A collaboration among the Wilson Center’s Global Health Initiative (GHI), Maternal Health Task Force (MHTF), and United Nations Population Fund (UNFPA), the ‘Advancing Dialogue on Maternal Health’ series … acknowledg[es] that policymakers and practitioners must adapt effective approaches to meet country-specific challenges,” the report summary notes (September 2013).

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