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Kaiser Daily Global Health Policy Report

In The News

IPS Examines Debate Surrounding TPP Trade Agreement Tobacco Regulation Proposals

“Between concluding rounds of negotiations towards the Trans-Pacific Partnership (TPP), a major U.S.-proposed free trade agreement, a divisive fight has heated up over the extent to which countries should be allowed to regulate the sale of foreign — potentially far cheaper — tobacco products,” Inter Press Service reports. “In dueling proposals offered during the latest round of negotiations, in Brunei late last month, the United States and Malaysia put forward starkly different approaches,” IPS writes, noting, “While Washington is urging that tobacco products be given no special consideration, the Malaysian government has countered that these items should receive a special ‘carve-out,’ exempting them from a broader lifting of trade restrictions.” The news service adds, “Now, critics of the U.S. proposal are hoping to emphasize the health implications of these proposals ahead of the next 12-country TPP talks, slated to take place here in Washington starting September 18.”

New York City Mayor Michael Bloomberg, “a long-time proponent of greater tobacco control, recently suggested that the U.S. proposal could directly contribute to ‘tens of millions’ of deaths globally,” IPS continues, adding, “Advocates of tougher restrictions are warning that the U.S. scheme would be particularly dangerous to developing countries.” The news service writes, “Not only could the proposal open these economies to potentially cheap cigarettes coming from other countries, but it would also make them vulnerable to expensive litigation from powerful tobacco interests if these countries try to impose trade restrictions.” IPS notes, “In the TPP negotiations, the new U.S. position rescinds an earlier draft proposal that included an exemption for tobacco-control measures,” adding, “Instead, the new proposal simply recognizes that countries are allowed to put in place health regulations, similar to other treaties.” According to the news service, “The administration of President Barack Obama had initially hoped to have a final agreement text by October, but that now looks extremely unlikely” (Biron, 9/7).

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Secretary Kerry Reaffirms U.S. Commitment To Help Swaziland Address HIV/AIDS Epidemic

“The U.S. has restated its commitment to working with Swaziland to fight HIV/AIDS in the African country, where the disease poses a major challenge to socio-economic development,” PANA/Afrique Jet reports. “‘Our productive collaboration has helped the people of Swaziland make steady progress towards an AIDS-free generation,’ U.S. Secretary of State John Kerry said in a message to Swaziland on the occasion of its 45th independence anniversary,” recognized on September 6, the news agency notes. “The United States remains dedicated to working with Swaziland not only to turn the tide against this disease, but also to strengthen democratic governance and promote economic development and trade,” Kerry said, according to PANA, which adds, “On June 4, 2009, the U.S. and Swaziland signed the Swaziland Partnership Framework on HIV and AIDS for 2009-2013” (9/6).

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USAID Official Discusses Agency's Efforts To Address Gender Issues In Armed Conflict

Noting “[w]omen and girls are disproportionately harmed in armed conflict,” as they are often “targets of sexual violence” and “are more likely to be sidelined from peace-building and conflict resolution efforts,” Devex interviews Caren Grown, outgoing senior coordinator on gender equality and women’s empowerment at USAID, about the agency’s efforts to address these issues. “Grown, who is also senior gender adviser at USAID’s Bureau of Policy, Planning and Learning, said the agency is working to ensure women in refugee camps have fuel-efficient stoves, for example, so that women won’t have to leave their shelters to look for fuel,” the news service writes, noting she “also discussed how USAID is engaging men and boys in the drive for gender equality, such as using the education system to help change norms of masculinity that tolerate or accept gender-based violence or abuse of women.” Devex includes a video of the complete interview (Parmanand, 9/9).

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Malaysian Newspaper Profiles Ambassador Goosby

Malaysia’s “The Star” profiles Ambassador Eric Goosby, head of the U.S. State Department’s Office of Global Health Diplomacy and the U.S. global AIDS coordinator, recounting his early career as a doctor in San Francisco, where he treated HIV/AIDS patients at the San Francisco General Hospital. “Now, almost three decades on, he is still involved in the fight against HIV, his ultimate aim being to achieve a generation free of the virus,” according to the newspaper. “His role is to lead all of the international HIV/AIDS efforts of the U.S. government,” the newspaper notes and includes comments from Goosby on the cost associated with working toward an AIDS-free generation, the “‘extraordinary’ importance” of discussion about ending stigma, and the significance of continued commitment to ending AIDS (Edwards, 9/8).

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Saudi Arabia Reports Additional MERS Cases, Deaths; Study Examines Possible Treatment

Saudi Arabia’s health ministry on Friday “announced five new cases of infection of the [Middle East Respiratory Syndrome (MERS)] coronavirus,” Agence France-Presse reports. Saudi Arabia, which also reported three deaths from the virus, “is the country worst hit by MERS,” the news agency writes (9/7). On Saturday, the WHO said in a statement, “Globally, from September 2012 to date, WHO has been informed of a total of 114 laboratory-confirmed cases of infection with MERS-CoV, including 54 deaths” (9/7). “The WHO … has not recommended any travel restrictions but has urged health authorities worldwide to maintain vigilance. Recent travelers returning from the Middle East who develop severe respiratory infections should be tested for MERS-CoV, it said,” Reuters notes (Aboudi, 9/7).

In related news, researchers from the National Institute of Allergy and Infectious Diseases have published a study in Nature Medicine showing “[a] combination of two well-known antiviral drugs protects monkeys against MERS and could potentially be used to save humans from the lethal disease,” the New York Times reports. “The ribavirin/interferon cocktail tested on the monkeys is currently used to treat chronic hepatitis C in humans,” the newspaper notes (McNeil, 9/8).

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Appeal Calls For Post-2015 Development Target On Water, Sanitation

The Stockholm International Water Institute on Friday “issued a call for a post-2015 development target on water aimed at making better use of scarce water supplies, realizing the human right to safe drinking water and sanitation, and increasing resilience to droughts and floods by 2030,” IRIN reports. “The appeal … came after a week of discussions and consultations with aid agencies, development organizations and water experts on how to build on the Millennium Development Goals (MDGs), which set a 2015 target to improve access to safe drinking water and basic sanitation,” the news service writes. “This issue was one of the key topics of debate at World Water Week,” IRIN states, adding, “The next 12 months are seen as essential to securing a target for water and sanitation that will help guide relief and development efforts for the next 15 years.” The article discusses mixed outcomes on the water and sanitation MDG so far, potential targets for the post-2015 development agenda, links between water and sanitation and other development issues, and the importance of data collection (James, 9/6).

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Editorials and Opinions

To Achieve Child Health MDG, Use Technology To Better Educate Mothers

“The more educated a mother, the less likely her child is to die,” Leith Greenslade, co-chair of child health at the MDG Health Alliance, writes in a post in the Huffington Post’s “Global Motherhood” blog, published as part of “One Story, One World,” a month-long series in partnership with Johnson & Johnson “to highlight the successes and remaining opportunities in the Every Woman Every Child movement.” She states, “This is one of the most powerful relationships in global health and development — a mother’s level of education and her child’s chance of survival,” adding, “This is why educating adolescent girls and young women is one of the most important ways to reach Millennium Development Goal 4 (MDG4) — the global child survival goal that will only be achieved when we reduce the number of children under five dying each year from seven million to four million.”

“At the moment, the world is seriously off track to meet that goal by the deadline — December 31, 2015,” Greenslade continues, adding, “It will take a massive outreach effort to educate girls and mothers in these countries, but if we can do that, up to two million deaths could be prevented, taking us one big step closer to MDG4.” She writes, “Technology is on our side, and on the side of all uneducated girls and women,” noting the Mobile Alliance for Maternal Action (MAMA) last week “released a set of free text and voice messages that can be sent directly to a mother’s cell phone anywhere, offering her advice on child nutrition and how to prevent and treat pneumonia, diarrhea and malaria — to name just a few of the messages.” She adds, “If all of the organizations engaged in child survival routinely communicated directly with the most vulnerable mothers and families during pregnancy and in the critical weeks after with messages like these, millions of families could be reached quickly and at low cost, and children’s deaths would be prevented,” concluding, “We need a massive outreach effort to get it to mothers on phones, tablets, televisions, radios and any other channels of communication that reach directly into homes” (9/4).

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Public-Private Partnerships Can Successfully Address Neglected Diseases

“In my experience, public-private partnerships that bring together the best talents, expertise, and resources from the government, non-profit and business sectors have proven essential for tackling the most complex challenges in global health and international development,” David Addiss, director of Children Without Worms, a partnership of Johnson & Johnson and the Task Force for Global Health, writes in the Huffington Post’s “Global Motherhood” blog. Noting “the most entrenched — and most neglected — problems in global health are infections with intestinal worms,” he states, “Given the magnitude of this neglected problem, meeting the challenge will take the collaboration of partners with a range of expertise and a shared vision of long-term success. Together these partners can effect a transformation that results in a brighter future for all the affected children.”

Addiss discusses a “comprehensive approach” to addressing worms, including product donations, drug treatment, improved water, sanitation, and hygiene (WASH), “health and hygiene education, vitamin A and nutritional supplementation, [and] maternal and child health and community-based programs.” He describes several programs and partnerships working to prevent intestinal worm infections, and he writes, “As momentum grows, the challenges of nurturing, coordinating, and sustaining this multifaceted partnership will also increase. Success will depend on visionary leadership, receptivity to collaborative and innovative relationships, and the resolute commitment of all partners” (9/6).

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'More Is Needed' In Global Effort To Eradicate Polio Virus

In a Deseret News opinion piece, John Hoffmire, a professor at Saïd Business School at the University of Oxford, reflects on the global effort to eradicate polio, writing, “The world is now, 25 years [after Rotary International, a humanitarian organization made up of nearly 1.2 million members in more than 200 countries, began a process to purge polio from the planet], on the verge of eliminating one of the most dreaded diseases of the 20th century.” He notes, “To date, Rotary clubs worldwide have contributed $1.2 billion to the protection of more than two billion children in 122 countries,” adding, “Since 1995, donor governments have contributed in excess of $6 billion to polio eradication, due in part to Rotary’s advocacy efforts.” However, he continues, “much more is needed. More than 20 years of steady progress is at stake, and polio — now on the ropes — stands to stage a dangerous comeback unless the funding gap is bridged.”

“Today, there are only three countries in the world where polio still breeds, Pakistan, Nigeria and Afghanistan,” Hoffmire writes, adding, “Outbreaks occur elsewhere from time to time, and nearly all of those cases can be traced back to these three countries.” He notes a resurgence of the virus in Somalia and the Horn of Africa as well as a new outbreak in a part of Pakistan, and he highlights two recently published articles on the final push for worldwide eradication. “Because of such persistence and focus, in June of this year, the Bill & Melinda Gates Foundation and Rotary helped fund the campaign with another $535 million pledged for the future,” he states, concluding, “Once eradicated, polio will join smallpox as one of only two diseases ever eliminated. And the volunteers of Rotary will continue their humanitarian work, living up to its motto, ‘service above self’” (9/9).

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Recent Releases

MSF Webcast Examines Issues Of Access To Medicines

Médecins Sans Frontières/Doctors Without Borders (MSF) features an archived webcast from September 5 of “a short preview and discussion of [the new documentary] ‘Fire In The Blood’ and current U.S. government trade and global health policies, with expert panelists, including the film’s director, as they examine this history and explain how the battle for affordable medicines and equal access for all patients continues today, through, for example, the proposed provisions in the Trans-Pacific Partnership Agreement (TPP) which threaten to restrict access to generic competition.” Panelists include Els Torreele, director of the Access to Essential Medicines Initiative of the Open Society Foundations; James Love, director of the Knowledge Ecology International; Dylan Mohan Gray, director, producer, writer and editor of “Fire in the Blood”; and Sharonann Lynch, HIV/AIDS policy adviser with Doctors Without Borders (9/6).

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WFP Highlights 7 Infographics On Hunger, Nutrition

The U.N.’s World Food Programme (WFP) published on its webpage on Friday seven “must-see infographics on hunger and nutrition,” noting they “highlight different aspects of the problem and between them help point the way to solutions.” Among others, the post links to an infographic from the 1,000 Days partnership highlighting “the importance of proper nutrition during the critical 1,000 days from the start of a woman’s pregnancy,” an infographic from the U.N. Food and Agricultural Organization (FAO) (.pdf) “that provides the latest stats on food insecurity,” and an infographic from UNICEF “explain[ing] the causes and concerns of stunting” (9/6).

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Online Discussion To Address Risks, Challenges Of Integrated Community Case Management

On Thursday, September 12 from 1-3pm BST, The Guardian’s “Global Development Professionals Network” will host an online discussion on child health care and integrated community case management (ICCM), “a strategy that aims to extend services beyond health facilities, by identifying and training community health workers who can deliver quality care closer to home.” According to the discussion description, the expert panel will discuss the risks and challenges of ICCM and address questions such as, “[I]s ICCM worth the investment? How can its unique features be specifically geared towards reducing child mortality? What can be learned from existing programs about how to take scale up these initiatives and integrate them into existing health care systems? Finally, just how sustainable is an approach that relies on volunteer health workers?” (Young, 9/6).

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