Kaiser Daily Global Health Policy Report
Friday, November 20, 2009
A special edition of UNICEF's annual State of the World's Children report, released 20 years after the U.N. Convention on the Rights of the Child, shows that "fewer youngsters are dying and more are going to school – but an estimated 1 billion still lack services essential to their survival and development," the Associated Press reports. The AP writes: "The convention ensures children of the right to a name, a nationality, an education, the highest possible standards of health and protection from abuse and exploitation. UNICEF said these rights are based on four core principles – non-discrimination, the child's best interests, the right to life, survival and development, and respect for the views of children" (Lederer, 11/19).
According to UNICEF Executive Director Ann Veneman, "the number of deaths of children under 5 around the world has dropped from 12.5 million in 1990 to 8.8 million in 2008. About 84 percent of the world's primary school age children are enrolled in school, and the education gap between boys and girls is closing," United Press International reports. Still, Veneman said, "It is unacceptable that children are still dying from preventable causes, like pneumonia, malaria, measles and malnutrition. … Many of the world's children will never see the inside of a school room, and millions lack protection against violence, abuse, exploitation, discrimination and neglect" (11/20).
The U.N. says that "24,000 children under the age of five still die every day from preventable disease and illness and that governments must not cut back on provision for children in times of financial hardship," the BBC reports (11/20).
The U.S. and Somalia are the two nations that never ratified the Convention on the Rights of the Child, according to a second AP story. The news service writes: "The Clinton administration signed the convention but never submitted it to the Senate for ratification because of opposition from groups that argued it infringed on the rights of parents and was inconsistent with state and local laws." Veneman said that President Barack Obama and U.S. Ambassador Susan Rice 'have expressed a strong desire to move the U.S. in the direction of approving the convention," according to AP (Lederer [2], 11/19).
Afghanistan Ranks As Most Dangerous Place For Child To Be Born
UNICEF's report singled out Afghanistan as the most dangerous place to be born, according to Reuters. The news service writes: "Afghanistan has the highest infant mortality rate in the world – 257 deaths per 1,000 live births, and 70 percent of the population lacks access to clean water, the agency said. As Taliban insurgents increase their presence across the country, growing insecurity is also making it hard to carry out vital vaccination campaigns against polio, a crippling disease still endemic in the country, and measles that can kill children" (Nebehay, 11/19).
AP Examines Biggest Child Killers
Diarrhea and pneumonia kill more children under age 5 "than HIV and malaria combined," writes the AP in a story that examines attention and money allocated to fighting a variety of childhood afflictions. "Pneumonia is the biggest killer of children under 5, claiming more then 2 million lives annually or about 20 percent of all child deaths. AIDS, in contrast, accounts for about 2 percent," according to the AP, which adds, "Diarrheal diseases received more attention in the 1980s and 1990s … but interest has waned or been diverted elsewhere, allowing them to creep back," according to John Wecker of the Program for Appropriate Technology in Health (Mason, 11/19).
President Barack Obama's nominee to head USAID, Rajiv Shah, "made the rounds" on Capitol Hill Thursday, which included a meeting with Senate Foreign Relations Committee Chair John Kerry (D-Mass.), Politco's Laura Rozen reports on her foreign policy blog. Rozen also examines this week's markup of the Kerry-Lugar foreign aid reform bill and quotes a Hill staffer saying that there is a "fundamental disagreement between what USAID should look like and what it should do between the administration and Congress."
Rozen writes: "While the Shah appointment has been viewed with excitement by many in the development and USAID community, some have expressed concern about the larger direction and independence of USAID in the Obama administration, saying signals have been mixed" (11/19).
Foreign Policy's "The Cable" blog also reports on the State Department and some in Congress not seeing "eye to eye on how to move forward with foreign aid reform" and how State's current Quadrennial Diplomacy and Defense Review plays into the equation. "The Cable" writes that "Dec. 1 is being considered for [Shah's] nomination hearing although nothing has been formally scheduled" (11/19).
Politico reports that Shah is "expected to meet with House Foreign Affairs Committee chairman Howard Berman (D-Calif.) later this week" (11/19).
The deaths of 41 people from six countries who had received the H1N1 (swine flu) vaccine were not directly linked to the vaccine, the WHO said Thursday, the Associated Press/MSNBC reports (11/19).
"Although some investigations are still ongoing, the results of the completed investigations reported to WHO have ruled out that the pandemic vaccine is the cause of death," Marie-Paule Kieny, WHO's top vaccine expert, said during a telephone conference, Reuters reports. "Reporting so far reconfirms that the pandemic flu vaccine is as safe as the seasonal flu vaccine," she added.
According to Kieny, 65 million doses of the HIN1 vaccine doses have reportedly been administered against H1N1. "Side-effects commonly reported include swelling and redness or pain at the injection site, although some had fever or headache, and all symptoms usually disappear after 48 hours," the news service writes (Nebehay, 11/19).
FDA Rejects New Type Of Flu Vaccine
Also on Thursday, a U.S. "federal advisory committee narrowly rejected a new type of influenza vaccine … that's made without relying on decades-old technology that employs millions of chicken eggs to grow viruses used for flu vaccines," the Wall Street Journal reports (Dooren, 11/19).
The FDA panel rejected a new type of influenza vaccine made in insect cells, requesting additional safety data before moving forward, Reuters reports. "The U.S. government is struggling to vaccinate the population against H1N1," the news service writes, and the new vaccine could be produced more quickly than the egg-based method, according to the company that developed it (Fox, 11/19).
Drugmakers Defend Vaccine Production, Say Regulatory Approval Slow
"Manufacturers of the H1N1 influenza vaccine summoned to appear before a congressional committee on Wednesday defended their production of the vaccine and said they were prompt in informing federal officials of problems in manufacturing," CQ HealthBeat reports (Norman, 11/18).
"Pharmaceutical executives said their companies were working on ways to make flu vaccines more quickly and in greater quantities, but said regulatory approval was slow," Reuters reports. "They complained about U.S. reluctance to use additives called adjuvants that can boost a vaccine's effects," according to the news service (Fox, 11/18).
Chinese Health Ministry Calls For Accuracy In Reporting Of H1N1 Deaths
The Chinese health ministry on Thursday ordered health officials to ensure accuracy in their reporting of the cases of deaths from H1N1 in the country, after suspicions emerged Wednesday "when medical expert Zhong Nanshan was quoted by a newspaper in southern China's Guangdong province as questioning the official nationwide tally of 53 deaths out of nearly 70,000 cases," Agence France-Presse reports. According to the news service, "Zhong's opinion carries weight because he became something of a national hero by openly defying the official line on SARS to help reveal the true extent of the illness" (Martin, 11/19).
In related news, the AP reports on how aggressive measures to contain the H1N1 virus in China have had minimal success. "Despite initially declaring success, Beijing now acknowledges its swine flu outbreak is much larger than official numbers show," the news service writes, adding, "China's official count of some 63,000 reported illnesses with 53 deaths dwarfs estimates of millions of cases with nearly 4,000 deaths in the United States, a nation with about a third of China's population."
Despite the recent increase in the number of reported H1N1 cases, "China's Health Minister Chen Zhu defended his country's aggressive quarantine policy, telling the AP on Wednesday that the measures helped slow the spread of the virus long enough for China to develop a vaccine, which authorities are now scrambling to administer." The article includes comments from health experts about the failure of measures such as border closures and quarantines to contain the H1N1 virus and skepticism about the total cases of H1N1 reported in China (Cheng, 11/18).
Experts at an American Society of Tropical Medicine and Hygiene meeting this week said that resistance to the best available drug to treat malaria "is more widespread in Southeast Asia than previously reported," Science News/Wired Science reports. Researchers have been monitoring drug resistance along the Thailand-Cambodia border where patients taking artemisinin combination therapy – the most potent treatment for malaria – have been clearing the parasite from their bodies more slowly.
According to Science News/Wired Science, now this resistance "has appeared in Vietnam and in two spots along the Burma border with Thailand and China." Robert Newman, who heads up the Global Malaria Program at WHO, indicated these findings are preliminary and require further investigation, but said, "Things are changing. There's no doubt the signs are concerning" (Seppa, 11/19).
In related news, VOA News reports that "[w]ith a promising new anti-malaria vaccine [RTS,S] in its final stage of testing, researchers around the world are optimistic they are finally making progress toward ending the deadly disease." The article features quotes from several experts, including WHO medical officer Vasee Moorthy, who said, "A vaccine, we would see as one element of a coordinated malaria control program, and it will be for countries to determine how any new vaccine would fit in with all of the existing malaria control measures, which would continue to have an absolutely vital role."
The article looks at other issues surrounding the vaccine and the socio-economic impact eradicating malaria in Africa could have (Babb, 11/19).
In an article that examines the recent history of the world's food supply and related policy, The Economist looks at the global effort to boost food security. The publication writes, "Agriculture and food security have become 'the core of the international agenda', as the G8 called it. … [Pres.] Barack Obama asked Congress to double to just over $1 billion America’s aid for agricultural development in 2010."
The article continues, "Perhaps the most striking trend is the move from 'food security' towards 'food self-sufficiency' as a goal of national policy. The first means ensuring everyone has enough to eat; the second, growing it yourself" (11/19).
Antibiotic resistance is increasing throughout the world because of excessive use, Agence France-Press reports. The news service writes, "Experts at the 2nd annual European antibiotics awareness day held by the Stockholm-based European Centre for Diseases Prevention and Control (ECDC) said new, hyper-resistant bacteria were emerging, threatening the pillars of global health."
According to the AFP, "ECDC stressed the situation is particularly worrisome in southern and eastern Europe where antibiotics consumption is higher than elsewhere" and noted "the situation could be even worse in poor countries, where antibiotics circulate more freely and are often available without a prescription" (Preel, 11/18).
A survey of European doctors by ECDC published in the infectious disease journal Eurosurveillance found that "one in five had seen more than three patients and some had seen more than ten patients with" an antibiotic-resistant infection in the last six months, according to the Telegraph (Smith, 11/18).
A Lancet World Report examines how a small group of village volunteers trained in basic health care are helping to improve the health of Ugandan children. "In a country where government spending on health is US$39 per person and 13% of children younger than 5 years die, trained volunteer health workers can make a substantial difference in remote rural areas," said Jerome Kabakyenga, dean of Medicine at the Mbara University of Science and Technology (MUST).
The article examines a program offered by a local university in Western Uganda where "a pair of volunteers in each of 175 villages in the region" receive training "in a set of basic child health concepts known as Integrated Management of Childhood Illness (IMCI)," a child health approach designed by WHO and UNICEF.
The article also looks at the debate over the role volunteers can play in improving health conditions (Webster, 11/21).
Fact Sheets Examine U.S. Role In Global Health Programs
The Kaiser Family Foundation has released three new fact sheets examining the U.S.'s role in global health programs, including PEPFAR, the Millennium Challenge Corporation (MCC), and the Global Fund to Fight AIDS, Tuberculosis and Malaria (11/20).
Lancet Comment Looks Back On Tenure Of UNICEF's Veneman
In looking ahead to whether or not President Barack Obama will nominate a new leader for UNICEF, a Lancet comment reflects on Executive Director Ann Veneman's first term at the agency, which began in 2005. The editorial summarizes the success and failures of Veneman's tenure, as described by technical and policy experts in child health. "UNICEF's Executive Director is an important global leader in health. The person appointed should not be in the gift of one powerful government," the author writes, proposing that instead the next UNICEF director should be selected "through a transparent, merit-based appointment process. …UNICEF is too important an agency to leave to the contingency of domestic U.S. political pay-back. Such an appointments process only erodes the integrity of the U.N. It is time to stop that erosion" (Horton, 11/21).
Lancet Comment Calls For 'Democratisation Of Data' To Improve Global Health
"Despite the instant availability of an abundance of statistics in the information age, accurate statistics about our most basic need – our health – remain elusive," write the authors of a Lancet comment that examines the need for improved data collection and program evaluation. "Democratisation of data – encouraging those who collect data to participate in analysis and publication – would ensure that local health workers and researchers have a vested interest in data quality," the authors write. "The new culture of sceptical optimism and international communication creates the perfect environment for renewed sharing and standardisation of health data, changes that could increase the effectiveness of national health systems and global initiatives alike. Future work in global health should rest in local and international involvement—working together to improve health" (Birnbaum et al., 11/21).
Global Health Leaders Send Letter To Obama
The "Science Speaks: HIV & TB News" blog writes of a letter sent to President Obama on Thursday "urging him to maintain robust scale up of AIDS services as part of his Global Health Initiative." The blog, which links to the letter, says, "The missive to Obama comes as the Administration hones a new approach to global health" and "argues we cannot effectively address other health threats by pitting AIDS funding against other health needs, as some in Washington seem to be advocating" (Shesgreen, 11/19).
Blog: Malaria Experts Hold Capitol Hill Briefing
The Malaria Policy Center blog reviews a Capitol Hill briefing sponsored by the American Society of Tropical Medicine and Hygiene, PATH and Malaria No More. Experts "called for further funding for research into vaccines that could ultimately block malaria infection." The blog concludes, "Hopefully, Congress will continue to demonstrate the United State's leadership in this crucial area" (Brophy, 11/18).
Blog: Sheldon Brown Appeals For TB To Be 'Focal Point' of Global Health Initiative
The blog, "Science Speaks" examines the recent letter (.pdf) by Sen. Sherrod Brown (D-Ohio) to President Obama asking that the White House make tuberculosis "a focal point" of its Global Health Initiative (Shesgreen, 11/18).
Senate Committee Approves Assistance Revitalization and Accountability Act of 2009
After a mark-up, the Senate Committee on Foreign Relations approved S.1524, the Foreign Assistance Revitalization and Accountability Act of 2009 (Policy Tracker, 11/17). More information on recent U.S. global health policy developments is available on Kaiser's Policy Tracker tool.
Blog Examines Global Fund Round Nine Grants
In light of the Global Fund to Fight AIDS, Tuberculosis and Malaria round nine grants, the Center for Global Development's "Global Health Policy" blog looks at "how and where the Global Fund has made cuts to address the funding gap between what is being requested in proposals and what is being provided by donors" (Wendt, 11/17).
Blog: Veneman Reflects On Child, Maternal Nutrition In Huffington Post
UNICEF head Ann Veneman reflects on the UNICEF report, "Tracking Progress on Child and Maternal Nutrition," released last week, in the Huffington Post: "Undernutrition steals a child's strength and makes illnesses that the body might otherwise fight off far more dangerous. But far more devastating is the fact that more than one-third of the children who die from pneumonia, diarrhea and other illnesses could have survived had they not been undernourished," she writes. "Global commitments on food security, nutrition and sustainable agriculture are part of a wider agenda that will help address the critical issues raised in this report. Unless attention is paid to addressing the causes of child and maternal undernutrition today, the costs will be considerably higher tomorrow" (Venemen, 11/16).
Blog: Shah 'A Different Kind Of Leader'
Jonathan Greenblatt on Huffington Post writes that Rajiv Shah, who was nominated by President Barack Obama last week to head USAID, "is a different kind of leader, someone with origins far from the Beltway and whose point of view promises a very new approach to development … [and] can reassert our enduring and interlinked values of compassion and democracy around the world." Greenblatt highlights the work of "a small group of social entrepreneurs who are caring for the world through action," and how Shah and "USAID needs to learn from their examples" (11/15).
Blog: Health System Strengthening
The Center for Global Development's "Global Health Policy" blog examines growing interest in health systems strengthening (HSS). "What is HSS and how does it occur? Most importantly, how will it be measured? Questions abound, and answers do too – especially here in Washington where the Obama Administration says that HSS will be central to its new Global Health Initiative," the blog writes. The blog includes a link to a free, 10-unit course on health systems (Nugent, 11/13).
Journal of Health Care For The Poor and Underserved Study Examines Factors Contributing To Child Survival
A Journal of Health Care for the Poor and Underserved study examines the contributing factors to child survival in developing countries. The authors find, among other things, "[n]utrition, external resources, and per capita income were shown to be significant factors in child survivability." The authors conclude, "countries should also make commitments to good governance, equitable distribution of resources, and transparency, and to making child survival a priority. With the global economy in a major recession we are at risk, not only of failing to meet the international goal, but of actually losing ground" (Lykens et al., 11/09).
The Kaiser Daily Global Health Policy Report is published by the Kaiser Family Foundation. © 2009 Henry J. Kaiser Family Foundation. All rights reserved.