Kaiser Daily Global Health Policy Report
Friday, September 25, 2009
International drug makers are expected to produce three billion doses of the H1N1 (swine flu) vaccine, "enough for just under half the world's population," a WHO official said Thursday, Canwest News Service/Ottawa Citizen reports. "The agency was hoping pharmaceutical companies would be able to make about five billion doses a year, but data collected over the summer led to the revised estimate," the news service writes (Fitzpatrick, 9/24).
"These supplies will still be inadequate to cover a world population of 6.8 billion people in which virtually everyone is susceptible to infection by a new and readily contagious virus," the WHO said in a written statement. "Global manufacturing capacity for influenza vaccines is limited, inadequate and not readily augmented" (9/24).
The organization hopes to acquire a total of 300 million doses of the H1N1 (swine flu) vaccine – 100 million doses more than total pledged donations – for countries having difficulty accessing the vaccine, a WHO official said Thursday, the Washington Post reports. The WHO's goal is to distribute a supply of H1N1 vaccines to 90 countries, who combined make up "about 3 billion of the world's 6.8 billion people," the newspaper writes. "They either can't afford vaccine or have been unable to find a manufacturer able to supply it to them over the next few months, when the swine flu pandemic is expected to peak."
"We hope that the whole world will have some access to the vaccine," said Marie-Paule Kieny, director of WHO's Initiative for Vaccine Research. "In some countries it will be possible to vaccinate the whole population and in some countries only 10 percent." So far, the vaccine makers Sanofi Aventis and GlaxoSmithKline have agreed to donate a total of 150 million doses of H1N1 vaccine, and, last week, nine developed countries pledged to give 10 percent of their stockpiles – which Kieny estimated at "about 50 million doses in all," the first of which will become available in late October.
"In the meantime, WHO officials are seeking to fill the projected 100 million-dose gap with donations from other countries and manufacturers, of which there are 36 worldwide," the newspaper writes (Brown, 9/24). Kyodo News/Japanese Times reports the Foreign Ministry of Japan on Thursday announced the country would offer about $12.2 million in emergency aid to the WHO to help purchase H1N1 vaccines for developing countries (9/25).
Kieny also said the H1N1 vaccine continues to appear safe, Bloomberg reports. "Side effects from the swine flu vaccine given to 44,000 people in China have so far been mild, with just 14 cases of adverse events reported," Kieny reported Thursday, according to the news service (Serafino, 9/24).
Critics Question U.N.'s $1.5 billion H1N1 Appeal
In a related story, the Associated Press examines a recent report by the U.N. that the organization needs nearly $1.5 billion to fight the H1N1 virus. According to the news service, WHO Director-General Margaret Chan on Thursday met with top health officials to discuss the report and the appeal on the sidelines of the U.N. General Assembly meeting.
Because "most people recover [from H1N1] without ever being treated, not all experts are convinced swine flu merits such attention — and some critics even suspect the U.N. is using the pandemic as a convenient way to raise money," the news service writes. The WHO has rejected this claim, arguing even if the H1N1 virus fails to mutate into a more deadly form it could devastate already weak health systems in developing countries.
"Globally, WHO estimates more than 3,500 people have died of swine flu — far fewer than those killed by diarrhea, pneumonia, or road accidents," leading some experts, in turn, "to contend that WHO's prediction the virus could lead to 'civil disruption' in poor countries may be overblown." The article includes comments by health experts who question the WHO's recent funding appeal and the organization's handling of the H1N1 pandemic (Cheng, 9/24).
U.S. Health Officials Anticipate 6M H1N1 Vaccine Doses By Early October
Also on Thursday, U.S. health officials announced "[m]ore than six million doses of swine flu vaccine will be available by the first week in October, more that twice as many as had been recently expected, federal health officials said," the New York Times reports. Most of that vaccine "will be the FluMist nasal spray, which is recommended only for people ages 2 to 49 and not for pregnant women or people with health problems" (McNeil, 9/25). HHS Secretary Kathleen Sebelius emphasized there would be "plenty of vaccine for everyone who wants it," CNN reports (9/24).
The Bill & Melinda Gates Foundation on Thursday announced the launch of the Living Proof Project that aims to highlight how U.S. foreign aid contributes to improving global health, the Associated Press reports. Bill Gates said in a statement, "We want to show Americans that their investments in global health are working" (Pace, 9/24).
The project includes a new Web site, "an advertising campaign in Washington, D.C., that will feature children and adults helped by U.S. global health aid, and a presentation by Bill and Melinda Gates on Oct. 27 in Washington, D.C., that will be 'highlighting opportunities to build on today’s global health successes,'" the Puget Sound Business Journal writes (9/24). The Chronicle of Philanthropy's blog, "Government and Politics Watch," reports that the campaign is geared toward "the public and politicians" (Moore, 9/24).
The campaign's message is that millions of "children and adults are surviving and leading more productive lives, 'living proof' that U.S-supported initiatives to fight malaria, AIDS, and other diseases are working," the Seattle Times' blog, "The Business of Giving," reports. Senior program officer at the foundation, Cynthia Lewis, "said [the Gateses were] struck by the disconnect between the optimism and progress they saw on their trips and the pessimism they were hearing about when they came home," the blog reports. Melinda Gates said in a statement, "We think if more Americans learn about progress in global health, they’ll be inspired to maintain these investments – even in difficult economic times – so that we can do even more" (Heim, 9/24).
A draft G20 communique revealed Friday that the group of countries "has called on the World Bank to work with donor agencies to create a multilateral trust fund to increase agricultural investment in poor countries," Reuters reports. In July, the G8 launched a $20 billion agriculture initiative to help developing countries.
Leaders who are meeting in Pittsburgh called for the World Bank and regional development banks to review "capital needs ... by the first half of 2010," Reuters writes (Wroughton, 9/25).
London's Times reports on a Wednesday evening dinner on the sidelines of the summit where "300 of the globe's most influential women" came together to "tackle one of the most pressing but least noticed issues holding back global economic recovery: maternal health."
In a speech, "Sarah Brown, wife of the British Prime Minister, said ... more than half a million women worldwide die each year from pregnancy-related causes, most of them preventable. Millions more suffer injuries and develop lifelong disabilities," the Times writes. Brown said that improvements in maternal health could promote economic growth "by ensuring that women remained alive to feed, vaccinate, educate and nurture the next generation, as well as make their own economic contribution," according to the Times.
Brown also "called on world leaders at the G20 meeting in Pittsburgh ... to put maternal health high on their agenda. This would help to ensure that the United Nations' Millennium Development Goals outlined in 2000, which include reducing maternal deaths by 75 percent, could be achieved by 2015" (Frean, 9/24).
Shipping company UPS on Thursday at the Clinton Global Initiative (CGI) annual meeting, "announced a multi-year, $9 million project to help relief organizations respond better to global emergencies," the Atlanta Journal-Constitution reports (9/24).
UPS said its pledge will assist several relief organizations, including the American Red Cross, UNICEF, the World Food Programme, CARE and the Aidmatrix Foundation, according to the Atlanta Business Chronicle. Ken Sternad, president of The UPS Foundation, said in a statement, "We are combining our supply chain expertise, our assets and linking our key partners to enable more effective response to global emergencies." The article reports on the grants made to the specific groups (9/24).
Also on Thursday at the CGI meeting, the Alliance to Stop Slavery and End Trafficking called for companies to determine whether they are indirect sponsors of "human trafficking and forced labor," which "could even boost business," according to some leaders, Reuters reports. Julia Ormond, founder and president of the alliance, "said consumers often seek out products that are made using ethical sources and demand could increase." The Body Shop International CEO Sophie Gasperment said her company plans to issue "progress cards" addressing how well countries tackle child sex trafficking, according to Reuters.
The news service writes, "U.S. Labor Secretary Hilda Solis pledged that her agency will work with companies that want to root out child and forced labor from their supply chains and adopt monitoring systems. Solis said the Labor Department is giving $58 million in grants to fight child labor in 16 countries. The article includes information about child labor and trafficking and comments from other advocates (Geller, 9/24).
In light of the U.S. Army's announcement yesterday that an experimental HIV vaccine trial it is sponsoring in Thailand showed modest potential for preventing infection, the Associated Press/Washington Post examines how military research is contributing to the fight against major diseases around the world.
"Though military research has also benefited the civilian world, the main reason for the huge effort is to protect the U.S. armed forces as they are exposed to disease and injury while deployed around the world," the news service writes. Pentagon spokesperson Cynthia Smith said, "If half of your force comes down with malaria, you can't do the mission." According to Smith, "the Defense Department budget for medical research in budget year 2009 was more than $917 million, but [she] noted the figure doesn't include money also spent by the individual services," the news service writes.
"Having our labs placed overseas where the diseases are endemic is very important because that's where the diseases are," said Eric Hall, a spokesperson for the Naval Medical Research Center. "In Peru, for instance, researchers study infectious diseases such as the pandemic flu or the dengue virus. They also help train local workers in how to investigate outbreaks and help local U.S. diplomatic missions where they are located," according to the news service (Jelinek, 9/24).
IRIN examines how fees for medical services have kept poor populations from accessing services, in light of the recent announcement by British Prime Minister Gordon Brown that he was launching a program aimed at greatly reducing such fees in Malawi, Liberia, Sierra Leone, Ghana, Nepal and Burundi.
"The role of user fees in healthcare has long been a subject of debate in development policy," IRIN writes. "Initially supported by the World Bank and International Monetary Fund as a way to finance healthcare costs in the 1980s, Brown referred to the fees as 'bad development advice and bad development policy.'" The article includes information about the correlation between user fees and high child and maternal mortality rates as well as optimism that Brown's work will have an "immediate impact on healthcare" (9/24).
In a separate story on user fees, IRIN examines how eliminating user fees is only one step towards improving the poor's access to healthcare. The article addresses the need for "high-level political commitment" as well as "sustained financial and technical support," and examines "the state of health care" in Sierra Leone, Burundi and Mozambique (9/24).
Journal Of Infectious Diseases Explores Why Safe Water Alone Does Not Stop Diarrhea Among Infants Born To HIV-Positive Mothers
A study appearing in the Journal of Infectious Diseases explores how well access to safe drinking water reduces rates of diarrhea experienced by 6-month-old infants born to HIV-infected mothers following weaning. The authors write, though HIV-infected mothers showed high rates of adherence to the recommended intervention, the safe water system did not decrease the risks of diarrhea among infants, suggesting "in these infants, weaning-associated diarrhea might not be caused by waterborne pathogen transmission, and it raises questions about diarrheal etiologies and other transmission routes" (Harris et al., 10/15). An accompanying comment examines what the findings may mean for future public health interventions (Kuhn/Aldrovandi, 10/15).
Lancet Editorial Examines New U.N. Women's Agency
In light of the recent U.N. decision to create a women's agency, a Lancet editorial points out many details about the agency have yet to be clearly defined. "The U.N. system already has its share of deadweight agencies. If the new agency for women is to avoid going down this same route, it needs a clear mission like that of WHO or UNICEF, serious investment, and strong leadership," the editorial states, adding, "If the new U.N. agency takes a form along these lines, it could represent a substantial step towards improving the lives of women worldwide. If not, it will just be paying lip service" (9/26).
MMWR Cites Progress In Improving Measles Control In Africa
The MMWR summarizes the progress in improving measles control in the WHO African Region between 2001 and 2008, including an increase in the number of children receiving their first dose of the measles vaccine and a drop in the number of reported measles cases by 93 percent and global measles deaths (WHO, 9/25).
Lancet Comment Examines Canada's Opportunity To 'Make A Decisive Impact On Global Health'
As Canada prepares to take over the G8 presidency, the country "has an opportunity to make a decisive impact on global health," Lancet editor Richard Horton writes in a Lancet Comment. "The most prominent anomaly Canada has to address is the failure of the international institutional and donor architecture to address in any comprehensive and coherent way the catastrophic failure in progress towards the Millennium Development Goals (MDGs)," Horton writes before outlining lessons Canada can take from its "unique experience as a nation" and apply "to make important contributions in five further dimensions of global health" (Horton, 9/24).
Blog: Increased Ownership Can Help U.S. Foreign Aid Make A 'Lasting' Difference
"One billion people have been left behind by global development. Sixty years of foreign aid have shown that donors alone cannot fix their problems," but "[a]id can be delivered in ways that make a lasting difference, through ownership," according to a One blog post that examines a recent Oxfam report with recommendations for how to improve U.S. foreign aid. "[E]very country is different," according to Oxfam. "Where governments are corrupt or not responsive, the U.S. can provide full information about our aid, and work mostly with civil society groups. However, where governments have a record of providing for their citizens, the U.S. should let countries control their own development" (McConnell, 9/24).
Blog: Improving Women's Lives Is 'Central' To Big Picture
"Saving and improving the lives of girls and women is central to tackling every issue -- whether poverty, nutrition, education, child health, economic prosperity, environment -- of, in short, saving the world. And one of the greatest gaps has been in addressing maternal health which has prevented the achievement of any real development progress for decades," Sarah Brown, the wife of British Prime Minister Gordon Brown, writes in a Huffington Post blog entry. "Girls and women are key to unlocking progress. And now we are at a turning point. Right now I am concerned that we are at the point where we could get it right and we musn't blow it" (Brown, 9/24).
Lancet Study, Comment Focus On Improving Maternal Health
In a recent Lancet study, researchers describe how their mathematical model helped to elucidate several contributing factors to maternal mortality in Africa, which they say can help guide studies of future interventions (Pagel et al., 9/23). In an accompanying comment, Lancet editor Richard Horton calls for the international community to make maternal health a top global health priority. He writes, "It is time to place maternal health—as part of the continuum of care—at the centre of existing global health initiatives. It is the very least that women deserve" (Horton, 9/23).
Release: Sleeping Sickness Treatment Is First New Drug In 25
"NECT (Nifurtimox-Eflornithine Combination Therapy), the first new treatment in 25 years against Human African trypanosomiasis (HAT) or sleeping sickness - is now available," according to a Drugs for Neglected Diseases initiative press release. NECT – which was announced at the International Scientific Council for Trypanosomiasi Research and Control in Kampala, Uganda – "cuts the cost of treatment by half" (9/22).
Interview: Improving Adolescent Girls' Health Worldwide
Ahead of the Clinton Global Initiative's annual meeting where one of the themes is "to improve the lives of girls and women in poor countries," the Center for Global Development (CGD) published an interview with CGD Vice President Ruth Levine who is the co-author of an upcoming report that "provides a clear plan for taking action to improve adolescent girls' health worldwide." The interview includes questions about health among adolescent girls globally and implementation recommendations (9/21).
Obama Nominates New MCC Head
President Obama recently nominated Daniel Yohannes as chief executive officer of the Millennium Challenge Corporation (MCC). The U.S. Global Health Policy Tracker includes links to statements from the White House and MCC (9/18). More information on recent U.S. global health policy developments is available on Kaiser's Policy Tracker tool.
Report Highlights HIV/AIDS Security Threats
A new AIDS, Security and Conflict Initiative report highlights the threats that HIV/AIDS pose to international and national security. It describes how security influences "HIV risk" and finds that "HIV prevention and AIDS care and treatment are poorly integrated with security sector reforms, humanitarian assistance, peacekeeping and post-conflict peacebuilding" (9/09).
The Kaiser Daily Global Health Policy Report is published by the Kaiser Family Foundation. © 2010 Henry J. Kaiser Family Foundation. All rights reserved.