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AfricaFocus Bulletin May 30, 2017 (170530) (Reposted from sources cited below)
“3.3 million more abortions. 15,000 more mothers dying. 8 million more unplanned pregnancies. … Those grim numbers from the Guttmacher Institute show the potential real-world impact of the Trump administration’s unprecedented proposed cuts to global family planning efforts; the budget the White House released Tuesday would basically eliminate those programs.” – Sarah Wildman, Vox, May 24, 2017
The headline (my wording) may seem alarmist, but detailed examination of the health agendas being advanced by the Trump administration and right-wing Republicans leaves little doubt of the consequences should they be fully implemented. There will indeed likely be millions of deaths resulting both from the House domestic healthcare plan, which would remove 23 million from health insurance, according to the Congressional Budget Office, and from the provisions for global health in the administration’s new budget. That would eliminate funding for family planning, threaten funding for HIV/AIDS and famine relief, and impose massive cuts on institutions such as the Center for Disease Control which are vital to protection against epidemics.
One may withhold judgment on the motivations of the policymakers, including the relative weight of ideology, indifference, lack of human empathy, and greed. And most observers say the full package is unlikely to survive Congressional scrutiny, even among many Republicans. But much of the damage, such as the Global Gag Rule cited above, comes from executive decisions already being implemented, such as the new version of the Global Gag Rule. The proponents of this agenda, it is clear by their explicit statements, reject the universal right to health, and give little or no value to the lives of those who are not wealthy and white.
This AfricaFocus Bulletin continues two summary articles on the Global Gag Rule and the Trump budget, as well as a reflection on the pressures facing progressive health advocates stretched by the attacks on both domestic and global health.
A few additional short articles highlight the threat:
Siobhán O’Grady, “How teen moms in Nigeria could wind up hurt by Trump’s U.N. Cuts,” Washington Post, May 5, 2017 http://tinyurl.com/y9dn2odb Documents effects of cutting support for the U.N. Population Fund.
Los Angeles Times, “Editorial: Trump’s new global gag rule will devastate healthcare in poor countries,” Los Angeles Times, May 22, 2017 http://tinyurl.com/n6kprqw “The rule was bad enough in its earlier form [under previous Republican administrations], when it barred aid to family planning organizations that offered abortion or abortion counseling. … But the new Trump administration incarnation of the rule is far more expansive. … it will now cover approximately $8.8 billion in funds given out to healthcare providers of all sorts.”
Nurith Aizenman, “Trump’s Proposed Budget Would Cut $2.2 billion from Global Health Spending,” National Public Radio, May 25, 2017 http://tinyurl.com/y9xgbc87 “Overall, Trump would cut the annual global health budget by about 26 percent, or around $2.2 billion in the 2018 fiscal year that begins October 1, decreasing it from about $8.7 billion in the current fiscal year budget to less than $6.5 billion.”
Emily Baumgaertner, “Proposed Cuts Alarm Bioterrorism Experts,” New York Times, May 29, 2017 http://tinyurl.com/yavxmskg The CDC’s budget would be cut by 17%. At the NIH, a program training foreign medical professionals in pandemic response would be eliminated.
For previous AfricaFocus Bulletins on health, visit http://www.africafocus.org/intro-health.php
++++++++++++++++++++++end editor’s note+++++++++++++++++
By Ann M. Starrs, Guttmacher Institute
The Lancet, February 4, 2017
http://www.thelancet.com – Direct URL: http://tinyurl.com/ya8ngh4h
On Jan 23, 2017, on his fourth day in office, President Donald Trump signed an executive order imposing the global gag rule, an anti-abortion policy that under other conservative presidential administrations has caused serious disruptions to US overseas family planning efforts. Alarmingly, Trump’s order goes even further than in the past, with potentially devastating effect.
Credit for graphic: Human Rights Watch      Â
The global gag rule, also known as the Mexico City policy, was devised in 1984 by the administration of Ronald Reagan to impose a draconian set of anti-abortion rules on US overseas family planning programmes. This policy banned US family planning funds from going to foreign non-governmental organisations (NGOs) that provide abortion services, counselling, or referrals, or advocate for liberalisation of their country’s abortion laws–even if they use non-US government funds for these activities. In 1984, and every time the global gag rule has been imposed since then, foreign governments were exempt for diplomatic reasons, as were US-based NGOs on constitutional grounds.
To be clear, legislation was already in place in 1984, and is still in place now, that bans the use of US funds under the Foreign Assistance Act from paying “for the performance of abortion as a method of family planning”. But for anti-abortion activists this Helms Amendment, passed in 1973, did not go far enough; they wanted to limit any activity that could possibly enable or promote abortion. Hence, the global gag rule.
Under Trump’s order, the gag rule now applies not only to US bilateral family planning assistance (US$575 million for fiscal year 2016), but also to all “global health assistance furnished by all departments or agencies”–encompassing an estimated $9.5 billion in foreign aid. Foreign NGOs that receive US funding to work on a broad range of health programmes in about 60 low-income and middle-income countries–including on HIV/AIDS, the Zika virus, malaria, tuberculosis, nutrition, and maternal and child health, among others–will potentially be subject to the same ideological restrictions that have hampered family planning aid at points in the past. Thus, President Trump’s version of the global gag rule represents a wider attack on global health aid writ large.
Adding to the widespread concern among US government agencies, global health NGOs, and advocates is the Trump administration’s failure to provide any guidance on the interpretation or application of the new policy.
Those details may emerge in the coming weeks and months. But we already know that, when last in effect, the gag rule crippled family planning programmes. Many foreign NGOs, as a matter of principle and out of dedication to the patients they serve, refused to let the US Government muzzle their abortion advocacy efforts or dictate what services or counselling they provided using their non-US funds. These health providers were forced to reduce staff and services, or even shut clinics. As a result, many thousands of women no longer had access to family planning and reproductive health services from these clinics–sometimes the only provider of such services in the local community. Various actors, including the governments of Canada and the Netherlands, are mobilising to compensate for at least some of the damage that will be done by the gag rule. But the US is the largest funder of global health programmes worldwide, and the disruption this aid effort will suffer is massive.
Moreover, there is no evidence that the global gag rule has ever resulted in its stated aim of reducing abortion. The first study to measure the effect of the gag rule showed that this policy could actually have resulted in an increase in abortions. Another study assessed the gag rule in Ghana and found that because of declines in the availability of contraceptive services, both fertility and abortion rates were higher during the gag rule years than during non-gag rule years in rural and poor populations. This is consistent with anecdotal data that the gag rule’s main effect has been to reduce women’s access to quality contraceptive services, thereby increasing the probability of unintended pregnancy and making recourse to abortion more likely.
But the harmful effects of Trump’s order are likely be even greater. NGOs in lowincome settings often provide integrated health services; for instance, they offer patients contraceptive care, HIV prevention or treatment, maternal health screenings, immunisations, and information on safe abortion care all under one roof. By expanding the gag rule to the full scope of US global health aid, hundreds more national and local NGOs will be forced to choose between drastic funding cuts (if they decline to sign the gag rule) or denying their patients the information and services that are their right (if they sign, and can no longer provide or discuss abortion). Millions of women living in low-resource settings may now be unable to obtain the care they need, when they need it.
The unprecedented scope of the Trump global gag rule validates the fears of many observers: reproductive health and rights worldwide will face a sustained attack in the next 4 years of the Trump Administration. This assault will almost certainly include defunding the United Nations Population Fund (UNFPA), as well as potentially drastic cuts to US overseas family planning aid. It will be mirrored domestically by efforts to restrict abortion access–for instance, by banning all private and public insurance coverage of abortion or prohibiting the most commonly used method for second-trimester procedures–and to shred the nation’s family planning safety net, including by defunding Planned Parenthood.
It is becoming clearer with each Trump executive order that not only reproductive health but also global health programmes and overall foreign assistance supported by the US Government are in grave jeopardy, as indicated by President Trump’s repeated promises to “put America first”. The social conservatives driving this agenda–who now control the US Presidency and both Houses of Congress–are showing complete disregard for the millions of women, men, and children who will suffer the consequences, intended or not, of these regressive policies.
by Sarah Wildman
Vox, May 24, 2017
http://www.vox.com – Direct URL: http://tinyurl.com/lrtqf72
3.3 million more abortions. 15,000 more mothers dying. 8 million more unplanned pregnancies. Up to 26 million fewer women and couples acquiring contraception and family planning advice.
Those grim numbers from the Guttmacher Institute show the potential real-world impact of the Trump administration’s unprecedented proposed cuts to global family planning efforts; the budget the White House released Tuesday would basically eliminate those programs.
It also calls for gutting a key US famine relief program, slashing half the budget for the USAID’s internal disaster relief organization, and cutting $222 million from funds allocated to fight HIV, AIDS, tuberculosis, and malaria. The justification listed in the budget is a simple hope for others to fill the shortfall:
The United States has been the largest donor by far to global HIV/AIDS efforts, providing over half of global donor funding in recent years to combat this epidemic. The Budget reduces funding for several global health programs, including HIV/AIDS, with the expectation that other donors can and should increase their commitments to these causes.
If Congress were to agree to those cuts (and that’s a big if), advocates say the global impact of America’s abrupt departure from world health and disaster relief would be immediate — and devastating.
“The family planning elimination is the headline here,” said Rachel Silverman, a senior policy analyst on global health at the Center for Global Development. “It will have the most impact on people’s lives.”
But Trump’s proposed cuts to food aid and disaster relief would also deal a major blow to some of the world’s neediest and most desperate. Marilyn Shapley, a top official at the aid group Mercy Corps, said some 70 million people need emergency food assistance, while 20 million more are in famine-like conditions.
“This is going to take away food assistance from 33 million people in a year when famine risk is higher than in decades,” she said in an interview. “Before today I wouldn’t have thought it possible.”
Funding family planning actually makes economic, not just moral, sense
This isn’t the first time the Trump administration has taken aim at global family planning and women’s health.
In January, Trump reinstated the “Mexico City Policy,” also known as the global gag rule, which literally bars family planning providers from mentioning abortion in their work. (The United States has long banned funds for abortion services.)
The policy is one that changes depending on the party of the president in power. Obama immediately rescinded the policy when he moved into the White House; Trump, like other Republican presidents before him, immediately reinstated it when he came into office. As I wrote in January, the policy has traditionally limited the ability of global family planning providers to give women and families comprehensive care if in any aspect of their work they recommend, discuss, or even mention abortions to clients, let alone provide abortion services.
But Trump went further than his predecessors. Previous Republican administrations limited the policy to family planning providers; the Trump administration extended the gag rule to all global health providers. That meant health care providers working on everything from maternal and child health to malaria, tuberculosis, HIV/AIDS, and vaccinations were now at risk of losing all US funding if they discussed abortion in their work.
The NGO PAI estimated that the extended gag rule would affect about 15 times more US funding than the gag rule had in the past. In mid-May, when the new rule went into effect, Suzanne Ehlers, president and CEO of PAI, said Trump’s move would do “unspeakable damage to integrated care efforts.”
That’s a problem. With integrated care, a woman can come to a single clinic for, say, vaccines for her children, then see a physician about her own contraceptive needs, and finally seek advice, or refill prescriptions. In other words, she can meet all her family’s health care needs in one spot. For families traveling long distances, an all-in-one clinic makes far more sense than one clinic for maternal health and another for child care and still another for other medical services.
The Trump administration spent the first quarter of 2017 signaling plans to undermine that sort of integrated care by reinstating the gag rule and beginning to reduce US funding for maternal and infant health around the world.
In April, the administration announced it would strip the United Nations Populations Fund (UNFPA), which works on reproductive health, family planning, HIV/AIDS, and infant and maternal mortality in more than 150 countries, of all US funding. The putative reason was a specious one.
“This decision is based on the erroneous claim that UNFPA ‘supports, or participates in the management of, a program of coercive abortion or involuntary sterilization’ in China,” a statement on the UNFPA website read. “UNFPA refutes this claim, as all of its work promotes the human rights of individuals and couples to make their own decisions, free of coercion or discrimination.”
A State Department memo obtained by the Associated Press found no evidence that US money had supported forced abortion or sterilization in China.
The decision costs the UNFPA $32.5 million in funding from the 2017 budget; the United States was the fourth-largest donor to the organization.
The new budget would hit global health even harder.
Silverman noted that there’s a “dissonance” between White House messages on women and families. Ivanka Trump, the president’s daughter, has claimed to be championing the idea of women’e economic empowerment. That sort of program, Silverman says, would be completely undermined by stripping global family planning from the budget.
“There is a lot of evidence that family planning contributes to women’s empowerment,” says Silverman, ticking off a list of things that planning, delaying, and spacing pregnancies allow women to do — like receiving an education, or even simply advancing at work. “When women have control over fertility, they have control over their lives.”
Silverman points out that USAID directly funds 28 percent of contraceptives and distribution in the developing world.
“If you cross-reference that with the number of women using contraceptives in those countries — a back-of-envelope calculation — that suggests that 10 million women are directly relying on USAID for contraceptives,” she said, adding that enormous numbers of women will “see a major disruption in their lives if this goes through and other donors don’t step up in a major way.”
But there aren’t other donors looking to step in. Jonathan Rucks, who runs PAI’s advocacy efforts, says there is no other donor government that can make up the shortfall, and even major private family foundations, like the Bill and Melinda Gates Foundation, simply cannot replace the US on family planning. In February, Bill Gates told the Guardian that Trump’s proposed reinstatement of the global gag rule could “create a void that even a foundation like ours can’t fill.”
“If you are cutting maternal health funding, then you don’t care about survival of women,” Rucks says bluntly. “We are also going to be really frank and say this is not pro-life. This is undermining all your pro-life credentials.”
by Michelle Morse
Praxis, May 17, 2017
https://www.kzoo.edu/praxis/global-health-backlash/
Over the past thirty years, American medicine has witnessed an unprecedented expansion in global health engagement amongst its trainees and faculty, partially, if not largely, fueled by the health care injustices lived so dramatically by patients in resource-limited countries around the world during the HIV/AIDS epidemic. Initially seen as disruptive, the interventions in the health sectors of Global South countries by American health professionals were eventually accepted as essential acts in the movement towards achieving global health equity. As America experiences the Trump era, endless questions have arisen amongst global health professionals about the implications of Trump’s “America first” platform on global health. Will Trump’s nationalist agenda eliminate funding for life-saving global health programs, cause progressive health professionals engaged in global health to make a reactionary turn towards the fire at home, and even force global health practitioners to more closely examine their own prejudices?
It is no secret that American physicians leading the guard in global health tend to be part of the political left. Global health tends to attract left leaning physicians because of the global health movement’s belief that every human being has a right to receive high quality health care. Asserting that Global North countries have a responsibility to contribute towards strengthening health care systems in the Global South (a redistribution of resources, of sorts), global health offers the opportunity to practically address urgent health care access inequities in the Global South. Considering these principles, global health professionals like myself are deeply frustrated by the Trump administration’s efforts to repeal the Affordable Care Act and cut global health spending at USAID and other similar programs. Though many of us are rightfully drawn towards activism in the USA to resist these moves by the new administration, I worry that the health and health systems of the Global South will suffer if the majority of global health professionals shift to focus domestically without continuing their engagement in global health.
While some would say that the current neoliberal structure of development aid is already ineffective, especially since so many of the aid resources are actually directed back to the country where the aid comes from, what would it mean if global health funding was eliminated, and American global health professionals suddenly focused exclusively on domestic health? Would it allow Global South countries to assume stronger leadership, decision-making, and self-directed problem solving? Or would it mean that Global South communities would be even more deprived of much needed resources and health care access? Post-earthquake Haiti, where I have worked for seven years and lived for two of those years, is one compelling example of both the peril and the potential of aid. Of the $8 billion US funds provided in aid after the earthquake, less than 1% went to the Haitian government who was ultimately responsible for rebuilding the country. Yet, as appalling as this statistic is, it does not adequately describe the individual impact of short- and long-term global health engagement by American health professionals in response to the earthquake. Take EqualHealth for example, the organization I co-founded. EqualHealth is a nongovernmental organization focused on bringing light to the socially determined root causes of illness and creating equity in opportunity for Haitian health professionals whose talent and vision are often overshadowed by negative media narratives about Haiti, weaknesses in the Haitian public health system, and limited opportunities for professional development. All things considered, the reality is that countries like Haiti rely on the shrinking aid from global health programs such as PEPFAR to keep their health systems running despite fluctuations in attention from the donor world. Where Global South countries would find themselves without USAID, or partnership with Global North health professionals, or other mechanisms to ensure more adequate resources for pressing health concerns is as predictable as where Americans, who rely on the Affordable Care Act for health insurance, will find themselves when it is repealed and replaced with a market-based solution.
What I have witnessed in my academic institution is an exciting and growing interest amongst trainees in building infrastructure to resist the new administration’s domestic health care and civil rights policies. To mount a harmonized response, they are looking into establishing indivisible chapters and partnerships with community based organizations, learning and using direct action methods such as bird-dogging, non-violent protest, and holding teach-ins on community organizing. These are often the very same trainees that are also interested in global health. Though many of them are considering careers in global health, opportunities for long-term global health engagement with clear career paths and mentorship are often limited, and may now become even more limited given the policies of the new American administration. On the other hand, recent significant increases in donations to organizations like Planned Parenthood could mean new opportunities for engagement for these trainees, shaping careers focused on domestic health care. This is occurring at a time when structural competency and social medicine are emerging as key areas of focus in medical school and residency curricula, and trainees are being encouraged to engage in activism as a professional obligation rather than aspiration. Health professionals often hesitated to engage in activism as it was not an explicit part of their training, and opportunities to act were difficult to identify, but these barriers seem to be evaporating under the new administration.
In response to mounting evidence documenting how health care provider prejudice impacts health, American medical schools are also developing competencies in which trainees and faculty alike are encouraged to reflect on their personal biases. These competencies are even more relevant now as the policies of this new administration threaten the rights and livelihoods of people of color, women, Muslims, and immigrants. Efforts to establish global health competencies, while laudable, have often been silent on addressing the issues of racism, sexism, and other forms of prejudice amongst global health professionals. The social and cultural power and privilege clash that occurs when predominantly white global health professionals from Global North countries descend on countries in the Global South to work hand in hand with local health professionals who are predominantly people of color is a tinderbox for racism and prejudice in all its forms. The global health movement can learn from the new light being shed on the old problem of racism, as a result of the racist policies and messages coming from the Trump administration in its first 100 days. The global health movement needs to take the necessary steps to explicitly address racism and other forms of prejudice amongst its members, and ask honest questions about why more Americans of color are not currently a part of it. The far too common assumption that being left leaning, progressive, or engaged in global health is incompatible with being racist is simply incorrect.
As communities and countries in the Global South continue to suffer the consequences of neoliberalism-induced fragile health systems, some global health professionals may decide to deepen their engagement outside the USA, attempting to flee the nationalist, racist, and sexist trends of the new administration by moving and working abroad. Other global health professionals may decide to engage domestically to resist the actions of the new administration, seeing the battle for health care access and civil rights at home as more urgent and compelling. Ideally, all progressive global health professionals, whether choosing a domestic or globally focused path, will begin to address their own prejudices in new action-oriented ways.
There is a delicate but important balance between advocating for ongoing American engagement in addressing global health inequities, while also addressing domestic health care threats. One shouldn’t be prioritized over the other or at the expense of the other, as they represent two parts of the same global battle for health as a human right that culminated in the Alma Ata Declaration, lost its way, and is reemerging. Perhaps the real test will lie in America’s response under the Trump administration to the next Ebola, the next Zika, or the next HIV/AIDS epidemic.
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AfricaFocus Bulletin is an independent electronic publication providing reposted commentary and analysis on African issues, with a particular focus on U.S. and international policies. AfricaFocus Bulletin is edited by William Minter.
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http://en.granma.cu/cuba/2017-03-31/cuban-doctors-head-to-peru-in-the-wake-of-severe-flooding
Cuban doctors departed for Peru early this Friday, March 31, to provide services in areas of the country affected by the recent heavy rains. On leaving, they dedicated their solidarity efforts to the historic leader of the Cuban Revolution, Fidel Castro
Cuban health personnel departed for Peru early this Friday, March 31, tasked with providing services in areas of the country affected by the recent heavy rains.
Gathered at the Central Medical Cooperation Unit for a farewell ceremony yesterday evening, they dedicated their solidarity efforts to the historic leader of the Cuban Revolution, Fidel Castro.
They were joined by Public Health Minister Roberto Morales Ojeda, who presented this 23rd Brigade of the Henry Reeve International Contingent of Doctors Specializing in Disasters and Serious Epidemics, with the customary Cuban flag.
The 23-strong brigade is made up 12 physicians and 11 health professionals, with more than ten years experience and having fulfilled other international missions.
Morales Ojeda, who is also a member of the Party Political Bureau, noted that the Henry Reeve Contingent was formed as part of the solidarity initiatives led by Fidel, and that today 50,000 Cuban collaborators are offering their services across 62 countries.
The Minister also told reporters that the brigade is armed with 7.2 tons of medicines and expendable supplies, which will allow these professionals to provide health care services to some 20,000 people.
Dr. Rolando Piloto, leading the medical mission, noted that Cuba has provided solidarity of this kind on two previous occasions to the people of Peru, flowing earthquakes in May, 1970, and August, 2007.
More in Congress Sign On As CoSponsors of HR 676, Single Payer Healthcare Bill In December six representatives, Danny Davis (IL), Grace Napolitano (CA), Emanuel Cleaver (MO), Jerry McNerney (CA), Robin Kelly (IL), and Alan Lowenthal (CA), added their names as cosponsors on HR 676, Congressman John Conyers' Expanded and Improved Medicare for All, the national single payer legislation. The total number of cosponsors is now 59, not including chief sponsor Conyers. The more cosponsors that are added, the more quickly this real solution becomes politically viable. The more representatives who speak boldly for HR 676, the higher single payer advances on the nation's agenda. Call your representative and ask her or him to sign on to HR 676. The Capitol switchboard number is (202) 224-3121. Ask to speak to your representative by name. If you need to look up a representative, you can do so here. When talking with representatives who have already signed on, encourage them to speak up for HR 676 on the House floor, to the press, in town hall meetings, and to put their support for HR 676 on their website. If they need further information, spend the time to bring the facts about HR 676 to their attention. This clear and simple statement of Dr. Marcia Angell may help. The list of representatives who have already signed on to HR 676 is here. The list of representatives who were cosponsors of HR 676 in earlier Congresses but have not yet signed on in the 114th is below. This is a good place to start. Rep. Xavier Becerra, California 34th Rep. Sanford D. Bishop, Jr., Georgia 2nd Rep. Corrine Brown, Florida 5th Rep. G. K. Butterfield, North Carolina 1st Rep. Andre Carson, Indiana 7th, Rep. Marcia Fudge, Ohio 11th, Rep. Eddie Bernice Johnson, Texas 30th, Rep. David Loebsack, Iowa 2d Rep. Nita M. Lowey, New York 17th Rep. Ben Ray Lujan, New Mexico 3d Rep. Stephen F. Lynch, Massachusetts 8th Rep. Gregory W. Meeks, New York 5th Rep. Donald M. Payne, Jr., New Jersey 10th Rep. Jared Polis, Colorado 2nd Rep. David Scott, Georgia 13th Rep. Bennie G. Thompson, Mississippi 2nd Rep. Nydia M. Velazquez, New York 7th Rep. Peter J. Visclosky, Indiana 1st Rep. Maxine Waters, California 43rd "According to myth…a single-payer system is a good idea, but unrealistic.... What is truly unrealistic is anything else." --Marcia Angell, MD, former editor-in-chief, New England Journal of Medicine, June 10, 2009 #30# HR 676 would institute a single payer health care system by expanding a greatly improved Medicare to everyone residing in the U. S. Patients will choose their own physicians and hospitals. HR 676 would cover every person for all necessary medical care including prescription drugs, hospital, surgical, outpatient services, primary and preventive care, emergency services, dental (including oral surgery, periodontics, endodontics), mental health, home health, physical therapy, rehabilitation (including for substance abuse), vision care and correction, hearing services including hearing aids, chiropractic, durable medical equipment, palliative care, podiatric care, and long term care. HR 676 ends deductibles and co-payments. HR 676 would save hundreds of billions annually by eliminating the high overhead and profits of the private health insurance industry and HMOs. In the current Congress, HR 676 has 59 co-sponsors in addition to Congressman Conyers. HR 676 has been endorsed by 622 union organizations including 151 Central Labor Councils/Area Labor Federations and 44 state AFL-CIO's (KY, PA, CT, OH, DE, ND, WA, SC, WY, VT, FL, WI, WV, SD, NC, MO, MN, ME, AR, MD-DC, TX, IA, AZ, TN, OR, GA, OK, KS, CO, IN, AL, CA, AK, MI, MT, NE, NJ, NY, NV, MA, RI, NH, ID. For a list of union endorsers, or a sample endorsement resolution, contact: Kay Tillow All Unions Committee for Single Payer Health Care--HR 676 c/o Nurses Professional Organization (NPO) 1169 Eastern Parkway, Suite 2218 Louisville, KY 40217 (502) 636 1551 Email: nursenpo@aol.com  http://unionsforsinglepayer.org https://www.facebook.com/unionsforsinglepayer
Africa/Global: Health Challenges & Threats
AfricaFocus Bulletin
October 13, 2015 (151013)
(Reposted from sources cited below)
Editor’s Note
Last week was the first week since March 2014 that no new cases of
Ebola were reported in the affected West African countries. And late
last month the World Health Organization announced official
guidelines for beginning antiretroviral therapy for all persons
infected with HIV even before they show symptoms of AIDS. Fully
eradicating either disease and building sustainable health system
remain formidable challenges, however. At the same time, U.S.
policy to promote greater protection for large pharmaceutical
companies in trade negotiations poses a still rising threat to
global efforts to guarantee the universal right to health.
For a version of this Bulletin in html format, more suitable for
printing, go to http://www.africafocus.org/docs15/rth1510.php, and
click on “format for print or mobile.”
To share this on Facebook, click on
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This AfricaFocus Bulletin contains one short article on the threat
to health in the least developed countries from hard-line U.S.
policy on protection for pharmaceutical companies, followed by links
with short excerpts from other recent articles on Ebola, the cost of
medicine and the current dysfunctional pharmaceutical system,
HIV/AIDS, and a promising advance in medical technology providing
cost-effective blood auto-transfusion in developing countries.
While progress has been made both on the long-term pandemic HIV/AIDS
and the West African Ebola epidemic more recently, neither battle is
completely won. Neither have the economic, personal, and societal
damages been repaired, nor the world’s health systems prepared for
new epidemics, nor the necessary resources invested to guarantee the
universal right to health.
For previous AfricaFocus Bulletins on health and related issues,
visit http://www.africafocus.org/intro-health.php
The WHO Ebola Situation Report is available at
http://apps.who.int/ebola/ebola-situation-reports
Updates on AIDS are available at http://www.unaids.org
Frequent updates on the status of access to medicines are available
on the MSF / Doctors Without Borders website on this issue at
http://www.msfaccess.org/
++++++++++++++++++++++end editor’s note+++++++++++++++++
LDCs be damned:Â USTR and Big Pharma seeks to eviscerate Least
Developed Countries’ insulation from pharmaceutical monopolies
Professor Brook K. Baker, Health GAP and Northeastern U. School of
Law
HealthGap blog, October 12, 2015
http://www.healthgap.org/blog – Direct URL:
http://tinyurl.com/pbhd94q
Professor Brook K. Baker, Health GAP (Global Access Project) &
Northeastern U. School of Law, Program on Human Rights and the
Global Economy
Honorary Research Fellow, Faculty of Law, Univ. of KwaZulu Natal, SA
In November of 2001, at the height of the global AIDS pandemic,
every WTO member country in the world, including the United States,
voted unanimously in the Doha Declaration on the TRIPS Agreement and
Public Health that WTO Least Developed Countries members should be
granted an unconditional extension of any obligation to grant or
enforce patents, data protections, or exclusive marketing rights on
pharmaceutical products. These countries desperately needed access
to affordable generic medicines and freedom from the pillage of Big
Pharma’s monopoly pricing. This sensible and humane transition
policy was confirmed by votes of the WTO TRIPS Council and General
Council in 2002.
Fast forward to 2015, and LDCs are again seeking an extension of
that same no-pharmaceutical-monopolies policy, which expires on
January 1, 2016. Their request has reportedly received approval in
nearly every capital of the world – except Washington D.C. (with
some weakening opposition from Australia, Canada, and Switzerland).
Nothing in the plight of least developed countries has changed –
they remain desperately poor, they continue to lead the world in
negative health statistics and early death, and they continue to
struggle with development challenges and inadequate capacity in
their industrial, technological, and administrative sectors. More
to the point, they continue to need access to affordable medicines,
and, if possible, new manufacturing capacity and expertise to
produce at least some medicines on their own.
What the LDCs seek is simple: rather than another time limited
extension (even a relatively long 15 year one like the one they
first got), is an extension that lasts as long as they remain an
LDC. Once an LDC member transitions to lower-middle income status,
its obligation to begin to process, grant, and enforce patents and
data protections on medicines would change. But in the meantime,
countries that were still LDCs could import cheaper generics legally
from abroad or manufacture them locally with no intellectual
property restrictions whatsoever.
What does the United States Trade Representative want – what pound
of flesh is it seeking from LDCs for an further extension that is
guaranteed to them by paragraph 7 of the Doha Declaration and by
Article 66.1 of the TRIPS Agreement? After all those documents
state that initial TRIPS transition periods, like LDCs had for
pharmaceuticals, were granted without prejudice to further
extensions and that WTO member “shall, upon duly motivated request
by a least-developed country Member, accord extensions [of LDC
TRIPS-compliance transition periods].” In this context, “shall”
means “must,” no “ifs,” “ands,” or “buts.”
Instead of acceding to these clear TRIPS mandates, the USTR is
unwilling to discuss an extension for as long as an LDC remains an
LDC and instead is demanding a more miserly, time-limited extension.
The US has been unwilling to state its position publicly. Instead,
it has selectively listened to corporate “stakeholders” at home,
namely PhRMA and BIO, who oppose an unlimited extension because …
well, because of what they say to back up every IP monopoly demand:
“We need more profits, even from the poorest countries in the world,
in order to research the next generation of life saving medicines.”
Unfortunately, the USTR has not listened to access-to-medicines
advocates who wrote a letter urging US support for the LDC extension
over a month ago with no response to date. Nor is the USTR
listening to other “key” US stakeholders including Senator Sanders,
and Representatives Jan Schakowsky (D-Ill.), Rosa DeLauro (D-Conn.),
Jim McDermott (D-Wash.), Raúl M. Grijalva (D-Ariz.), Keith Ellison
(D-Minn.), Barbara Lee (D-Calif.), and Sam Farr (D-Calif.), elected
officials who have all have expressed unequivocal support for the
LDC request. Even the European Commission has voted unanimously in
favor of the unlimited extension.
At a meeting in Geneva with 15 Ambassadors from the LDC Group on
Friday October 9, Ambassador Michael Punke, Deputy United States
Trade Representative and U.S. Ambassador and Permanent
Representative to the World Trade Organization, and gave a
startling, unbelievably craven and subservient justification for the
US demand for a short-duration extension. He said that Big Pharma
was disappointed with the additional intellectual property and
pharmaceutical protections the US secured for it in Trans Pacific
Partnership negotiations and thus that the US could not give ground
on the LDC extension.
Right, the poorest countries in world should get shortchanged on
their desperately needed access to more affordable generic medicines
because Big Bio did not get 12 years of data exclusivity monopoly
protections on their $100,000-plus per-patient-per-year biologics.
The USTR’s policy positions on the LDC extension request are deadly.
They cynically safeguard Big Pharma’s global monopoly empire with
potential catastrophic effects on LDCs ability to strengthen their
human and technological well-being. At a time when we see migrants’
bodies washing onto European beaches, the USTR wants to make sure
that pharmaceutical capacity is stillborn in many of the countries
those migrants come from. This dour and ethically demented policy
position cannot stand.
Is President Obama’s administration so out of touch with
humanitarian values and common decency that it wants the US to be
the sole country at the WTO to oppose a mandatory, unconditional
pharmaceutical extension for LDCs that is their legal right?
*************************************************************
Links on Ebola (with very short excerpts)
(1)http://www.npr.org/sections/goatsandsoda – Direct URL:
http://tinyurl.com/q7trnqv
Amy Maxmen, “To Prevent The Next Plague, Listen To Boie Jalloh,” NPR
Goats & Soda, Oct. 8, 2015
“This is a landmark week in West Africa. For the first time since
the Ebola outbreak, there were no new cases reported in Guinea,
Liberia and Sierra Leone.
There are many unsung heroes who deserve credit for this milestone.
One of them is Dr. Boie Jalloh, age 30. Ten days after he showed up
for his medical residency at 34th Military Hospital in Freetown,
Sierra Leone, he received a letter requesting his presence at the
hospital’s newly constructed Ebola unit.”
“To me, first and foremost, I wish the government and our
international partners would invest in medical education. We really
need more doctors and nurses here — we needed them before Ebola. You
can supply all the drugs you want, but people won’t be able to get
those drugs if there is only one health care provider for 10,000
people. [Note: According to the World Bank, the number is 1.8 —
compared to 100 in the U.S.]”
(2) http://www.eboladeeply.org / Direct URL:
http://tinyurl.com/obf26pm
Brooks Marmon, “In Liberia, Paying Tribute to Those Who Sang Against
Ebola,” Ebola Deeply, Sept. 22, 2015
Last week, the conference room of Monrovia’s Young Men’s Christian
Association (YMCA) was decked out in red, white and blue balloons:
the colors of Liberia’s Lonestar flag. The event? A tribute by the
Musicians’ Union of Liberia (MULIB) to the artists – singers, hip-co
stars, songwriters and other musicians – who joined the Ebola fight.
Bernard Benson, better known as D.J. Blue, the manager of Hott FM,
one of Liberia’s most popular radio stations, was the M.C. for the
event. He set the tone by noting, ‘We took Ebola from 100 percent to
0.0 … no one must underestimate what Liberian music did. It
resonated to every Liberian, to the people that matter.’ G. Bennie
Johnson, MULIB’s vice president, echoed his words, adding that
‘musicians have the power, real power, to do something good for this
country.’
Nearly a dozen videos accompanying Ebola awareness songs were
screened as part of the festivities.”
[see full article at link above for embedded videos.]
*************************************************************
Links on Cost of Medicines (with very short excerpts)
(1) http://www.doctorswithoutborders.org – Direct URL:
http://tinyurl.com/qchbgz5
MSF / Doctors without Borders, “The Cost of Medicine,” Alert, Fall
2015, pages 10-12 on “Fundamental Changes Needed in the Biotechnical
Innovation System.”
“A primary driver of biomedical innovation is public funding coupled
with the granting of patents and other intellectual property rights
that give pharmaceutical companies exclusive domain to make and sell
a new medicine or vaccine for a stipulated period of time. This in
turn gives companies monopoly control over the market for that
product, allowing them to charge high prices and inhibiting
competition that would drive down costs.
Companies therefore decide where to allocate resources based on the
revenues they believe a particular product could generate, not the
public health burden they could address. What this means in
practical terms is that public health priorities and needs rarely
determine how corporate efforts are directed. In the current
ecosystem, companies watching their profit margins and stock prices
are effectively dis-incentivized from focusing resources and
attention on diseases and conditions that primarily affect people in
the developing world, people who don’t represent a lucrative market.
From our vantage point, it’s a broken system that is both
inefficient and ineffective at responding to the most pressing
global public health needs. And our field teams witness these costs
on a daily basis.”
“In addition, there is a lack of transparency from the
pharmaceutical industry, so we don’t really know what the R&D costs
are for specific products, what proportion of a given product was
publicly financed, or how much it costs to manufacture. The accuracy
of industry-funded estimates on the cost of developing a drug is
questionable at best.
(2) http://www.msfaccess.org/ / Direct URL:
http://tinyurl.com/o7yj4ms
MSF Access, “TPP trade pact will deepen global crisis of exorbitant
drug prices unless dangerous terms are removed.” Press release,
Sept. 25, 2015
“As public outrage about exorbitant drug prices features in new
headlines in the US and around the world, negotiators and trade
ministers from the 12 Trans-Pacific Partnership (TPP) countries are
converging in Atlanta to potentially finalize the trade pact, which
has been negotiated in secret over a period of more than five years.
Recent leaked copies of the TPP’s intellectual property chapter
confirm the inclusion of harmful rules that will lock in high prices
and block affordable generic medicines for years. MSF urges all TPP
countries to firmly reject provisions that will deepen the global
crisis of unaffordable medicines and health products.”
Also includes link to 4-page briefing paper on the TPP: “Trading
Away Health”
*******************************************************
Links on HIV/AIDS (with very short excerpts)
(1)http://www.healthgap.org/blog – Direct URL:
http://tinyurl.com/qdbyf52
Health GAP, “Celebration and Call to Action – New WHO Guidelines on
HIV Treatment and PrEP
“(September 30, 2015) Health GAP welcomes the World Health
Organization’s release of new global guidelines on HIV treatment,
recommending that all people living with HIV be started on HIV
treatment regardless of disease stage and encouraging expanded
availability of pre-exposure prophylaxis (PrEP) to groups at
particularly high risk of contracting HIV.
Earlier guidelines recommended that health care providers wait until
people with HIV reached a certain level of disease progression
before starting treatment, despite the fact that years ago many
wealthy countries including the United States had already begun
providing treatment immediately upon diagnosis to all people living
with HIV regardless of how advanced their disease. The shift in
guidelines comes after new results from the NIH-funded START trial,
which provided conclusive evidence of the benefits of immediate
initiation in May of this year.”
“Only 15 million people are currently on treatment and 37 million
are infected, meaning that an additional 22 million people are now
eligible for immediate treatment. HIV testing has to be
significantly increased, people need to be enrolled in treatment
when they test positive, and they will need durable connection to
quality care.”
“Unfortunately donors and major funders are acting as if additional
resources are not needed. Just a few days ago the US announced a
major initiative to expand treatment and to reduce infections among
young women, but it identified no additional resources. ‘Preliminary
estimates show that the US must add at least $300 million new
dollars each year over the next few years to existing global AIDS
funding to help meet the new treatment and prevention goals,’ said
Professor Brook Baker, Health GAP’s Senior Policy Analyst.”
(2) http://www.thelancet.com/ – Direct URL:
http://tinyurl.com/nq5btzp
“Vancouver Consensus: antiretroviral medicines, medical evidence,
and political will,” The Lancet, August 8, 2015
“In 1996, the global HIV community gathered in Vancouver, Canada,
for the XI International AIDS Conference and shared the clear
evidence that triple-combination antiretroviral treatment held the
power to stem the tide of deaths from AIDS. The HIV treatment era
had begun. As we gathered again in Vancouver in July, 2015, it was
clear that a new transformative moment is upon us. The Vancouver
Consensus statement,1 which emerged at the recently concluded 8th
International AIDS Society Conference on HIV Pathogenesis, Treatment
and Prevention (IAS 2015), signals the scientific affirmation that,
rather than limiting access to those who are immune compromised,
immediate access to antiretroviral medicines holds the power to
rapidly advance the fight to end AIDS.
The consensus—signed by more than 500 researchers, clinicians, and
civil society experts—is clear: ‘All people living with HIV must
have access to antiretroviral treatment upon diagnosis. Barriers to
access in law, policy, stigma and bias must be confronted and
dismantled. And as part of a combination prevention effort, PrEP
(Pre-Exposure Prophylaxis) must be made available to protect those
at high risk of acquiring HIV. The strategic use of ARVs—through
treatment and other preventive uses—can save countless millions of
lives, reduce new infections, and move us vastly closer to our goal
of ending the epidemic. A new era of opportunity against this
epidemic has dawned, and we must seize it.’
…
Medical evidence is unambiguous. At this point, further delays
threaten not only millions of lives but also threaten a resurgence
of this pandemic. But if we act rapidly, we can drive down HIV
incidence, death, and long-term costs. Political will is needed to
complete the work of what can be one of the most effective public
health interventions in history.”
*****************************************************
Links on technical advances for developing countries
Sisu Global Health (http://www.sisuglobalhealth.com/)
A recent start-up led by three women from Michigan, Sisu Global
Health was initially based in Grand Rapids, Michigan, and has
recently moved to Baltimore, near the Inner Harbor.
“The Hemafuse [now being tested by doctors in Zimbabwe and Ghana] is
a manual autotransfusion device is that used to retransfuse a
patient’s own blood during an internal hemorrhage, specifically
ruptured ectopic pregnancies or road traffic accidents. The current
procedure commonly used in Sub-Saharan Africa consists of salvaging
blood with a kitchen soup ladle and filtering it with gauze.
Compared to this soup ladle autotransfusion, Hemafuse takes 1/3 of
the time, 1/9 of the staff, and is significantly safer. The Hemafuse
functions much like a giant syringe to suction blood through a
filter when a handle is pulled up. When the handle is pushed down
the blood is transferred directly to a blood bag in a closed
system.”
“This device is surgical – meaning that it can intervene during a
pivotal moment in an individual’s care. Compared to most moments
when autologous blood transfusion occurs, the Hemafuse, as an
intervention, will be both more urgent and more evident in terms of
results. Its handheld, sleek design reduces both blood flow issues
and failure modes from a slippery, gloved hand mid-surgery. In many
of the surgical suites that we’ve been in, space is at a premium.
Improvements on hospitals and buildings are not keeping up with the
increase in patient admittance and population growth, meaning
smaller rooms for more people.
This device, as one Tanzanian doctor put it, will eliminate a
‘messy’ and sometimes futile process.
All opinions from these doctors point to the success of this device,
however, the glaring fact that autotransfusion, the recycling of a
person’s own blood, has been debated solely in Western countries. Of
all the published material concerning African healthcare, only 1-2%
have contributions from the continent’s own physicians.
Additionally, these articles and the repository services that
attempt to collect thousands of articles are often not
internationally indexed to include African medical papers. They come
from a continent that has been performing autotransfusion for years,
but whose voices have not been given the mechanism to be heard in
the medical community.”
*****************************************************
AfricaFocus Bulletin is an independent electronic publication
providing reposted commentary and analysis on African issues, with a
particular focus on U.S. and international policies. AfricaFocus
Bulletin is edited by William Minter.
AfricaFocus Bulletin can be reached at africafocus@igc.org. Please
write to this address to subscribe or unsubscribe to the bulletin,
or to suggest material for inclusion. For more information about
reposted material, please contact directly the original source
mentioned. For a full archive and other resources, see
http://www.africafocus.org
AfricaFocus Bulletin
July 29, 2015 (150729)
(Reposted from sources cited below)
Editor’s Note
In analyzing high-profile presidential visits, it is difficult to
sort out symbolism from substance in the sheer volume of news
coverage and commentary. And despite the flurry of announcement of
“deals” at each stop, the main lines of policy are rarely altered
and often reflect continuity not only within one presidential
administration but also from one administration to another. The
content of private conversations of lower-level officials as well as
others involved in the visits may be just as significant as the
formal meetings of presidents. Even more significant may be the
issues not discussed because common assumptions go unquestioned on
both sides.
For a version of this Bulletin in html format, more suitable for
printing, go to http://www.africafocus.org/docs15/usaf1507.php, and
click on “format for print or mobile.”
To share this on Facebook, click on
https://www.facebook.com/sharer/sharer.php?u=http://www.africafocus.org/docs15/usaf1507.php
As regular readers know, AfricaFocus seeks to select and repost
particularly insightful news and commentary that readers might not
have seen elsewhere. With such a visible event, that is difficult.
The “news” is available to anyone who has internet access and is
paying attention. And almost all the commentary is predictable and
repetitive.
So this issue of AfricaFocus is different, and consists primarily of
links for readers to explore as they wish, to supplement what they
have already seen or read.
I have included (1) links to the speeches that seemed to me most
significant, (2) suggestions for custom google searches that might
turn up a wide variety of other sources, (3) links to a few
commentaries, including audio from radio programs in which your
editor was included, and (4) links to previous AfricaFocus Bulletins
covering questions that were “off the radar screen” in the visit as
well as in media commentary.
++++++++++++++++++++++end editor’s note+++++++++++++++++
President Obama’s Speeches
Among the speeches and other events made available by the White
House in video form or transcripts, these stand out, particularly
the first. Unfortunately neither the introduction by his sister in
Kenya nor the remarks by African Union Chairperson Nkosazana Dlamini
Zuma were kept on-line by the White House, although they were
available in the live webcast.
President Obama’s Speech to Kenyan People, July 26, 2015
Video: https://www.youtube.com/watch?v=x_Kw9YnNXJk
Transcript: http://tinyurl.com/qbh23t9
President Obama’s Speech to African Union, July 28, 2015
Video: https://www.youtube.com/watch?v=BNife3N3X0Q
Transcript: http://allafrica.com/stories/201507281847.html
Custom Google Searches
Note: With the “site:” operator, one can limit a google search to a
single website or to all websites with the same country code, to get
a better idea of how an event or a topic is covered. Some examples
for President Obama’s trip include these, including the two
principal international organizations focusing on human rights
issues:
* Obama visit to Africa 2015
* Obama visit to Africa 2015 site:nytimes.com
* Obama visit to Africa 2015 site:amnesty.org
* Obama visit to Africa 2015 site:hrw.org
* Obama visit to Africa 2015 site:allafrica.com (includes many
articles from African press)
* Obama visit to Africa 2015 site:saharareporters.com
* Obama visit to Africa 2015 site:.ke (from websites in Kenya)
* Obama visit to Africa 2015 site:.et (from websites in Ethiopia)
search web not news since .et not well-represented in news)
Additional country codes can be found at
http://www.web-l.com/country-codes/
Several short articles I found worth noting:
Simon Allison, “Barack Obama’s convenient truths,” Daily Maverick,
July 27, 2015
Oped: http://tinyurl.com/o64s46p
Simon Allison, “Obama at the African Union,” Daily Maverick, July
28, 2015
News: http://tinyurl.com/oduwce4
Hassen Hussein, “What exactly is Obama’s Africa legacy?,” Al
Jazeera,
July 28, 2015
Opinion: http://tinyurl.com/ne2f28y
Paul Korin, “A visit of firsts, but Obama’s Africa policy mostly
symbolic,” Globe and Mail, July 28, 2015
http://tinyurl.com/pnj3sp6
Audio of radio interviews in which I participated:
KPFA Sunday Show, July 26, 2015, 1st hour, interview with William
Minter, Editor, AfricaFocus Bulletin
Audio: https://kpfa.org/player/?audio=210725
KPFA Upfront, July 27, 2015
Horace Campbell, Syracuse University and William Minter, Editor,
AfricaFocus Bulletin
Audio: https://kpfa.org/player/?audio=211164 (start at 34 minutes)
WPFW, July 29, 2015 1pm-2pm Eastern US time – Mwiza Munthali with
Nii Akuetteh and William Minter – will be live at
http://www.wpfwfm.org/radio/
and later archived at
http://www.wpfwfm.org/radio/programming/archived-shows
Aspects of Topics Avoided, with some links to previous AfricaFocus
Bulletins
* On Counter-Terrorism
With the exception of President Obama’s diplomatic critique of
Kenyan and Ethiopian use of the threat of terrorism as an excuse
human rights violations, there was little reference to other
critiques of the policies of USA, Kenya and Ethiopia. For
alternative views, see in particular the background history and
commentary on the USA, Kenya, and Ethiopian involvement in Somalia
at http://www.africafocus.org/country/somalia.php, particularly
http://www.africafocus.org/docs15/gar1504.php,
http://www.africafocus.org/docs15/som1502.php,
http://www.africafocus.org/docs11/som1108.php, and
http://www.africafocus.org/docs07/som0701a.php
* On Corruption & “Illicit Financial Flows”
While President Obama spoke eloquently about corruption in Africa,
and briefly mentioned “illicit financial flows” in response to a
remark by African Union Chairperson Nkosazana Dlamini Zuma, there
was clearly no recognition of the critical role played by
multilateral institutions in the United States and the international
financial system more generally in extracting capital from Africa.
For coverage of this, see, in particular, the recent
AfricaFocus Bulletin on “Stop the Bleeding”
(http://www.africafocus.org/docs15/iff1507.php) as well as previous
AfricaFocus Bulletins on related issues
(http://www.africafocus.org/intro-iff.php)
See also the July 27 article by Soren Ambrose of ActionAid
International, “Opinion: Developing Nations Set to Challenge Rich
Ahead of SDG [Sustainable Development Goals] Summit,”
http://tinyurl.com/nr7po7g
* On Economic Policy
Despite brief mentions of the need to address inequality and jobs,
the dominant assumption in President Obama’s speeches was the
“trickle-down” theory that all “trade and investment” will
eventually pay off for all, and that the primary engine of growth is
the private sector. And while there was much mention in the press of
the competition between China and the United States, there was scant
mention, if any, of alternate African and global perspectives on
sustainable development strategies deviating from the dominant U.S.
market fundamentalism.
For previous AfricaFocus Bulletins including material on economic
growth and strategies, visit http://www.africafocus.org/econexp.php
* On Climate Change
Although there was much talk of “Power Africa,” the approach
paralleled the Obama administration’s domestic policy in its stance
toward fossil fuels and renewable energy, namely “all of the above.”
Despite brief references to off-the-grid and renewable energy, much
of the private investment to come under the “Power Africa” label is
likely to support traditional fossil fuels, particularly natural gas
power generation. And there were no new commitments to major
increases in global funding to support climate change mitigation.
For a wider discussion of these issues in previous AfricaFocus
Bulletins, visit http://www.africafocus.org/intro-env.php
* On Health
In spite of token references to AIDS and Ebola, the visit did not
focus major attention on health challenges, including the need for
adequate financing for major investments in public health
See http://www.africafocus.org/intro-health.php for AfricaFocus
talking points and previous Bulletins.
*****************************************************
AfricaFocus Bulletin is an independent electronic publication
providing reposted commentary and analysis on African issues, with a
particular focus on U.S. and international policies. AfricaFocus
Bulletin is edited by William Minter.
AfricaFocus Bulletin can be reached at africafocus@igc.org. Please
write to this address to subscribe or unsubscribe to the bulletin,
or to suggest material for inclusion. For more information about
reposted material, please contact directly the original source
mentioned. For a full archive and other resources, see
http://www.africafocus.org
MLToday
CPUSA National People’s World Political Affairs