I’m honored to be traveling in China this week on behalf of Hope Through Healing Hands as a member of the Global Board of Directors for The Nature Conservancy. We will be spending eight days at the intersection of global health and nature, conservation and climate. Climate change disproportionately affects the most vulnerable people in the world, and I’m looking forward to learning more about how we can help both conservation efforts and global health.

May 4, 2016 | The Hill

U.S. Capitol

While headlines harp that the U.S. is a nation “hopelessly divided,” there is something lawmakers can band together on: forging a solution to our obesity epidemic.  In addition to being one of the greatest health threats our nation has ever faced, it is a terrible burden for employers, who are forced to spend more than $73 billion in costs associated with overweight-related medical and lost productivity costs every year. Obesity also threatens national security, as the leading medical reason why 71 percent of young adults between the ages of 17 and 24 cannot qualify for military service.

The good news is that Congress has the opportunity to sustain recent improvements to school nutrition programs—a major step forward since many young people consume up to half of their daily calories during the school day.

That’s the headline from Capitol Hill, thanks to the Senate Agriculture Committee unanimously passing the bipartisan Improve Child Nutrition Integrity and Access Act in January.

Last week, a House version of the child nutrition reauthorization was introduced, but without the strong bipartisan support the Senate garnered.  It is now up to the House Education and Workforce Committee to find common ground with the Senate to move this issue forward. 

This is important for two key reasons. First, the bipartisan precursor to this legislation, the Healthy, Hunger-Free Kids Act of 2010, became one of the most meaningful factors in the fight against obesity because it required the U.S. Department of Agriculture to update nutrition standards for school meals and for snack foods sold in school vending machines and cafeterias. As a result of this, 98.5 percent of schools across the country are now implementing the updated standards and serving meals with more fruits, vegetables, and whole grains and less sugar, fat, and salt.

A growing body of research shows that the healthier school meals are working. One of the most rigorous studies to date on the updated school meal standards recently published in the journalJAMA Pediatrics found that students are selecting healthier foods in the lunch line and continuing to participate in the meal program at a stable rate.

Another respected study published in the journal Childhood Obesity last year found that students ate nearly 20 percent more of their entrees and 40 percent more of their vegetables and threw less food away when the new guidelines went into effect.

Second, we need to give schools the flexibility to make these new nutrition standards work in their districts. Although schools around the nation continue to share success stories, the transition hasn’t been universally easy. Some schools have found it more difficult to create healthier options due to outdated equipment and/or challenges in obtaining healthier ingredients. Others have found it more difficult to foster student acceptance of the new offerings.

To address these challenges, the Senate’s bipartisan bill responds to concerns from schools while maintaining the integrity of the updated nutrition standards. It includes compromises on sodium and whole grain standards that will give school food service directors more flexibility in how they plan menus and choose products. It also authorizes new federal funding for schools to purchase kitchen equipment and provide training for school cafeteria staff.

This progress is promising, but as former U.S. Senate Majority Leaders from different political parties, we want to ensure this effort to improve nutrition at school crosses the finish line. That’s why we stand with the retired military leaders who, as members of Mission: Readiness, are encouraging members of the House Education and Workforce Committee to take steps to protect these nutrition standards when they take their bill up in Committee, while urging the full Senate to pass the Improve Child Nutrition Integrity and Access Act as well. 

Senators Pat Roberts (R-KS) and Debbie Stabenow (D-MI) bridged a large policy divide to find a bipartisan compromise with the Improve Child Nutrition Integrity and Access Act, and our hope is that the House will learn from their successes as they seek to strengthen their bill in Committee.  These are the smartest moves we can make right now to support a Culture of Health and national security in future years.

This article was originally published on The Hill.

April 11, 2016 | The Guardian

Polio

The World Health Organisation is confident polio is in its dying days and could be eradicated within 12 months, despite challenges in Pakistan and Afghanistan, where the virus is still endemic and vaccination campaigns are sometimes targeted by extremists.

If the virus is wiped out, polio will become only the second human-hosted virus to be eradicated since the end of smallpox in 1980.

“We absolutely need to keep the pressure up, but we think we could reach the point where we have truly interrupted the transmission at the end of the year or the end of the low season [winter] next year,” said Michel Zaffran, the WHO’s director of polio eradication.

So far this year, just nine cases of wild – as opposed to vaccine-derived – polio virus have been recorded: two in Afghanistan and seven in Pakistan. Noting that there were generally fewer cases of polio in the cold winter months, Zaffran said that, even if there was a spike in recorded cases during the summer, the WHO believed it could still end transmission by early next year.

Read the full article on The Guardian.

Eighteen former senators urged appropriators this week not to shortchange the diplomacy and development account amid concerns that statutory limits on discretionary spending make the foreign aid budget vulnerable to cuts.

“We appreciate the enormous decisions currently facing the Senate and understand that you continue to work under a constrained budget environment,” reads the letter sent on Monday to the chairmen and ranking members of the Senate Appropriations Committee and subcommittee for State-Foreign Operations. “However, today America faces unprecedented global challenges, including rapidly increasing humanitarian crises, while funding for International Affairs has been cut by 12 percent since FY10 when adjusted for inflation, and base funding has declined 30 percent in that same period.”

Among the signatories are former Senate majority leaders William H. Frist and Thomas A. Daschle and former Sens. Kay Bailey Hutchison, Richard G. Lugar and Ben Nelson. The letter was organized by the U.S. Global Leadership Coalition, a foreign aid advocacy umbrella group.

The Obama administration has requested almost $52.8 billion in mandatory and discretionary fiscal 2017 funding for the State Department, U.S. Agency for International Development and other aid initiatives.

Approximately 28 percent of that amount is proposed to come from Overseas Contingency Operations -- war funds that are not subject to budget caps. Last December’s bipartisan fiscal 2016 spending deal is estimated by the Congressional Research Service to have provided roughly $100 million more than what the administration has requested this year.

Foreign aid advocates have criticized the administration’s proposal as being insufficient, given the number of crises around the world where the United States is looked to to set the example for humanitarian aid contributions. Advocates also are upset at the continued shifting of money out of the State-Foreign Operations budget and into the OCO account, which is supposed to sunset at some point.

The House signaled last month it was considering cutting into the foreign aid account when the Budget Committee released a report accompanying its fiscal 2017 Budget Resolution (H Con Res 125) that recommended $39.8 billion in total budget authority for the International Affairs account, which in addition to State Department and USAID funding also includes money for the Agriculture Department’s Food for Peace program.

This week, though, Senate Majority Leader Mitch McConnell said the chamber would begin work on appropriations bills in a few weeks and subcommittee allocations would be set based on the discretionary limits established by last year’s bipartisan budget agreement (PL 114-74). That means there is a good chance the State-Foreign Operations account will be somewhat higher than what was recommended by the House Budget Committee.

Sen. Patrick J. Leahy, the top Democrat on the State-Foreign Operations Appropriations subcommittee, sounded unperturbed when asked if he was concerned conservative opposition in the House would make it difficult to get a strong foreign aid bill passed.

“It’ll be interesting,” the senior senator from Vermont said. “We’ll see how they vote. I was surprised a couple of years ago that every Republican voted against aid to Israel and everything else in the foreign aid bill, but eventually we’ll get it done.”

Read the full article on CQ.com

One of the first ex-laps I did here in Kijabe was a planned gastrectomy on a 74-year-old female for gastric cancer. She was thin and frail and had progressive difficulty with eating for over a year now with resultant profound weight loss. I feared the worst when I felt her abdomen after she had been put to sleep; when she was fully relaxed, you could feel a large mass in her upper abdomen.
It seems to me that global surgery, or really any work in a resource-poor country, requires a different type of intelligence to be successful. Indeed, it requires ingenuity, the ability to think outside the box at nearly every level to make do with the resources available. This has been demonstrated to me over and over again for the last four weeks here in Kijabe, Kenya.

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