Inter Press Service » Health News and Views from the Global South Wed, 25 Nov 2015 08:06:54 +0000 en-US hourly 1 Asia Wants Paris Climate Talks to Tackle Historic Emissions and Make Some Real Change Sun, 22 Nov 2015 15:14:05 +0000 Amantha Perera 0 Where Technology and Medicine Meet in Rural Zambia Fri, 20 Nov 2015 06:29:22 +0000 James Jeffrey 0 Open Defecation to End by 2025, Vows UN Chief, Marking World Toilet Day Thu, 19 Nov 2015 22:39:07 +0000 Thalif Deen By Thalif Deen

The state of the world’s toilets reveals the good, the bad and the ugly – but not necessarily in that order.

As the UN commemorated its annual World Toilet Day on November 19, a new study says, contrary to popular belief, not everyone in the rich nations of the developed world has access to a toilet.

The study, released by the UK based WaterAid, points out that Canada, UK, Ireland and Sweden are among nations with measurable numbers still without safe, private household toilets.

Russia has the lowest percentage of household toilets of all developed nations, while India, the world’s second-most populous country, holds the record for the most people waiting for sanitation (774 million) and the most people per square kilometre (173) practising open defecation.

The report highlights the plight of more than 2.3 billion people in the world (out of a total population of over 7.3 billion) who do not have access to a safe, private toilet.

Of these, nearly 1.0 billion have no choice but to defecate in the open – in fields, at roadsides or in bushes.

The result is a polluted environment in which diseases spread fast. An estimated 314,000 children under five die each year of diarrhoeal illness which could be prevented with safe water, good sanitation and good hygiene.

Still, the tiny South Pacific island of Tokelau has made the most progress on delivering sanitation, holding number one position since 1990, followed by Vietnam, Nepal and Pakistan.

Nigeria has seen a dramatic slide in the number of people with access to toilets since 1990 despite considerable economic development.

The world’s youngest country, South Sudan, has the worst household access to sanitation in the world, followed closely by Niger, Togo and Madagascar, according to the study.

WaterAid’s Chief Executive Barbara Frost says just two months ago, all UN member states promised to deliver access to safe, private toilets to everyone everywhere by 2030.

“Our analysis shows just how many nations in the world are failing to give sanitation the political prioritisation and financing required. We also know that swift progress is possible, from the impressive advances in sanitation achieved in nations like Nepal and Vietnam.”

No matter where you are in the world, everyone has a right to a safe, private place to relieve themselves, and to live healthy and productive lives without the threat of illness from poor sanitation and hygiene.

“On this World Toilet Day, it’s time for the world to make good on their promises and understand that while we all love toilet humour, the state of the world’s sanitation is no joke,” said Frost.

The UN children’s agency UNICEF says lack of sanitation, and particularly open defecation, contributes to the incidence of diarrhoea and to the spread of intestinal parasites, which in turn cause malnutrition.

“We need to bring concrete and innovative solutions to the problem of where people go to the toilet, otherwise we are failing millions of our poorest and most vulnerable children,” said Sanjay Wijesekera, head of UNICEF’s global water, sanitation and hygiene programmes.

“The proven link with malnutrition is one more thread that reinforces how interconnected our responses to sanitation have to be if we are to succeed.”

In a report released Wednesday, the 21-member UN Advisory Board on Water and Sanitation (UNSGAB), calls for the mainstreaming of sanitation.

The focus should widen beyond the home – because toilets are needed in schools, clinics, workplaces, markets and other public places.

“Prioritize sanitation as preventive medicine and break the vicious cycle of disease and malnutrition, especially affecting women and children.”

And “get serious about scaling up innovative technologies along the sanitation chain and unleash another sanitation revolution, as key economic and medical enabler in the run-up to 2030, and make a business case for sanitation by realizing the resource potential of human waste.”

Additionally, it says, “de-taboo the topic of menstrual hygiene management, which deserves to be addressed as a priority by the UN and governments.”

In its report, WaterAid is calling on world leaders to fund, implement and account for progress towards the new UN Global Goals on sustainable development.

Goal 6 – water, sanitation and hygiene for all – is fundamental to ending hunger and ensuring healthy lives, education and gender equality and must be a priority.

“Improving the state of the world’s toilets with political prioritisation and long-term increases in financing for water, sanitation and hygiene, by both national governments and donor countries like the UK.”

Secretary-General Ban Ki-moon said the recently adopted 2030 Agenda for Sustainable Development recognizes the central role sanitation plays in sustainable development.

“The integrated nature of the new agenda means that we need to better understand the connections between the building blocks of development.”

In that spirit, he said, this year’s observance of World Toilet Day focuses on the vicious cycle connecting poor sanitation and malnutrition. He said poor sanitation and hygiene are at the heart of disease and malnutrition.

Each year, too many children under the age of five have their lives cut short or altered forever as a result of poor sanitation: more than 800,000 children worldwide — or one every two minutes– die from diarrhea, and almost half of all deaths of children under five are due to undernutrition.

A quarter of all children under five are stunted, and countless other children, as well as adults, are falling seriously ill, often suffering long-term, even lifelong, health and developmental consequences.

Parents and guardians carry the cost of these consequences. Women in particular women bear the direct brunt, he noted.

“Despite the compelling moral and economic case for action on sanitation, progress is too little and too slow,” Ban complained.

By many accounts, sanitation is the most-missed target of the Millennium Development Goals.

“This is why the Call to Action on Sanitation was launched in 2013, and why we aim to end open defecation by 2025,” he added.

The writer can be contacted at

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Opinion: China’s New South-South Funds – a Global Game Changer? Mon, 16 Nov 2015 22:02:16 +0000 Martin Khor

Martin Khor is the executive director of the South Center, based in Geneva.

By Martin Khor
GENEVA, Nov 16 2015 (IPS)

South-South cooperation is usually seen as a poor second fiddle to North-South aid in the world of development assistance. Indeed, developing countries’ policy makers themselves insist that South-South cooperation can only supplement but not replace North-South cooperation.

Martin Khor

Martin Khor

However, this widespread view received a jolt recently when China announced it was setting up two new funds totalling a massive 5.1 billion dollars to assist other developing countries.

The pledges, made by Chinese President Xi Jinping during his visit to the United States in September , have given an immediate boost to the status of South-South cooperation in general, and to the rapidly growing global role of China.

President Xi first announced that China would set up a China South-South Climate Cooperation Fund to provide 3.1 billion dollars to help developing countries tackle climate change.

Secondly, speaking at the United Nations, Xi said that China would set up another fund with initial spending of 2 billion dollars for South-South Cooperation and to aid developing countries to implement the post-2015 Development Agenda.

The sheer size of the pledges gives a big political weight to the Chinese contribution. Xi’s initiatives have the feel of a “game changer” in international relations.

It is significant that Xi used the framework of South-South cooperation as the basis of the two funds.

In the international system, there have been two types of development cooperation: North-South and South-South cooperation.

North-South cooperation has been based on the obligation of developed countries to assist developing countries because the former have much more resources and have also benefitted from their former colonies.

Indeed, developed countries have committed to provide 0.7 per cent of their gross national income (GNI) as development assistance, a target that is regularly monitored and taken seriously but unfortunately is currently being met by only a handful of countries.

South-South cooperation on the other hand is based on solidarity and mutual benefit between developing countries as equals, and without obligations as there is no colonial history among them.

This is the position of the developing countries and their umbrella grouping, the G77 and China.

Xi himself described South-South cooperation as “a great pioneering measure uniting the developing nations together for self-improvement, is featured by equality, mutual trust, mutual benefit, win-win result, solidarity and mutual assistance and can help developing nations pave a new path for development and prosperity.”

In recent years, as Western countries reduced their commitment towards aid, they tried to blur the distinction and have been pressing big developing countries like China and India to also commit to provide development assistance just like they do, and preferably within the framework of the OECD, the rich countries’ club.

However, the developing countries have stuck to their political position: the developed countries have the responsibility to give adequate aid to poor countries and should not shift this on to other developing countries. The developing countries however will also help one another, through the arm of South-South cooperation.

This has increasingly led some developed countries to advocate, during negotiations at several UN meetings, that for them to continue with their aid commitment, some of the developing countries should also pay their share.

The traditional framework in international cooperation may now be changed by the two Chinese pledges, both interesting in themselves.

It is noted by many that the 3.1 billion dollar Chinese climate aid exceeds the 3 billion dollars that the US has pledged (but not yet delivered) to the Green Climate Fund (GCF) under the United Nations Climate Convention.

China has now taken that South-South route by announcing it will set up its own South-South climate fund, with the unexpectedly big size of 3.1 billion dollars, an amount larger than any developed country has pledged at the GCF.

With such a large amount, the Chinese climate fund has the potential to facilitate many significant programmes on climate mitigation, adaptation and institutional building.

As for the other fund announced by Xi, the initial 2 billion dollars is for South-South cooperation and for implementing the post-2015 development agenda just adopted by the United Nations. The agenda’s centrepiece is the sustainable development goals. Xi mentioned poverty reduction, agriculture, health and education as some of the areas the fund may cover.

This new fund has the potential of helping developing countries learn from one another’s development experiences and practices and make leaps in policy and action.

Xi also said an Academy of South-South Cooperation and Development will be established to facilitate studies and exchanges by developing countries on theories and practices of development suited to their respective national conditions.

The next steps to implement these pledges would be for China to set up the institutional basis for the funds, and design their framework, aims and functions. It is a great opportunity to show whether South-South cooperation can contribute as positively as North-South aid.

Of course, aid is not the only dimension of South-South cooperation, which is especially prominent in the areas of trade, investment, finance and the social sectors.

The regional trade agreements in ASEAN, East Asia, and the sub-regions of Africa and Latin America, as well as the trade and investment links between the three South continents, have shown immense expansion in recent decades.

Recently, the world’s imagination was also captured by the creation of the BRICS New Development Bank, the Asian Infrastructure Investment Bank and the Chinese One Belt One Road programme, which all contain elements of South-South cooperation.

South-South cooperation in aid, however, is symbolically and practically of great importance, as it tends to assist the more vulnerable – including poor people and countries, and fragile environments including biodiversity and the climate undergoing crisis.

Let’s hope that the two new funds being set up by China will give a much-needed boost to South-South cooperation and solidarity among the people.


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Drinking Water Shortages Plague Pakistan Region Sun, 15 Nov 2015 06:26:05 +0000 Ashfaq Yusufzai 0 Gay Cruising Spots a Challenge for HIV/AIDS Prevention in Cuba Fri, 13 Nov 2015 22:21:02 +0000 Ivet Gonzalez At night, groups of people from the lesbian, gay, bisexual, transsexual and intersex (LGBTI) community gather in meeting spots like this one in the El Vedado neighbourhood in Havana, Cuba. Others go to cruising spots for quick anonymous sex. Credit: Jorge Luis Baños/IPS

At night, groups of people from the lesbian, gay, bisexual, transsexual and intersex (LGBTI) community gather in meeting spots like this one in the El Vedado neighbourhood in Havana, Cuba. Others go to cruising spots for quick anonymous sex. Credit: Jorge Luis Baños/IPS

By Ivet González
HAVANA, Nov 13 2015 (IPS)

When night falls, young men can be seen sitting on a dismantled bus stop on a remote hill far from the centre of the Cuban capital. Later they climb uphill to have sex with other men in the thick forest.

“On my way home from work, I go by that place, and I always see people gathered at the old bus stop,” 36-year-old biologist Daniel Hernández told IPS. The spot he was talking about is near the Calixto García Hospital in Havana’s El Vedado neighbourhood.

“People have lost their inhibitions. I can see they’re more out in the open in that area, where everyone knows why people go there. They’re not so afraid anymore,” said Hernández, who is himself gay and says he has occasionally gone there and to similar gay cruising spots in Havana.

Remote, isolated spots in Cuba’s cities, like forests, coastal areas or abandoned buildings, are colonised at night by men seeking quick anonymous sex with other men.

These cruising spots, known here as “potajeras”, represent a challenge for the work of prevention of HIV/AIDS, say activists, researchers and men who have sex with men (MSM) who spoke to IPS.

“I have witnessed unprotected group sex. All kinds of people go there, and not everyone has an awareness about the epidemic,” said Hernández, who described the potajeras as “key to the spread” of HIV/AIDS.

In his view, gay meeting places are necessary, but “not the remote spots that exist, where people are extremely unprotected due to the risk of infection and violence.”

The HIV/AIDS adult prevalence rate is low – just 0.1 percent, or 19,500 people – in this Caribbean island nation of 11.2 million people, up from 16,479 in late 2013.

MSM make up 70 percent of those living with HIV/AIDS. But women represent a growing proportion: 21 percent today, up from 18.5 percent in 2013, according to official figures.

Curbing the slow steady growth of new cases is a challenge that requires a greater prevention effort in this socialist island nation where healthcare is free and universal, including antiretroviral treatment for people living with HIV/AIDS.

The good news is that on Jun. 30, Cuba became the first country across the globe to receive World Health Organisation (WHO) validation for eliminating mother-to-child transmission of HIV and syphilis.

“In health promotion interventions we emphasise the risks of having sex in a place without minimum conditions,” said Avelino Matos, coordinator of community work with the MSM-Cuba Project, a network of 1,800 volunteer health promoters who have been working for 15 years to prevent the spread of HIV/AIDS among the most vulnerable segment of society.

In these remote areas, “there’s no light and people are nervous, so it’s impossible to negotiate the use of a condom,” Matos told IPS.

The entrance to a nightclub in Havana’s El Vedado neighbourhood, which offers drag queen shows and is a meeting place for people from the lesbian, gay, bisexual, transsexual and intersex (LGBTI) community. Credit: Jorge Luis Baños/IPS

The entrance to a nightclub in Havana’s El Vedado neighbourhood, which offers drag queen shows and is a meeting place for people from the lesbian, gay, bisexual, transsexual and intersex (LGBTI) community. Credit: Jorge Luis Baños/IPS

The project, which falls under the umbrella of Cuba’s National Center for the Prevention of STDs and HIV/AIDS and is active in all 15 provinces, monitors MSM cruising and gathering spots, with an emphasis on the 49 municipalities that have top priority because they have the highest HIV/AIDS rates.

Matos described gay hangouts or socialising places – by contrast with cruising spots – as public spaces where MSM gather to meet each other, chat, and arrange dates.

He said the project’s health promoters are present around the country, although the ones in the capital are the best-known.

According to Matos, the project’s prevention work does get results, and today is using new strategies, targeting gay meeting spots in parks and on city street corners and in the growing number of gay bars, cafes and private parties.

But he lamented that they barely reach the potajeras, although in some provinces ingenious interventions have been carried out.

In the daytime, activists hang bags of condoms on tree branches, for example, in cruising spots in the central province of Villa Clara and the eastern provinces of Holguín and Granma.

And in a shantytown in the western province of Mayabeque, the project provided training in health promotion to two-seater bicycle taxi drivers, the form of transportation used to reach the cruising spots. The drivers were also given condoms, to hand out to their passengers.

Matos said it is difficult to reach bisexual men with HIV/AIDS prevention messages, because they face more prejudice than homosexuals. “That’s why they are less likely to admit to their sexual orientation; many hide their meetings with men and maintain relationships with women,” he said.

Homophobia is a major factor contributing to the spread of HIV and others STDs in the cruising sites.

“These are places in the here and now. But with this I don’t mean that everyone who engages in cruising has unprotected sex,” said Jorge Carrasco, a young journalist who in 2013 reported on the main cruising spots in Havana, such as the Playa del Chivo beach and areas around the Calixto García Hospital.

“Because of the anonymity, a lot of sick people feel better there, because they can have quick sex without the need to talk about their lives with the other person,” said the 25-year-old reporter, who defends these places as “cultural spaces” that are legal under Cuba’s current laws.

Carrasco warned of other dangers in these places, where assaults and even murders are reported, as well as police abuses. “The police, instead of only arresting the thieves, also arrest the homosexuals,” said the reporter, who recommended more training for the national police.

Amaya Álvarez, a legal adviser at the governmental National Sex Education Centre (CENESEX), told IPS that “the largest number of legal complaints by the homosexual and transgender population in the meeting places are in response to the interaction with law enforcement bodies like the police.”

For that reason, she said, CENESEX organises awareness-raising workshops for police officers.

Edited by Estrella Gutiérrez/Translated by Stephanie Wildes

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Maternal Deaths Decline by 44 Percent, Says New Study Thu, 12 Nov 2015 20:10:31 +0000 Thalif Deen By Thalif Deen

When world leaders adopted a set of eight Millennium Development Goals (MDGs) at a summit meeting in September 2000, one of the heavily-publicised goals was the commitment to reduce extreme poverty and hunger by the end of 2015.

But an equally important goal– that drew less attention– was Goal number Five aimed at improving maternal health – and reducing by three quarters the maternal mortality ratio, by the end of 2015.

A new report, released Thursday, focuses specifically on maternal deaths, which have fallen by 44 per cent since 1990— described as a significant improvement, but still falling short of total success.

World-wide, maternal deaths dropped from about 532,000 in 1990 to an estimated 303,000 this year, according to the report, the last in a series surveying progress under the MDGs.

This equates to an estimated global maternal death ratio of 216 maternal deaths per 100,000 live births, down from 385 in 1990, says the joint report by the World Health Organisation (WHO), the UN children’s agency UNICEF, the UN Population Fund (UNFPA), the World Bank Group and the UN’s Population Division.

Maternal death is defined as the death of a woman during pregnancy, childbirth or within 6 weeks after birth.

Despite global improvements, however, only nine countries achieved the MDG 5 target of reducing the maternal death ratio by at least 75 per cent between 1990 and 2015.

Those countries include Bhutan, Cabo Verde, Cambodia, Iran, Lao People’s Democratic Republic, Maldives, Mongolia, Rwanda and Timor-Leste.

Despite this important progress, the maternal death ratio in some of these countries remains higher than the global average, says the report titled ‘Trends in Maternal Mortality: 1990 to 2015’.

“The MDGs triggered unprecedented efforts to reduce maternal mortality,” said Dr. Flavia Bustreo, WHO Assistant Director-General, Family, Women’s and Children’s Health.

“Over the past 25 years, a woman’s risk of dying from pregnancy-related causes has nearly halved. That’s real progress, although it is not enough. We know that we can virtually end these deaths by 2030 and this is what we are committing to work towards.”

Achieving that goal will require much more effort, according to Dr. Babatunde Osotimehin, the Executive Director of UNFPA.

“Many countries with high maternal death rates will make little progress, or will even fall behind, over the next 15 years if we don’t improve the current number of available midwives and other health workers with midwifery skills,” he said.

“If we don’t make a big push now, in 2030 we’ll be faced, once again, with a missed target for reducing maternal deaths.”

The report also points out that ensuring access to high-quality health services during pregnancy and childbirth is helping to save lives.

Essential health interventions include: practising good hygiene to reduce the risk of infection; injecting oxytocin immediately after childbirth to reduce the risk of severe bleeding; identifying and addressing potentially fatal conditions like pregnancy-induced high-blood pressure; and ensuring access to sexual and reproductive health services and family planning for women.

“As we have seen with all of the health-related MDGs, health-system strengthening needs to be supplemented with attention to other issues to reduce maternal deaths,” said UNICEF Deputy Executive Director Geeta Rao Gupta.

“The education of women and girls, in particular the most marginalized, is key to their survival and that of their children. Education provides them with the knowledge to challenge traditional practices that endanger them and their children.”

By the end of this year, about 99 per cent of the world’s maternal deaths will have occurred in developing regions, with sub-Saharan Africa alone accounting for two in three (66 per cent) deaths.

But that represents a major improvement: sub-Saharan Africa saw a nearly 45 per cent decrease in maternal death ratio, from 987 to 546 per 100,000 live births between 1990 and 2015, according to the report.

The greatest improvement of any region was recorded in Eastern Asia, where the maternal death ratio fell from approximately 95 to 27 per 100,000 live births (a reduction of 72 per cent).

In developed regions, maternal deaths fell 48 per cent between 1990 and 2015, from 23 to 12 per 100,000 live births.

Besides poverty and hunger, the MDGs also included goals to eliminate HIV/AIDS, provide adequate shelter, promote gender equality, achieve universal education, protect the global environment and build a global North-South partnership for development.

At a summit meeting in September, world leaders adopted a set of 17 Sustainable Development Goals (SDGs), a successor to MDGs, with the objective of meeting these new goals by 2030.

The SDGs have a target of reducing maternal deaths to fewer than 70 per 100,000 live births globally.

Reaching that goal will require more than tripling the pace of progress – from the 2.3 per cent annual improvement in maternal death ratio that was recorded between 1990 and 2015 to 7.5 per cent per year beginning next year.

“The SDG goal of ending maternal deaths by 2030 is ambitious and achievable provided we redouble our efforts,” said Dr. Tim Evans, Senior Director of Health, Nutrition and Population at the World Bank Group.

“The recently launched Global Financing Facility in Support of Every Woman Every Child, which focuses on smarter, scaled and sustainable financing, will help countries deliver essential health services to women and children,” he said.

The writer can be contacted at

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Acute Malnutrition: A Community Fights Back Thu, 12 Nov 2015 07:08:23 +0000 Stella Paul 0 Opinion: The Grant of Patents and the Exorbitant Cost of “Lifesaving” Drugs Tue, 10 Nov 2015 13:35:45 +0000 German Velasquez

Germán Velásquez is Special Adviser for Health and Development, South Centre, Geneva

By Germán Velásquez
GENEVA, Nov 10 2015 (IPS)

The important relationship between the examination of patents carried out by national patent offices and the right of citizens to access to medicines hasn’t always been well-understood. Too often these are viewed as unrelated functions or responsibilities of the state. And the reason is clear: patentability requirements are not defined by patent offices, but frequently by the courts, tribunals, legislation or treaty negotiators.

Germán Velásquez

Germán Velásquez

This is the case when patent policy is implemented in isolation from, rather than guided by, public health policy.

Given the impact of pharmaceutical patents on access to medicines, patent offices should continue to align their work in support of national health and medicine policies, using the freedom permitted by the Trade Related Aspects of Intellectual Property Rights Agreement (TRIPS) to define patentability requirements.

The TRIPS Agreement requires all World Trade Organization (WTO) member states to incorporate into their legislation universal minimum standards for almost all rights in this domain: copyright, patents and trademarks.

A patent is a title granted by the public authorities conferring a temporary monopoly for the exploitation of an invention upon the person who reveals it, furnishes a sufficiently clear and full description of it, and claims this monopoly.

As with any monopoly, it may lead to high prices that in turn may restrict access. The problem is compounded in the case of medicines, when patents confer a monopoly for a public good and essential products needed to prevent illness or death and improve health.

According to the TRIPS Agreement, the patentability requirements used by national intellectual property offices require a product or manufacturing process to meet the conditions necessary to grant patent protection, namely: novelty, inventive step and industrial applicability (utility).

These three elements, however, are not defined in the TRIPS agreement and WTO Member States are free to define these three criteria in a manner consistent with the public health objectives defined by each country.

It is widely held that patents are granted to protect new medicines to reward the innovation effort. However, the number of patents obtained annually to protect truly new pharmaceutical products is very low and falling. Moreover, of the thousands of patents that are granted for pharmaceutical products each year, a few are for new medicines – e..g. new molecular entities (NMEs).

All of the above led the World Health Organization (WHO), in collaboration with the United Nations Conference on Trade and Development (UNCTAD), the United Nations Development Programme (UNDP) and the International Centre for Trade and Sustainable Development (ICTSD), to develop, in 2007, guidelines for the examination of pharmaceutical patents from a public health perspective.

The guidelines were intended to contribute to improving the transparency and efficacy of the patent system for pharmaceutical products, so that countries could pay more attention to patent examination and granting procedures in order to avoid the negative effects of non-inventive developments on access to medicines. The major problems can be identified in the current use of the patent system to protect pharmaceutical innovation: reduction in innovation, high prices of medicines, lack of transparency in research and development costs, and proliferation of patents.

A study carried out by the journal Prescrire analysed the medicines that were introduced to the French market between 2006 and 2011, arriving at the conclusion that the number of molecules that produced significant therapeutic progress reduced drastically: 22 in 2006; 15, 10, 7, 4 in the following years up to 2011, which was a year in which Prescrire declared that only one medicine of significant therapeutic interest was brought to the market. Given that France is one of the largest pharmaceutical markets in the world, the reduction in innovation confirmed France is a good indicator of the global situation.

Oncologists from fifteen countries recently denounced the excessive prices of cancer treatments, which are necessary to save the lives of the patients, and urged that moral implications should prevail; according to them, of the 12 cancer treatments approved in 2012 by the United States Food and Drug Administration, 11 cost more than 100,000 dollars per patient per year.

Since the 1950s, there have been some references to the costs of Research and Development (R&D) for pharmaceutical products. According to some sources the average cost of research for a new pharmaceutical product these figures have increased from 1 million dollars in 1950 to 2.5 billion dollars for the development of a single product.

During the summer of 2014, a number of European countries, including France and Spain, spent many months negotiating with the company Gilead on the price of a new medicine for hepatitis C known as Solvaldi. The price fixed by Gilead was 56,000 Euros per patient for a twelve-week treatment, or 666 Euros per tablet. According the newspaper Le Monde the price of each tablet was 280 times more than the production cost. In France, it is calculated that 250,000 patients should receive this medicine, the cost of which would represent 7 per cent of the annual state medicine budget.

The application of patentability requirements for medicines, given their public health dimension, should be considered with even more care than in the case of regular merchandise or luxury items. The first and most important step is to use the freedom permitted by the TRIPs Agreement to define the patentability requirements: novelty, inventive step and industrial applicability (utility) in a way that keeps sight of public interest in the wide dissemination of knowledge.


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Opinion: From Despair to Hope – Fulfilling a Promise to Mothers and Children in Mandera County Mon, 09 Nov 2015 23:04:48 +0000 Ruth2 Ruth Kagia is a Senior Adviser in the Office of the President of Kenya. Follow her on twitter:@ruthkagia. Siddharth Chatterjee is the United Nations Population Fund (UNFPA) Representative to Kenya. Follow him on twitter: @sidchat1]]> The First Lady of Kenya, Governor Ali Roba and the Executive Director of UNFPA, Dr Osotimehin, in Mandera County.  Credit: UNDP Kenya

The First Lady of Kenya, Governor Ali Roba and the Executive Director of UNFPA, Dr Osotimehin, in Mandera County. Credit: UNDP Kenya

By Ruth Kagia and Siddharth Chatterjee
NAIROBI, Kenya, Nov 9 2015 (IPS)

Mandera in northeastern Kenya, has often been described as “the worst place on earth to give birth.” Mandera’s maternal mortality ratio stands at 3,795 deaths per 100,000 live births, almost double that of wartime Sierra Leone at 2,000 deaths per 100,000 live births.

But Mandera also demonstrates what can be achieved with strong political leadership and strategic partnerships. Just under a year ago, on December 2, 2014, we were part of a team from the United Nations, World Bank, charities and the Office of the President of Kenya that undertook the two-hour flight to Mandera to determine what could be done to address this critical development bottleneck.

Minutes before take-off, news came through that 36 Kenyans had been brutally murdered in Mandera by the Somali militant group al Shabaab.

No official briefing could have better highlighted the challenges of the task ahead. Rather than acting as a deterrent, it strengthened our resolve and we continued with our journey.

Marginalization combined with internecine conflicts, pockets of extremism, poor human development and cross border terrorism have trapped so many of Mandera’s people in poverty and misery. In addition, women and girls are subjected to cultural practices such as female genital mutilation and child marriage, which contribute to high school dropouts and complicate delivery.

The government has been focused in its resolve to change the narrative in Mandera and in other historically disadvantaged parts of Kenya. The introduction of free maternity services, for example, has increased the number of Kenyan women giving birth under skilled care from about 40 to 60 per cent since 2013.

Together with the government, the United Nations Population Fund (UNFPA) Kenya mobilised private sector partners to develop innovative strategies to improve maternal and child health, especially in the six counties with the highest maternal and child health burden: Lamu, Isiolo, Wajir, Mandera, Marsabit and Migori.

On October 13, we launched a Community Life Centre in Mandera with the technology company Philips. The centre, equipped with solar lighting, fridges, lab and diagnostic equipment, will provide better healthcare services for about 25,000 people.

UNFPA Executive Director Dr Babatunde Osotimehin has given a very clear message that UNFPA must help the hard to reach and the most vulnerable. With this resolve, UNFPA, together with the World Bank, UNICEF and the World Health Organization, supported by the Ministry of Health, mobilized 15 million dollars to improve maternal, child and adolescent health services in the six counties in March 2015.

These efforts were given a major boost on November 6, 2015, when Kenya’s First Lady H.E. Margaret Kenyatta handed over a fully-kitted mobile clinic to Mandera. The First Lady launched the Beyond Zero campaign in 2014 to reduce maternal and child mortality in Kenya.

Dr. Osotimehin flew in from New York for the event, and was joined by the ambassadors of the European Union, Denmark, Sweden and Finland.

The First Lady said: “For too long, the prospect of childbirth in Kenya, to thousands of women, has been tantamount to a death sentence. No one should die giving life.”

Dr Osotimehin said: ‘‘When we invest in strengthening the health system from the community to the facility, when we invest in strong referral systems and complementary basic services, we save women’s lives but we also underwrite our future as humanity.”

Maternal health is a perfect illustration of the fact that the process of development is multi-dimensional. Poor maternal health affects women, their children and their communities. It affects nutrition, human development, population dynamics and it undermines the quality of the labour force.

When you improve maternal health, you create healthy families, strong communities and strong economies.

Like the tentative steps of an infant beginning to walk, these may seem modest achievements in the face of the significant challenges in these remote counties. The counties require structural changes which can lead women out of poverty, eliminate gender inequalities and build stronger health systems.

The partners’ grit and the commitment demonstrated by the government together with leaders like the First Lady and Mandera County Governor Ali Roba give reason for optimism that these challenges can be overcome.

Improving maternal health is not only achievable, it is a goal worth reaching.


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Opinion: Eliminating Malaria in the Americas: An Opportunity We Cannot Afford to Miss Tue, 03 Nov 2015 12:36:10 +0000 Herve Verhoosel

Hervé Verhoosel is representative in New York and Head of External Relations of the Roll Back Malaria (RBM) Partnership.

By Hervé Verhoosel

An issue mostly associated with Africa and Asia, malaria may not initially come to mind when we think of the Americas.

Hervé Verhoosel, Representative in New York & Head of External Relations, Roll Back Malaria (RBM) Partnership

Hervé Verhoosel, Representative in New York & Head of External Relations, Roll Back Malaria (RBM) Partnership

It has been over 60 years since the United States was declared malaria-free, and many countries in the region have made great strides against the disease in recent years, largely making malaria either a thing of the past or an irrelevant topic of discussion.

Yet, as we mark the 9th annual Malaria Day in the Americas on November 6, an estimated 120 million people in the region are at risk of malaria. With so many of these countries nearing elimination targets, we must use this occasion to reflect on the lessons we’ve learned and recommit ourselves to pushing this disease out of the Americas once and for all.

With just weeks left under the Unied Nations Millennium Development Goals (MDGs) and a newly adopted 2030 Agenda for Sustainable Development to take its place, there’s no better time than now.

Since 1998, when the Roll Back Malaria (RBM) Partnership was founded, 100 countries worldwide have become free from malaria, over six million malaria-related deaths have been averted and the MDG target for malaria has been achieved and in some cases even surpassed.

This is thanks to global investments – including from regional donors like the US President’s Malaria Initiative and the Canadian government – as well as multilateral mechanisms like the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Latin America is no exception to this unprecedented progress. Technical leadership by the the World Health Organisation’s Pan American Health Organization (PAHO) and political commitment has helped scale-up interventions that have reduced malaria-related deaths by nearly 78 per cent between 2000 and 2013.

Next year, Argentina may become the second country in the Western Hemisphere to be certified malaria-free – and Costa Rica, El Salvador, Ecuador and Paraguay are not far behind, making the region closer to achieving malaria elimination than ever before.

With the Sustainable Development Goals (SDGs) – including a target to eliminate malaria by 2030 –, we must build on our achievements so that we can save lives and unlock potential in communities across the region.

To answer this call, WHO and the RBM Partnership have developed their respective Global Technical Strategy for Malaria 2016–2030 (GTS) and Action and Investment to Defeat Malaria 2016–2030 – toward a malaria-free world (AIM), which together provide a forward-looking, complementary framework to tailor local strategies and mobilize action and resources to achieve elimination in the next 15 years.

First launched in July at the Third Annual Financing for Development Conference in Addis Abba by the UN Secretary General and several heads of states, this vision will be presented next week at the Ministers of Health meeting in Brazil.

But ambition and strategic vision alone will not carry us across the finish line. We must also ensure the financial underpinning required to deliver on the promise of malaria elimination our leaders have made in the SDGs – something which experts estimate will cost more than 100 billion dollars.

While total international and domestic financing for malaria peaked at 2.7 billion dollars in 2013, current figures show a significant gap in much-needed funding. In Latin America alone – a region positioned to lead the way in global elimination efforts – funding for malaria has decreased from 214 million to 140 million dollars between 2011 and 2013.

Staying on track will require increased financing by the international donor community, as well as increased domestic financing by affected countries. It won’t be cheap, but our front-loaded investment is paltry compared to the consequences of not investing now.

With malaria showing signs of resurgence in places like Venezuela, Guyana and Haiti, largely due to cross-border migration and patchy surveillance systems, a failure to act now places our achievements in jeopardy and threatens broader development efforts of the region.

Beyond being morally compelling, investing in malaria is a solid economic investment. If the financial targets outlined in the AIM are met, nearly 3 billion malaria cases globally will be averted and over 10 million lives saved. These are not simply numbers; they are people that fill classrooms and form a healthy workforce capable of returning more than an estimated 4 trillion dollars of additional economic between 2016-2030.

As we move forward, with our eyes on the finish line, governments in the region must continue – and even increase – their commitment to malaria control, including through multi-sectoral and cross-border collaborations like the Mesoamerica Malaria Elimination Initiative, the Malaria Champions of the Americas and the Amazon Malaria Initiative.

The private sector also has a role to play, through continued investment in their employees and their communities of operation. Expanded efforts will not only help save lives and decrease financial burden to societies and governments, they will also drive regional trade and tourism.

As we join together to commemorate the last Malaria Day in the Americas before transitioning to a post-2015 era, let us remember that we are not malaria-free until we are all free of malaria, and achieving this is critical to achieving the broader development targets set by the SDGs.

We have the tools and knowledge, and now with the GTS and AIM, we are able to learn from past lessons, build on our successes and come together – across borders and sectors – to finally and sustainably achieve malaria elimination.


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How Climate Change Threatens Zambia’s Already Fragile Nutrition Record Sat, 31 Oct 2015 09:36:07 +0000 Friday Phiri By Friday Phiri
PEMBA, Southern Zambia, Oct 31 2015 (IPS)

It is slightly after 10 o’clock in the morning and 48-year-old Felix Muchimba of Siamuleya village in Pemba district has just finished having breakfast – a traditional drink called Chibwantu, made of maize meal and grit.

48-year-old Felix Muchimba sitting on a stool outside his house. Photo Credit: Friday Phiri/IPS

48-year-old Felix Muchimba sitting on a stool outside his house. Photo Credit: Friday Phiri/IPS

Nutritionally, the drink does not offer much except energy for the day’s work. Normally, the next meal should be one o’clock, followed by the final meal of the day taken in the evening.

However, Muchimba and his six member family will be having their next and last meal of the day at four o’clock. Because of food scarcity, the family now takes two instead of three meals per day.

“I harvested slightly over 200kgs (4 by 50kg bags) of maize and this could finish in two months if we maintain the normal three meals per day,” said Muchimba, who has been living with HIV since 2007, told IPS.

Muchimba says, “My status as a bread winner has not changed despite my living with HIV. When disaster strikes such as drought leading to crop failure, we cope with the changed situation and have reduced our meals to two per day,” he said.

Muchimba’s family is among the over 133,000 households countrywide that have suffered crop failure due to drought and now require relief food assistance, according to the country’s Disaster Management and Mitigation Unit (DMMU) 2015 Food Security Map.

While Muchimba’s immediate concern is undoubtedly food availability, a more subtle problem in the context of sustainable development goals (SDGs) numbers 1 and 2 (ending poverty and ending hunger) is undernourishment. Muchimba and his 28-month-old child (born HIV negative) both need nutritious food continuously.

“Children who are undernourished suffer from a number of short and long term consequences. It is the long term effects that we are seriously worried of; poor development of the brain, leading to poor performance in school and even reduced productivity later in life,” Eustina Besa of the National Food and Nutrition Commission told IPS.

A typical meal in Zambia is a monotonous intake of key staples: Nshima (a hard porridge made of maize or cassava starch), usually eaten with steamed vegetables (rape or pumpkin leaves) and, not so often, chicken or meat.

According to HarvestPlus, a research Program on Agriculture for Nutrition and Health (A4NH).

maize – a staple food for more than 1 billion people in sub-Saharan Africa and Latin America – lacks essential micronutrients such as vitamin A. This common deficiency in the diets of poor malnourished populations leads to retarded growth, increased risk of disease and reproductive disorders.

With this background, Muchimba’s family is likely part of the larger world population still grappling with “silent hunger” – malnourishment that is serious enough to affect personal growth and development.

According to the World Food Programme’s 2015 statistics, some 795 million people worldwidee world do not have enough food to lead a healthy active life with sub-Saharan Africa recording the highest prevalence (percentage of population) of hunger. One person in four on the continent is said to be undernourished.

Zeroing in on Zambia, the picture is not different. According to the 2014 UN Food and Agricultural Organisation (FAO) State of the Food Insecurity in the World report, the country was ranked second to the world’s worst case scenario in terms of undernourishment, rated at 48.3 per cent of the country’s population, better only than Haiti with 51.8 per cent.

However, with several multi-sectoral measures such as the First 1000 Most Critical Days campaign launched in 2012, the 2015 Zambia Demographic Health survey has shown some improvement.

“The survey has revealed that stunting has reduced to 40 from 45 per cent”, Eneya Phiri, Head of Advocacy and Communications at the Civil Society Organisation for Scaling-Up Nutrition, told IPS.

Phiri added that “The First 1000 Most Critical Days programme has brought about a coordinated approach to the fight against under nutrition especially that the inter-ministerial committee is chaired by the Secretary to the Cabinet.”

But even with such progress, stakeholders are getting concerned with the frequency of climate induced disasters such as drought that have a direct bearing on both food availability and good nutrition.

“We are still concerned that climate change could reverse these gains. We are afraid for rural communities affected by drought for they may not be getting the right nutritional balance as a result of reduced meals which is usually their easy way out in difficult times,” said Phiri.

Eustina Besa, Head of Communications at the National Food and Nutrition Commission (NFNC), says the programme has a set of priority interventions, also known as the minimum package, that aims to raise awareness of under-nutrition, increase demand for optimal nutrition and hold government leaders accountable.

In linking drought to nutrition, there is an emerging argument that climate-smart agriculture practices, such as crop diversification and planting drought tolerant crops, must be accompanied with nutrition smart technologies.

According to the Global Panel on Agriculture and Food Systems for Nutrition, an independent group of influential experts with a commitment to tackling global challenges in food and nutrition security, the regions of the world facing the prospect of the most serious impacts of climate change are sub-Saharan Africa and South Asia which already have the highest burden of malnutrition and where the poor rely heavily on agriculture for their livelihoods.

John Kufor, former President of Ghana and co-Chair of the Global Panel, believes the challenges of malnutrition and climate change come together as an opportunity in agriculture by integrating nutrition into climate-smart agricultural practices.

And HarvestPlus seems to have embraced this model by using conventional crop breeding techniques to develop five new Vitamin A-rich varieties of maize in Zambia.

The varieties produce orange coloured maize cobs, and in farmer trials they have been found to produce yields similar to hybrid white maize varieties.

“Zambia has made a lot of effort to address Vitamin A deficiency. However, regardless of all these efforts, we are still scoring high on Vitamin A deficiency. That is why HarvestPlus thought of an additional or complementary approach,” said Dr Eliab Simpungwe, the HarvestPlus Country Manager.

And backing the climate and nutrition smart approach, Emely Banda, the Programme’s Demand Creation Specialist, told IPS: “Our varieties were bred for drought resistance owing to challenges of unpredictable and erratic rainfall to tackle both food and nutrition security.”


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Opinion: Integrating Water, Sanitation and Health are Key to the Promise of the UN Global Goals Fri, 30 Oct 2015 22:46:44 +0000 Princess Sarah Zeid

HRH Princess Sarah Zeid of Jordan is a global advocate for maternal, child and newborn health in fragile and humanitarian settings.

By H.R.H. Princess Sarah Zeid
AMMAN, Oct 30 2015 (IPS)

The 193 member states of the United Nations have adopted an ambitious 15-year sustainable development agenda, the 2030 Global Goals.

H.R.H. Princess Sarah Zeid

H.R.H. Princess Sarah Zeid

To understand the impact these Global Goals must have on our world, I need only remember my summer visit to a school in Basra, in southern Iraq.

To enter through the school gates, I had to negotiate a fetid stream of sewage, broken glass and garbage. The condition of the school building itself was terrible, and even worse were the bathrooms. You could see their appalling state because they had no doors, and thus, zero privacy. All this in a place where the temperature can reach above 120 degrees Fahrenheit (49 degrees Celsius) – it was so hot I felt as if my cheeks were frying.

I look back at this now through the eyes of a mother, and my horror is all the greater. No girl could go to this school, because no girl could go to the bathroom. No child could safely attend this school, because no child could do so without being exposed to disease.

With daughters denied education, confined to home and sons locked in a cycle of exposure to ill health, how can we expect women to participate in commerce, politics, peace and sustainability? How do we think the next generation is going to be educated, skilled and healthy enough to make a positive contribution?

The solutions to women’s and children’s dignity, health and wellbeing lie well beyond the health sector alone, and demand instead an integrated approach, including solutions that deliver water, sanitation and hygiene (WASH) in health and in education.

No one’s needs divide neatly into our professional sectors, and sustainable wellbeing and prosperity will not come from fragmented interventions. A holistic approach spanning across all these domains is urgently needed.

The linkages between WASH, health, education and nutrition for that matter are stark. In the Democratic Republic of the Congo, for example, more than half the cases of measles in the country are caused by lack of clean water, and poor WASH conditions are a leading cause of malnutrition.

Illness and death in childbirth, and in maternal and child health, are not only the result of the lack of access to quality medical care, nursing or pharmaceuticals. They also happen because nearly 40 per cent of health facilities worldwide have no source of water.

In low-income countries – where preventable mortality is at its highest – an estimated 50 per cent of health care facilities lack access to the electricity they need to boil water and sterilize instruments.

WASH also helps promote gender equality. If water, sanitation and hygiene are designed so that the practical burdens women carry daily are reduced, they will be able to play broader and more creative roles in their community’s development, paving the way towards equitable development in countries and globally. Everyone benefits from these contributions.

There is recognition of the importance of joining up. Last autumn, 16 researchers from the World Health Organization, Unicef, WaterAid and others came together to call for action on joining water, sanitation and hygiene to efforts on maternal and newborn health. The World Health Organization has launched an action plan to address the need for water, sanitation and hygiene in healthcare facilities.

This new sustainable development agenda and, quite frankly, the state of the world today, demands of us another dimension of this integration, too: an integration of our development and humanitarian efforts.

The renewed Every Women Every Child Global Strategy for Women and Children’s Health is working to make this happen. Headed by the Office of the UN Secretary General and supported by a global movement of governments, philanthropic institutions, multi-lateral organizations, civil society organizations, the business community and academics, the renewed Strategy gives new priority to humanitarian and fragile settings and pledges the needed integration to save more lives as life is given.

After all, the right to live life in dignity, the rights to health and to water and sanitation are human rights, universal and indivisible. They are rights to be upheld even in the toughest of situations and at the hardest of times. However, without joined-up pipelines of delivery to enable that flow of human dignity for everyone, everywhere, the promise of the Global Goals will just drain away.


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Medicinal Plants Popular and Unprotected in Mexico Wed, 28 Oct 2015 07:27:54 +0000 Emilio Godoy Clemente Calixto, a certified traditional healer, discusses the healing properties of a plant during a workshop in Mexico City. In his community in the southern state of Oaxaca, he uses different medicinal plants to make soap and ointments, and to heal a variety of ailments. Credit: Emilio Godoy/IPS

Clemente Calixto, a certified traditional healer, discusses the healing properties of a plant during a workshop in Mexico City. In his community in the southern state of Oaxaca, he uses different medicinal plants to make soap and ointments, and to heal a variety of ailments. Credit: Emilio Godoy/IPS

By Emilio Godoy
MEXICO CITY, Oct 28 2015 (IPS)

“This plant heals 150 ailments, like diabetes, high blood pressure and gastritis. It’s prepared as an infusion or blended with water, and you take it every day,” says Clemente Calixto, a traditional indigenous healer in Mexico, holding up a green leafy branch.

Calixto, who belongs to the Mazateco indigenous community, is talking about palomilla or common fumitory (Fumaria officinalis), an herbaceous annual flowering plant in the poppy family – one of the more than 3,000 plants in frequent use in this Latin American country to treat a broad range of health problems.

“We work with medicinal plants. Some grow wild in the countryside and others we plant in yards and patios. We make soaps, ointments, cough syrups, dewormers,” Calixto told IPS.

The healer, from the town of Jalapa de Díaz in the state of Oaxaca, 460 km south of Mexico City, also uses chaya or tree spinach (Cnidoscolus chayamansa) and caña agria or spiked spiralflag ginger (Costus spicatus), which he said help heal kidney problems.

Calixto, one of the 30 registered traditional healers with credentials from the health authorities in his region, is one of thousands of herbalists who process, sell and prescribe medicinal plants in Mexico, where they enjoy only weak legal protection.

The Digital Library of Traditional Medicine, created by the National Autonomous University of Mexico (UNAM), lists more than 3,000 species of plants in daily use. Many of them are sold fresh or dried.

In this Latin American country of 120 million inhabitants, eight out of 10 people use traditional plants or animal products to cure ailments.

“There is little legal protection,” Arturo Argueta, a professor at UNAM’s Centre for Interdisciplinary Research in Science and Humanities, told IPS. “We don’t have adequate legislation; there should be a federal law and institutions that are replicated at the level of the states to prevent biopiracy and grant recognition to this ancestral wisdom.”

In 1994 Argueta, a veteran researcher, and other colleagues published the first “atlas of plants used in Mexico’s traditional medicine”. Their research found that the sale of these plants is especially common in areas to the south of Mexico City, their habitual users come from all socioeconomic strata, and their prices are low.

“The most widely used are 50 herbs,” said the expert. “Many of them grow wild, and others are planted. Use expanded from exotic users in the south of the country to a much wider population.”

Several of the species are protected by Mexican law, as they are listed as threatened or endangered.

Traditional indigenous medicine is recognised in Mexico’s constitution as a cultural right of native peoples.

In addition, the health ministry’s office of traditional medicine, created in 2002, has a list of 125 species that can be prescribed in the national health system since reforms introduced in 2008 in the general health law, which incorporated and regulated traditional medicine.

The general health law recognises the existence of herbal medicine and the “regulations on health inputs” regulates the definition, registration, preparation, packaging, advertising and points of sale of herbal medicines and remedies.

The “regulations on health inputs” office issues credentials annually to traditional healers, authorising them to practice the healing arts that have passed from generation to generation.

Lorenza Euan, a Maya Indian, makes soaps, ointments, mosquito repellent, antibacterial gel, cough syrups and shampoo, together with four other women in the Maya Dzak – Maya medicine, in that tongue – cooperative in the town of Lázaro Cárdenas in the southeastern state of Quintana Roo.

“We inherited it from our ancestors. You heal with the plant’s stalks or roots,” she told IPS, holding up an ointment used to treat muscle pain or bruises, which has extracts from 18 varieties of plants, as an example of the products they make.

“We pick fresh plants, weigh them, wash them, crush them, and boil the mixture,” to prepare the products, she explained.

In their herb garden, the women in the cooperative grow around 25 different species, including nettles, arnica, aloe vera and basil.

The World Health Organisation (WHO) calls for the protection of traditional knowledge, the integration of alternative medicine in national health systems, the certification of those who practice traditional healing, and the fomenting of research.

Euan joins her voice to those who demand greater protection and greater recognition and promotion of traditional healing.

Mexico’s health ministry drew up a guide for strengthening health services using traditional medicine. It recognises as a threat the loss of biodiversity, caused by land-use change, deforestation and the depletion of natural resources.

In its “traditional medicine strategy: 2014-2023″, WHO states that as traditional medicine becomes more popular “it is important to balance the need to protect the intellectual property rights of indigenous peoples and local communities and their health care heritage while ensuring access to (traditional medicine) and fostering research, development and innovation.”

WHO also warns that while intellectual property “may support innovation and provide a stimulus to invest in research, it can also be abused to misappropriate” traditional medicine.

The World Intellectual Property Organisation (WIPO) protects traditional medical knowledge against unauthorised use by third parties.

But WIPO’s Intergovernmental Committee on Intellectual Property and Genetic Resources, Traditional Knowledge and Folklore has not yet reached an agreement on an international legal instrument “for the effective protection of traditional cultural expressions and traditional knowledge, and to address the intellectual property aspects of access to and benefit-sharing in genetic resources.”

Meanwhile, the Mexican government has banned the use of some species of plants in infusions or vegetable oils because of the level of toxicity – a position rejected by traditional healers and experts.

The latest list, from 1999, prohibits 76 species, including some that are habitually used by herbalists and traditional medicine practitioners, such as calamus or sweet flag, hemp (a variety of cannabis), belladonna, wormseed, rue and salvia.

An updated version of the catalogue, expanded to 200 prohibited plant varieties, was prepared by the current government of conservative President Enrique Peña Nieto in September 2014, but has not yet gone into effect.

Argueta said the list is a “contradiction, because instead of informing about the problems, it acts in a punitive manner, without providing information.”

Calixto said: “We don’t agree that curative plants should be declared toxic.”

Euan also disagrees. “We don’t understand why they want to hurt us, when what we need is support,” she complained.

Argueta suggested that one solution would be to register traditional medicine as intangible cultural heritage with the United Nations Educational, Scientific and Cultural Organisation (UNESCO).

“We are dedicated to collecting quality information about this sector, to offer a complete, dignified image,” he said.

Edited by Estrella Gutiérrez/Translated by Stephanie Wildes

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Zimbabwe’s Smallholder Farmers Seek Address Food Security and Health Risks with Air Tight Storage Technology Mon, 26 Oct 2015 22:23:48 +0000 Busani Bafana 1 Agricultural Keys to Malaria in African Highlands Fri, 23 Oct 2015 17:33:32 +0000 Mzizi Kabiba By Mzizi Kabiba
KAMPALA, Uganda, Oct 23 2015 (IPS)

Sixty-five years after a major international summit here on malaria, the mosquito-borne disease remains a scourge and its incidence may even be rising in parts of sub-Saharan Africa due to the combined effects of climate change, agricultural practices and population displacement.

Almost half the world’s population is deemed at risk of malaria, and an estimated 214 million people will contract it in 2015, with nearly half a million dying.

Credit: FAO

Credit: FAO

“Malaria is the number one public health problem in our country,” says Babria Babiler El-Sayed, director of Sudan’s Tropical Medicine Research Institute. Sudan has begun, with the assistance of FAO and the IAEA, to release sterilized male mosquitoes into the air in hopes that they crowd out their virile brethren and lead to reduced mosquito populations.

The Unite d Nations Food and Agriculture Organization (FAO) and the International Atomic Energy Association (IAEA) have used this “nuclear” technique with success against the lethal tsetse fly and the produce-destroying fruit fly. Malaria is a new area, and the two agencies are experimenting across East Africa with this so-called Sterile Insect Technique (SIT) of pest control.

And yet malaria is demonstrably preventable – and that is why it is explicitly named in Sustainable Development Goal No. 3 as something to be ended by 2030.

The key is not to rely on one method or tool but to develop integrated efforts to subdue the disease, notes El-Sayed.

That fits FAO’s broader approach. While working with the IAEA on the logistics and technology of SIT, field officers emphasize the need to integrate agricultural practices ranging from crop selection, tilling technique, water use and even rural home locations.

It’s a shift from 1950, when a World Health Organization conference held in Kampala resolved to support the intensive use of Dichlorodiphenyltrichloroethane (DDT) to eradicate the disease. As was learned the hard way, even such a potent chemical cannot on its own sustainably solve the problem. Indeed, in the emblematic case of the Tennessee Valley in the United States, it was a mass anti-poverty campaign coupled with a huge hydroelectric public-works program that led to the rapid demise of malaria without the use of chemicals in the 1930s.

Warmer climate helps bugs fly higher

Particularly alarming is malaria’s literal ascent into the densely-populated highlands of east Africa. Inhabitants of southwest Uganda and parts of Zambia and Rwanda typically lack the genetic resistance to malaria developed by farmers in mosquito-prone areas.

Climate change wreaks all sorts of changes in the risk profile of the human environment. For example, more and more Zambians are killed by crocodiles, lions and buffalos as they travel further for water in times of drought. Less headline-grabbing, but more pervasive, is the way one poor harvest can wipe out livelihoods, driving people to sell their livestock, tools and even land in a bid to survive and ending up mired in poverty. Similarly, pressure on the land – sometimes linked to civil conflict – is driving record flows of migrants, the majority of whom don’t leave their countries, but move into new ecosystems, as scores of Ugandans are doing by moving to the hilly southwest regions of this country and ultimately taking up a form of farming that enhances the risk of malaria.

Add to this the steady climb in average temperatures, which increase the potential habitat for the main malarial vectors and are “related to altitude rather than latitude,” according to recent research done by the International Food Policy Research Institute into why the incidence of malaria has risen so dramatically in Uganda’s upcountry. That spells special risks for elevations above 2,000 meters in Kenya, Ethiopia and Burundi, too.

Strategies must be integrated and local

Despite popular images today, malaria is not particularly a tropical disease. Indeed, it was the successful use of DDT in postwar Italy that galvanized the Kampala conference, even though it now appears the rising incomes linked to Marshall Plan-funded economic growth was the determining factor.

Integrated methods – farming techniques, crops themselves, and human practices such as the use of nets – are all part of any success story in malaria. Zambia’s Malaria Institute at Macha has, with international support, practically eliminated malaria in its southern district, and the credit should go primarily to an engaged community effort, according to Dr. Phil Thuma, one of the institute’s mainstays and an advocate of what he calls “full court press” tactics in battling the epidemic.

FAO has long been involved in distributing mosquito nets, one of the simple but critical tools in any effort. Indeed, one current FAO project promotes the use of insecticide-treated nets around livestock barns in Kenya and has led to a sharp uptick in dairy production as both humans and animals are healthier.

The media has long indulged in donor-depressing tales about Zambian fishermen using anti-mosquito nets to boost their catch or – in one quirky story from Uganda but published in Botswana – p eople using the nets to make bridal dresses. But in fact most people in eastern Africa have and use their government-provided nets today, and many buy another one in a sign of conviction about their utility, according to a detailed survey of actual behaviour in Tanzania.

The real problem is that many farmers have to get up before dawn, or stay out in their fields late, and as a result their work forces them to forgo protection during the biting hours.

Almost everybody knows the basics about malaria, but few had heard about climate change. Intriguingly, those with secondary or higher education tended to worry about unpredictable rain patterns while those with only primary education are focused on rising temperatures.

Empirical surveys clearly show that where cultivation practices reduce vegetation cover, temperatures rise in mosquito breeding sites. That means land use and reforestation efforts need to be part of the community-driven policy mix. Farmer field schools, a longtime FAO priority focus, are key to spreading knowledge that is locally useful, such as casting shade on breeding places or fostering fish in ponds.

Developing “malaria-smart” programs need to be drawn up with that in mind, especially given efforts to increase irrigation infrastructures to boost agricultural yields in sub-Saharan Africa. One survey in Ethiopia found that the rate of childhood malaria was seven times higher in villages within three kilometres of a microdam for irrigation than children living more than eight kilometres away.

Maize cultivation, a huge force in the region, may also be lifting the incidence of malaria because the higher-yield hybrid varieties used pollinate later in the year, helping fatten up mosquito larvae – meaning more, bigger and longer-living adult ones.


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Opinion: TPP is Bad for One’s Health Thu, 22 Oct 2015 20:14:05 +0000 N Chandra Mohan

Chandra Mohan is an economics and business commentator.

By N Chandra Mohan
Oct 22 2015 (IPS)

Reflecting President Barack Obama’s pivot to Asia, the US, Japan and 10 other Pacific Rim nations have inked a Trans-Pacific Partnership (TPP) agreement. This is the largest mega free trade agreement (FTA) in two decades and represents 40 per cent of the global economy.

N Chandra Mohan

N Chandra Mohan

This pact puts tremendous pressure on the European Union to conclude its Transatlantic Trade and Investment Partnership with the US. China, too, will seek to hasten the Regional Comprehensive Economic Partnership. With the Wold Trade Organization (WTO) unable to conclude the Doha Round, India’s policy makers feel that it is in the country’s interest to be part of at least one of these mega FTAs that reflect the new global architecture for trade.

What are India’s gains if it joins the TPP? According to economic theory, the trade creation after joining this grouping will benefit India as its exports go up manifold. Cheaper imports, in turn, lower inflation. There will also be much greater Indian participation in US and Japanese supply chains in the Indo-Pacific region. Larger export markets would bring economies of scale to textile and other manufacturing firms. But there will be an adverse impact on the demand for its products if it does not join. Vietnam thus will gain at India’s expense in garment exports as it enjoys duty free access to the US while India faces duties of 14-30 per cent.

But TPP is less about trade and more to do with stricter intellectual property rights (IPRs), labour, environment standards and investor-state dispute settlement. Its IPR regime is Big Pharma-driven with provisions that adversely affect the availability of affordable medicines in the developing world. In fact, it would be disastrous for public health in India. The proviso to grant patents to “new uses of a known product” is fraught with grave implications as it may lead to ever-greening of patents. Similarly, the special treatment extended to pharmaceutical patents, placing them in a preferred category compared to other technologies, by patent term adjustment for regulatory delays, also will lead to a longer term for patents, argued TC James, consultant with the think-tank RIS at a recent panel discussion on TPP.

This trade pact thus will bring in new handicaps for India’s pharmaceutical industry, which are mostly generics, from getting marketing approvals. A case in point is the data exclusivity provisions for test data of biologics – which are grown from live cells – for five to eight years. These constitute a major barrier for the entry of cheaper generic versions, or biosimilars, in which India has a proven world-class capability. US law protects data collected during the development of biologics for 12 years. Pressure from Australia and others ensured that this was brought down to five years but this could go up to eight years.

In the fine-print of Article QQ.E.20, Big Pharma ensured that market exclusivity for biologics is provided either through at least eight years of data protection, or at least five years of data protection with other measures to “deliver a comparable outcome in the market,” As the latter option is problematical, market exclusivity will inevitably extend further by another three years. This means a longer period when monopoly pricing can be exercised by Big Pharma that will raise the price of drugs and take them out of reach for many people in India and even in the 12-menber grouping, for that matter.

India will thus seriously compromise its public health objectives if it chooses to join TPP. It has a well-established legal framework for IPRs and its courts have been active in enforcing this regime, exemplified by the denial of a patent for an anti-cancer drug to a foreign drug major in 2013 as it did not meet the criteria of inventiveness in India’s Patent Act. Such judicial activism has also been manifested in the award of a compulsory licence for the local manufacture of an anti-cancer drug due to the unaffordable prices charged by the global pharma giant that held the patent.

Not surprisingly, Big Pharma has for long been up in arms against India’s IPRs and has sought to pressurize the country to dilute some of the rigours of its legislation for drug patents. The United States Trade Representative has listed India under the Priority Watch list for the enforcement of its patent legislation, especially for drugs even though it is Agreement on Trade Related Aspects of Intellectual Property Right-compliant. What better opportunity to make amends under the guise of joining TPP. Compulsory licensing thus is a no-no. So is Section 3(d) of India’s Patent Act, which raises the bar for what is inventive to be granted a patent. These flexibilities provided by WTO’s TRIPS agreement are bound to clash with TPP that has low inventiveness thresholds to be granted patent protection.

India must not buckle under such pressures to weaken its IPR legislation. According to its national policy on IPRs, the right to health is an integral part of the right to life enshrined in the Constitution of India. India is committed to providing its citizens access to affordable medicines, quality healthcare and innovative products and services. The Patents Act as amended in 2005 protects innovation in pharmaceuticals and provides for measures to safeguard public health. India should continue to use the flexibilities available under TRIPS agreement and not compromise on the patent linkage and patent term extensions sought by TPP.

Nonetheless, India shouldn’t desist from efforts to engage with Big Pharma if it entails win-win outcomes that ensure affordable drugs to its people. The US drug major Gilead Sciences Inc introduced tiered pricing, whereby it charges lower prices in India compared to prices in the US. Gilead and nine Indian companies entered into a partnership based on effective IPR protection and licensing to produce an affordable version of a drug for Hepatitis C. India thus has access to patented products at affordable prices while ensuring a decent return for the innovating company. Can’t other US drug majors be persuaded to follow Gilead’s example? India does not need to join the 12-member grouping for such outcomes that further its public health objectives.


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Africa’s Senior Citizens Cornered By Poverty Wed, 21 Oct 2015 19:34:48 +0000 Miriam Gathigah2 0 Kenya: Transforming Mandera County’s Deadly Reputation for Maternal Health Mon, 19 Oct 2015 06:31:04 +0000 Siddharth Chatterjee @sidchat1) is the UNFPA Representative to Kenya.]]> Photo Credit: @islamicrelief

Photo Credit: @islamicrelief

By Siddharth Chatterjee
Mandera County, Kenya, Oct 19 2015 (IPS)

For many women in Mandera County – a hard to reach, insecure and arid part of North Eastern Kenya – the story of life from childhood to adulthood is one about sheer pain and struggle for survival.

As little girls, they undergo female genital mutilation (FGM), a painful carving out of the external genitalia that leaves them with lifelong physical and psychological scars.

Most girls will be married off when barely into their teens, forcing them to drop out of school, their immature bodies thrust into the world of childbearing.

As a result, Mandera – just a two-hour flight from the dynamic, modern East African hub of Nairobi – has maternal mortality ratio of 3,795 deaths per 100,000 live births, a rate that surpasses that of wartime Sierra Leone (2000 deaths per 100,000 live births) and far above Kenya’s national average (448 deaths per 100,000 live births).

Mandera is an example of a marginalized community rife with internecine conflicts, pockets of extremism, poor human development and cross border terrorism, where residents are trapped in poverty, misery and desperation. Cultural norms like status of the women, FGM and child marriage makes it worse. Among the poor, inequities hurt women and girls most.

However, things are looking up. Kenya’s decision to devolve government, putting much more power in the hands of local authorities, is having an impact on the ground. Indicators such as number of health facilities offering basic maternal and child health, and the number of women giving birth in a health facility, are improving.

Just as critical to these improvements is the recently established private sector’s coalition to transform the health landscape of this county, long considered a lost frontier. The goal of this coalition is to develop new products and service delivery models, like community life centers (CLCs) to improve maternal and new-born health among most vulnerable populations in Kenya.

An inter-agency team consisting of the Office of the President of Kenya, Ministry of Health, Kenya Red Cross, UNOCHA, Save the Children, technology company Philips, Amref, Safaricom, GlaxoSmithKlein and UNFPA, visited Mandera on 13 October 2015 with the ambassadors of Turkey and Sweden to Kenya, to launch a Ministry of Health-UNFPA–Philips innovation partnership.

The UNFPA and Philips CLC project is expected to bring quality primary healthcare within reach of about 25,000 people through small improvements that enhance the functionality of health facilities like 24-hour lighting that will allow facility deliveries to take place and sick children attended after dark. If successful, this initiative could be scaled-up and transform maternal and child health in Mandera county.

Mandera has long remained out of bounds for most international UN staff and diplomats due to insecurity. Hopefully the visit by the Turkish and Swedish ambassadors , who are ardent advocates of the rights of women and children, will pave the way for more visits to all the country’s North Eastern counties which face similar challenges.

The ambassadors spoke of their countries’ commitment to work with the county to change the narrative, especially to advance the rights and wellbeing of all women and girls.

The broader partnership, which also includes Huawei, Kenya Health Care Federation and MSD, together with the United Nations’s H4+ partners, will focus on the six counties with a high burden of maternal mortality: Wajir, Marsaibit, Lamu, Isiolo, Migori and Mandera.

The main activities in these six counties will include strengthening supply chain management for health commodities, increasing availability and demand for youth-friendly health services, capacity building for health professionals, youth empowerment and research. These activities be complemented by the results-based financing supported through the Health Results Innovation Trust Fund managed by the World Bank.

It is also in line with the full-scale Kenyan government commitment to reduce maternal deaths and the new polices of free maternity care and user fee removal.

Kenya’s First Lady Margaret Kenyatta once remarked that “I am deeply saddened by the fact that women and children in our country die from causes that can be avoided. It doesn’t have to be this way. This is why I am launching the ‘Beyond Zero Campaign’ which will bring prenatal and postnatal medical treatment to women and children in our country.”

The dividend from healthier women will be a more educated and healthy society, with more economic opportunities and reduced exclusion which will engender peace and hopefully reduce the drivers of violent extremism.

It will be a major score for Mandera towards fulfilling the vision of UN Security Council Resolution 1325, which is about empowerment and participation of women, ending discrimination and the scourge of harmful traditional practices like FGM and child marriage.


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In Hawaii, Concern Rises about Use of Farm Pesticides Fri, 16 Oct 2015 21:32:24 +0000 Christopher Pala Tammy Brehio of Kihei, Hawaii, pointing from her back balcony to a Monsanto cornfield a few hundred yards from her house.  The inset photo, taken by Tammy, shows a Monsanto tractor spraying pesticides. Credit: Photo by Christopher Pala.  Inset photo by Tammy Brehio.

Tammy Brehio of Kihei, Hawaii, pointing from her back balcony to a Monsanto cornfield a few hundred yards from her house. The inset photo, taken by Tammy, shows a Monsanto tractor spraying pesticides. Credit: Photo by Christopher Pala. Inset photo by Tammy Brehio.

By Christopher Pala
KIHEI, Hawaii, Oct 16 2015 (IPS)

Tammy Brehio stood on the back balcony of her home in Kihei on the island of Maui and pointed to a brown field a few hundred yards away.

“That’s where they spray the pesticides, even when the wind is blowing directly at us,” said the 40-year-old year mother of three small children. “Ever since we moved here, we all have sore throats and we cough all the time.”

She and a neighbour, who declined to be identified because he works for an agricultural company and feared losing his job, said the spraying often takes place at night. “It wakes me up, it smells really strong and it’s hard to breathe,” Brehio said.

“We do not apply pesticides at night,” said Monica Ivey, the spokeswoman for Monsanto, which grows genetically modified corn on the field. “Monsanto complies with all federal and state laws that govern responsible pesticide use.”

Whether or not the companies respect these laws, which forbid allowing pesticides sprayed on a field to drift beyond it, has become one of the biggest controversies in Hawaii in the past few years.

Over the past decade or so, Monsanto, DuPont and Dow Chemical of the United States, Bayer and BASF of Germany and Syngenta of Switzerland have more than doubled their acreage in Hawaii. Attracted by a year-round growing season that cuts in half the time it takes to bring a new variety to market, they have turned the Aloha State into the epicentre of corn grown with genes modified in laboratories – designed mostly to tolerate the pesticides the companies produce and sell to farmers with the corn.

The kernels grown in Hawaii are sent the mainland United States, where they are planted and harvested. Those kernels are then sold to farmers, whose production ends up mostly as cattle feed and ethanol. The corn sold as food is known as sweet corn and constitutes perhaps one percent of the industrial variety, which is known as field corn.

The agro-chemical companies now own or lease about some 25,000 acres on the islands of Maui, Molokai, Kauai and Oahu – about 2 per cent of the land area. Because the islands are mountainous and farmland is scarce, the fields often abut homes, businesses and schools. Most of these fields were previously used to grow sugar cane and pineapple, and the towns grew around them in the 19th and 20th centuries.

At any given time, about 80 per cent of the fields are bare and brown. The crops are grown in small patches of a few acres and sprayed often with pesticides, which residents complain that they often are forced to inhale.

Even a mile from the nearest cornfield in downtown Waimea, on the island of Kauai, Lois Catala, 75, reports that the pesticide clouds percolate into her home with no warming. “All of a sudden, your eyes are burning and you’re itching all over, and you hear everybody complaining,” she said. A local doctor says she stopped biking to work on a road that bisects cornfields because she went through clouds of pesticides too many times. Other residents interviewed told of similar experiences.

Testing new varieties of pesticide-resistant field corn and growing seed corn from them requires 17 times more restricted-use insecticides and more frequent applications than farmers in the US use for their crops, a study by the Center for Food Safety has concluded. Court documents filed by attorneys for Waimea homeowners who successfully sued DuPont for pesticide and dust impacts to their homes show the company sprayed 10 times the mainland average, based on internal pesticide records obtained from DuPont.

The frequent, sometimes daily, sprayings have led to a spate of complaints that the companies violate with impunity federal and state laws.

The laws say that commercial applicators who spray pesticides that winds carry out of their property is liable for a $25,000 fine and/or six months in jail. The pesticides receive approval from the federal Environmental Protection Agency only after being tested for their legal use, which does not include human inhalations.

In 2006 and 2008, Howard Hurst was teaching special-education classes at Waimea Middle School, on Kauai, when clouds of what he believes were concentrated pesticides blew into the school from an adjoining field operated by Syngenta. “It feels like you have salt in your eyes, your tongue swells, your muscles ache, it’s awful,” he said in an interview at the school. Both times, the school was evacuated and several students were treated at the nearest emergency room.

But the state authorities, instead of prosecuting the Swiss company, which denied that it was spraying on those days, insisted that the evacuations were caused by mass hysteria triggered by an onion-like plant called stinkweed.
Without ever accepting responsibility, Syngenta stopped using the field adjacent to the school. The closest is now a half-kilometer away. Hurst said pesticide odors have become much less frequent.

In 2013, the Kauai county council passed a law ordering the companies to create wider buffer zones and to disclose in far more detail than they do now what they spray, where and when. A group of doctors in Waimea, which is surrounded by cornfields on three sides, testified that the number of cases of serious heart defects in local newborns was 10 times the national rate.

Meanwhile, in Honolulu, a pediatrician said in an interview that he’d noticed a statewide spike in another birth defect called gastroschisis, in which the baby is born with the abdominal organs outside.

“Data suggest that there may also be an association between parental pesticide use and adverse birth outcomes including physical birth defects,” the American Academy of Pediatrics reported this year.

“I think it’s serious,” says Bernard Riola, a pediatrician in Waimea. “We need an in-depth epidemiological study. Right now, we just don’t know” if the pesticides are causing the birth defects. Another doctor at the hospital said he tried to get the state to do just such a study, to no avail.

Bennette Misalucha, the head of the agro-chemical companies trade group, the Hawaii Crop Improvement Association, dismissed the doctors’ concerns. “We have not seen any credible source of statistical health information to support the claims,” she wrote in an e-mail after declining to be interviewed.

The companies she represents strongly opposed the buffer-zones and disclosure law, which resembled others passed in 11 other states. They argued that it would drive away the companies and cause job losses, and that critics of the pesticide-drift problem were simply victims of scare-mongering by opponents of genetically modified food.

They sued and a federal judge struck the law down, arguing that only the state can regulate pesticide use. Civil Beat, a Hawaii news site, reported here that it effectively does not.

In Maui and Molokai, which form one county, a bitterly fought ballot initiative was approved by the voters in November 2014 banning genetically modified agriculture until an Environment Impact Statement is performed and proves the industry is safe.

The companies spent $8 million to fight it, reportedly the most spent on any political campaign in Hawaii history. Another federal judge struck it down on the same grounds as the Kauai ordinance: that only the state can regulate pesticide use. Both rulings are being appealed.

Back in Maui, Brehio, the mother of three who says she is dispirited by the lack of progress in curbing illegal pesticide drift, was remodeling her kitchen with her husband and preparing to sell their house. “This is a not a safe place for me and my family,” she said.

Meanwhile, construction has started on a strip of land between her house and the Monsanto field for a 660-unit affordable-housing development where the cheapest units will be right against the Monsanto fields.

“This report was supported by a grant from the Fund for Investigative Journalism.”

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