Children involved in the UActive visit a school in the Mykolaiv region that Russian forces destroyed. It cannot be rebuilt. Credit: UActive

By Ed Holt
BRATISLAVA, Apr 28 2026 (IPS)

“What’s important is to make sure that you can immerse yourself in an environment that is positive for your mental health and wellbeing,” says Olena*.

Olena, from Ukraine’s Kharkiv region, was just 12 when Russia’s full-scale invasion of her country began on February 24, 2022. Over the last four years she has seen all her close friends leave the small town she lives in, most to move abroad, and experienced deadly bombings by Russian forces on her home town.

Meanwhile, much of her schooling in that time has been online because the permanent threat of shelling makes it unsafe for authorities to keep her school open.

She admits all this has taken a toll on her mental health.

“I had the most devastating experience when my town was bombed and some people were killed. The sound of explosions and drones causes constant tension still,” she tells IPS.

“I miss having all my friends here. Before the war, we used to spend so much time together – walking around the city, celebrating each other’s birthdays, and simply sitting somewhere and talking for hours. Now many of them are abroad, building new lives. I’m happy they are safe, but I deeply miss the feeling of unity,” she says.

“And for almost four years we [kids in the town] have been studying online. We see our classmates much less, and simple things like chatting during breaks or working on group projects feel like something from another life. We grew up faster than we expected.”

Olena is just one of millions of children in the country whose lives have been upended by the conflict.

As the full-scale invasion goes into its fifth year, research shows the devastating effect it has had on Ukrainian children, displacing millions, plunging many into poverty, and exposing them to the loss of loved ones and other trauma. Meanwhile, 1.6 million have had their education disrupted due to displacement, facility damage, and insecurity. According to UNICEF, one in three children are unable to attend in-person school full-time and more than 1,700 schools have been damaged or destroyed. The Save the Children group has said that Ukrainian children missed 20 percent of lessons during the last academic year alone because of frequent air raid warnings.

Meanwhile, Save the Children has estimated that over a million children have spent hundreds of days with either no or limited face-to-face teaching as schools have moved to online learning for security reasons since the start of the war. This came not long after schools had finished lengthy periods of online learning implemented during the Covid pandemic, meaning some children have had little in-class learning since 2020.

All this has taken a huge toll on the mental health of children and adolescents, local and international groups working with kids in the country have said.

According to UNICEF, a third of households have reported children displaying signs of psychosocial distress.

“Children’s mental health is increasingly under strain. The constant fear of attacks, displacement, endless sheltering in basements, and isolation at home with limited social connections have left children and adolescents struggling,” Toby Fricker, UNICEF Ukraine Chief of Advocacy and Communication, told IPS.

This has been expressed in a variety of emotional and physical expressions of symptoms, mental health experts have said.

These include irritability and emotional instability, particularly among adolescents, and social withdrawal.

“It can be said with sad certainty that since the start of the full-scale invasion of Ukraine by Russia, which is now in its fifth year, the most common issues observed among adolescents are increased anxiety, fear, and chronic stress related to a constant sense of danger and uncertainty. Many teenagers experience emotional exhaustion, sleep problems, difficulties with concentration and learning, as well as decreased motivation,” Daria Lavrenko, a psychologist in the Kyiv region who works with children aged 12 to 18 who have been displaced from regions near the frontlines, told IPS.

Children participate in UActive programmes which include rebuilding infrastructure damaged in the war. Credit: UActive

“Manifestations of social isolation and difficulties communicating with peers have also become quite common, largely due to prolonged distance learning, frequent air raid sirens, and the loss of a familiar school environment. In addition, adolescents often show deep grief reactions due to the loss of relatives on the frontline or as a result of Russian attacks on civilians. Increased irritability, emotional instability, and difficulties with emotional regulation are also frequently observed, which are natural psychological responses to the prolonged traumatic experience of war,” she said.

But severe somatisation of symptoms, including facial tics, involuntary head movements, and speech disorders, have also been frequently reported. Sleeping disorders are common, especially among young children.

“These are common reactions when the body is suffering the consequences of mental health strain,” Viktoria Kondratyuk, a psychologist who works with the humanitarian group War Child on projects in Ukraine, told IPS. “It affects the immune system, weakens it, and that’s why you see so many [children] getting sick, especially in the winter],” she added.

Since the full-scale invasion, the Ukrainian government has moved to increase provision of mental health support through the approval of key legislation and the implementation of a nationwide mental healthcare programme.

At the same time, NGOs are working with regional administrations and local communities to improve public access to mental health services and psychosocial support, including providing informational and educational activities and integrating psychosocial support into existing social and educational services. It is hoped this will expand access to assistance for vulnerable groups and greater support for children and adolescents.

However, problems with access to such services, and recognition of mental health problems by those affected, mean many children are not getting the help they need, experts say.

“Many teenagers who experience psychological difficulties as a result of the war do not receive the help they need in time. This is partly due to limited access to specialists in certain regions where infrastructure has been damaged or where there is a shortage of mental health professionals. At the same time, attitudes toward mental wellbeing remain an important barrier,” said Lavrenko.

“Some teenagers avoid seeking help because they fear judgement, do not want to appear ‘weak’, or believe that their experiences are not serious enough. In addition, prolonged life under the conditions of war changes how young people perceive their own emotions. Many painful feelings—such as fear, anxiety, and helplessness—may be minimised or suppressed as the psyche attempts to adapt to constant danger and maintain the ability to function. This is a natural psychological defence mechanism; however, it can also lead to children and adolescents remaining without the support they need for long periods of time.

“Furthermore, adults do not always immediately notice or correctly interpret children’s emotional difficulties, as they themselves are often exhausted by the ongoing traumatic reality of war,” she said.

Lavrenko added that a different approach needed to be taken to mental health care given that Ukraine has been at war for so long.

“Under current conditions, improving adolescents’ mental health cannot be limited only to traditional approaches to psychological care. Ukraine is living through a full-scale war for a fifth year, and in this context, support for mental health often comes from things that are considered a normal part of life for teenagers in other countries: the ability to study consistently, communicate with peers, participate in extracurricular activities, think about the future, and make plans for their careers. This is why it is extremely important to create and expand programmes aimed at addressing educational losses and restoring opportunities for adolescents to socialise,” she said.

IPS spoke to a number of teenagers in different parts of Ukraine about mental health and access to services for them and their peers.

While not all have accessed specific mental health services, some said they had and that it had helped them. Some said they felt there was adequate access for them to psychosocial services, but others said it was woefully lacking, especially in schools where they felt it should be either discussed in classes more frequently or even taught formally as a subject.

“Teachers rarely discuss this in schools – it needs to be made part of the curriculum,” Andrej*, 16, from the Kyiv region, told IPS.

However, all of them pointed to the benefits of the kind of programmes referred to by Lavrenko.

The teenagers who spoke to IPS were involved in one such programme, UActive, in which children participate in initiatives helping rebuild towns and cities damaged by fighting.

They all said the project had given them a sense of purpose and hope for the future.

“Being part of UActive became a source of hope. It reminded me that even in dark times we can build something meaningful. Through our meetings and projects, I felt unity, support, and real motivation to act instead of just worrying,” said Olena.

“Some special sessions organised by UActive orientate toward working with different aspects of mental health… encouraged me to seriously analyse my mental health and seek support when I need to,” Nadezhda*, a teenager from Kyiv, told IPS.

Organisations involved in projects for children in the country told IPS that programmes focused on child mental health could have a profound effect on improving child wellbeing.

“For adolescents, civic engagement helps them connect with their peers and find a sense of purpose amid the uncertainty of war. UNICEF’s UPSHIFT programme is one example of this, where we train youth teams and equip them with the skills they need to lead and implement projects that support the needs of their communities. Such activities also provide a sense of purpose at a time when they feel like they have little control over their lives and the situation unfolding around them,” said Fricker.

However, while both the children and organisations which spoke to IPS said access to such programmes and other forms of psychosocial care are key to helping children at the moment, they also believed that ultimately the best way of improving child mental health would be for the war to end.

Even then, though, experts believe that even after an end to the fighting, people will be struggling with mental health problems related to the conflict for many years to come.

“When a child lives for years in an atmosphere of danger, loss, instability, and constant stress, it inevitably affects the development of their psyche, their sense of safety in the world, and their ability to trust in the future. In terms of long-term consequences, some teenagers may continue to experience heightened anxiety, difficulties with emotional regulation, challenges in relationships, or uncertainty about their future for many years even after the war ends,” said Lavrenko.

She added though that there was hope that with proper action now, some of the worst long-term effects among children might be mitigated.

“It is important to remember that the human psyche has significant potential for recovery, especially when adolescents receive support, a stable environment, access to education, and opportunities for socialisation. This is why it is extremely important to invest in programs that support children and adolescents now, helping them gradually regain a sense of safety and build a healthy future,” she said.

*Names of all children have been changed for security reasons.

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Rescue workers survey the damage in the town of Toul in Lebanon’s Nabatieh governorate in the south, following bombing by Israel in response to rocket attacks by militant group Hezbollah. Credit: Action Against Hunger

By Ed Holt
BRATISLAVA, Apr 20 2026 (IPS)

Aid groups have welcomed a ten-day ceasefire agreed between Israel and Lebanon but warn only a permanent halt to fighting can allow for the kind of response needed to address the dire humanitarian situation in the country.

A ten-day truce ​to enable peace negotiations between the two countries came into effect on April 16. It can be extended by mutual agreement by both sides after that period.

The ceasefire comes after more than a month of conflict following Israel’s response to rocket attacks by the Iran-backed militant group Hezbollah.

Since March 2, more than 2,000 people have been killed and 7,000 wounded in Israeli attacks, according to the Lebanese health ministry. Meanwhile, more than 1.2 million – one fifth of the estimated total population – are internally displaced, including over 400,000 children, according to humanitarian organisations, and Israeli strikes have destroyed essential civilian infrastructure and heavily affected healthcare services.

This has deepened what was already a fragile humanitarian situation following years of economic problems, a Syrian refugee crisis, and previous conflict between Israel and Hezbollah.

And while the attacks may have stopped, many people continue to face displacement, massive destruction and a lack of access to basic services and real relief will only come with a long-term end to fighting.

“We welcome the truce as a critical pause in violence, but it is not enough. Only a permanent ceasefire will allow for a response at the scale required—one that reaches families across all of Lebanon, including those in border areas who remain among the most vulnerable,” Suzanne Takkenberg, Lebanon Country Director of humanitarian group Action Against Hunger (ACF), told IPS.

Following the announcement of the truce, there have been reports of huge numbers of displaced people returning to their home towns. Aid groups have warned, though, that many are likely to return to find they have no homes left, or even if they do, conditions are so bad it will be impossible to remain there.

“Families are beginning to return to their homes, but the scale of destruction is staggering. Many are finding their houses damaged or completely destroyed, with no access to water, electricity, or basic services. People who fled with almost nothing are now returning to even less—facing conditions that make dignified living impossible,” said Takkenberg.

The destruction has been worst in the south of the country. Israel has been looking to create what it has called a “security zone”, keeping troops in an area around 10 kilometres deep inside southern Lebanon. Reports suggest many villages in that area have been utterly destroyed.

Recent, intense Israeli airstrikes targeted Tyre, Lebanon, causing significant casualties and damage to residential areas and infrastructure. The strikes were part of an ongoing conflict between Israel and Hezbollah. Credit: Action Against

“This new buffer zone that Israel is talking about – from videos I’ve seen, it’s completely demolished. We don’t expect them to allow [people] to return there, and I don’t think people will be trying to move back to that buffer zone,” Elizabeth Cossor, Head of Country Office Lebanon at Terre des hommes, which is providing humanitarian aid to children and their families in the country, told IPS.

“Hundreds of thousands of people are expected to remain displaced. They’re not going to be able to return. That’s really devastating [for them],” she added.

The impacts of the attacks on civilians have alarmed rights groups and humanitarian organisations.

A coalition of NGOs last week released a report documenting the effects of Israeli attacks on the civilian population.

It highlighted how the continued displacement in the country is driving significant health and protection risks, with women, children, the elderly and persons with disabilities disproportionately affected.

Reports indicate high instances of respiratory infections due to cold temperatures in collective shelters, gastroenteritis cases linked to insufficient food and cooking facilities, and disruption to treatment for patients with chronic diseases. Shelters are invariably overcrowded and lack adequate water and sanitation infrastructure, severely limiting privacy, dignity and psychological safety for residents, the group said. Moreover, roughly 88% of those displaced are living outside collective shelters, many in cars, public spaces or other insecure settings, the groups said.

Children have been impacted especially hard by the fighting.

Aid groups working with children have highlighted serious problems with child nutrition. According to Action Against Hunger, while 24 percent of the population faces acute food insecurity, around 15 percent of children aged 6 to 23 months in displacement zones are being fed only milk.

Meanwhile, one in five children in Lebanon has been forced from their homes by the conflict, with many suffering acute psychological distress and anxiety, according to UNICEF.

“The humanitarian situation for children in Lebanon is severe and deeply alarming. Over the past 46 days, children have paid a devastating price, with reports of at least 172 children killed and 661 injured. More than 415,000 children have been displaced, some for the third or fourth time. Their most urgent needs are safety, healthcare, safe water, nutrition, psychosocial support, child protection and access to learning,” Ricardo Pires, Communication Manager at UNICEF, told IPS.

“Children have been uprooted repeatedly, many are under acute stress, and essential services have been badly disrupted. The health system is still operating, but under severe strain. Hospitals and health workers have come under repeated impact, facilities have been damaged or forced to close, and access to care is increasingly difficult in high-risk and isolated areas. The destruction already caused to homes, schools, hospitals, water systems and roads means many children and families are likely to face serious hardship for some time, even if the fighting stops. It continues to have serious humanitarian consequences for children and families,” he added.

Cossor said the conflict could have a long-term impact on a generation of Lebanese kids.

“We still don’t have a sense of just how many children have lost their parents, their caregivers. We’re visiting hospitals where children are waking up and discovering that they’ve lost their parents and, you know, it’s just devastating. For those who also cannot return to their childhood home, you know, they’re not in school, missing family, they’ve lost their homes…. They’re losing part of their childhood, their connection to the place of their family, the place of their community. This has very long-term impacts for children,” she said.

As well as highlighting the harm caused to the civilian population, the NGOs’ report pointed to serious concerns regarding compliance with International Humanitarian Law (IHL), particularly the principles of distinction, proportionality and precautions in attacks. Likewise, IHL affords special protection to medical and humanitarian personnel and infrastructure, yet the conflict has been marked by a concerning number of attacks affecting healthcare and growing restrictions on humanitarian access, the groups said.

They also called for adherence to the IHL by all parties to the conflict, as well as urgent, sustained, and flexible funding from the international community to support the growing needs of displaced persons and those remaining in vulnerable areas.

International help will be vital given the damage that has been done, no matter what efforts the Lebanese government makes to help the population.

“The government will repair things as best they can in the cities that are north – again, north of that buffer zone area. They will do their best to restore, rehabilitate, but services will be heavily impacted. Eight bridges [in southern Lebanon] have now been destroyed, and Lebanese forces have managed to sort of put rubble together so that the last destroyed bridge is passable one car at a time. But that’s not enough to start bringing big trucks of humanitarian assistance or to start bringing in food and vegetables and other medical supplies and other things that they need in the south,” said Cossor.

“Infrastructure is destroyed, including in heavily populated areas. The Lebanese government will need enormous assistance to restore this infrastructure,” she added.

Beyond these problems, another major concern is the fragility of the current ceasefire – within hours of it coming into force, there were reports of violations.

UNICEF’S Pires said the ceasefire offered a critical opportunity to improve humanitarian access and begin restoring basic services in all areas impacted by the recent attacks. He warned, though, that if it collapsed, there would be “a grave risk of further killing, injury, displacement and trauma”.

“The weapons must remain silent and humanitarian access and workers must be protected at all times,” he said.

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The UNFPA released a report detailing how women were suffering widespread mistreatment during childbirth across Eastern Europe and Central Asia. Credit: UNFPA

By Ed Holt
BRATISLAVA, Mar 30 2026 (IPS)

Government and medical professionals must implement systematic changes to deal with a “crisis” of obstetric violence (OV) across Eastern Europe and Central Asia (EECA), experts and rights campaigners have said.

The call comes as the United Nations Population Fund (UNFPA) released a report on March 12 detailing how women were suffering widescale mistreatment during childbirth across the region.

“This report is a wake-up call. All stakeholders must make sure that women’s rights are respected and protected in all facilities in the health system and beyond,” Tamar Khomasuridze, UNFPA Sexual and Reproductive Health Adviser for Eastern Europe and Central Asia, told Inter Press Service (IPS).

The report, Respectful Maternity Care: Women’s Experiences and Outlooks in Eastern Europe and Central Asia, highlighted what the UNFPA said was a “pervasive yet often hidden OV crisis that violates women’s fundamental human rights and dignity”.

The survey, which was based on online responses from over 2,600 women who gave birth recently and conducted across 16 countries and territories in the region, found that 67 percent of respondents reported at least one form of mistreatment, including non-consensual medical procedures, verbal and physical abuse, and significant breaches of privacy.

Nearly half (48.1 percent) of women underwent obstetric procedures – such as episiotomies, Caesarean sections, or the administration of oxytocin – without their informed consent.

Meanwhile, about 24 percent of surveyed women reported experiencing verbal abuse, including yelling and humiliation, and 1 in 10 endured physical or sexual abuse during labour or gynaecological examinations. For example, 12 percent of the surveyed women reported being physically restrained during labour, such as being tied to the bed or subjected to aggressive physical contact under the pretext of facilitating delivery. Just over 10 percent experienced different forms of sexual abuse, ranging from inappropriate touching to more severe forms of assault (disrespectful manipulation of the genitals).

The survey also revealed a massive lack of awareness of OV among women in the region – almost 54 percent of surveyed women said women were unfamiliar with the term “obstetric violence”. And of those that knew they were victims of OV, very few reported such incidents – only two percent of those mistreated officially reported their experience, often due to a lack of trust in accountability mechanisms or fear of retaliation.

Previous research into the extent of OV in the region is limited and experts say it is difficult to gauge whether the situation in the region has changed in recent years.

But campaigners say the report underlines that it remains a serious problem.

“Obstetric violence has always existed, but for a long time it remained invisible, normalised, and embedded within what was perceived as ‘standard medical practice’. The major shift over the past decade is not necessarily in the prevalence of the phenomenon but rather in its increased visibility at the public, legal, and institutional levels, including its inclusion on the global agenda of human rights and public health,” Alina Andronache, a gender public policy expert at the Partnership for Development Center (CPD) in Moldova, who helped author the UNFPA report, told IPS.

“The report outlines a mixed picture: recognition and visibility of the phenomenon are increasing, yet the prevalence of experiences of abuse, coercion, and lack of consent remains alarmingly high,” she added.

Rights activists say that the phenomenon is closely linked to the wider issue of prevalent attitudes to women in the region.

“The report clearly shows that obstetric violence is not merely an issue of inadequate medical practices but is deeply embedded in broader social and cultural structures—particularly gender discrimination, power imbalances between the patient and medical staff, rigid institutional hierarchies, and norms that socialise women to accept authority without questioning it, including in highly intimate and vulnerable contexts such as childbirth,” said Andronache.

She highlighted the report’s finding that 58.4 percent of respondents believe that a mother must accept any intervention for the benefit of the child, even if it may harm her, while 19.6 percent consider that doctors may take a decision without a woman’s consent to protect the child.

“These perceptions reflect a profound internalisation of the idea that women’s bodily autonomy can be suspended during childbirth in favour of a medical authority perceived as unquestionable. This internalisation has two major consequences: it legitimises abusive or coercive practices, which are no longer perceived as violations of rights but as ‘necessary’ or ‘medically justified’ interventions, and it  directly contributes to underreporting and to the difficulty of recognising obstetric violence as such. If women are socialised to believe that they do not have the right to refuse, to ask questions, or to negotiate interventions, then their experiences are not necessarily identified as abuse but rather as a ‘normal’ part of childbirth,” she explained.

The report includes a call to action that outlines critical steps to address systemic problems with OV in the EECA states. These include legislation to protect women against OV; human rights-centred training for all healthcare personnel to shift clinical attitudes and ensure dignity is maintained at the point of service, as well as implementing monitoring and other measures to ensure accountability; and strengthening education and wider awareness of OV.

The UNFPA says its call to action has been endorsed by all countries in the survey and other stakeholders and will become part of action plans on OV at the national level.

But it is unclear how easy it will be to effect meaningful change, especially in a region where some countries have very conservative social cultures and wider problems with women’s rights.

The report showed that among respondents from Central Asian countries, such as Kazakhstan, Kyrgyzstan and Uzbekistan, around two thirds of women were unaware of OV. The report says this is due, in part, to traditional norms surrounding women’s roles and childbirth, which may make women less open to discussions about obstetric abuse.

Khomasuridze admitted that there were “of course sensitivities in different countries” in the region but was confident that with the help of various stakeholders, including civil society organisations, women’s rights groups and patient groups, changes would be implemented.

Andronache said that in countries where strongly conservative political policies and societal attitudes are prevalent, it was crucial that “the message be adapted to the context”.

“In more conservative societies, the approach should not be perceived as confrontational or ideological but rather framed as an issue of safety, dignity, and quality of care for both mother and child. Emphasising health, respect, and communication may be more readily accepted than a discourse focused exclusively on rights,” she said.

She added that it was essential that women be made aware of OV during their engagement with healthcare professionals – prenatal courses should be accessible and include, alongside medical information, clear explanations about women’s rights, informed consent, and what respectful care entails. ‘Meanwhile, information must reach those who need it most, she said — particularly in rural areas and in communities with more limited access to education.

“This requires simple messages, delivered in accessible languages and through channels that women already trust, including healthcare providers, community leaders, or other women sharing their experiences,” Andronache said.

“Awareness is built not only through the dissemination of information, but also through the creation of a space in which women feel able to ask questions, understand what is happening to them, and recognise when their rights are not being respected,” she added.

However, even in places where there is more awareness, serious problems with OV remain.

The study found that awareness of OV is higher in Eastern European countries, in part because advocacy initiatives regarding women’s rights during childbirth have contributed to increased visibility of the issue. Yet OV is widespread in some of these states.

In the survey the highest dissatisfaction rates with their childbirth experience were recorded among respondents from the Western Balkans (Albania, Serbia and Kosovo).

In 2022, a study by lawyers in Serbia found that women in the country are regularly subjected to various forms of violence at maternity clinics and hospitals, including not just verbal abuse and humiliation at the hands of staff, but violent physical examinations and invasive procedures without consent.

In January 2024, Marica Mihajlovic, a Roma woman, claimed that during labour her doctor jumped on her stomach, slapped her and racially abused her. Her baby died soon after birth.

A 2023 report on OV in Moldova included testimony from scores of OV victims, some of whom were left with serious physical and mental health issues afterwards.

As well as having to deal with the physical and mental damage of their experiences, victims of OV in the region also often face significant barriers to any redress for their suffering.

“Women who are aware of obstetric violence and would like to take action encounter, in reality, a form of distance—not only physical, but also emotional and institutional. In theory, reporting mechanisms should be ‘within reach’: easy to understand, accessible, and safe. In practice, in many countries this distance is far too great,” explained Andronache.

She said many women who want to report OV struggle with difficult and bureaucratic systems for doing so. Many are also put off by feelings that reporting what happened to them will not change anything or, worse, “that they would be placed in a position of having to prove their suffering, of being questioned, or even invalidated”.

“In the absence of clear and credible accountability mechanisms, reporting is not perceived as a solution, but as a long, uncertain, and emotionally draining process,” Andronache said.

Some also find that after a difficult or traumatic experience, they simply do not have the emotional resources to engage in a formal process. “They seek calm, recovery, and the ability to care for their child. The question ‘is it worth going through this?’ becomes very real,” said Andronache.

While the report identifies the scale of the OV crisis in the region and changes needed to reverse, or at least lessen it, fundamental improvement is not expected to come overnight, regardless of how enthusiastically governments embrace the UNFPA’s recommendations.

“Some changes can be implemented relatively quickly—for example, establishing clear and accessible reporting mechanisms, informing women, introducing more transparent procedures, or providing basic training for medical staff. These depend largely on political will and organisational capacity and can be achieved within a relatively short timeframe.

“However, the more difficult aspect is the transformation of mindsets—both within the medical system and in society at large. A deeper transformation to a system in which women feel safe to speak out and which responds with accountability and respect is a long-term process that may take a decade or more. At its core, this is a cultural shift, not merely a regulatory one,” said Andronache.

Khomasuridze agreed.

“We and our partners have a long way to go. Progress depends on action at the national level and we are very well positioned in [EECA] countries to accelerate progress, working with government, professional societies, civil societies, women’s groups, and patients’ groups to make sure that this transformative agenda is implemented,” she said.

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A gathering organised for the families of victims of Duterte's war on drugs in Quezon City ahead of the opening of the ICC confirmation hearing. The signs which are held up in a few of the pictures read: 'Justice! Jail everyone involved in the war on drugs.' Credit: IDEFEND

By Ed Holt
BRATISLAVA, Mar 17 2026 (IPS)

Gito* had just arrived at his father’s house in Caloocan City in the Philippines on December 7, 2016, when three armed policemen burst into the home, grabbed his father, took him outside and shot him multiple times. Gito told IPS his father had put his hands up when the officers told him they had come to arrest him, but they opened fire anyway.

Then they turned on Gito, who was 15 at the time and had come to see his father to get his lunch money for school. He says they told him his father was a drug dealer and that he would be facing charges because he was with him. He was taken away and tortured – beaten and forced to drink urine – and later jailed for three years. He and his four siblings were all forcibly separated; his mother’s mental health deteriorated, and even after release, Gito needed years of mental health help.

Andrea*, from the same city, told IPS a similar story. One day in October 2017, she and her husband and father-in-law were watching television at their home when two men wearing masks and black jackets and carrying guns burst in, shouting the name of a person none of them knew. Despite their protestations, the two men executed her husband and father-in-law, shooting them many times while they knelt in front of them. Andrea, who was five months pregnant at the time, was also injured in the shooting – a bullet hit her leg.

A priest prays at a gathering organised for the families of victims of Duterte’s war on drugs in Quezon City, ahead of the opening of the ICC confirmation hearing. Credit: IDEFEND

Left without any means of income with both the family’s breadwinners dead, she had to drop out of the vocational course she was on and spiralled into a deep depression. She eventually recovered. “When I looked at my baby, I saw my husband in her, so I picked myself up and faced life bravely,” she explained. She said, though, it is still hard financially, as she also supports her mother-in-law.

Gito’s father, and Andrea’s husband and father-in-law, were just a few of the estimated tens of thousands of victims of the brutally repressive anti-drugs policy implemented by former Philippine president Rodrigo Duterte.

For years, people like Gito and Andrea have fought an often seemingly futile battle for justice for their loved ones even as local and international rights groups have detailed the horrific crimes committed under Duterte’s “war on drugs”.

But a recent hearing at the International Criminal Court (ICC) in The Hague, Netherlands, has given them, and others, hope that they could see justice.

Both Gito and Andrea, along with other relatives of people who were killed under Duterte’s violent crackdown on drug use, were at the Hague during confirmation hearings between February 23 and 27 to decide whether Duterte should stand trial on charges of crimes against humanity linked to his deadly anti-drug crackdown.

Launched in 2016, it remains one of the deadliest anti-narcotics campaigns in modern history, activists say. While official police figures show 6,252 people killed by May 2022, human rights groups estimate there could have been as many as 30,000 deaths, including vigilante-style executions.

The case against Duterte covers 49 incidents of alleged murder and attempted murder, involving 78 victims, including children. But prosecutors at the hearing said these incidents are only a fraction of the thousands of killings attributed to police and hired hitmen during Duterte’s anti-drug campaign.

At the trial the prosecution said that Duterte played a “pivotal” role in a campaign of extrajudicial killings that saw thousands murdered, alleging he personally drew up death lists, incited murders and then boasted about them afterwards.

The court was shown videos of Duterte threatening to murder alleged drug users and boasting of his own skills in extrajudicial killing.

Statements from victims’ relatives submitted at the trial also highlighted the devastating toll the repressive policy had taken on not just individual families but also wider communities which were already impoverished and marginalised.

Illegal drug use in impoverished communities was often a mechanism, the prosecution said when submitting witness testimony, to cope with terrible living conditions. They said victims’ marginalised and vulnerable conditions were exacerbated exponentially when targeted by police and that the campaign against them targeted their humanity.

The prosecution pointed out that victims were often killed in front of their families, usually in their homes and local neighbourhoods, which subsequently became crime scenes. Following the killings, the families were left with not just lasting personal trauma but stigma within their close-knit communities.

Meanwhile, by targeting marginalised groups, law enforcement authorities were specifically going after those who would be least likely to be able to file complaints in the domestic justice system, human rights lawyers at the hearing argued. They said this was calculated to ensure no one was held accountable ultimately for what happened.

Duterte’s defence claimed the 80-year-old did not issue specific orders to kill drug suspects as part of his policy to take down the illegal drug trade in the country. They said that what actions he took were within the law. Duterte himself waived his right to attend the hearing and said he does not recognise the court’s authority.

The ICC has 60 days in which to issue a decision on whether to proceed with the case against Duterte, ask for more evidence, or stop the process against him.

Activists who were at the trial have expressed hope that the case against him will go ahead.

“It was very clear that the prosecution had enough [evidence] to convince the judges that the case should proceed to trial.

“The truth of the matter is that the evidence presented by the prosecution was backed up by true narratives by witnesses and by families themselves who saw how their loved ones were killed,” Rowena Legaspi, spokesperson for the Philippine group In Defense of Rights and Dignity Movement (IDEFEND), told IPS.

Both Gito and Andrea said they were convinced of the strength of the evidence presented, although Gito admitted he feared Duterte might still somehow not be tried.

“This is a grave concern for me. There are fears around political interference or procedural issues that Duterte’s defence may raise in an attempt to stop the proceedings. But I also trust the ICC process and the sufficient documents they have,” he said.

Activists also see the fact that the confirmation hearings have taken place at all as a step towards justice for the victims of Duterte’s drug crackdown.

“For the families of the victims in the court and those watching back in the Philippines, this was like seeing light at the end of the dark day when Duterte was the president. Reaching this stage of confirmation charges continues to at least gradually break the pain that is embedded in them,” Legaspi added.

“This case moving to trial is a step towards healing for all of us,” said Andrea.

Campaigners also see it as essential to ongoing campaigning for justice in the Philippines.

For years, domestic institutions failed to deliver justice, local rights groups say, with findings by rights institutions stonewalled, courts offering no meaningful accountability, and families of victims silenced by fear.

And while Duterte’s arrest and transfer to The Hague was a breakthrough in itself, activists say. They also point out that at the same time, his allies at home continue to push immunity bills and resolutions questioning ICC jurisdiction.

IDEFEND said the hearings are a political and moral test of whether international law can pierce impunity and whether Filipino society will stand with victims against state-sanctioned violence and a litmus test of the Filipino people’s pursuit of accountability.

“Duterte’s arrest and the ICC process prove persistence matters. Leaders cannot forever hide behind power, sovereignty, or dynasties. The law may be slow, but history bends toward accountability when people insist on truth.

“This case is not just about putting Duterte on trial. It affirms that the lives lost — mostly the poor and voiceless — mattered. It restores dignity to families. It exposes the machinery of state violence. And it warns future leaders that mass killings will not be tolerated,” Legaspi said.

“It also challenges the culture of impunity shielding not just Duterte but also his enablers and successors. Senate resolutions, immunity bills, and denial campaigns show the fight is far from over. But every manoeuvre is proof of accountability’s power: they are afraid because truth is catching up,” she added.

Meanwhile, other drug policy reform campaigners say it serves as an example of the massive damage that can be caused by repressive drug policies and sends a strong signal to other leaders implementing similarly brutal, hardline anti-drug campaigns.

“The large-scale human rights violations committed under Duterte’s war on drugs – which have resulted in tens of thousands of extrajudicial killings – are one of the starkest examples of the devastating impacts of punitive drug policies. And the Philippines is not an isolated case. Around the world, lethal force continues to be justified in the name of drug control – mostly in contexts of entrenched impunity,” Marie Nougier, Head of Research and Communications at the International Drug Policy Consortium (IDPC), told IPS.

“The decision by the International Criminal Court to pursue the case of Duterte sends an important signal: drug control cannot be used as a pretext for unlawful killings and the erosion of fundamental rights, and that political leaders are not beyond the reach of international law,” she added.

Back in the Philippines, the drug policies Duterte implemented remain in place and there continue to be drug-related killings, although not at the levels seen under Duterte.

And nearly a decade on from when Duterte’s hardline policies were introduced, only nine police officers have been convicted. Rights groups such as Human Rights Watch (HRW) say the vast majority of those responsible, including senior officials, have not faced any repercussions.

Legaspi said there have been some bills introduced by lawmakers on possible investigations of extrajudicial killings and discussion of treating drug use as a health issue rather than criminal and looking at harm-reduction measures to combat it.

She added, though, that Duterte’s drug policies had “an impact so huge that it continues to be felt to this day”.

Both Gito and Andrea said they were hopeful the hearings may bring about some change in the country’s drug policy.

In the meantime, though, both are waiting to see what the ICC decides and hoping for justice.

“For me, justice will be fully served when Duterte has been convicted and his co-perpetrators of the drug war have also been arrested, detained, and convicted. That is justice for me,” said Gito.

*Identity protected for their safety.
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Ukrainian Red Cross teams have delivered over 3,300 hot meals to Kyiv residents at support points around the city. Credit: Red Cross

By Ed Holt
BRATISLAVA, Feb 24 2026 (IPS)

“We have a saying here in Ukraine now – ‘young people meet at their friends’ funerals rather than at weddings.’ It’s sad, but very true.”

As Russia’s full-scale invasion of her country moves into its fifth year, Iryna Yakova, 29, is looking back at how her life has changed over the past four years.

Speaking from Lviv, the western Ukrainian city where she lives, she tells IPS that her “values and attitude towards life” have changed. “Material things become unimportant when your loved ones or friends are in danger,” she says. She has also developed a keen sense of her national identity and an empathy for the suffering of her fellow Ukrainians.

“During the full-scale invasion, I realised that all of Ukraine is my home. I cry for people who were killed by a missile in Kyiv while they were sleeping at night. Even though I didn’t know them, it hurts me because they are Ukrainians. It also pains me to see children growing up without their parents because their parents are at the front. The war has intensified my sense of empathy and belonging.”

Her mental health has suffered. She says anxiety is ever-present in her life.

But what she returns to often as she answers questions about how her life is today compared to before the war is the loss she, and others, have experienced.

“What I miss most [from my life before the full-scale invasion] are the people who have been killed in the war. I have lost friends, acquaintances, and relatives. Nothing compares to human loss. The hardest thing I have had to deal with during this war is going to the funerals of friends — people you used to go to parties with, travel with, study with,” she says.

The human cost of Russia’s full-scale invasion of Ukraine has been enormous – Ukraine’s government does not officially give figures for military casualties, but it has been estimated they could be up to 600,000 (Russian military casualties are thought to be more than twice that amount).

But the scale of civilian casualties has been huge, too. According to UN bodies, more than 15,000 civilians have been killed and over 41,000 injured in Ukraine since the start of the invasion on February 24, 2022.

Worryingly, as Ukraine marks the fourth anniversary of the start of the war, research suggests there has been a sharp increase in civilian casualties over the last year.

Data from Action on Armed Violence (AOAV), released earlier this month, showed civilian casualties in Ukraine increased by 26 percent in 2025 compared with 2024, despite there being a 6 percent drop in the number of injurious explosive weapon incidents recorded nationwide.

In Kyiv, response efforts continue amid attacks on energy infrastructure and severe cold. The Ukrainian Red Cross is supporting warming centres around the clock, providing people with a safe place to warm up, receive assistance, and feel cared for during difficult conditions. Credit: Red Cross

The group said its data showed a worrying shift in the character of the conflict – the average number of civilians killed or injured per incident in Ukraine rose 33 percent over the year, with a total of 2,248 civilians reported killed (an 11 percent rise) and 12,493 injured (a 28 percent rise) by explosive violence.

This suggests that explosive weapons are being used by Russia in Ukraine in ways that generate greater civilian impact, whether through more drone strikes, heavier munitions, specific targeting choices of populated areas, or repeated strikes on urban infrastructure, the group said.

Nearly seven in ten civilian casualties recorded in AOAV data occurred in residential neighbourhoods, up from just over four in ten in 2024.

Niamh Gillen, a researcher at AOAV, told IPS it was impossible to definitively say that Russian forces were deliberately targeting Ukrainian civilians, but that “the data speaks for itself.”

“It shows that civilian areas are being attacked, that the attacks are occurring within civilian areas like hospitals, schools, cities, towns. In general, in areas where civilians are heavily concentrated, like cities and towns, villages, anywhere like that, if you’re using an explosive weapon with wide area impacts, then you’re likely to harm more civilians,” she said.

On top of the deaths and destruction Russian attacks have caused, they have also led to massive displacement. It is thought that at least 3.4 million people are internally displaced in the country. This has put massive pressure not just on the displaced themselves, but also on host communities and services.

People’s physical health has deteriorated in such conditions – the World Health Organisation (WHO) has said that more than two-thirds of the population have reported a worsening of their health since the start of the invasion.

But the harm caused by these attacks is far from just physical. Mental health professionals in the country, as well as international bodies including the WHO, have warned of a mental health crisis in Ukraine, with possibly up to 10 million people suffering with mental health problems.

IPS spoke to scores of people in cities and towns across Ukraine about how the war had affected their mental health. Many spoke of experiencing anxiety, sometimes permanently to some level, which could be intensified at any moment by the frequent sound of air raid sirens warning of an attack, or for those closer to frontlines, the sounds of explosions and bombings.

“What affects my mental health on a daily basis are the constant nighttime drone and missile attacks. Because of them, it is impossible to relax or get proper rest, as reaching a shelter for safety is essential, even at night,” Mihail*, a teenager who lives in the Kyiv region, told IPS.

The situation for many Ukrainians has acutely worsened this winter. In what has been one of the coldest winters the country has seen for many years, Russian forces have repeatedly attacked Ukraine’s energy infrastructure, resulting in massive, widespread power outages. Thermal heating facilities have also been destroyed in targeted attacks.

As temperatures have plunged to as low as minus 30 degrees Celsius on some occasions, millions of people have been left freezing in their homes.

Jaime Wah, Deputy Head of Delegation with the International Federation of Red Cross and Red Crescent Societies (IFRC) in Ukraine, said people were suffering desperately in the cold.

“Some nights have been very unbearable. There is no escape from the cold. When you leave your apartment, it’s cold. Sometimes people have been joking that it’s warmer inside a fridge than inside their apartment. I’ve been here for over four years now, and it’s been the worst winter,” she told IPS.

Humanitarian organisations, including the Ukrainian Red Cross, and state emergency services have set up emergency heating points in cities and towns where people can keep warm, recharge devices and get food.

But Wah said while this has become a humanitarian crisis, it is one of just many crises Ukrainians are battling.

“In frontline regions, there are communities that are under evacuation orders, and some communities have essentially had most of their resources cut off. Family ties are quite strained – mental health needs are also immense, not only in the frontline regions but across Ukraine,” she said.

“There are lots of repairs to homes that are needed, not to mention the energy crisis, which is a humanitarian crisis… with no heating and no electricity, just the day-to-day things – just even heating your food becomes a problem. A lot of families are having to spend more time outside their homes, having to spend more money. On top of that, the cost of living has increased. These are some of the real, tangible situations that people in Ukraine are facing now,” she added.

Amid these problems, many Ukrainians admit that they are exhausted after four years of war.

But among the many people IPS spoke to on the eve of the fourth anniversary of the war, there was a widespread, although certainly not universal, determination to not give up.

“I feel a sense of responsibility. I do not have the right to give up, because many people have died so that I could have the chance to live. Of course, there is exhaustion, but, unlike those in the military, a civilian like me has time to rest and reset,” said Iryna.

For many, such resilience is born out of a desire not just for them and their country to survive what they see as Russia’s attempt to destroy them as an independent state and nation, but also a hope that, ultimately, there will be some justice served for what has been done to them.

The Russian military and authorities have repeatedly been accused of war crimes, crimes against humanity, breaches of international humanitarian law, as well as genocide, during the invasion of Ukraine.

The sheer volume of alleged crimes – at least 180,000 war crimes have been registered by Ukraine’s Prosecutor General – and the constraints of documenting, investigating and prosecuting during an ongoing conflict mean that bringing those behind them to justice was never expected to be easy. Only over 100 people have been prosecuted in Ukraine so far for crimes during the invasion.

But there are fears that international bodies such as the International Criminal Court (ICC), which has issued an arrest warrant for, among others, Russian President Vladimir Putin over alleged war crimes, could be rendered increasingly toothless in their ability to ever prosecute major figures who ordered such crimes because world leaders, such as US President Donald Trump, are no longer interested in upholding international justice for war crimes.

“I truly hope that the war will end very soon and that all war criminals will be brought to justice. However, what I see happening right now is the opposite: while institutions like the UN are unable to punish Russia, people are starting to forget about its war crimes. Countries are gradually lifting sanctions,” said Mihail.

“For example, Russian athletes are going to be able to take part in the Paralympics this year. As a result, people who committed war crimes just months or years ago can now take part in one of the world’s biggest sporting events. So we need to act – by refusing to normalise aggression, keeping sanctions firm and, most importantly, remembering about war.”

Others, though, are more hopeful.

“There is no doubt among Ukrainians that war criminals can be brought to justice,” Oleh Martynenko, an expert at the Ukrainian NGO Center for Civil Liberties, which documents war crimes, told IPS.

“This is evidenced by the participation of Ukrainians in international missions and courts where war criminals have been convicted. Also, thanks to the European Union, Ukrainians are building their own criminal prosecution systems, which provide for the arrest and imprisonment of Russian war criminals in accordance with UN international standards,” he said.

Regardless of these concerns and the other problems Ukrainians are facing as the full-scale invasion goes into its fifth year, some are looking to the future with a degree of hope.

“I feel a mix of determination, resilience, anger, and hope of victory,” Tetiana, a nurse in the Dnipropetrovsk region, who asked not to be identified for security reasons, told IPS. “Glory to Ukraine!” she added.

*Name changed to protect identity.

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Policing exhibit at the Museum of Weed. An IDPC report paints a picture of an increasingly punitive approach to drugs in some countries, but also highlights reforms. Credit: Bret Kavanaugh/Unsplash

By Ed Holt
BRATISLAVA, Feb 19 2026 (IPS)

Drug reform campaigners have called for an overhaul of global drug controls amid an increasingly complex and deadly drug situation in the world and as hardline anti-drug approaches are increasingly being used as cover for repression of civil society and human rights defenders.

A report released earlier this month by the International Drug Policy Consortium (IDPC) assessed progress made since the 2016 UN General Assembly Special Session (UNGASS) on drugs, widely viewed as a potential turning point in global drug policy.

It found that the promise of UNGASS remains largely unfulfilled – despite notable progress in some areas – and that punitive and prohibitionist approaches continue to dominate global drug control, despite their enormous human and financial cost.

“Punitive approaches [to drugs] are costing lives, undermining human rights and wasting public resources, while silencing the very communities that hold the solutions. This report shows why governments must move beyond rhetoric and commit to real structural reform,” Ann Fordham, IDPC Executive Director, said.

Advocates of drug policy reform have for decades pointed to evidence showing how hardline drug policies have completely failed.

The IDPC report documents how current prohibitive policies have, far from curbing drug markets, contributed to their massive expansion and diversification, while at the same time the number of people who use drugs continues to rise and is now estimated at 316 million worldwide – a 28 percent increase since 2016.

The group says repressive policies are also driving devastating and preventable harms. These include:  2.6 million drug use-related deaths between 2016 and 2021, with projections indicating further sharp increases since; mass incarceration – one in five people globally incarcerated are for drug offences – disproportionately affecting marginalised communities; over 150 countries report inadequate access to opioid pain relief due to overly restrictive controls on essential medicines;  expanding use of the death penalty for drug offences; and the displacement of illegal drug activities into remote and environmentally fragile regions, including Central America and the Amazon basin, as a result of interdiction and eradication efforts.

Despite this evidence, many countries continue to pursue hardline drug policies.

Fordham said this was because of “the vast vested interests in the status quo”.

“The prison industrial complex is a prime example of this. Our report documents that one in five people in prison are incarcerated for drugs globally, while evidence shows that this strategy has done nothing to reduce the scale of the illegal drug markets,” she told IPS.

The group has also highlighted a worrying return to prominence of ‘war on drugs’ rhetoric – popular in the 1970s and 1980s – which it says is increasingly being used to justify militarisation, repression and violations of international law, including the Trump Administration’s weaponising of ‘narco-terrorism’ narratives to legitimise extraterritorial force and roll back rights, health and development commitments enshrined in the UNGASS Outcome Document.

“Punitive and hard-on-drugs narratives serve other interests for populist leaders, with drug policies being used to scapegoat people who use drugs and other people involved in the illegal drug market for broader societal issues, including homelessness and increases in levels of violence.

“Drug control is also increasingly used to restrict civil society space by threatening or attacking civil society and community organisations promoting much-needed reforms and condemning their governments for egregious human rights violations,” said Fordham.

Other drug policy reform advocates and experts have said this trend has become increasingly evident in the last year.

“Over the last year, we can definitely see the emergence of some new [drug policy] trends. First of all, there has been a radical change of rhetoric and narratives under US President Donald Trump’s administration,” Anton Basenko, Executive Director of the International Network of People Who Use Drugs (INPUD), told IPS.

He also highlighted how governments are using drug policy as a cover for breaches of international law to further other political aims, citing the claim by the US administration that the recent abduction of Venezuelan leader Nicolás Maduro by US forces was connected to stopping illegal drugs from coming into America.

“Over the last year, there have been completely different narratives from leading countries [on drug policy], like the U.S. And of course, some countries politically are always looking to the U.S. and listening to what they are saying and they might try to replicate something similar politically, using America’s action as an example,” he said.

Other experts fear there is a real risk this could lead to a worsening of wider human rights problems in other countries.

“The shamelessness with which the US is now trampling on international law, using the war on drugs as cover for some of its most egregious violations, is deeply troubling. There is certainly a risk that it licenses other actors to be even more brazen in their abuses of international human rights law regarding drugs and more generally,” Steve Rolles, Senior Policy Analyst at the UK-based Transform Drug Policy Foundation, told IPS.

The IDPC report draws a set of conclusions emphasising the need for reform and modernisation of current UN drug control treaties as well as, among others, a reconfiguration of the global drug control system so that it is orientated on rights, health and development.

The group says this is especially important now as the United Nations prepares to implement system-wide reforms and an independent expert panel begins reviewing the international drug control regime, providing a rare opportunity to “correct course”.

But that call also comes at a time when, as the IDPC points out, the work of organisations which have been successful in driving drug policy reform, as well as the implementation of life-saving harm-reduction programmes, community advocacy and civil society are battling funding crises.

Cuts to foreign aid funding by major donor states, especially the US, over the last year have been devastating for civil society, including groups working  to combat HIV and help vulnerable communities, including drug users, around the world. Funding for harm reduction, which has historically been low, is now in crisis, campaigners say.

“In 2022, available harm reduction funding amounted to just 6% of the USD 2.7 billion needed annually. The Trump administration’s decision to halt funding for HIV and harm reduction in 2025 has turned the harm reduction funding crisis into a catastrophe,” said Fordham.

“State-funded and third-sector voluntary services are all feeling the pinch, and even services funded by philanthropy are seeing priorities shift towards emerging crises. Many services will struggle on as best they can, but inevitably there is a terrible cost when services proven to save lives are starved of funds or closed down,” added Rolles.

However, it is precisely because of these funding constraints that it is vital, IDPC argues, that its recommendations are taken on board by global policymakers.

“The funding constraints and current challenges faced by the UN and multilateralism more broadly make our recommendations all the more important. The current system is clearly outdated and harmful, only serving to undermine health, human rights, development, human security, and environment protection – all the key objectives that the UN was created to uphold in the first place,” said Fordham.

But while the IDPC report paints a picture of an increasingly punitive and prohibitive approach to drugs in some countries, it also highlights significant progress in the introduction of more progressive policies in a number of countries.

These include important policy shifts in many jurisdictions towards decriminalisation and the legal regulation of cannabis, both for medical and recreational purposes.

Hundreds of millions of people now live in jurisdictions where recreational cannabis is legal, with markets having been created in Africa, Asia, Europe, and the Americas. The IDPC report also suggests a renewed interest in psychedelics may soon drive a new wave of regulatory innovation.

“Just over 10 years ago, nowhere in the world had legally regulated adult-use cannabis. Today more than 500 million people live in over 40 jurisdictions with some form of legally regulated adult access… for me, this demonstrates how reforms that seemed impossible just a few years ago are now being realised on every continent,” said Rolles.

He added that there had been “notable progress [on drug policy reform] across the last decade, including the continuing wave of cannabis reforms across the Americas, the EU and much of the world; the spread of innovative harm reduction in response to the opioid epidemic; progress on decriminalisation in other jurisdictions; and an increasingly sophisticated reform narrative gaining traction in high-level forums – including endorsements for reform, including regulation of all drugs”.

“An increase in jurisdictions legalising and regulating cannabis feels inevitable. There are strong movements and political support for change in a number of Latin American and European countries,” Rolles said.

These reforms were driven in large part by non-state and civil society organisations – those same organisations which are seeing their funding and the freedom to press their case increasingly shrinking in many states.

But drug policy reform advocates are not expecting progress to stop despite the challenges such groups face.

“Almost all of the [cannabis legal regulation] reform has been driven by civil society advocacy, rather than top-down leadership from governments. Just as with harm reduction and decriminalisation reforms over the past decades, civil society is showing the leadership where elected politicians so often fall down. This will doubtless continue to be the case going forward. This is the moment to step up the fight, not to cower in the face of rising authoritarianism,” said Rolles.

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On 26 September 2025, children stand outside a tent being used for medical services at Al Aqsa Hospital in Deir al Balah in the Gaza Strip. Credit: UNICEF/James Elder

By Ed Holt
BRATISLAVA, Jan 29 2026 (IPS)

“I’d never encountered anything like it before. I had no idea that there could be a place that needed humanitarian aid and that a government entity wouldn’t allow physicians or health workers into [that place],” says Jane.*

Jane, a nurse from a Western country, was part of a volunteer medical team that went into Gaza in early 2025 during a ceasefire that ran from January 19 to March 18 last year.

Gaza’s healthcare system had been devastated over the course of the Israeli offensive which had followed Hamas’s brutal attacks on Israel on October 7, 2023. According to UNICEF, 94 percent of hospitals have been damaged or destroyed.

Jane tells IPS her team had hoped that during the stop in fighting they would be able to help deliver vital treatment and services which were desperately needed by so many people in the country.

But she says that instead she and her colleagues, who set out for Gaza within weeks of the ceasefire coming into place, ran into seemingly arbitrary obstacles before they even set foot in the country.

Within hours of landing in Jordan, they found out that three physicians and one nurse in the team had been denied entry into Gaza. The following day there were more problems.

“We were at the border with many other NGOs and all of us had been approved to go in [to Gaza]. But then towards the end of the day, they decided that they were going to close the border and not allow anybody through that day. So we had to make our way back to Jordan,” Jane tells IPS.

She says her team lost a week of time when they could have been helping people before they managed to get in. And when they did, she was shocked at what she found.

“It was when we drove into Gaza that it really hit me. You see these kinds of dystopian places in movies or read about them in novels… a van came to pick us up and drove us to our hospital and on this drive I could see nothing but demolished buildings, rubble everywhere. I had to look away a few times because there were skeletons of animals. I’m not sure if there were skeletons of people because I had to look away once I saw the skeletons of animals,” she says.

Things did not improve when she got to the hospital.

“We got to the hospital and at first, although it was different from what I’m used to, it seemed like a functioning hospital… until I started work the next day.”

She describes the hospital, which is one of the largest in Gaza, as lacking even the most basic resources. “They didn’t have paper, they didn’t have gloves, they didn’t have hand sanitiser,” Jane says.

Life-saving equipment such as ventilators for patients struggling to breathe was unavailable, forcing physicians to perform emergency intubations in some cases.

Worst of all though, even when help could have been easily administered to relieve suffering, seemingly arbitrary decisions meant it was not.

“I had a patient – a little girl who had an infection that caused three out of four of her limbs to become gangrenous. All she needed to treat it was a simple medication. But, of course, we weren’t allowed to bring medications in – if [the authorities] found [those medicines on us], they could have either thrown them away or just completely denied us access in.

“This little girl had been in this hospital for at least more than a month – she’d been waiting for a medical evacuation to Jordan, but Israel continued to deny her medical evacuation. At the time I was there, she was supposed to be evacuated, but they denied it – twice while I was there. The first time they did not give a reason and then the second time they said it was because they wouldn’t allow her mother to go with her,” says Jane.

“This little girl was maybe two or three years old and for me, a paediatric and neonatal ICU nurse, this was unfathomable. To expect this toddler to go to another country, likely get her limbs amputated and then have rehabilitation in another country without her mother was ludicrous,” she adds.

Eventually, approval was given for the mother to go with her daughter. But, says Jane, the girl eventually had to have all three limbs amputated.

“It’s a tragedy in and of itself because this could have been remediated with a simple medication or an earlier evacuation. Her limbs became necrotic – they didn’t start out being necrotic. Her limbs being amputated was not something that needed to happen.”

Jane says that of all the patients she treated and all the suffering she saw in the hospital, the case of that girl stands out among her memories today.

Testimony from other doctors and healthcare workers shows that Jane’s experience was not unusual.

Two recent reports which detailed the almost complete destruction of maternal and reproductive healthcare in Gaza as a result of Israeli attacks were based on, or included, testimonies from physicians and healthcare workers, as well as affected women, which highlighted the appalling conditions in healthcare facilities.

Critics of Israel’s offensive in Gaza have variously described Israeli forces’ actions, including attacks on healthcare and other civilian infrastructure, as breaches of international humanitarian law, war crimes, crimes against humanity and even genocide.

Israel has repeatedly denied such charges and claimed that Hamas’s extensive use of the civilian environment for military purposes meant that large parts of urban Gaza had become legitimate military targets and accused the militant group of building a huge tunnel network under Gaza’s hospitals, schools, and other civilian buildings, housing its command centres and weapons stores.

But critics have also pointed to how the suffering caused by such attacks has been compounded by restrictions on aid coming into Gaza.

Jane, who is now back in her home country, says that these restrictions are continuing, despite a ceasefire having been in place since October.

Israeli authorities have banned certain items from being brought into Gaza over concerns they could be used by militants. But humanitarian and rights groups are critical of both the breadth and scope of ‘dual use’ restrictions imposed by Israel, a lack of clarity over what exactly constitutes a ‘dual use’ item, and seemingly ad hoc limitations on what can be brought in.

Jane said she knew of colleagues who were being refused entry to Gaza for carrying the most basic medical equipment.

“One doctor recently got denied entry because he was trying to bring his stethoscope in and when he said he needed it, the authorities said no, and they took his stethoscope from him and denied him entry,” she says.

Some rights groups say that continued restrictions appear to be irrational and could give rise to questions about their intent.

“Israeli officials, like Hamas officials, are being investigated for international crimes. Israel is being questioned as a state about its compliance with the Genocide Convention. There are provisional orders from the International Court of Justice about complying with the Genocide Convention, which demand that aid restrictions be lifted and that aid be provided, in particular medical aid. The refusal to follow those orders is legally significant,” Sam Zarifi, Executive Director of Physicians for Human Rights (PHR), told IPS.

“In analysis of criminal intent, reckless or intentional disregard of foreseeable harm is, and can be, viewed as evidence of intent. The Israeli government has some of the best lawyers in the world, and I hope those lawyers are advising their clients that some of these policies raise very, very important questions about the intent behind them, because they do not seem to be otherwise rational,” he added.

Regardless of any intent, humanitarian groups say restrictions on aid are driving ongoing massive, widescale misery and suffering in Gaza.

This is despite the fact that vital aid is available and ready to be delivered quickly if allowed.

“We have hundreds of truckloads of lifesaving assistance ready outside Gaza. The supplies exist. What we need is more access,” Ricardo Pires, Communication Manager, Division of Global Communications and Advocacy at UNICEF, told IPS.

“We are still hearing about significant restrictions on medical supplies under the notion of being dual use. But we’re [also] looking at things like antibiotics, painkillers, specialised baby food. And these are all available. I mean, what’s very frustrating is that we know from the UN that there are trucks and warehouses full of the necessary supplies, and they can be, and they need to be, and they must be moved in as soon as possible. It is absolutely heartbreaking and mind-blowing and tragic that people in Gaza are still suffering from completely avoidable misery and harm,” added Zarifi.

It remains unclear when, or if, such restrictions will be eased, while a recent announcement by Israel of plans to ban 37 NGOs from operating in Gaza has also been criticised by rights groups who say it will further hinder the delivery of humanitarian aid in the country.

Jane, who would like to return to Gaza for further humanitarian work soon, says she is not hopeful of any improvement for the people there in the near future.

“This has gone on for almost two and a half years and we still don’t have [political] leaders who will stop sending arms to Israel, who will call for a ceasefire when a ceasefire was needed, and then who would actually make sure that the terms of the ceasefire are being are being honoured, because as we’ve seen recently, [Isreal is] continuing to drop bombs. But more than that, you can’t just create a ceasefire, then still not allow aid in. So, it’s hard to have hope for the future for Gaza,” she says.

*Jane’s name and country of origin have been excluded from this feature for her safety.

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Excerpt:

Cardiologist Dr. Marwan Sultan, then Director of the Indonesian Hospital in north Gaza, in February 2025 showing damage to hospital equipment following an Israeli attack on the facility a few months prior. In July 2025, Dr. Sultan was killed in an Israeli strike on the apartment where he was sheltering with his family. Credit: PHR/GHRC

By Ed Holt
BRATISLAVA, Jan 14 2026 (IPS)

Israel must lift all restrictions on medicine, food and aid coming into Gaza, rights groups have demanded, as two reports released today (Jan 14) document how maternal and reproductive healthcare have been all but destroyed in the country.

In two separate reports released jointly, Physicians for Human Rights (with the Global Human Rights Clinic at the University of Chicago Law School) and Physicians for Human Rights–Israel (PHR-I) show how the war in Gaza has led to rising maternal and neonatal mortality, births under dangerous conditions, and the systematic destruction of health services for women in Gaza.

The reports from the two groups, which are independent organizations, provide both detailed clinical analysis of the collapse of Gaza’s health system and its medical consequences as well as firsthand testimonies from clinicians and pregnant and breastfeeding women in Gaza forced to live and care for their newborns in extreme conditions.

And the organizations say that with conditions improving only marginally for many women despite the current ceasefire, Israel must roll back restrictions placed on aid and immediately help ensure people in Gaza get access to the healthcare they need.

“Israel’s destruction of Gaza’s health infrastructure, combined with untreated malnutrition resulting from restrictions on food and medical supplies, including baby formula, has created an environment in which the fundamental biological processes of reproduction and survival have been systematically destroyed, resulting in known and foreseeable harm, pain, suffering, and death,” Sam Zarifi, Physicians for Human Rights (PHR) Executive Director, said.

“Israel must immediately allow food and essential medical material to enter Gaza with a proper medical plan for helping the besieged population,” he added.

Israeli military operations following Hamas’s attack on Israel on October 7, 2023, have left massive destruction across Gaza, including to healthcare facilities. According to UNICEF, 94 percent of hospitals have been damaged or destroyed.

Destroyed incubators and equipment at the Kamal Adwan Hospital Neonatal Intensive Care Unit in north Gaza, following the targeting and raid of the facility by the Israeli forces in December 2024. Credit: PHR/GHRC

Maternal and reproductive healthcare has suffered. Before the war, Gaza had eight neonatal intensive care units with 178 incubators. Today, the number of incubators has dropped by 70 percent. In the north, there were 105 incubators across three NICUs, now there are barely any functional units remaining, UNICEF told IPS.

It says that the numbers of low birth weight babies have nearly tripled compared to pre-war levels and the number of first-day deaths of babies increased by 75 percent.

The PHR and PHR-I reports paint a similar picture.

The PHR report, which focuses on the period between January 2025 and October 2025 when a ceasefire was agreed, details how between May and June last year, the Palestinian Ministry of Health reported a 41 percent decrease in the birth rate in Gaza compared to the same time period in 2022; there was a significant increase in miscarriages that affected more than 2,600 women, and 220 pregnancy-related deaths that occurred before delivery.

The ministry also reported a sharp increase in premature births and low birth weight cases; over 1,460 babies were reported to be born prematurely, while more than 2,500 were admitted to neonatal intensive care. Newborn deaths also increased, with at least 21 babies reported to have died on their first day of life.

Meanwhile, the PHR-I report includes personal testimonies illustrating the severe problems pregnant women and women with newborns have faced in Gaza during the war, from lacking safe routes to care and being forced to give birth in unsanitary, dangerous conditions to battling hunger and severe food shortages as they try to breastfeed their children.

One woman, Samah Muhammad Abu Mustafa, a 30-year-old mother of two from Khuza’a, Khan Youni, described how when her contractions began in the middle of the night, because there were no vehicles and very few ambulances, which are reserved for shelling or other critical emergencies, she had to walk a long distance through rain. When she eventually reached the hospital, she said it was “horrifying.”

“I swear, one woman gave birth in the corridor, and her baby died. It was very crowded, and the doctors worked nonstop. I felt as though I could give birth at any moment. After giving birth to my eldest daughter, I was told I should not deliver naturally again because my pelvis was too narrow. Despite this, the doctors said I would have to deliver naturally because a cesarean section required anesthesia, and there was not enough available. I stood for three hours until it was finally my turn, without sitting even for a moment,” she said.

But despite the October 2025 ceasefire, massive problems remain with women’s access to and the provision of, maternal and reproductive healthcare in Gaza.

“Maternal health units in Gaza are largely non-functional and face critical shortages of essential medicines, consumables, and equipment,” Lama Bakri, project coordinator in the Occupied Territories Department at PHR-I, told IPS.

“Neonatal and diagnostic equipment remains scarce or blocked, including portable incubators for premature and low-birth-weight newborns. Although some aid has entered since the ceasefire, these gaps are not being addressed at the scale required, and meaningful improvement in the immediate future remains unlikely.”

Malnutrition also remains a serious problem.

“The ceasefire has allowed us to significantly scale up our nutrition response, but we are still treating pregnant and breastfeeding women for acute malnutrition in alarmingly high numbers,” Ricardo Pires, Communication Manager, Division of Global Communications & Advocacy at UNICEF, told IPS.

He said that between July and September 2025 about 38 percent of pregnant women screened were diagnosed with acute malnutrition.

“In October alone, we admitted 8,300 pregnant and breastfeeding women for treatment, about 270 a day, in a place where there was no discernible malnutrition among this group before October 2023,” he added.

UNICEF has documented almost 6,800 children admitted for acute malnutrition treatment in November 2025 compared to 4,700 cases in November 2024. So far, the number of admitted cases more than doubled in 2025 compared to 2024: almost 89,000 admissions of children to date in 2025, compared to 40,000 cases in 2024, and almost none before 2023.

“What we’re seeing is that no child meets minimum dietary diversity standards, and two-thirds of children are surviving on just two food groups or less. Around 90 percent of caregivers reported their children had been sick in the previous two weeks, which compounds the malnutrition crisis,” Pires said.

And there are fears for the longer-term demographic future of Gaza given the damage to maternal and reproductive healthcare.

“For Gaza’s demographic future, the implications are serious. Even with reconstruction, we will be dealing with a generation of children who were scarred before they took their first breath, children who may face lifelong health complications, developmental challenges, and the effects of stunting. The rebuilding must start now, but we should be clear-eyed: the damage to maternal and newborn health will echo for years, potentially decades,” said Pires.

But others say that with cooperation between international actors and the right political will, the situation need not remain so dire.

“To rehabilitate the population after everything that has happened is going to be a real issue, [but] now there is a Board of Peace, the needs of pregnant women and maternal and reproductive healthcare can be prioritized,” Zarifi told IPS.

“The capacity and the will exist among Gazans and Gazan healthcare workers to rebuild the healthcare system, including maternal and reproductive health services,” added Bakri. “The primary obstacle is not technical or professional but political: Israel’s control over Gaza’s borders and the restrictions on the entry of essential equipment, medical supplies, and reconstruction materials. With unrestricted access to what is needed to rehabilitate hospitals, rebuild destroyed units, and restock essential medicines, recovery is entirely feasible. Whether maternal and reproductive healthcare can return to pre-war levels depends on sustained international pressure to allow that access.”

However, while both NGOs like PHR and PHR-I and others, alongside international bodies like the UN, stress that any recovery and reconstruction in Gaza requires the ceasefire to hold and consolidate, repeated violations underline its fragility, and the effect that has on women.

Meanwhile, PHR and PHR-I point out that extreme weather and ongoing Israeli restrictions on medicine and food getting to Gaza to this day continue to severely affect pregnant women, new mothers, and babies. On top of this, Israel has also announced it will bar 37 international aid groups from working in Gaza, potentially compounding the problems.

Bakri said such measures were jeopardizing what small gains had been made since the ceasefire and “raise serious concerns about whether the situation can improve.”

“Even after the ceasefire, while bombardment has decreased, the reality these women face remains catastrophic – not only for their bodies and well-being but for the survival of the entire society,” said Bakri.

Zarifi added, “We are worried that the restrictions placed by Israel on some of the major actors in the humanitarian response will hamper access to assistance for those that need it. We have raised questions with the Israeli government as to why specific medicines are not allowed to be brought into Gaza and they say that they are not stopping them from being brought in but they can be brought in by commercial means. That is hard for people who can barely put any money together. These medicines should definitely be coming in through humanitarian channels.”

He also highlighted how important the issue of accountability is in ensuring any progress is made in rebuilding healthcare in Gaza and also limiting the probability of similar devastation in the future.

Both reports concluded that the harms caused by Israeli attacks are not isolated incidents but part of an ongoing pattern of systematic damage to the health of women and their children in Gaza, amounting to reproductive violence.

Israel has denied this and said that attacks on hospitals in Gaza have been because the medical facilities are being used by Hamas, and it has maintained that its forces adhere to international law.

While under international law healthcare facilities have special protection even in war, and attacks on them are prohibited, that protection is lost if they are deemed to fulfill criteria to be considered military objectives, such as housing militaries and arms.

However, any attack on them must still comply with the fundamental principles of distinction, proportionality and precautions in attack and failure to respect any of these principles constitutes a breach of international humanitarian law, according to the UN.

“These attacks are part of a deliberate policy designed to create a domino effect of suffering. From starvation and militarized aid distribution by the GHF, to lack of access to clean water, repeated displacement orders, living in shelters under continuous bombardment, and exposure to infections, disease, and harsh weather, the attacks on maternal and reproductive healthcare are another piece of this puzzle. Together, these conditions were created to systematically destroy the fabric of life in Gaza and reduce the population’s ability to survive,” said Bakri.

“The Israeli government has justified attacks on healthcare facilities by saying this was a problem caused by Hamas. We haven’t had an indication of this but it might be true. But in any case there has to be an investigation of these incidents and we hope the Israeli government will carry out such an investigation,” said Zarifi.

“But what is really alarming to us is that the norms prohibiting attacks on healthcare have been repeatedly violated, and there are also laws governing the protection of women and children that appear to have been violated. The only thing that makes these norms work is accountability. There has to be accountability for what happened, as it is the only way we can ensure that what has happened won’t happen in other conflicts. Impunity is watched by other actors around the world,” he added.

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The maternity ward at Kharkiv City Multifunctional Hospital No.25. Credit: UNFPA/Ukraine

By Ed Holt
BRATISLAVA, Jan 7 2026 (IPS)

“It was an emergency caesarean section when the life of the pregnant woman was at risk. We did the operation with just flashlights and no water, and against a backdrop of constant explosions,” says Dr Oleksandr Zhelezniakov, Director of the Obstetrics Department at Kharkiv Regional Clinical Hospital, in eastern Ukraine.

He is recalling what he says was “one of the most difficult” medical procedures he has been involved in since the start of Russia’s full-scale invasion of his country.

But it was far from the only time he has had to work in extreme conditions while his city is pounded by Russian shelling. In fact, he says, it has become routine for him and his colleagues.

“The current reality is that, given we are in a frontline city, we work like this almost every day, because the alarms never stop and we hear explosions almost every day,” he tells IPS.

“You just do what you have to do to save a life, to save the future. In such moments, you only think about saving a life. We work [in these conditions] because life must always prevail,” he says.

Staff look at the beginnings of construction of a bunkerised facility at Kharkiv City Multifunctional Hospital No. 25. Credit: UNFPA/Ukraine

Zhelezniakov’s hospital has, like many other medical facilities in Ukraine, been repeatedly attacked and damaged since the start of the war. The World Health Organisation (WHO) had documented more than 2,700 attacks on Ukrainian healthcare facilities since February 24, 2024.

These have included attacks on more than 80 maternal healthcare facilities – with devastating consequences for maternal health, as recently released data has shown.

According to analysis by the United Nations Population Fund (UNFPA) released in December, there has been a sharp rise in the risk of dying in pregnancy or childbirth in Ukraine as the conflict grinds on.

The agency says repeated strikes on hospitals and the breakdown of essential services are forcing women to give birth in increasingly dangerous conditions, and health workers have warned that a combination of violence, chronic stress, displacement and widespread disruption of maternity care is driving a surge in pregnancy complications and preventable deaths.

Its analysis of national data shows a 37-percent increase in the maternal mortality rate from 2023 to 2024 – the most recent full year of national data available. In 2023, Ukraine recorded 18.9 maternal deaths per 100,000 live births. In 2024, that figure rose to 25.9. The organisation says most of these are preventable deaths, reflecting a health system operating under extreme strain.

It said it had also seen sharp increases in severe pregnancy and childbirth complications. Uterine ruptures — among the most dangerous obstetric emergencies — have risen by 44 per cent. Hypertensive disorders of pregnancy have increased by more than 12 per cent, while severe postpartum haemorrhage has risen by nearly 9 per cent – from 2023 to 2024. Delays in accessing care, stress, displacement and disrupted referral pathways are key contributing factors.

Meanwhile, the situation in frontline regions is particularly acute. In Kherson, premature births are almost double the national average, and the region has the highest stillbirth rate in the country, according to UNFPA.

It cites contributing factors including stress, insecurity and difficulties in accessing care, which can lead to preterm labour and premature rupture of membranes.

Another indicator of system strain is the Caesarean section rate. Nationally, the rate now exceeds 28 per cent, already above recommended levels. In frontline regions, the figures are among the highest in Europe: 46 per cent in Kherson and approximately 32 per cent in Odesa, Zaporizhzhia and Kharkiv. These high rates often reflect the need for doctors and women to time deliveries around short windows of relative safety and can additionally show an increased pregnancy complication rate that requires surgical intervention, according to UNFPA officials.

“Attacks [on healthcare, including maternity and neonatal facilities] have had measurable and severe consequences for maternal health. Ukraine is entering another winter under conditions that sharply increase risks for pregnant women, newborns and the health workers who care for them,” Isaac Hurskin, Head of Communications, UNFPA in Ukraine, told IPS.

In early December, a maternity hospital in Kherson, a facility supported by UNFPA, was struck by artillery fire. During the strike, hospital staff moved women in labour and newborns into a bunkered maternity ward—one of many such facilities constructed by the government with help from groups like UNFPA to protect mothers and babies during active hostilities.

While everyone survived the attack and a baby girl was born in the bunker during the shelling, Hurskin said it was “a stark illustration of the conditions under which pregnancy and childbirth are now taking place — conditions no woman or health worker should ever have to face”.

But the devastation wrought by the war in Ukraine is also impacting wider reproductive health.

IPS has spoken to women in Ukraine who have admitted they are avoiding getting pregnant because of concerns about their ability to access maternal healthcare safely but also the conditions in which they may have to raise an infant.

“Women in conflict-affected areas have specific reproductive needs. It is very hard to meet them when a maternity hospital gets bombed on a regular basis, or when energy infrastructure is targeted, limiting the functionality of hospitals and forcing pregnant women to unequipped hospital shelters. A woman considering getting pregnant needs to make a decision based on these factors – whether a hospital is safe, whether she can have access to services, and whether she is able to care for the child afterwards, with no electricity, heating, or water at home,” Uliana Poltavets, International Advocacy and Ukraine Program Coordinator at Physicians for Human Rights (PHR), told IPS.

“This is a trend which is being observed,” added Zhelezniakov. “Women fear not only for their lives and the lives of their unborn children during childbirth under shelling but also an uncertain future—a lack of safe housing, work, and normal conditions for raising a child. This is a rational fear in the irrational conditions of war. It is one of the reasons for the sharp decline in the birth rate.”

But he added that conversely, the effects of the war were impacting women’s ability to conceive.

“Chronic stress, high cortisol levels, anxiety, and sleep disorders directly affect hormonal balance and reproductive function. Constant stress also leads to hormonal imbalances (dysfunction of the hypothalamic-pituitary-ovarian axis). This causes an increase in cases of secondary infertility, premature ovarian failure, and endometriosis. We are already seeing an increase in the number of pathological menopauses in young women,” he said.

These threats to fertility and maternal health come at a time when Ukraine is facing a demographic crisis.

According to UNFPA, since 2014, when Russia illegally annexed Crimea and supported separatist paramilitary movements in eastern Ukraine, the country has lost an estimated 10 million people through displacement, mortality and outward migration. Fertility has fallen to below one child per woman — one of the lowest rates globally.

It says that rising maternal deaths, increasing complications and pervasive uncertainty about the safety of childbirth reinforce one another, with long-term consequences for families, communities and national recovery.

“This is not only a humanitarian emergency. It is a demographic crisis with implications that will extend far beyond the end of hostilities. Protecting maternal health is central to Ukraine’s long-term recovery and future stability,” said Hurskin.

Indeed, examples from other recent conflicts where there has been widescale destruction of healthcare have shown the long-term effects of war on maternal and reproductive healthcare long after they have finished, from problems with rebuilding damaged and destroyed facilities, ongoing displacement, and continued shortages of medical staff just some of the barriers to women being able to access services.

“Look at Syria, for example. The healthcare system is being built back up, there is rebuilding of facilities, things are improving, but it will take decades to get back to where it was before. And maternal healthcare tends to be deprioritised both during and after a conflict – resources tend to go to other areas such as emergency and trauma care. Women in Syria will have problems with accessing maternal healthcare for years and years to come,” an expert on healthcare in war zones working for an international human rights group, who spoke on condition of anonymity for security reasons, told IPS.

Zhelezniakov admits that a worsening of the demographic crisis in Ukraine is inevitable.

“The expectation is that it will get worse. The destruction of the maternal health care system only exacerbates existing problems caused by the war: the migration of women and children abroad, loss of life, economic instability, and psychological pressure,” he says.

But he adds that even now measures can be taken to improve maternal healthcare, including strengthening primary care, improving digitalisation (e-health systems), investment in prevention, mental health support programmes, environmental improvement, legislative regulation, and raising awareness of reproductive health to reduce mortality and disability, among others.

Developing international cooperation by creating “medical hubs” in relatively safe regions with the support of international partners, such as UNFPA and WHO, to ensure services, would also help.

“Even during active hostilities, we can and must work to adapt the system,” he says.

He also vows that, no matter what happens, he and other medical staff will not stop their work, recalling the emergency caesarean section performed by flashlight as shells rained down on Kharkiv.

“The birth of a child in such conditions is always a miracle and a powerful motivator to continue working, despite everything,” he says.

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UNAIDS campaigns have dominated the global effort to end HIV/Aids as a public threat since 1999. Credit: UNAIDS

By Ed Holt
BRATISLAVA, Dec 1 2025 (IPS)

“It’s like adding fuel to an already burning fire,” says Aditia Taslim.

“We have not recovered from the impact of the US funding cuts earlier this year, and closing down UNAIDS prematurely will only make things worse, especially for key populations and other criminalized groups, including people who use drugs,” Taslim, who is Advocacy Lead at the International Network of People Who Use Drugs (INPUD), tells IPS.

Her view is shared widely by HIV activists around the world who were stunned by a proposal from UN Secretary-General Antonio Guterres in September, included in a report on progress on UN reforms, to shut down the UN’s main agency to fight HIV/AIDS next year.

UNAIDS, the civil society groups that sit on its board, experts, and national governments across the globe had already been working on a transformation plan for the agency, which would see it end in its present form around 2030 when current HIV targets expire.

And many still do not understand exactly why closure next year is now being planned.

“There is a lot of confusion around this right now. We’re not sure why 2026 was chosen. Perhaps it was because we were in fact already in a process of transformation,” Angeli Achrekar, Deputy Executive Director of the Programme Branch at UNAIDS, told IPS.

But the proposal has been met with vociferous pushback—a call from the UNAIDS Programme Coordinating Board (PCB) NGO Delegation to the Secretary General urging him to reconsider was endorsed by more than 1 000 NGOs.

World Aids Day has been commemorated since 1988 and is a significant platform for people to unite against the disease. Credit: UNAIDS

Many of those same groups have warned that if the early closure does go ahead, gains in fighting the disease will be at risk, and, some are certain, lives will be lost unnecessarily.

“If this happens, the world will be much less effective in preventing and treating HIV, which means more people dying from a disease that is completely preventable and treatable. There’s no doubt in my mind that closing UNAIDS will lead to more HIV infections and deaths,” Julia Lukomnik, Strategic Advisor at Dutch organization Aidsfonds, told IPS.

UNAIDS, which started operations in 1996, is unique among UN structures in that its governing board actually includes civil society groups. This, experts say, has meant that in all its work, those on the ground working directly with the communities affected by the disease – not just people living with HIV (PLHIV), but also key populations most at risk, including drug users, sex workers, members of the LGBT+ community, and others—have had a crucial say in developing its policy and implementing its work.

Indeed, while the agency’s activities include treatment projects, in many countries it is seen as a vital bridge, directly and through partnerships with local NGOs, between communities and local, regional, and national authorities.

“If UNAIDS were to close in 2026, the impact would be significant, particularly in countries like Vietnam where community-led organizations depend on UNAIDS for data, technical guidance, coordination, and engagement space. UNAIDS has played a critical bridging role, connecting governments, donors, and civil society in Vietnam,” Doan Thanh Tung, Executive Director at Lighthouse Vietnam, one of the largest LGBTQ+ organizations in Vietnam, told IPS.

This is of particular concern at a time when marginalization and criminalization of key populations and PLHIV in many countries is worsening.

UNAIDS has played a crucial role in advocating for the rights of key populations and PLHIV, including helping bring in landmark legislation enshrining some rights and access to services.

UNAIDS workers provide support to communities in need of their services. The organization and its workers have been badly affected by the impact of a sudden acceleration of cuts to international HIV financing. Credit: UNAIDS

Campaigners fear that without UNAIDS presence, some communities would very quickly face increased marginalization or criminalization, without anyone to speak up for them.

“We’re in a context of increasing criminalization of key populations for the HIV epidemic. We know—in part because of UNAIDS— that violating the rights of key populations leads to increased HIV cases. When you criminalize gay and trans people, you increase HIV cases. When you criminalize sex workers, you increase HIV cases. When you criminalize safe injection sites, you increase HIV cases,” said Lukomnik.

“Closing the UN body that most strongly advocates for the human rights of these groups at the very time when these rights are increasingly threatened will almost certainly increase both rights violations and HIV cases,” she added.

Within UNAIDS, officials are aware this could be a problem.

“The question is where can advocacy for key populations be maintained [without UNAIDS] in countries. UNAIDS can raise issues to do with key populations with governments. Will other organizations be able to do that?” Eammon Murphy, UNAIDS Director, Regional Support Teams for the Asia Pacific and Eastern Europe and Central Asia regions, told IPS.

“One of the critical functions we perform is being the voice of communities. The voice of the community must be safeguarded at the local, regional and global levels,” Achrekar said.

As well as allowing it to advocate for communities, the trust that communities have with the agency means it can have a better view of an epidemic in a given country than state authorities might have, say experts.

They highlight UNAIDS’ vital role in collecting and evaluating data on the disease in specific communities and using data to develop effective interventions and national policies and set HIV targets. If that monitoring and evaluation capacity is lost suddenly with no time to replace it properly, the impact on authorities’ efforts to fight an HIV epidemic could be devastating, they argue.

“UNAIDS set the targets for the global AIDS response that has given countries the ability to shape their strategic plans to respond to HIV and AIDS. Those targets and strategic plans ensured high-impact interventions that led to a reduction of new HIV infections, addressing inequalities, gender-based violence and stigma and discrimination against people with HIV or AIDS,” Tendayi Westerhof, National Director, Pan African Positive Women’s Coalition-Zimbabwe, told IPS.

“It was responsible for the Global AIDS  Programme report that monitored progress of the AIDS response by countries. If UNAIDS is closed, this will have a huge impact on the monitoring of progress by countries in fighting AIDS,” she added.

The proposed closure of the agency also comes at a time when HIV groups are still reeling from recent upheavals in global aid funding.

The withdrawal of US aid at the start of this year, which had previously accounted for 73 percent of international HIV/AIDS financing, has already had a devastating effect on the fight against the disease, forcing many organizations on the frontline of the HIV response to close.

UNAIDS modeling forecasts the funding cuts could lead to an additional 6.6 million new HIV infections and 4.2 million AIDS-related deaths by 2029.

Closing UNAIDS against this backdrop could further imperil the sustainability of the HIV response in some places, especially in those where services for key populations are already underfunded.

“We have seen the impact of the abrupt funding cuts from the US, which have crippled a lot of harm reduction services and forced many drug user-led networks and organizations to close their operations. Harm reduction has also been severely underfunded. Closing down UNAIDS will only create reasons for governments to close down services and programmes, as well as funding for people who use drugs,” said Taslim.

“In most low- and middle-income countries, services and programmes for people who use drugs… are still heavily dependent on international donors. Closing UNAIDS prematurely means that services and programmes for our community will be the first to be removed from national priorities. There is no sustainability strategy in place for services and programmes for people who use drugs and other key populations, as well as other criminalized and marginalized communities,” he added.

Tung warned that dismantling UNAIDS at a time when global funding for HIV is shrinking “would likely erode global-to-local solidarity, reduce community engagement in the HIV response, and weaken independent data systems, which could further exacerbate the epidemic and undo decades of progress in HIV prevention and control that would be extremely difficult to recover.”

But while activists warn of the potential for a 2026 closure of UNAIDS to profoundly impact the world’s HIV response, they also point out that so far it is only a proposal and that there is some hope it may not come to pass.

“The proposal to end UNAIDS in 2026 was made by the UN Secretary General, but it’s really up to the UNAIDS PCB to make this call,” said Lukomnik.

UNAIDS officials point out that the agency had already begun a process of transforming itself.

Earlier this year, the PCB set out its plan to restructure between 2025 – 2027, and then review its structure and mandate again in 2027. It had been expected that after that, a transition period would see key UNAIDS functions shifted to other parts of the UN system or other actors involved in the HIV response by 2030.

The first phase of this restructuring involved the agency this year beginning a huge reduction in the number of its staff and offices around the world—both are to be cut by more than 50 percent.

Achrekar said the transformation was in part a response to global funding changes but also to reflect moves towards greater sustainability in the global HIV response.

“Our transformation is partly because of the current funding volatility, but it was already underway before that. We are focused on ending AIDS as a public health threat by 2030 and even before the General Secretary’s proposal, we at UNAIDS knew that we had to transform for where the HIV response was shifting to in the future—that as countries start to approach 2030 HIV targets, the HIV response would need to be sustainable after 2030. Our transformation means we can be fit for when the HIV response needs to become sustainably supported by countries,” said Achrekar.

“We are not certain if this SG proposal can be turned back. But we believe there could be a way to bring some coherence to what the SG has proposed and the transition we had already planned. UNAIDS is not afraid of transforming,” she added.

However, if the proposal does come to pass and UNAIDS closes next year, the organization is hoping others involved in the global HIV response will be able to step up, to some extent, to help maintain the response.

“We are just one player in the HIV response and all the others have critical roles too. The global solidarity in the HIV response must be maintained in future and we have to be able to safeguard what is critical in the HIV response and the people affected by HIV,” Achrekar said.

Note: This article is brought to you by IPS Noram in collaboration with INPS Japan and Soka Gakkai International in consultative status with ECOSOC.

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Damaged greenhouse in Bent Jbeil, Nabatieh governorate. Credit: Action Against Hunger

By Ed Holt
BRATISLAVA, Nov 10 2025 (IPS)

Food security and livelihoods in southern Lebanon are under severe threat as the repercussions of Israeli bombing continue to be felt across the region, a report released today (NOV 10) has warned.

Almost a year since a ceasefire was agreed, many farmers in Southern Lebanon are still denied access to their land due to displacement, ongoing Israeli attacks, and soil contamination, a joint report from Action Against Hunger, Oxfam and Insecurity Insight has found.

The impacts of the war, coupled with regular Israeli attacks and occupation, have wiped out farmland and destroyed crops and essential food infrastructure, threatening food security and livelihoods in some of the country’s most fertile and productive areas, according to the report.

“Food insecurity is a huge concern in Lebanon, affecting around a fifth of its population, and this report shows how damage and displacement are devastating production in some of its most fertile lands. As winter approaches, more and more families face hunger and poverty,” Suzanne Takkenberg, Action Against Hunger Country Director, told IPS.

The report, “’We Lost Everything’: The Impact of Conflict on Farmers and Food Security in Lebanon,” lays bare the effects of repeated and ongoing attacks by Israeli forces on Lebanese agricultural land and food production.

It highlights the lasting disruption to the agricultural sector and damage to the rural economy as seeds, fuel and other items necessary to plant and harvest, such as fertilizer and fuel, fodder, workers, and equipment, have become harder to obtain, while damaged roads mean transporting goods can sometimes be impossible.

Displacement and continued lack of access to land are among the major problems farmers are facing.

Almost half of the farmers interviewed for the report had been internally displaced and nearly a year on since the ceasefire was agreed, approximately 82,000 people remain unable to go home due to ongoing Israeli occupation and armed violence.

The ongoing presence of Israeli troops in southern Lebanon, despite a February 2025 deadline for their withdrawal, is also preventing people from accessing land to farm.

“Agricultural losses are not only caused by shelling or burning. When farmers cannot reach their land because of displacement or military presence, the outcome is the same: fields go unplanted, and food disappears,” Christina Wille, Director of Insecurity Insight, told IPS.

The five areas in southern Lebanon remaining under Israeli occupation as of September 2025.
Credit: Map: Insecurity Insight. Base Map: UN OCHA

But farmers have also complained of another serious effect of the bombings – contamination with/from explosive remnants of war (ERW) and white phosphorus.

White phosphorus can have detrimental effects on soil fertility and plant growth, which affects farmers’ ability to grow and harvest crops – with a knock-on effect for food security.

“ERW also poses a serious risk, as not only can these weapons degrade over time and contaminate water and soil, but they can also lead to serious injury and even death if unexploded ordnance detonates unexpectedly,” explained Wille.

“Explosive contamination freezes life in place. It keeps people displaced, fields uncultivated, and entire communities in limbo. Farmers told us that the war didn’t just destroy their crops but also their confidence. Food security is not only about seeds and soil. It is also about whether people feel safe enough to work the land,” she added.

The scale of the losses farmers have endured since the start of the conflict is immense.

“Our findings show that around 90% of farmers we interviewed have seen their food production drop since October 2023. That is a systemic collapse, not a seasonal shock,” Drew East, Researcher at Insecurity Insight, told IPS.

The food production of several farmers in Khiam, Bodai, Saaideh, Baalbek and Aitaroun has completely stopped, depriving them of their main income sources.

Meanwhile, farmers in areas of southern Lebanon and Bekaa that have seen some of the worst conflict incidents have seen losses not just of land but of homes, livestock, and agricultural assets.

But it is not just the livelihoods of farmers that have been ruined.

“Some farmers have lost everything and this will have devastating repercussions not just for them and their families, but also for the communities they help to feed,” said Wille.

The ongoing threat of violence and the levels of destruction witnessed throughout the conflict have also had a profound impact on the physical and psychological well-being of affected communities, according to the report.

“Farmers across Lebanon are already in crisis as historically low rainfall has led to the worst drought on record. This climate stress is being exacerbated by the ongoing effects of the conflict, including contamination of the land, restricted access and disruption to supply chains. Urgent action is needed to restore hope for farmers and communities who rely on them,” said Takkenberg.

Farmers also warned of the need for urgent assistance to address worsening hunger and poverty among communities.

Experts believe that until the ceasefire agreed upon one year ago is fully adhered to, affected farmers will not be able to recover fully.

“The repeated attacks on farmland in South Lebanon and Bekaa are not only destroying livelihoods but undermining Lebanon’s food security. There must be an immediate end to these violations and the full withdrawal of Israeli forces so that farmers can safely return to their land and rebuild their lives,” Oxfam in Lebanon Country Director Bachir Ayoub said.

“Three key elements farmers identified that would enable them to end the negative cycle afflicting southern Lebanon and fully resume food production were financial assistance, a complete cessation of hostilities, and the clearance of ERW-contaminated land,” added Wille.

The report comes just months after the same groups warned at least 150,000 people had been left without running water across the south of Lebanon after Israeli attacks had damaged and destroyed swathes of water sanitation and hygiene (WASH) facilities since the beginning of the conflict.

A report detailed how repeated attacks on Lebanese water infrastructure between October 2023 and April 2025 had led to long-term disruption to supplies of fresh water and caused losses estimated at USD171 million across the water, wastewater and irrigation sectors.

Meanwhile, a severe rainfall shortage had exacerbated the problem, increasing risks of outbreaks of waterborne diseases.

In the latest report, its authors point out that all parties to the conflict have clear obligations under International Humanitarian Law to protect objects indispensable to the survival of the civilian population, including foodstuffs, agricultural areas, crops and livestock.

And they have issued a call for urgent action to push for more humanitarian and development material support and funding to help with the situation and have stressed the need for a full withdrawal of Israeli forces from Lebanese territory as part of the ceasefire.

“The most urgent call could be to help people to safely return home and to work and address food insecurity as soon as possible,” said Wille.

“This is not last year’s conflict. The report tells the story of communities that are not just struggling to recover but under ongoing attack- as we’ve seen most intensely in the last few days,” said Takkenberg.

“Our teams are operating in this highly volatile environment to support those in need – rebuilding greenhouses, restoring roads, distributing cash and providing essential agricultural inputs. Working side by side with local authorities and communities, we are doing what we can to repair livelihoods and create space for renewal. But ultimately, this won’t be possible until we have lasting peace,” she added.

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Alexander Soros accepts the European Civil Rights Prize of the Sinti and Roma on behalf of his father, George. Credit: Gorden Welters

By Ed Holt
BRATISLAVA, Oct 27 2025 (IPS)

Billionaire philanthropist George Soros has been awarded the European Civil Rights Prize of the Sinti and Roma for his decades of work supporting Roma rights.

Through sustained philanthropic efforts, Soros, who founded the Open Society Foundations (OSF), has supported projects across the continent advancing the rights, dignity, and empowerment of Roma—Europe’s largest ethnic minority.

His son Alexander, who is chair of the board of directors of the OSF, accepted the prize, which was established in memory of Holocaust survivors and pioneers of the Roma civil rights movement, Oskar and Vinzenz Rose, in Berlin on October 23, on his father’s behalf.

He said, “My father’s partnership with Roma communities has always been grounded in a deep belief in justice, dignity, and self-determination. This prize is a powerful recognition of that shared journey—and a call to continue the fight against prejudice and exclusion.”

Soros’s philanthropy has supported Roma-led organizations to confront discrimination, expand access to education and justice, improve early childhood development and healthcare, and amplify Roma voices in public life.

Among some of the most significant projects have been the creation of the European Roma Rights Centre, the Roma Education Fund (REF), and the Decade of Roma Inclusion, which collectively helped more than 150,000 Roma students attend school, challenged segregation before the European Court of Human Rights, and elevated Roma voices in public discourse.

Meanwhile, the 2024 launch of the Roma Foundation for Europe (RFE)—an independent, Roma-led institution established with a 100 million EUR pledge from the Open Society Foundations—was a key moment in support for Roma across the continent.

Speaking after the prize was awarded, those involved in some of these institutions highlighted not just how these projects have changed the lives of Roma individuals and advanced Roma rights more widely, but also the impact Soros and his work have had on Roma communities in Europe.

“Over the past two decades, REF has supported thousands of young Roma across 16 countries to complete higher education and build successful professional careers,” Ciprian Necula, Executive President of the REF, told IPS.

“Today, there are Roma doctors, engineers, teachers, lawyers, IT specialists, economists, social workers, journalists, and artists whose professional journeys began with REF’s support. Our most meaningful contribution has been creating genuine pathways to education and employment, proving that talent exists in every community when access and opportunity are fair.

“The work of George Soros has been extremely important to Roma communities. No other individual or institution has supported Roma communities with such consistency and vision. His contribution went far beyond financial support; he helped us build institutions, nurture leadership, and develop long-term strategic perspectives.

“His legacy is one of trust, solidarity, and shared responsibility, a reminder that real progress happens when marginalized communities are not only supported but empowered to lead their own change.”

Zeljko Jovanovic, RFE President, told IPS, “Without the Open Society Foundations, the Roma movement as we know it simply wouldn’t exist.”

“George Soros put Roma issues on Europe’s agenda and helped build the first networks of activists, researchers and policymakers working together for change. Over time, his support helped cultivate a generation of Roma professionals and advocates able to design and run their own initiatives. That legacy made today’s Roma-led institutions possible, including the Roma Foundation for Europe,” he said.

“The Roma Foundation for Europe is the most important step in building a Roma-led institution on a European scale in decades. It builds on the long tradition of support for Roma civil society that started with the Open Society Foundations but takes it further—focusing on leadership, education, economic participation, culture and political voice. There’s been a strong sense of ownership and hope [among Roma towards the Foundation]. Many Roma see the Foundation as something long overdue—a space where Roma lead, set the agenda and work with others as equals. It’s not just another organization that speaks about Roma but one that gives structure, power and voice to Roma-led ideas, from business and education to culture and politics,” he added.

Soros has said that he would be donating the 15,000 EUR endowment that comes with the award to the Roma Education Fund.

Necula said the money would be used to expand the Fund’s digital education program.

“This initiative will give Roma children and youth access to technology, digital skills training, and new learning opportunities. In essence, we will turn vision into action, transforming education into opportunity for our children. By investing in digital education now, we ensure that no child is left behind in the transformation shaping our economies and communities,” he said.

In comments after being awarded the prize, Soros spoke of his long-standing relationship with the Roma and highlighted the continued discrimination they face.

“The Roma have endured centuries of discrimination and marginalization, rooted in a long history of violence—from the Holocaust to forced sterilization, child removals, and evictions. These injustices continue to resurface, as seen during the COVID-19 pandemic and, more recently, when Roma fleeing the war in Ukraine faced barriers to shelter and aid,” he said.

“I’ve always believed that open societies must protect the rights of all people—especially those who are excluded. Working alongside Roma leaders and communities has been one of the most meaningful parts of my life’s work,” he added.

Meanwhile, Alexander has pledged to continue his father’s fight for Roma rights, equality, and support for communities’ empowerment.

“As a child, I accompanied my parents on visits across Europe to meet Roma leaders and their families. Those experiences left a lasting impression on me and shaped my own commitment to human rights. Today, as chair of the Open Society Foundations, I am proud to carry forward this vital work and stand alongside Roma communities in their pursuit of equal rights and freedom. The discrimination that Roma experience is a threat to all of Europe. None of us is free until we are all free,” he said.

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Tsholofelo Msimango pictured at her home in Brakpan, near Johannesburg. Credit: TB Alliance/Jonathan Torgovnik

By Ed Holt
BRATISLAVA, Oct 20 2025 (IPS)

When Tsholofelo Msimango joined a small trial of a new drug regimen for tuberculosis (TB) treatment a decade ago, she had no idea whether the medicines she was about to be given would help her.

But having already spent six months in hospital after developing extensively drug-resistant TB (XDR-TB), the most lethal form of the disease, which at the time was barely curable—three-quarters of people with XDR-TB were thought to die before they even received a diagnosis and only a third of those who got treatment survived—Msimango decided she had little to lose.

“I had my doubts, of course, as to whether it would have any success,” she tells IPS.  “But to be honest, at that point all I could think about was that it might make me better, that I might be able to get out of hospital and go home. I was ready to take that chance. I’m glad I did. That trial saved my life—I am sure of it,” she says.

Msimango, who was 21 at the time, from Brakpan in South Africa, was one of 109 participants in the Nix-TB trial of a new drug regimen that ran across three sites in the country between 2015 and 2017.

Until then, typical treatment for the most severe drug-resistant forms of TB would involve patients taking daily doses of a potent cocktail of pills—dozens in some cases—as well as injections for sometimes as long as two years.

The side effects of such regimens can be horrific—deafness, kidney failure and psychosis have been reported—and there are high rates of treatment drop-out, leading not only to a worsening of the patient’s own condition but also to the further spread of the worst strains of the disease among communities.

The Nix-TB trial tested an all-oral six-month drug regimen, which was a combination of the drugs pretomanid, bedaquiline and linezolid (BPaL).

Its results—the regimen had a 90 percent treatment success rate —werehailed as groundbreaking by experts, and the trial proved to be a landmark moment in the fight against the world’s most deadly infectious disease.

Msimango says that until she joined the trial, she had been taking “lots of pills and having injections.” The latter, she says, had stopped working against the disease.

But not long into the trial, she noticed a change. Before the trial she had struggled to keep weight on because of her illness and treatment.

“It was when I started to gain weight that I began to think that the treatment was working. We had check-ups, including for weight, every week and when I saw myself putting on weight, I knew then that I was getting better,” she says.

By the end of the trial, she says she felt like a different person.

Tests showed she was free of TB.

“Of course I was excited about the fact that I could finally stop taking medicines, and because I was then healthy and free of TB and could live a normal life again, but I was also excited about the fact that I was going to be able to finally leave hospital after a year and go home.

“I had already been in hospital for seven months before the trial started, and then another six months for the trial, and it was hard being away from home for a year. The hospital was a long way from where I lived so it was very hard for my mother to come and visit me and bring me things,” she says.

Tsholofelo Msimango and her son at her home in Brakpan, near
Johannesburg. Credit: TB Alliance/Jonathan Torgovnik

But while now healthy and free of TB, the disease has continued to play a large role in Msimango’s life.

She decided she wanted to help others affected by TB. Today she is a TB community advocate and educator and helps to recruit people for medical studies.

“I would recommend to anyone that if they get the chance to take part in a study like the one that I got to take part in, that they should go for it,” she says.

Now a mother to a young boy, she says she speaks to him about what she went through and about TB so that he understands about the disease and the risks it poses.

“I talk to my son about what happened to me, why I was in hospital and why I now work in the TB community. I tell my son and his friends about TB and what can be done to stop its spread and how they can help, for instance, by covering their mouths when they cough,” she says.

“Actually, I tell my story a lot because I hope it might help other people,” she adds.

Another participant in the trial, Bongiswa Mdaka, says the same.

“I talk to people all the time about TB and my experience with it—I’m very open about it. If I see someone has been coughing for more than two weeks, I tell them about the disease and about getting tested and treated as early as possible,” she told IPS.

Speaking from her home in Vereeniging, Gauteng, Mdaka, who was 27 when she started the trial, said that, like Msimango, it changed her life.

“The trial was a lifesaver for me. It not only changed my life but saved it. It gave me a second chance. Ten years ago, before the trial, the situation for people with XDR-TB was not good. I was diagnosed with MDR-TB and when my condition continued to get worse, I was hospitalized. I was in the hospital for three days and they told me that no, I don’t have MDR-TB; I have XDR-TB, the worst I could have. It was like hearing a death sentence.

Tsholofelo Msimango’s late mother, Zeldah Nkosi. She says her mother was a “pillar of support” during her time when she had TB. Credit: TB Alliance

“So when the people doing the trial came to me, it seemed like a godsend. I had no major expectations—I just hoped that I would get better. Today I am healthy and free of TB. I’m strong. I have a family and a normal life. Life is good,” she said.

Speaking to experts who were involved in the trial, it becomes clear that going into it, no one knew how important it would eventually prove to be in the future of TB treatment.

Dr. Pauline Howell managed the patients during the Nix-TB trial at the Sizwe Tropical Diseases Hospital in Johannesburg, where Msimango was a patient.

“Prior to the Nix trial we knew that treatment was too long, too toxic, worked in less than half of people afflicted with TB, and in those diagnosed with XDR TB (per the pre-2021 definition), only 20 percent were still alive after 5 years. I was still junior in clinical trials in 2015, but it was clear to everyone that knew anything about XDR-TB that replacing the extended treatment, which included at least 6 months of injectables, and all the other drugs (the kitchen sink approach) with just three drugs made us more than a little anxious,” she told IPS.

But like many of the trial’s participants, she saw relatively quickly how well the treatment was working.

“When trial participants started telling newly admitted patients about this trial and brought them to the research site before we had had a chance to speak with them, that was speaking loudly. When certain patients, who had been admitted for over two years, were suddenly starting to respond to TB treatment and culture convert, it was wonderful to celebrate with them, Howell, who is now Clinical Research Site Leader at Sizwe Tropical Disease Hospital, said. “When patients were relocating from the Eastern Cape to Gauteng just to get access to the trial, we knew this was the treatment we’d also want for ourselves and our loved ones.”

“There are definitely a few [trial participants] who may not have survived without this treatment, but for the majority, they were able to get back to their lives faster, potentially cause fewer onward infections and suffer less loneliness and other repercussions of having drug-resistant TB,” she added.

However, while the trial had an immediate effect on its participants, its results, which suggested the enormous potential of the regimen, paved the way for BPaL to revolutionize TB treatment.

“I had no idea that this trial would be the first step towards changing the treatment for drug-resistant tuberculosis worldwide,” Howell said.

“It’s good to remember that although TB is deadly, it is curable, and the side effects of the BPaL/M regimen are common but predictable and manageable. A decade ago, patients put an end to rental agreements for their homes, quit their jobs, told their partners to move on and their families took out funeral policies. These days, patients sit in front of me and say, ‘I have been here for two weeks already! I need to get home and back to my life’. It makes my head spin how much has changed, partially due to the Nix trial,” she added.

In 2022, the World Health Organization (WHO) endorsed BPaL with or without another drug, moxifloxacin (M), and BPaL(M) is today the preferred treatment option for drug-resistant TB.

According to data from the TB Alliance, the nonprofit group that developed pretomanid, BPaL and BPaL-based regimens, they treat about 75 percent of the overall number of drug-resistant TB cases treated annually. This number is projected to soon reach 90 percent.

Meanwhile, the group says, the regimens have already saved more than 11,000 lives and USD 100 million for health systems globally and by 2034 are expected to save an additional 192,000 lives and health systems almost USD 1.3 billion.

In some countries classed as having high-burden TB epidemics, they have already altered the TB landscape significantly.

“In South Africa, which adopted the BPaL/M guidelines in Sep 2023, we are seeing a single-digit percentage lost to follow-up for the first time in the history of our TB programme,” she says.

But the regimen’s potential may be in danger of not being fully fulfilled as richer nations cut foreign aid budgets, impacting funding that has traditionally helped support disease and other healthcare programmes in poor countries.

“The eternal challenge with TB is how closely it is tied to lack of access, poverty, substance use, being undomiciled and general lack of funding to overcome these challenges… Unfortunately, as long as there is poverty and lack of access, political will and funding, TB will continue to live side by side with us,” said Howell.

“Some people now can’t get their medications because of these cuts,” said Msimango. “They’re costing people’s lives.”

Note: This article is brought to you by IPS Noram in collaboration with INPS Japan and Soka Gakkai International in consultative status with ECOSOC.

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Excerpt:

Headlines reflecting the release of Belarusian political prisoners. Graphic: IPS

By Ed Holt
BRATISLAVA, Oct 7 2025 (IPS)

As Belarusian president Alexander Lukashenko continues to pardon political prisoners in an apparently increasingly successful attempt to improve diplomatic relations with the US, rights groups have warned the international community must not let itself be ‘tricked’ into thinking repressions in the country are easing.

Lukashenko, who has ruled Belarus for more than 30 years, last month (SEP) ordered the release of more than 75 prisoners, the majority of them political prisoners, after negotiations with US officials.

But critics have said while the release of any prisoners is welcome, it should not be taken as a sign that the persecution of the regime’s opponents is about to stop, and they point out that people are being jailed for their politics in Belarus at a faster rate than any are being released.

“While it is good that prisoners have been released, they should never have been in prison in the first place. There is a risk now that the attention of the international community will be diverted from the continuing repressions in the country. People are still in prison, and still being imprisoned, for exercising their human rights. While Lukashenko is releasing people, he is at the same time arresting more – it’s like a revolving door,” Maria Guryeva, Senior Campaigner at Amnesty International, told IPS.

The warnings follow the release on September 11 of 52 prisoners—the majority of whom were political prisoners—and the freeing on September 16 of a further 25 prisoners from Belarusian jails.

This came after direct negotiations with US officials and in return for an easing of sanctions on Belarus’s national airline, Belavia.

The releases were also followed by confirmation from US officials involved in the negotiations that US President Donald Trump had told Lukashenko that Washington wants to reopen its embassy in Minsk. Trump also spoke to Lukashenko on the phone earlier in the summer and has reportedly even suggested that a meeting between the two could take place in the near future.

Political experts say that much closer ties between Washington and Minsk, not to mention an easing of sanctions, would be a major PR coup for Lukashenko. It could also be attractive to President Donald Trump, as it would underscore his own touted credentials as a master conciliator and a defender of human rights who can free political prisoners.

Rights activists, though, fear that seeing such political gains from his actions will only embolden Lukashenko to use prisoners as “bargaining chips” to extract further political concessions in the future.

“It seems like this is a new tactic [by the Belarusian regime] to use political prisoners as bargaining chips, [and] it seems to be working in that Belarus is getting political favors for releasing prisoners. As long as the regime sees it can use them as bargaining chips, this policy will continue,” Anastasiia Kroupe, Assistant Researcher, Europe and Central Asia, at Human Rights Watch, told IPS.

Activists argue that ultimately, any concessions by the US, or other western nations, to the regime will do nothing to improve the dire situation with human rights violations in Belarus, especially given that there remain so many political prisoners in Belarusian jails—the rights group Viasna said that as of September 18 there were 1,184 political prisoners in Belarus—that Lukashenko could release when it is expedient.

They also point out that in some cases the individual releases in September were barely even pardons as such, given that many who were freed were just months or even weeks away from the end of their sentences anyway. The prisoners were, once ‘free,’ also forcibly deported from the country—one, opposition politician Mikalai Statkevich, refused to leave Belarus after being freed and was soon after re-arrested—to neighboring Lithuania.

“The fact that these prisoners were forcibly exiled is a further form of reprisal against them… for some it is a continuation of their punishment,” said Kroupe.

Belarusian rights activists told IPS that the mood among those who had been released was mixed.

While some were glad to be free, others were angry.

“A number of those released are extremely frustrated. Some had literally just a month left to serve and were planning to continue living in Belarus. They had almost fully served their, albeit unjustly imposed, sentences, but instead of freedom, they were punished once again,” Enira Bronitskaya, an activist with the Belarusian rights group Human Constanta, whose activities include helping exiled Belarusians, told IPS.

“They were thrown out of their country; many had their passports taken away (torn up), effectively stripped of their citizenship (deprived of documents, expelled from the country, with no intention from the state of their citizenship to provide any support). These actions are unlawful. People have been deprived of everything they had in Belarus, from property to the possibility of visiting the graves of their relatives who died while they were in prison,” she added.

Others among the Belarusian community in exile told IPS there were concerns the releases could actually be used as a distraction from an even more intense crackdown on dissent.

“In our community, some are hopeful that the releases are a sign of successful negotiations, but the majority, me included, does not find the news particularly positive. Of course it is a great relief for the people released and their relatives, but we are expecting an intensification of repressions,” Maryna Morozova*, who left Belarus for Poland soon after Lukashenko launched a massive crackdown on dissent following disputed elections in 2020, told IPS.

Just days after the 52 prisoners were released, a Belarusian court sentenced prominent independent journalist Ihar Ilyash to four years in prison on charges of extremism over articles and commentaries critical of Lukashenko.

The Belarusian Association of Journalists said the verdict was a sign that the authorities had no intention of softening their clampdown on independent media, pointing out that at least 27 journalists are currently behind bars in the country.

Exiled Belarusian opposition leader Sviatlana Tsikhanouskaya told international media after the September releases that “the regime’s repressions are continuing despite Trump’s pleas.”

Viasna pointed out that just on the same day the 52 prisoners were released, it had recognized eight new political prisoners.

Activists who spoke to IPS said it seemed likely that, given the apparent success of the prisoner releases in easing, to some extent, Belarus’s international isolation and sanctions, more prisoners could be freed in the near future.

“Of course we expect more releases. Lukashenko’s been doing it for many years—he did it in 2010 and 2015 when political prisoners were released. Lukashenko has a lot of experience in this ‘market,’” Nataliia Satsunkevich, an interim board member at Viasna, told IPS. “Generally, we can see that his policy [of using prisoner releases to get political concessions] works. There are goals he is trying to achieve [by using it],” she added.

Meanwhile, campaigners are urging governments to put human rights, and not politics, at the center of any future negotiations on prisoner releases.

“Every effort should be taken to free political prisoners but there needs to be a clear signal that human rights abuses are not being forgotten about and that no one is being tricked into thinking the repressions are over,” said Kroupe.

“Lukashenko is treating political prisoners like political currency, like hostages. Governments should stop this trade-off and force Lukashenko to comply with human rights law and put pressure on him to unconditionally release all political prisoners,” added Guryeva.

*NAME HAS BEEN CHANGED FOR SECURITY REASONS

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Damage to the water tank at the Maisat water pumping station. Credit: WaSH Sector Lebanon

By Ed Holt
BRATISLAVA, Sep 17 2025 (IPS)

Just under a year into a fragile ceasefire, 150,000 people in southern Lebanon continue to deal with the potentially lethal aftermath of Israeli bombing, highlighting the devastating long-term effects of conflict.

A report published late last month (AUG) by Action Against Hunger, Insecurity Insight, and Oxfam said that at least 150,000 people remain without running water across the south of Lebanon after Israeli attacks had damaged and destroyed swathes of water sanitation and hygiene (WASH) facilities since the beginning of the conflict in Lebanon.

The report, When Bombs Turn the Taps Off: The Impact of Conflict on Water Infrastructure in Lebanon, laid bare both the immediate and long-term effects of repeated attacks on Lebanese water infrastructure between October 2023 and April 2025.

It said that more than 30 villages were without any connection to running water, leading to long-term disruption to supplies of fresh water, fueling dependence on water trucking that many people cannot afford and, according to the World Bank, losses estimated at USD171 million across the water, wastewater and irrigation sectors.

A severe rainfall shortage in recent months has exacerbated the problem, increasing risks of outbreaks of waterborne diseases as  vulnerable communities are forced to resort to utilizing unsafe or contaminated water sources for their daily needs.

But groups behind the report warn that without mitigating action, the situation could become even worse.

“We can see there is the potential for some severe long-term repercussions of these attacks. There are 150,000 people without running water at the moment, but that number could rise in the future,” Suzanne Takkenberg, Action Against Hunger’s country director, told IPS.

Among the groups’ biggest concerns is the effect of the destruction on local agriculture.

In villages near the southern Lebanese border, farmers’ irrigation networks have been destroyed, cutting off vital water supplies to farms. Trucked-in water supplies have not been sufficient to replace this and allow them to irrigate land or give drinking water to their livestock, farmers say.

Meanwhile, farmers have also been unable to access their land due to security concerns—a November ceasefire between Israel and Hezbollah has held only partly, with violations reported regularly—compounding problems with food production.

“One of our major worries is the mid- to long-term effects of the difficulties for farmers to irrigate their land,” explained Takkenberg.

“They have been struggling to irrigate their land since October 2023, due to security concerns hindering access to their land, as well as water problems. We have seen as a consequence of these attacks that food prices have increased and food productivity has decreased.”

Another concern is the growing reliance on trucked-in water for communities.

“Worryingly, people are becoming dependent on using water that is trucked in. This is sometimes ten times more expensive than using water from a public network, and the checks on that water are not the same as those carried out on public water supply networks,” said Takkenberg.

“Water quality after any kind of conflict is a concern and we are definitely worried about it in southern Lebanon after these attacks,” she added.

Illness and disease related to water quality and shortages are major concerns.

A destroyed water pumping station in Tyre, Lebanon, following an airstrike in November 2024.
Credit: Insecurity Insight

While the report states that waterborne and water-related illnesses were not reported by people interviewed, some highlighted the limited resources available for testing water quality and possible contamination. There are also worries that water may have been contaminated by white phosphorus, the use of these munitions in Lebanon having been verified by Human Rights Watch.

Meanwhile, there are further concerns that residents may resort to using unsafe water sources due to limited supplies, a situation exacerbated by low rainfall and water shortages at critical reservoirs.

Local officials interviewed for the report also highlighted damage to sewerage networks in some areas. This, combined with the known large-scale damage to water infrastructure and the possibility that damaged sewerage infrastructure has contaminated water sources, ramps up the potential of negative long-term effects on health if the water supply crisis is not adequately addressed, the report states.

It also points to evidence from Ethiopia, Ukraine and the Middle East, demonstrating clear links between damage to water and sanitation infrastructure during conflict and adverse public health outcomes.

“People are cutting back on their water use, which can have an effect on health and hygiene and raises disease risk—cholera is already epidemic in Lebanon and this situation could exacerbate that. Other diseases could also be spread. We have already seen cases of watery diarrhea, which is bad not just in itself, but also because in children it can cause problems with malnutrition as their bodies struggle to absorb nutrients,” Takkenberg said.

But while the potential long-term impact of the damage and destruction to water infrastructure is severe, early action could mitigate the worst possible outcomes, experts say.

“There is an urgent need to repair systems and while this is ongoing, to track water into the area. The consequences of water system destruction are rarely immediate. Most often, the impacts accumulate over time. It is the combination of destroyed infrastructure with the failure to repair it, insufficient water trucking, or lack of access to trucked-in water that eventually produces devastating outcomes for individuals and communities,” Christina Wille, Director of Insecurity Insight, told IPS.

“This is why the destruction of infrastructure demands close attention: if not effectively mitigated, cascading consequences are inevitable. People may be forced to leave, adding to the numbers of displaced populations, or they may fall ill. Yet there is also an opportunity—by addressing damaged infrastructure early—to prevent the worst outcomes of displacement and disease and to save lives,” she added.

But while repairing and rebuilding water infrastructure is essential to preventing the most severe long-term impacts on local communities, implementing it is a different matter.

Authorities have managed to carry out some limited repairs to some networks, but issues around the continued presence of Israeli forces and concerns about ongoing conflict violence have prevented wider-scale or more extensive reconstruction. Finances for repairs are also under strain amid the socio-economic crisis the country has faced since 2019.

“Disease outbreaks are very predictable and the cost of not dealing with them is much worse than dealing with them now. The health ministry has been good in warning [of potential health risks] but there is a limit to what the government can do with the resources that are available after years of economic crisis. It is a very difficult situation,” said Takkenberg.

The report ends with a call for, among others, all parties to the conflict to strictly comply with the ceasefire agreement and adhere to international humanitarian law (IHL) and ensure the protection of civilians, health workers, and essential infrastructure.

It urges humanitarian programmers and donors to support the rehabilitation and operationalization of conflict-affected water infrastructure and ensure temporary access to safe water and basic sanitation services through the provision of water trucking, emergency water points, and safe wastewater discharge.

The report also says UN member states should push for the establishment of independent, impartial, and transparent investigations into all allegations of IHL violations.

Satellite imagery shown in the report indicates that in at least several incidents the damaged or destroyed facilities were located in large open areas without clearly identifiable military targets, suggesting that in some cases they may have been specifically and deliberately targeted.

The authors of the report point out that under IHL, parties to a conflict must always distinguish between lawful military targets and civilians and civilian objects and that deliberately targeting civilians and civilian objects is prohibited and amounts to a war crime. The various kinds of water infrastructure are protected as civilian objects under IHL and must never be attacked.

“Determining whether each incident deliberately targeted water infrastructure would require access to confidential military decisions, which is not available, as well as information on whether any military objectives were present at the time of the attacks. Our data is limited to the observable effects on the ground following the attacks. Nevertheless, the scale and nature of the observed damage raise serious questions regarding compliance with international humanitarian law, which governs the conduct of hostilities,” said Wille.

While it may not be possible to determine whether the attacks were deliberate, their impact is clear and highlights the need to look at not just the direct but also indirect effects of conflict, said Wille.

“Conflict deaths are not only direct (caused by weapons) but also indirect, when the destruction of systems produces cumulative and deadly consequences. The more complex and interconnected our societies become, particularly in securing food and water, the more vulnerable they are to such systemic shocks. At the same time, it becomes harder to trace devastating outcomes back to a single act of destruction.

“This is why we must learn to examine conflicts through the lens of systems and interconnectivity and to apply this knowledge to our legal analysis of the conduct of warfare,” she said.

“The public needs to ask more direct questions about the conduct of warfare and how the principles of distinction, proportionality, and precaution are being applied. We need a broader debate on how these principles should be interpreted in today’s conflicts. Modern societies rely on highly interconnected and complex infrastructure to secure basic needs such as food and water, while warfare is increasingly conducted remotely through advanced technologies. In this context, what counts as proportional? And what kinds of precautions are necessary in today’s world?” she added.

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The home of Oksana Serhienko, Merefa village, near Kharkiv, Ukraine. Credit: Akos Stiller

By Ed Holt
BRATISLAVA, Aug 6 2025 (IPS)

As Russian forces continue to lay waste to civilian areas of towns and cities across Ukraine, Roma in the country are struggling to access compensation to help them rebuild their damaged homes.

Russia’s relentless bombing has, according to the World Bank, left 13 percent of Ukraine’s housing damaged or destroyed, affecting over 2.5 million households.

Despite this, many Ukrainians, including Roma, have refused to leave their homes in the face of relentless bombing and instead are determined to carry on living in sometimes severely damaged homes to keep their communities alive.

But a new report has shown that many Roma—one of the most vulnerable communities in Ukraine—have been unable to access state property damage compensation: only 4 percent of Roma households surveyed successfully secured compensation for war damage, despite suffering widespread destruction.

This is because requirements for applicants mean the Roma population, whose lives were already precarious long before the war began, are being disproportionately excluded from the scheme, according to the Roma Foundation for Europe (RFE), which was behind the report.

“Many of the issues we identify [in our report] affect non-Roma applicants too—particularly in occupied or frontline areas… [but] what makes the situation more severe for Roma is the combination of these factors with long-standing exclusion and economic precarity,” Neda Korunovska, Vice President for Analytics and Results at RFE, told IPS.

As in many countries in Europe, the Roma community in Ukraine has long faced social exclusion and, many claim, systemic discrimination at societal and institutional levels.

But like the rest of Ukrainian society, they have felt the full effects of Russia’s brutal full-scale invasion over the last three and half years and many have seen their homes damaged or even destroyed.

State compensation for property damage caused by the fighting is available, but experts say there are significant barriers for claimants, some of which are specifically greater for Roma people.

These include requirements such as possession of official property documents and proof of ownership—both sometimes difficult for Roma from communities where informal housing and disputed property rights are not uncommon—as well as a need for a level of digital literacy, which can be a problem for communities where levels of digital exclusion are high, according to RFE.

The group’s analysis, based on cases across four Ukrainian regions, including Zaporizhzhia, Kryvyi Rih, Odessa and Kharkiv, shows that deeply entrenched legal, administrative, and digital hurdles are blocking Roma communities from accessing aid intended for rebuilding homes and lives, the group claims.

Zeljko Jovanovic, RFE president, said that current compensation systems, although designed for order and efficiency, often overlook those with fewer resources but no less damage, and that they lack “…the required flexibility for the complex realities of pre-war informality of homes, displacement, and occupation.”

“Many affected families cannot afford the property registration fees or the costs associated with inheritance procedures. The average damage of 2,816 Euros represents several months of pre-war salary,” he added.

RFE points out that in regions like Odesa, more than half (54 percent) of Roma families lack formal property registration, while in Kryvyi Rih, not a single claim from the surveyed households has been submitted to the state registry due to legal limbo over inheritance, missing paperwork, and lack of resources to navigate the system. Even in Zaporizhzhia, where property records are strongest, low application rates point to deep mistrust in institutions, amplified by experiences of discrimination.

Some Roma contacted for the survey said they had not even bothered to apply for compensation for fear that the government might later come and demand the money back from them.

“This is a reflection of deep institutional mistrust,” said Korunovska. “This mistrust isn’t unfounded—it’s rooted in long-standing patterns of discrimination. In previous research we have undertaken, many Roma respondents have described negative treatment by public officials when seeking housing or services. Surveys consistently show high levels of social distance between Roma and the broader population in Ukraine, which reinforces these feelings of exclusion.”

RFE points out that nationally, around 61% of submitted claims have been approved, but that among Roma, the figure was only 28%—and the vast majority (86%) of people surveyed for its report never submitted claims at all due to systemic barriers.

Liubov Serhienko, 69, has lived in her home in Merefa, near Kharkiv, for the last forty years. But it has suffered severe damage from bombings by Russian forces—during one attack the roof and some ceilings collapsed and one room is now entirely uninhabitable. During a short evacuation from the house, thieves stole her boiler, fridge, and furniture.

Her daughter, Oksana, describes how the family—three generations all living under the same roof, including Oksana and her children—is forced to use blankets to try to retain whatever heat they can in rooms now largely completely exposed to the outside because walls are no longer standing. In winter, snow blows straight into the home, she says.

While neighbors have helped with some repairs, resources are limited and the building remains in disrepair. Relying solely on her pension of 3,000 UAH (around €70) to support the household—the war has taken away all job opportunities for her and members of her family—she says all she wants is the state to help fix the roof and ceiling, as she no longer has the physical strength or finances to do it herself.

In testimony to RFE, which was passed on to IPS, Serhienko said, “What I want most right now is for my family to have a roof over their heads.”

Oksana criticizes the lack of help from the state for them and other Roma in similar situations.

“The government doesn’t care. They’ve done nothing,” she said.

Her mother goes even further, explicitly linking her experience to deliberate discrimination by authorities.

“[Just] Gypsies, they say. As if we’re not people. Maybe they don’t see us as people.”

Andriy Poliakov has stayed in his home in Andriivka in the Kharkiv region since the start of the full-scale invasion, despite the severe damage the dwelling has suffered in Russian attacks.

Windows are broken and there are cracks in the walls, as he has suffered several damages to their house, windows were broken, and there are cracks in the walls, as his house has shifted structurally due to bomb blasts. Poliakov, 45, refuses to leave his home, as he is a sole caregiver for some members of his family, even though he is disabled himself, but he says life is difficult, as they have no gas or other reliable heating source and rely on a makeshift stove he built from stone and bricks.

As with almost all of those surveyed in the RFE report, Poliakov has had no help from the state with any of the damage to his home. One of the reasons so many Roma choose not to even attempt to apply for compensation is the distrust of authorities that is widespread among communities—a distrust Poliakov shares.

“They don’t care. Even though I’m disabled and it’s on paper that I’m disabled… It doesn’t matter to them,” he said.

In the wake of its findings, RFE is calling on the Ukrainian government to integrate urgent reforms into reconstruction planning, including accepting alternative proof of ownership such as utility bills or community testimony, waiving registration fees for war-affected families, and introducing temporary ownership certificates to ensure displaced or undocumented Roma have access to compensation.

RFE says it is hoping to present its findings to government representatives in the coming weeks.

“We hope this data will serve as a constructive basis for reform, especially in light of Ukraine’s broader efforts to align with European values of fairness and accountability,” said Korunovska.

Jovanovic added that “even if full compensation isn’t possible now, temporary support is essential. Roma living in damaged homes are part of Ukraine’s strength and its resistance.”

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Police line up at an anti-government outside the parliament building in Tbilisi. Credit: Gvantsa Kalandadze

By Ed Holt
BRATISLAVA, Jun 20 2025 (IPS)

Having attended hundreds of anti-government protests in the Georgian capital, Tbilisi, Gvantsa Kalandadze is no stranger to police intimidation and violence.

Police brutality has become common at the daily protests that have taken place in the city since the end of last year, when the autocratic government of the Georgian Dream party said it was stopping the country’s process of integration into the EU.

Kalandadze has seen others fall victim to police brutality and experienced it on more than one occasion herself—soon after leaving a protest in December last year, she was pushed to the ground and kicked viciously by a group of officers for questioning the arrest of a man in the street, and during another gathering a few weeks later, she was knocked out when officers pushed her and other protestors into a ditch.

But when the protests began, police violence against protesters seemed indiscriminate; research by rights group Amnesty International suggests that women protesters are now being targeted specifically and are facing escalating violence and gender-based reprisals.

Kalandadze says she is not surprised by the news.

“It’s true. The police are aggressive and they harass women both verbally, using demeaning terms such as ‘slut,’ ‘daughter of a whore,’ and others, and threaten us with rape and assault,” she says.

Amnesty’s research details the police’s methods to target women, which involves increasing use of gender-based violence including sexist insults, threats of sexual violence and unlawful and degrading strip searches against women involved in protests.

“We have spoken to people personally about what they experienced at the hands of the police, such as being forced to undergo strip-searches and threats of rape during detention,” Denis Krivosheev, Amnesty International’s Deputy Director for Eastern Europe and Central Asia, told IPS.

The group’s research also highlights individual cases of this abuse, including cases of women being violently restrained by officers, forced to strip naked, denied access to medical treatment, threatened with rape, and subjected to sexual insults.

Amnesty says these abuses not only violate Georgian law, which prohibits full undressing during searches, but also international human rights law and standards aimed at safeguarding human dignity and protecting people from gender-based violence.

“Forcing someone to completely strip naked [in detention] is against both international and Georgian law, yet despite this, the police are forcing protesters to do this. It is clearly a deliberate police policy, despite it being against the law,” said Krivosheev.

While Amnesty says it has spoken to numerous women about such abuse, Krivosheev said, “the number [of women who are victims of this targeting] is far more than we have been able to document simply because many victims are scared to speak out about what happened to them.”

Female protesters who spoke to IPS confirmed that police harassment of women at protests was widespread, but also that it was often used to provoke a specific response, and not always just from women.

“The thing is that women are never violent at protests; they would never attack police, and the police are insulting us—usually with sexual slurs like saying we’re all sluts, bitches, whores, and insults about oral and anal sex—to try and provoke us into doing something that would get us arrested or force the men around us to try and protect us and do something that will get those men arrested,” Vera*, who has attended scores of protests in Tbilisi, told IPS.

“I know multiple women who were physically pushed, dragged, or detained. Some were insulted with misogynistic language. A few were groped during arrests—and that isn’t isolated… many of us know someone personally who’s experienced this abuse,” Tamar*, a civil rights campaigner from Tbilisi who has attended scores of protests, told IPS.

She added that police were even cooperating with, or at least tolerating, criminals abusing women protesters.

“The police have used violence—tear gas, water cannons, rubber bullets, and physical force—but that’s only part of the story. What’s even more disturbing is the presence of organized criminal gangs. These groups operate with impunity, clearly coordinated, yet the police don’t intervene. They specifically target women activists—chasing them, splashing green substances on their faces, shouting threats, and trying to scare them off the streets.

“I was personally hit in the head with a stone by one of these thugs. When I asked a police officer for help, he sarcastically told me to ask my ‘fellow democratic fighters’ who did it, as if it had come from among the people protesting. There’s zero accountability when the violence comes from those orchestrated to look like random citizens. It’s a deliberate tactic to terrorize protesters, especially women, while maintaining official deniability,” she said.

Many female protesters believe the reasons behind the targeting of women are rooted in not just the role women are playing in the current protests but also the “misogynist tendencies” of many officers.

“There is also a culture of toxic masculinity that goes hand in hand with the conservative part of society—the police are angry that women are taking the initiative [in protests]—female participation in the current protests is a lot larger than ever before—and that causes their aggression. The police see (or, at least, saw at the beginning) women at protests as ‘inferior’ compared to men and think they will be easier to break morally and easier to overpower physically.

“Another factor is the sexual deviations of individuals in the police force—when they feel power over the women after detaining them, their perversion takes over,” Vera explained.

Others put it down to how police perceive women as a serious threat to their authority.

“I think that the real reason the police are targeting women is that women are truly fearless in these protests. They are very resilient and persistent and always on the frontlines. They have actually physically saved a lot of men from the hands of violent police. I truly believe that the police feel threatened by them,” Paata Sabelashvili, a rights campaigner in Tbilisi who has taken part in protests, told IPS.

He added, though, that “in light of the misogyny and sexism among police officers, this is, sadly, not unexpected, and I fear it will only get worse in the future.”

While Amnesty has called on Georgian authorities to immediately end all forms of gender-based reprisals and all unlawful use of force by law enforcement, investigate every allegation of abuse during the protests, and ensure accountability at all levels, neither the group itself nor protesters who spoke to IPS, believe that is likely to happen soon.

“There is little hope under the current government for accountability and effective investigation [of police abuse during protests],” said Krivosheev.

Local media have reported that investigations into complaints made by women about the violence and threats they have faced from police at protests have largely gone nowhere, as have investigations by the Special Investigation Service, which is tasked with independently investigating crimes committed by police, despite hundreds of reports of police violence in 2024 alone.

The government has not commented on claims of women protesters being targeted by police, but in the past it has justified police action at protests as being a response to violence from protesters and has claimed, without evidence, that the protests are being funded from abroad.

But while women protesters are suffering from abuse and harassment by police, the tactics appear to be galvanizing female participation in protests.

“These gender-based reprisals may have been aimed at scaring women into giving up, but that has not been the case. Women have continued protesting, and if anything, even more intensively. Many women continue to speak up about how the police are treating them,” said Krivosheev.

Kalandadze says that despite her experiences, she will not stop attending protests.

“The day the government announced it would suspend Georgia’s EU integration, I decided to join the street protests, and the violent suppression began the same night. Since then, I have attended every protest where protesters have been in danger—every gathering where the police special forces were called in. Even today, I take part in every protest where police forces are mobilized,” she says.

Vera pointed out that although the size of street protests in Tbilisi has grown smaller, they continue on a daily basis.

“The fact that there is some kind of protest in the capital every day is discomfiting for the government and also serves to ensure that the regime is not legitimized in the eyes of the country’s former western partners. There are lots of female activists and the leaders of the protest marches are always women. We have shown so much resilience. We believe in each other. This country is ours,” she said.

Tamar was even more defiant.

“When women lead, especially in a patriarchal society, it destabilizes the whole narrative. It’s not just about political dissent; it’s about cultural control. Yes, I fear things may get worse before they get better. But we aren’t taking a step back,” she said.

*Names have been changed for their safety.

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Protestors march down Valletta's Republic Street on the first anniversary of Daphne's assassination. Credit: Miguela Xuereb/Daphne Caruana Galizia Foundation

By Ed Holt
BRATISLAVA, Jun 16 2025 (IPS)

“We didn’t want revenge. We want justice—justice for Daphne and for the [crimes exposed in] her stories.”

Corinne Vella, sister of murdered Maltese journalist Daphne Caruana Galizia, is speaking to IPS soon after the sentencing of two men to life imprisonment for their involvement in the killing.

She explains that while the long sentences are an important step forward in her family’s pursuit of justice for her sister, they have wider ramifications for press freedom too.

“These sentences are a step towards that justice, but also a step towards making a safer world for journalists,” she says.

Caruana Galizia, Malta’s most prominent investigative journalist, was killed by a car bomb in October 2017 outside her home in the village of Bidnija.

Her murder made headlines around the world, focusing attention on the rule of law in Malta, as well as highlighting the murky links between Maltese politicians and big business—her investigations had exposed high-level government corruption linked to companies.

It also highlighted issues around the safety of journalists. A public inquiry held in the wake of the killing delivered a damning verdict of the state’s role in her murder and pointed to institutional failures to protect Caruana Galizia.

The inquiry’s findings, released in a 457-page report in 2021, were that her death had been preventable and that responsibility lay with the state for creating “an atmosphere of impunity… which led to the collapse of the rule of law.”

The report said, “…acts, certainly illicit if not illegal, were committed by persons within State entities that created an environment that facilitated the assassination. This even by failing to do their duty to act promptly and effectively to give proper protection to the journalist.”

Four years on from the publication of that report, Caruana Galizia’s family believes that the life sentences handed down on June 10 to local crime gang members Robert Agius and Jamie Vella, who were found guilty of complicity in the murder by supplying the bomb that killed her, have sent a powerful message.

“We believe the sentences will have a deterrent effect, telling potential killers that there are serious consequences when a journalist is murdered. The sentences have sent out shockwaves already. People literally thought they could get away with murder, and this has shown that they can’t,” Corinne Vella says.

She points out that the significance of the sentences for press freedom reaches well beyond just Malta.

Since the death of Caruana Galizia, other journalists investigating alleged corruption linked to high-level political figures have been killed in Europe, and press freedom groups have said it is imperative state institutions, including the judiciary, are seen as being able to not just protect journalists but bring to justice those behind killings to show they cannot act with impunity.

“The fight against impunity for the murder of journalists in Europe and around the world is fundamental to the wider climate for the safety of journalists,” Jamie Wiseman, Europe Advocacy Officer at the United International Press Institute (IPI), told IPS.

“Convictions like these send an important signal that those who carry out such assassinations will not escape accountability. So these sentences are another big step forward in the push towards full justice and emblematic of media freedom in Europe more widely,” he added.

However, despite the sentences, both Corinne Vella and press freedom groups remain concerned that the failings they say led to Caruana Galizia’s death have not been dealt with.

“Daphne’s murder did not take place in a vacuum. The murder of a journalist for their work happens because of failures in the system that happen before that person has been murdered. And the circumstances that led to Daphne’s murder have not been addressed. The whole post-inquiry history has been one of a lack of urgency and reluctance to respond to the problems identified in that inquiry,” said Corinne Vella.

Media freedom organization Reporters Without Borders (RSF) said the convictions of Agius and Vella mark progress in the quest for justice for Caruana Galizia.

But they pointed out the alleged mastermind behind the killing has yet to be brought to trial, and the majority of recommendations on journalist safety and press freedom that emerged from the public inquiry—including, among others, detailed legal and procedural proposals to bolster protection of journalists and journalism’s role in protecting democracy and helping ensure the rule of law—have yet to be implemented.

RSF says it is now essential that Maltese authorities ramp up efforts to do both.

Pavol Szalai, Head of the European Union-Balkans Desk at RSF, told IPS the sentences of Agius and Vella would act as a deterrent to other potential journalist killers but that “the biggest deterrent would be a timely conviction and long sentence for the mastermind of the killings.”

“Globally there is a clear pattern of the masterminds of such killings escaping justice while the middleman and hitmen are convicted. So it’s vital that we keep pushing and ensure the mastermind behind Daphne’s assassination is put behind bars. The Maltese government must also fully implement the recommendations of the Public Inquiry into Daphne’s murder, which would help tackle the culture of impunity in Malta that created an environment in which a leading journalist could be murdered in an EU member state,” added Wiseman.

Meanwhile, Caruana Galizia’s family continues to pursue justice for her.

Prior to the convictions of Agius and Vella, three other men were already serving sentences for installing and detonating the bomb in Caruana Galizia’s vehicle: brothers Alfred and George Degiorgio, sentenced to 40 years in prison, and Vincent Muscat, who negotiated a reduced sentence of 15 years in exchange for testimony, which was seen as key in the trial of Agius and Vella.

Another man, Melvin Theuma, the middleman in the murder, was granted a pardon in exchange for information on the suspected mastermind, businessman Yorgen Fenech.

Fenech, who was charged with complicity in Caruana Galizia’s murder in 2019 but released on bail in February this year, is awaiting trial.

“The convictions and sentencing [of Agius and Vella] are a step closer to justice for Daphne. But it’s not over yet,” said Vella.

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The aftermath of a Russian attack on the Okhmatdyt Children’s Hospital in Kyiv on July 8, 2024. Credit: Okhmatdyt Children’s Hospital

By Ed Holt
BRATISLAVA, May 19 2025 (IPS)

The international community must take action to uphold international humanitarian law, say healthcare and rights advocates, as attacks on healthcare in war zones reached a record high last year.

A new report from the Safeguarding Health in Conflict Coalition (SHCC) released today (May 19) documented more than 3,600 attacks on doctors and health care workers, hospitals, and clinics in zones of armed conflict in 2024—up 15 percent from 2023 and 62 percent since 2022.

The report’s authors say attacks on healthcare in war zones are not only more numerous but are also more destructive and involve heavier weapons—there was a growing use of explosive weapons in attacks against healthcare, rising from 36 percent of incidents in 2022 to 48 percent in 2023. Perpetrator use of drones against health care facilities drove much of the increase, as their use nearly quadrupled, according to the report.

Meanwhile, more than 900 doctors were killed last year—a rise of 21 percent from 2023—and almost 500 were arrested. More than 100 were kidnapped.

However, the report suggests attacks on healthcare in war zones may be even more widespread, as the collection of data on violence is impeded by insecurity, communications blockages, and the reluctance of some entities to share data on violence.

It also says the rise in attacks has come alongside attempts by perpetrators to limit legal protections for health care and civilians in war.

It highlights how Israel has “sought to dilute legal requirements of precaution and proportionality during conflict” while “campaigns to delegitimize the International Criminal Court (ICC) are underway,” with US president Donald Trump imposing sanctions on ICC staff and their families for having charged Israelis with war crimes, Russia criminalizing cooperation with the ICC or any foreign court seeking to hold Russians to account, and other countries announcing plans to leave the ICC.

The authors say regimes around the world are increasingly flouting international human rights laws, and action must be taken to bring actors behind these attacks to justice or risk a proliferation of military targeting of healthcare.

Christina Wille, Director of Insight Insecurity, an SHCC member, told IPS that the international community has a role to play.

“International humanitarian law, which says that healthcare in conflict must be protected, is not being respected. The international community should come together to ensure that there is accountability for these attacks and the people responsible for them are brought to justice. But if nothing is done and this continues, other states may see the targeting of healthcare as a tactic that they can use in conflict without risk of censure or sanction and will go ahead with it,” Wille said.

While the report documented more countries last year reporting attacks on healthcare, the majority of recorded incidents occurred in a handful of states.

By far the largest number of attacks on health care—more than 1,300—took place in Gaza and the West Bank, but there were also hundreds of attacks in other countries that have seen brutal conflicts, including Ukraine (544), Lebanon (485), Myanmar (308), and Sudan (276), where there has been evidence of systematic targeting of local healthcare facilities and workers by attacking, or both attacking and opposing, forces.

The results of these attacks have been dire, not just in terms of the immediate casualties among healthcare workers and civilians from such strikes but also the knock-on effects on the local civilian population from the destruction of facilities, as in some cases even the most basic of medical services subsequently become unavailable.

The report points out that in Gaza, every hospital has been hit, and many multiple times, with dire impacts on their capacity to address the massive number of traumatic injuries, treatment for chronic and infectious disease, and safe childbirth.

“The health system in Gaza has collapsed. Hospitals and clinics have been completely destroyed, like the of the civilian infrastructure. Today, only 22 out of 36 hospitals are partially functioning, and that can mean only being able to treat a few patients a day. Most of the labs are not running, there is very little material available, the staff is exhausted, and some are still detained,” Simon Tyler, Executive Director of Doctors of the World, the UK chapter of the international human rights organization global Médecins du Monde network, told IPS.

A charity organization working in Gaza, Medical Aid for Palestinians (MAP), said that devastating attacks on two hospitals – the European Gaza Hospital (EGH) and Nasser Hospital in southern Gaza—in the last week had worsened the situation.

“The attacks put the EGH out of service and increased the pressure on services at Nasser, as well as destroying parts of the hospital, including the burns unit. EGH was the only hospital in Gaza providing cancer services following the destruction of the Turkish Friendship Hospital in March,” MAP communications manager Max Slaughter told IPS.

Israeli forces have often claimed that hospitals in Gaza were being used as bases for Hamas military operations.

But the UN has said Israeli forces’ attacks on healthcare in Gaza are a war crime.

Doctors in Myanmar who spoke to IPS on condition of anonymity for security reasons said the intensified use of drones by government forces fighting rebel groups in the last 18 months “posed grave threats to the provision of humanitarian aid and healthcare services.”

“Deliberate attacks on healthcare facilities, including hospitals, rural health centers, and other related infrastructure, have resulted in severe damage to health facilities, injuries, fatalities, and, in some cases, permanent disabilities among healthcare workers,” one said.

The doctors added that a combination of people being afraid to travel and frequent displacement of healthcare service sites has significantly disrupted access to essential medical care, and drone attacks targeting group activities, such as the provision of humanitarian aid, hinder effective delivery by deterring gatherings of people and creating logistical challenges.

Meanwhile, the risk posed to humanitarian workers by these attacks has reduced the presence of organizations on the ground, diminishing aid availability for affected populations.

In Ukraine, the healthcare system has faced similar widespread destruction.

Earlier this month, Ukraine’s Health Ministry said that Russian forces had damaged or destroyed more than 2,300 medical infrastructure facilities since the start of the full-scale invasion in February 2022.

In some areas near the line, healthcare systems have all but disappeared, with people having to either rely on local aid groups and NGOs for basic care and essential medicines or travel long distances in difficult conditions to facilities that are still functioning.

But it is not hospitals that have come under attack, as Russian troops regularly target ambulances—since the beginning of the full-scale invasion, 116 ambulances have been damaged, 274 destroyed, and 80 seized.

But hospitals and clinics in areas far from the fighting have not been spared. In one of the worst attacks on healthcare since the start of Russia’s full-scale invasion, the Okhmatdyt Children’s Hospital, one of the largest of its kind in Europe, was hit by a missile on July 8 last year. Two adults were killed and at least 34 people, including nine children, were injured.

Despite initial denials by the Kremlin that its forces had hit the hospital, evidence showed the building had been deliberately struck with a hypersonic missile.

Another problem faced in many conflict zones is how attacks on other infrastructure, such as energy facilities, are impacting healthcare.

Volodymyr Hryshko, Senior Legal Counsel with Ukrainian group Truth Hounds, told IPS more intense Russian targeting of energy infrastructure in 2024 had had a devastating impact on healthcare. In a survey by the group, 92 percent of doctors reported such attacks had experienced power cuts at work, and 66 percent said medical procedures had been affected. The attacks had led to deaths from oxygen deprivation as life support systems failed and staff at some hospitals were forced to work in complete blackouts.

“But the impact is not only immediate risk to patients but also long-term system degradation, staff burnout—reported by over 80 percent—and psychological trauma among both patients and healthcare providers,” he said.

However, despite the death and destruction caused by such attacks, the report shows they are increasing in number.

Wille said the reasons for this are varied and that not all strikes on medical facilities documented may be deliberate.

“Weapons may not be as accurate as believed, and heavy weapons can also have a ‘wide area’ effect—attackers may not have been aiming to hit a hospital, but the impact of the strike still damaged it,” she said.

However, she pointed out that militaries are aware they can gain an advantage in conflict by targeting healthcare systems.

“Health systems are often seen by conflict parties as a system that can help keep the enemy going—treating injuries, helping them recover, and providing a place for them to rest and recuperate.

“Attacks on health systems can also damage morale significantly because health facilities and workers supply the services the population, especially very young and old people, desperately need,” she explained.

But groups working to provide medical and humanitarian help in war zones believe the fact that the regimes behind these attacks are carrying them out with seeming impunity is fueling continued attacks on healthcare in war zones.

“The principle that civilians and aid workers should be protected is being violated time and again. In recent times, we’ve seen clinics bombed, convoys attacked, and our colleagues targeted simply for doing their job in Gaza, the West Bank, and Ukraine. We can no longer rely on or guarantee protection for our staff and services. Civilians, humanitarian workers, health workers, and infrastructure should never be targets. We firmly condemn all attacks on healthcare and call for independent investigation and accountability for the perpetrators,” said Tyler.

“The continued inaction of… some of the most powerful governments in the world in the face of the Israeli authorities’ deadly blockade is indefensible—and could be judged as complicity under international humanitarian law and human rights law. We must hold all responsible for violations accountable to ensure justice for victims, deter further violations, and prevent future escalations,” he added.

MAP’s Slaughter warned that Israel’s “… deliberate blockade of aid and continued attacks on healthcare, all with no real accountability or impunity, are setting a precedent that the international community will permit such atrocities to be committed with no recourse.”

The SHCC report calls for UN states to take action to ensure healthcare is protected in conflicts, including ending impunity by encouraging investigations, data sharing, prosecutions through the International Criminal Court and empowering monitoring bodies.

Wille admitted, though it may be difficult to get a powerful international consensus that would lead to such attacks being stopped, or at least significantly reduced.

“I have little optimism that governments can prevent such attacks in the current climate. When major powers that should uphold the rules-based international order instead question its legitimacy—and even erode the rule of law at home, as in the US—it becomes nearly impossible to build the international consensus needed to enforce those rules,” she said.

“Yet it remains essential to keep calling for these attacks to stop and for perpetrators to be held accountable because even a fractured international order can be repaired, and justice demands persistence,” she added.

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An amendment to Hungary’s constitution includes the banning and criminalisation of Pride marches and their organisers. Credit: Sara Rampazzo/Unsplash

By Ed Holt
BRATISLAVA, May 13 2025 (IPS)

A controversial amendment to Hungary’s constitution has left the country’s LGBTQI community both defiant and fearful, rights groups have said.

The amendment, passed by parliament on April 14, includes, among others, the banning and criminalisation of Pride marches and their organisers, with penalties including large fines and, in certain cases, imprisonment.

It also allows for the use of real-time facial recognition technologies for the identification of protestors.

It has been condemned by domestic and international rights groups and members of the European Parliament (MEPs) as an assault on not just the LGBTQI community but wider human rights.

And there are now fears it will lead to a rise in violence against LGBTQI people whose rights have been gradually eroded in recent years under populist prime minister Viktor Orban’s authoritarian regime.

“There is serious concern that this legislative package could lead to an increase in threats, harassment, and violence against LGBTI communities in Hungary. When authorities criminalise Pride organisers and create a chilling effect on peaceful assembly, it not only emboldens hostile rhetoric but also signals impunity for those who wish to intimidate or harm LGBTI people,” Katja Štefanec Gärtner, Communications and Media Officer, ILGA-Europe, told IPS.

“The risks are not theoretical. Pride marches have long been a target for extremist groups, and this legal crackdown sends a dangerous message: that state institutions may no longer protect those marching but instead criminalise them. This creates an unsafe and unpredictable environment for all those standing up for human rights and democratic freedoms,” she added.

The amendment codifies legislation already passed in March banning LGBTQI events. It was met with widespread outrage in the LGBTQI community in Hungary. But there was also defiance, with Pride organisers insisting the event would go ahead.

Budapest’s mayor, Gergely Karácsony, also backed the organisers, pledging last month to help them find a way to hold the event despite the new legislation.

But while LGBTQI activists have said they will not give in to the new law, groups working with the community say some LGBTQI people have been shaken by the legislation.

“Depending on who you speak to, the mood now among the LGBTQI community is one of fear and worry or defiance,” Luca Dudits, press spokesperson for the Hatter Society, one of Hungary’s largest LGBTQI NGOs, told IPS.

“We will see how the new provisions [in the amendment] will affect the lives of LGBTQI people in the upcoming months, especially in June, which is Pride month, with the march taking place on the 28^th,” she added, noting that after legislation was passed in 2021 banning the depiction and promotion of “diverse gender identities and sexual orientations” to under 18s, there had been  “a wave of violence and discrimination against LGBTQI people”.

“I’m hoping this will not be the case this time. A lot of people have expressed their solidarity and said that they will attend the Pride March for the first time because of this shameful constitutional amendment,” Dudits said.

Outside Hungary, organisations and politicians have also raised the alarm over the legislation.

In a letter sent to the European Commission (EC) on April 16, dozens of LGBTQI and human rights organisations demanded the EC take immediate action to ensure the event can go ahead and that people can safely attend.

They said the ban on LGBTQI events was an attack on EU fundamental rights of freedom of peaceful assembly and freedom of expression and that its provisions marked a significant infringement on privacy and personal freedoms protected under EU law.

Meanwhile, MEPs among a delegation which visited Hungary from April 14-16 attacked the ban and said they were calling on the EC to request the European Court of Justice to suspend the law pending further legal action.

One of the MEPs, Krzysztof Smiszek, of the Polish New Left, said the new law had led to a rise in violent attacks and hate crimes against the LGBTQI community in Hungary.

The government has defended the amendment, with Orban saying after the vote in parliament that it was designed to “protect children’s development, affirming that a person is born either male or female, and standing firm against drugs and foreign interference”.

The amendment also declares that children’s rights take precedence over any other fundamental right (except the right to life) and codifies in the Constitution the recognition of only two sexes – male and female – essentially denying transgender and intersex identities.

It also allows for the suspension of Hungarian citizenship for some dual nationals if they are deemed to pose a threat to Hungary’s security or sovereignty.

Many observers see the ban and the other measures included in the amendment as part of a wider attempt by Orban’s regime to suppress dissent and weaken rights protections as it looks to consolidate its grip on power by scapegoating parts of the population, including not just LGBTQI people but migrants and civil society groups, to appeal to conservative voters.

“Authoritarian governments around the world have discovered a playbook for keeping in power – it involves vilifying certain communities. That’s the logic behind attacks on LGBTQI communities and that’s what’s behind this. I don’t think Orban cares one way or the other about LGBT people; it’s just that they are an easy target,” Neela Ghoshal, Senior Director of Law, Policy, and Research at LGBTQI group Outright International, told IPS.

“Once you prohibit one form of protest or dissent, it becomes easier to prohibit all forms of dissent. I really do think Orban wants to prohibit all forms of dissent. He is seeking absolute power; he is not interested in the traditional architecture of democracy, i.e., checks and balances and accountability,” she added.

Dudits also pointed out the absurdity of the reasoning behind the government’s defence of the amendment.

“It is true that a large majority of society are either male or female. However, there are some people who have sex characteristics (chromosomes, hormones, external and internal sex organs, and body structure) that are common to both sexes. Intersex conditions occur in many different forms and cover a wide range of health conditions. The amendment is therefore even scientifically unsound, contradicting the very biological reality that it claims to be defending so belligerently,” she said.

If picking up voter support is behind the regime’s attacks on its perceived critics, it is unclear to what extent this policy is working.

Parliamentary elections are due to be held in Hungary in April next year and current polls put Orban’s Fidesz party – which has been in power since 2010 – behind the main opposition party, Tisza, amid voter concerns about a struggling economy, a crumbling healthcare system, and alleged government corruption.

Meanwhile, although some MEPs have publicly condemned the amendment, since the parliamentary vote the EC has said only that it needs to analyse the legislative changes to see if they fall foul of EU law but would not hesitate to act if necessary.

Rights groups say EU bodies must take action or risk allowing even greater curbs on freedoms in Hungary under Orban.

“From scapegoating LGBT people to suspending Hungarian citizenship of dual citizens, the Hungarian government is cementing a legal framework that is hostile to the rule of law, equality, and democracy in blatant violation of EU law,” Hugh Williamson, Europe and Central Asia director at Human Rights Watch, said in a press release.

“Orban has shown once more his willingness to trample rights and shred protections, and there is no reason to think he won’t continue on this authoritarian path. EU institutions and member states should stand in solidarity with those in Hungary upholding EU values and do everything they can to halt the downward spiral toward authoritarianism,” he added.

Ghoshal said, though, that whatever happens, the LGBTQI community in Hungary would not give up their rights.

“The community has been through cycles of oppression and freedom. The younger members might not be able to remember it, but older members of the community will know what it is like to live under an authoritarian regime; it is in the country’s history. They have also had a taste of freedom too and they will not want to give that up.

“I think there will be a Pride march and I think there could be state violence and arrests there, but the community will remain defiant no matter what,” she said.

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A HALO demining worker carefully probes for mines in Ukraine. Credit: Tom Pilston/HALO

By Ed Holt
BRATISLAVA, May 5 2025 (IPS)

As a string of European states announce withdrawals from a global treaty banning antipersonnel landmines, campaigners are warning countless lives could be put at risk as decades of progress fighting the weapons come under threat.

On April 16, Latvia’s parliament approved the country’s withdrawal from the Ottawa Convention. This came just weeks after Estonia, Lithuania, Poland, and Finland all announced their intention to pull out of the treaty.

The countries have argued the move is a necessary security measure in light of growing Russian aggression.

But campaign groups have said that pulling out of the treaty is undermining the agreement itself with serious humanitarian implications.

“While far from the end of the treaty, this is a very big setback for the treaty and a very depressing development. Antipersonnel landmines are objectionable because they are inherently indiscriminate weapons and because of their long-lasting humanitarian impact,” Mary Wareham, deputy director of the Crisis, Conflict and Arms Division at Human Rights Watch, which is a co-founder of the International Campaign to Ban Landmines (ICBL), told IPS.

“The supposed military benefits of landmines are far outweighed by the devastating humanitarian implications of them,” she added.

The 1997 Ottawa Treaty bans the use, production, transfer, and stockpiling of antipersonnel landmines. It has been ratified or accepted by 165 countries—Russia, the United States, China, North Korea, Iran, and Israel are among those that are not signatories.

HALO demining in action. Credit: Tom Pilston/HALO

Campaign groups supporting the ban highlight the devastation landmines cause not just from direct casualties but also from driving massive displacement, hindering the delivery of humanitarian aid and impeding socio-economic recovery from conflict.

Meanwhile, the vast majority of those killed by landmines—80%—are civilians, with children particularly vulnerable.

“The presence of mines and other explosive ordnance continues to cause high levels of fatalities and serious injury, often resulting in life-long disabilities, with disproportionate impacts on children, persons with disabilities, and those forced to return under desperate conditions,” Shabia Mantoo, UNHCR spokesperson, told IPS.

“In addition to the high death toll, injuries and their aftereffects, including psychological damage, the presence of explosive devices hinders access to local livelihoods such as pastures, fields, farms, and firewood, as well as community infrastructure. They also affect the delivery of humanitarian aid and development activities. For humanitarian actors, their ability to safely reach communities with high levels of humanitarian needs and vulnerabilities and deliver life-saving assistance and protection  are often seriously constrained due to risks posed by explosive devices,” Mantoo added.

Humanitarian groups say the treaty has been instrumental in reducing landmine casualties from approximately 25,000 per year in 1999 to fewer than 5,000 in 2023. The number of contaminated states and regions has also declined significantly, from 99 in 1999 to 58 in 2024.

The treaty also includes measures requiring member countries to clear and destroy them as well as to provide assistance to victims, and as of the end of last year, 33 states had completed clearing all antipersonnel mines from their territory since 1999.

But in recent years, landmine casualties have grown amid new and worsening conflicts.

Data from the ICBL’s Landmine Monitor (2024) showed that in 2023, at least 5,757 people were killed or injured by landmines in 2023—a rise of 22 percent compared with 2022—in 53 countries.

The highest number of casualties—1,003—was recorded in Myanmar. This was three times the number in 2022. This was followed by Syria (933), Afghanistan (651), Ukraine (580), and Yemen (499).

In a special report on the continuing risks posed by mines and explosive remnants of war (ERW), the presence of which is known as ‘weapon contamination,’ released earlier in April, the International Committee for the Red Cross (ICRC)  warned that in 2025, the humanitarian impact of weapon contamination would likely continue to rise.

“The increased use of improvised explosive devices, shifting frontlines, and worsening security conditions will make survey and clearance efforts even more complex and therefore leave communities exposed to greater danger,” the report stated.

In two of the world’s most landmine-contaminated countries, Myanmar and Ukraine, the severe humanitarian impact of massive landmine use is being made horrifyingly clear.

In Myanmar, local aid groups say the ruling military junta’s use of landmines has escalated to unprecedented levels, while rebel groups are also deploying them. Roads and villages have been mined—ostensibly for military purposes, although many observers say they are just as often used to terrorize local populations—leading to not just civilian deaths and horrific injuries but also hindering vital medical care and aid efforts. Mines have been used in all 14 Myanmar states and regions, affecting about 60 percent of the country’s townships.

The mines have been an extra problem in the aftermath of the devastating earthquake at the end of March. The International Committee for the Red Cross (ICRC) said just days after the disaster, which killed more than 3,000 people, that as people relocated to areas less impacted by the earthquake and local and international organizations planned their response, ERWs were threatening not just the lives of those moving but also the safe delivery of humanitarian relief.

A group of HALO deminers with their equipment prepare for work. Credit: Tom Pilston/HALO

In Ukraine there has been extensive landmine use since Russia’s full-scale invasion of the country in February 2022. Russian forces have mined vast swathes of land, while there have been reports that Ukrainian forces have also used anti-personnel mines. It is estimated approximately 174,000 square kilometers, almost 30 percent of Ukraine’s territory, are affected by landmines and ERWs.

“According to NATO, Ukraine is now the world’s most mine-affected country and has seen the most mine laying since World War II.  The humanitarian impact of this contamination has been multifaceted—as well as vast swathes of prime farming land being contaminated, adversely affecting food security, civilian areas are also badly affected, including schools, residential zones, roads, and key infrastructure, leading to widespread displacement,” a spokesperson for the HALO Trust, a major humanitarian NGO carrying out demining operations around the world, including Ukraine, told IPS.

The spokesperson added that the effects of extensive landmine laying in the country may be felt for decades to come.

“HALO deminers are working in liberated areas, but it will take many years—if not decades— to clear Ukraine of landmines. Areas closest to the frontlines, such as Kharkiv and Sumy, are the areas where most people have been displaced, and some parts of these regions may remain uninhabitable until made completely safe. Any additional minelaying will extend the risk to civilian populations, agricultural production, and global trade for decades to come,” they said.

Anti-landmine campaigners also warn that if countries pull out of the Ottawa Convention, there is a risk that the use of landmines will become normalized.

“Increased acceptance [of landmines] could lead to wider proliferation and use, recreating the extensive contamination seen in Ukraine, Myanmar, and other conflict zones. In addition, withdrawal risks normalizing the rejection of humanitarian standards during times of insecurity, potentially undermining other crucial international norms. The ICBL has warned of a dangerous slippery slope where rejecting established norms during tense periods could lead to reconsideration of other banned weapons (e.g., chemical and biological weapons),” Charles Bechara, Communications Manager at ICBL, told IPS.

“Landmine survivors worldwide are shocked and horrified that European countries are about to undermine such progress and make the same mistake that dozens of other countries now regret. When European nations withdraw [from the Ottawa Convention], this sends a problematic message to countries facing internal or external security threats that such weapons are now acceptable,” he added.

However, it is not just withdrawals from the Ottawa Convention that are worrying anti-landmine groups.

Funding for demining efforts as well as services to help victims are under threat.

While the United States is not a signatory to the Ottawa Convention, it has been the largest contributor to humanitarian demining and rehabilitation programs for landmine survivors over the past 30 years. In 2023, it provided 39 percent of total international support to the tune of USD 310 million.

But the current halt to US foreign aid funding means that critical programs are now at risk, according to the ICBL.

“The US funding suspension threatens progress in heavily contaminated countries where casualty rates had been significantly reduced through consistent mine action work,” said Bechara.

He added the stop on funding would have “severe consequences for treaty implementation goals,” including the disruption or cessation of mine clearance operations in over 30 countries, a pause on victim assistance programs providing prosthetics and rehabilitation services, curtailment of risk education initiatives that help communities avoid mines, job losses at demining organizations, and problems implementing other humanitarian and development work because agencies depend on mine clearance to safely access areas.

Meanwhile, supporters of the Ottawa Convention are urging the countries currently intending to leave the landmine treaty to rethink their decisions.

“For Latvia and other countries considering withdrawal from the Mine Ban Convention, the ICBL is clear that weapons that predominantly kill and injure civilians cannot safeguard any nation’s security. Military experts, including Latvia’s own National Armed Forces commander, have concluded that modern weapon systems offer more effective defensive capabilities without the indiscriminate harm to civilians,” said Bechara.

“Despite the threats against the Mine Ban Treaty, the ICBL’s message is for countries to immediately cease their withdrawals and stand behind the treaty. Long-term security and safety cannot be ensured by a weakened international humanitarian law, which was conceived specifically to protect civilians in dire security situations,” he added.

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Sea of red indicates the parlous state of press freedom in the world. Credit: Reporters Without Borders

By Ed Holt
BRATISLAVA, May 2 2025 (IPS)

Global press freedom across the world is at a “critical moment,” campaigners have warned, as a major index mapping the state of global press freedom hits an unprecedented low.

In the latest edition of the annual press freedom index produced by Reporters Without Borders (RSF), which was published on May 2, the average score of all assessed countries fell below 55 points, falling into the category of a “difficult situation” for the first time in the index’s history.

More than six out of ten countries (112 in total) saw their overall scores decline in the index, while the conditions for practicing journalism are for the first time classified as poor in half of the world’s countries and satisfactory in fewer than one in four.

In 42 countries—harboring over half of the world’s population (56.7 percent)—the situation is “very serious,” according to the group. In these zones, press freedom is entirely absent and practicing journalism is particularly dangerous.

RSF says that while there has been a downward trend in press freedom globally for some time, the latest index scores are a distressing “new low.”

“Our index has been warning of this for the last ten years—the trajectory for press freedom has been a downward one—but this is a new low. Sixty percent of countries saw their scores [in the index] drop last year and the environment for media freedom globally has worsened. We are now at a critical moment for press freedom globally,” Fiona O’Brien, UK Bureau Director for RSF, told IPS.

Experts and campaigners have in recent years warned of growing threats to press freedom amid a rise of authoritarian regimes looking to muzzle dissent, as well as  growing economic pressures affecting the ability of independent media outlets to function.

RSF’s index is compiled using measurements of five different indicators—political context, legal framework, economic context, sociocultural context, and safety—to form an overall score. It says that this year the overall global index score was dragged down by the performance of the economic index.

It says that economic pressure is an often underestimated but major factor seriously weakening media in many countries. This pressure is being largely driven by ownership concentration, pressure from advertisers and financial backers, and public aid that is restricted, absent, or allocated non-transparently.

The group warns this is leaving many media trapped between preserving their editorial independence and ensuring their economic survival.

“The pressure on media sustainability is as bad as it has ever been,” said O’Brien.

The effects of this economic pressure have been severe. Data collected for the index indicates that in 160 out of the 180 countries assessed (88.9 percent), media outlets achieve financial stability “with difficulty” or “not at all.” Meanwhile, news outlets are shutting down due to economic hardship in nearly a third of countries globally.

While the struggles of media economies in some countries have been exacerbated by political instability, general lack of resources, and war, media in other rich, ostensibly more stable countries are also facing significant economic pressures.

RSF points out that in the US, a majority of journalists and media experts told the group that “the average media outlet struggles for economic viability.”

Meanwhile, independent media that rely heavily or exclusively on foreign funding have come under increasing pressure.

A freeze on funding for the US Agency for International Development (USAID), which halted US international aid earlier this year plunged hundreds of news outlets in different countries around the world into economic uncertainty or forced others to close.

This was particularly acute in Ukraine, where nine out of ten outlets receive international aid and USAID is the primary donor.

“The US cuts have had a profound effect there,” Jeanne Cavalier, head of RSF’s Eastern Europe and Central Asia desk, told IPS. “Independent media is vital in any country that is at war. It’s a real blow to press freedom in the country,” she said.

She added, though, that the cuts to US funding were “an existential threat to press freedom in all countries with authoritarian governments under Russian influence,” highlighting that exiled media in particular provide a vital service to people living under such regimes.

The Meduza news outlet is one of the most prominent exiled Russian media organizations. While more than half of its financing comes through crowdfunding, until earlier this year a part of its funding came via US grants.

The group said that the combined impact of the cut and previous financial problems presented a significant challenge to its operations. It was forced to cut its workforce by 15 percent and salaries were reduced.

Speaking to IPS at the time, Katerina Abramova, Head of Communications at Meduza, said the moves would “influence the diversity of our content.” But speaking this week after the release of RSF’s index, she said the group had managed to continue its work but admitted, “it is even more challenging now.”

“Our main goal is to maintain the quality of our reporting and to keep delivering news inside Russia,” she said.

However, she said she was concerned for the future of other organizations like Meduza as press freedom and the economic health of independent media wane globally.

“I hope that there will not be a complete loss of independent reporting on countries where free speech has become illegal. But I know that many independent newsrooms are suffering and are on the edge of closing. When you are in exile, you are in a vulnerable position, so such newsrooms face the most difficult challenges,” she told IPS.

“I am also worried that the USAID cuts may be seen as a ‘good sign’ for many authoritarian regimes around the world. They might say, ‘look, the USA also doesn’t like journalists anymore.’ It would be like a validation of what they are doing to independent media [in their own countries],” she added.

Meanwhile, other organizations have also raised the alarm over growing threats to press freedom, even in countries regarded as among the strongest democracies in the world.

While in the RSF index the European Union (EU)-Balkans zone had the highest overall score globally, and its gap with the rest of the world continued to grow, a report released this week by the Civil Liberties Union for Europe (Liberties) group highlighted how some EU governments were attacking press freedom and undermining independent media.

The report, based on the work of 43 human rights groups from 21 countries, warned that press freedom was being eroded across the bloc. It said EU media markets “feature high media ownership concentration, with these owners remaining obscured behind inadequate ownership transparency obligations, the continued erosion of public service media’s independence, ongoing threats and intimidation against journalists, and restrictions on freedom of expression and access to information.”

“The findings of this report should put EU officials on high alert: media freedom and pluralism are under attack across the EU, and in some cases they are in an existential battle against overtly undemocratic governments,” according to the group.

Liberties also warned that “EU legislation to bolster media freedom is being greeted with hostility, making enforcement efforts in 2025 and beyond decisive in protecting the free and plural media that European democracy depends on.”

However, it is this legislation, including the European Media Freedom Act (EMFA), which is designed to guarantee the protection of journalists and sources, independence of regulatory bodies and full ownership transparency, and the Anti-SLAPP Directive (Strategic Lawsuits Against Public Participation) to protect journalists and human rights advocates from abusive legal proceedings, that experts see as providing hope that some of the threats to media freedom can be dealt with.

“At the individual country level within the EU, there are some problems. Where there has been a recent change in government away from authoritarianism, there has been some positive progress, e.g., in Poland. But in other countries, like Slovakia, we are seeing the reverse,” Eva Simon, Senior Advocacy Officer at Liberties, told IPS.

“But at the EU level, we see positive prospects for media freedom in new legislation. The EU Media Act is coming into force soon and the anti-SLAPP directive will come into effect next year.

“The EU has the power to intervene in countries where there are persistent problems and we have high hopes that the EU will use its powers to enforce the European Media Freedom Act. The EU has more tools than ever at its disposal to ensure media freedom in member states,” she added.

On April 30, the Committee for the Protection of Journalists (CPJ) issued a damning report on how, since the start of US President Donald Trump’s second term in January, press freedom has come under attack.

The report warned that press freedom is no longer a given in the United States as journalists and newsrooms face mounting pressures that threaten both their ability to report freely and the public’s right to know.

It said the executive branch of the government was taking “unprecedented steps to permanently undermine press freedom” through restricting access for some news organizations, increasingly using government and regulatory bodies against media, and launching targeted attacks on journalists and newsrooms.

In a statement, CPJ CEO Jodie Ginsberg said, “This is a definitive moment for U.S. media and the public’s right to be informed. Whether at the federal or state level, the investigations, hearings, and verbal attacks amount to an environment where the media’s ability to bear witness to government action is already curtailed.”

The current threats to press freedom in the US are among the most worrying anywhere, many media experts say.

“There is a head-on attack on media freedom in the US. If you look at the scores for the US [in the index], the social indicator has dropped hugely, which shows that within the US the press is operating in a hostile environment. The economic situation there has deteriorated too, which makes things difficult for them,” said O’Brien.

“But also, a lot of people look to America as a bastion of press freedom, with its constitution’s First Amendment, and what is happening there to independent media is an absolute gift to authoritarian rulers around the world. If the rest of the world just sits back and watches this and lets press freedom be restricted and attacked and does nothing, other regimes will look and just think, ‘oh, it’s OK to do this.'”

“World leaders have to now stand up for press freedom. Independent journalism is fundamental to democratic societies,” she added.

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Mycobacterium tuberculosis drug susceptibility test. Credit: CDC

By Ed Holt
BRATISLAVA, Mar 24 2025 (IPS)

Governments and donors must ensure funding is sustained to fight tuberculosis (TB), organizations working to stop the disease have said, as they warn the recent US pullback on foreign aid is already having a devastating effect on their operations.

NGOs and other groups that play a critical role in national efforts to stop what is the world’s deadliest infectious disease say the US administration’s recent decisions to first freeze and then cancel huge swathes of foreign aid funding have put countless lives at risk around the world.

And they warn that if that funding gap is not filled, years of progress in fighting TB could be lost.

“The impact of these cuts has been massive. There’s a gaping hole in financing, and if we don’t keep the pressure up on TB it will come back,” Dr. Cathy Hewison, Head of Médecins sans Frontières (MSF)’s TB working group, told IPS.

Every year, 10 million people develop TB, and in 2023 1.25 million died from the disease. It disproportionately affects low- and middle-income countries, with the largest TB burdens being among the world’s poorest states.

While in many states government funding accounts for at least the bulk of first-line treatment, community groups play a crucial and outsized role in national efforts to combat the disease, providing vital diagnosis, prevention, advocacy, and support services.

Many such groups rely heavily or exclusively on foreign funding with financing through US schemes, primarily USAID, predominant. USAID is the largest bilateral donor in the fight to end TB, having invested more than USD 4.7 billion to combat the disease since 2000.

In late January, an executive order from US President Donald Trump put a 90-day freeze on all US foreign aid while a review of funded projects was carried out, and then earlier this month, it was announced that 83% of all USAID projects were to be cancelled.

The effects on community groups on the frontlines of the fight against TB have been immediate and severe.

“Many community organizations have suspended outreach services, such as active case finding, contact tracing, treatment adherence, and psychosocial support,” Rodrick Rodrick Mugishagwe, a TB advocate with the Tanzania TB Community Network (TTCN), told IPS.

“Furthermore, transportation allowances for community health workers conducting home visits have been reduced, resulting in lower TB case detection rates. There have also been job losses among community health workers and peer educators, undermining service delivery,” he added.

Mugishagwe recounted how a woman from the city of Arusha in northern Tanzania who was diagnosed with TB last year had relied on a USAID-supported community programme for transport to a clinic for monthly treatment. But following the funding cuts, her programme shut down, and she could not afford the transport costs.

“She has disappeared from her residence and can no longer be traced, putting her at risk of treatment failure and developing drug-resistant TB, while there is a risk of further transmission to the community,” he said.

Bruce Tushabe, regional training and capacity strengthening lead at the AIDS and Rights Alliance for Southern Africa (ARASA), which works with partners in South Africa on TB interventions, most of whom were supported through USAID, said treatment and access to TB medication had been stopped. There had also been a breakdown in community-led monitoring tracking progress in treatment access and availability, he said.

“There is a high burden of TB – an incidence rate of 468 per 100,000 of the population—and we now expect to see an increase in deaths, and in the long term, [rising] multi-drug resistant TB (MDR-TB) among the populace, as well as increased TB cases since contact tracing is now paused in many areas and facilities,” he told IPS.

The spread of drug-resistant (DR-TB) and MDR-TB in the wake of the funding cuts is a particular concern, especially in poorer countries where DR TB is often widespread, as it is much harder and costlier to treat, putting an even greater burden on limited resources.

“There is a lot of DR-TB here and when people don’t have the right information and don’t take the right medicine or don’t have support during lengthy, sometimes very hard treatment, they might not be able to finish their course or treat their TB properly, and then the disease spreads. People with TB who had been going to TB centers may now turn up and find there is no one to answer their questions or give them the right advice on treatment, and so they might just turn away,” Atul Shengde, National Youth Coordinator—Global Coalition of TB Advocates, India, told IPS.

While TB often affects the poorest and most vulnerable communities, even within those communities there are some groups which are especially at risk, such as children.

“Children’s immune systems are less developed, which makes them more vulnerable to TB. Figures show 25% of the world is infected with TB, but just because someone is infected it does not mean they will get sick from it. But if your immune system is less developed or compromised in any way you are more likely to get TB, more likely to get ill with TB, and more likely to have more severe TB,” Hewison said.

“Children at risk of having TB are often overlooked, either going undiagnosed or facing delays in diagnosis. Now, with the recent US funding cuts, these gaps in identifying and treating children with TB will only widen further which threatens to roll back years of progress in TB care,” she added.

The World Health Organization has issued stark warnings of the devastating effects of the abrupt cessation of US global health funding, and affected organizations have pleaded with the US to reverse its decision.

But community groups who spoke to IPS admitted it appeared unlikely funding would resume any time soon.

And because US funding played such a large role in global TB efforts, they worry it will be very difficult to plug the current financing gap, certainly in the short to medium term, and possibly even long term, especially at a time when governments in high-income countries, such as the UK, Germany, and France, among others, are reducing foreign aid.

“I see no high-income donor countries stepping in to fill the gap left by the US funding cuts. Countries are faced with a lot of resource pressures at the moment; for instance, defense is a big issue now, and to pay for that, cuts are going to have to be made elsewhere, and that usually starts with healthcare,” Dr Lucica Ditiu, Executive Director of the Stop TB Partnership, told IPS.

“In future, low and middle income countries, especially, will have to relearn the hard lesson, as they did with Covid, that they are on their own. They will have to think about reducing their reliance on external donors for their health programmes and put the resources in themselves,” she added.

Buy while some governments may be able to up their financing of national TB programmes, poorer countries are likely to struggle to do so, and new forms of financing need to be considered, experts say.

“Of course, raising funding is impossible for some low-income countries. Innovative forms of funding need to be looked at—for example, financing from the different international development banks, debt swaps between countries, and others,” said Ditiu.

However, even if the funding gap is plugged somehow, or there is an unlikely dramatic reversal of US policy in the near future, there are fears the damage has already been done.

“We are going to see a massive spread of TB, and especially DR-TB, whatever happens now because cases have been missed, people have gone undiagnosed, and treatment has been interrupted,” said Ditiu.

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Crowley Logistics in Miami, Florida, was one of three USAID shipping and logistics facilities in the nation. It could, in times of emergency humanitarian relief aid, respond with supplies delivered to aircraft at Miami International Airport within two hours. Credit: USDAID/Lance Cheung

By Ed Holt
Feb 17 2025 (IPS)

As the full effects of the US decision to freeze foreign aid funding begin to be felt across the world, organizations in Eastern Europe and Central Asia (EECA) are warning years of work in everything from delivering life-saving healthcare to defending human rights and strengthening democracy could be undone.

In many countries in the region, foreign aid is vital for the continued functioning of large parts of civil society and the activities NGOs and other groups carry out.

But since US President Donald Trump’s executive order on January 20 freezing foreign aid for 90 days and a ‘stop work order’ announced four days later, some groups have had to entirely, or partly, shut down their operations—with potentially devastating consequences.

One area that has been heavily affected is the fight against HIV/AIDS.

According to a UN report published in 2024, only half of the 2.1 million people living with HIV in the EECA region have access to treatment, and just 42% of people living with HIV have suppressed viral loads—the lowest rate in the world. In 2023, 140,000 new cases of HIV infection were registered in the region.

US funding has been central to the HIV response in EECA, including through the US President’s Emergency Plan for AIDS Relief (PEPFAR), as well as USAID.

According to UNAIDS, this support has helped fund community-based HIV prevention programmes, provision of antiretroviral therapy (ART), development of laboratory and diagnostic infrastructure, and training of health workers. It has also played a key role in prevention and harm reduction programmes among key populations.

This is critical in a region where 94 percent of new HIV cases occur among key populations and their partners.

While US aid is not the primary source of funds for HIV programmes in some countries in the region, in others it is vital.

In Ukraine, which has Europe’s second worst HIV epidemic, local groups working with key populations and people living with HIV say the aid freeze has had a dramatic impact.

The charity 100% Life provides treatment and prevention services to marginalized communities, including drug users and people with HIV, TB, and other diseases, often operating in frontline areas.

Dmytro Sherembei, head of the Coordination Council of 100% Life, told IPS that up to 25 percent of specialist staff carrying out testing, monitoring and other tasks would have to be laid off, while testing programmes and other assistance for state healthcare projects would be stopped.

“The funding suspensions stopped our whole programme, and it will cause a lot of damage,” he said.

Meanwhile, the Alliance for Public Health (APH), one of the country’s largest healthcare NGOs, said its HIV case-finding operations had been suspended after the aid freeze.

“About 35-40 percent of all HIV-positive cases in Ukraine are found, tested, and referred for treatment by APH and its partners. It will be difficult to find alternative funding,” Andriy Klepikov, Executive Director of APH, told IPS.

APH estimates the halt to testing could mean thousands of cases going undetected during the 90-day suspension of aid.

There are also concerns that treatment for more than 100,000 patients with HIV may be interrupted. Since the beginning of Russia’s full-scale invasion, the Ukrainian government has not had funds to procure antiretroviral drugs (ARVs), and PEPFAR has been procuring ARVs for all patients.

The country has ARV stocks for the next six months, “but a suspension of funding could impact the next delivery of medications planned for March,” Klepikov said.

“This funding stop threatens to turn a manageable epidemic into a deadly crisis,” warned Sherembei.

In Tajikistan, US funding has supported services including treatment and prevention among key populations, training of professionals, strengthening of local organizations, and support for community-led initiatives.

But the funding freeze is threatening to undo years of progress, local HIV activists told IPS.

Pulod Dzhamalov, Director of the Tajik NGO SPIN PLUS, said services for people living with HIV and other key populations in many places had “simply ceased to exist.”

“For many people who sought these services, it was the only place where they felt safe. And staff who worked on these projects have suddenly found themselves unemployed, without any means of livelihood or hope for the future. Significant resources were invested in building a positive image of these services, and now all of that has gone to waste. A considerable portion of the national HIV prevention programme’s budget was covered by PEPFAR funding, and this will inevitably impact the healthcare system as a whole,” he said.

Takhmina Haiderova, head of the Tajik Network of Women Living with HIV, said her organization was “facing serious challenges” and that the freeze on US funds had had a significant impact on all HIV-service NGOs in the country.

“Reduced funding results in fewer HIV prevention and treatment projects, staff reductions, and limited access to life-saving services such as testing, counseling, and treatment. In addition, it negatively affects the achievement of the Sustainable Development Goals, such as reducing the spread of HIV, improving the quality of life of people living with HIV, ensuring gender equality, and upholding human rights,” she said.

The decision to freeze funding, especially in places where the epidemic is not improving, such as EECA, risks doing irreparable harm to global efforts to fight HIV, activists say.

“[The Trump administration’s] efforts are doing irreparable harm to the global HIV response and global health more broadly. These are inefficient, wasteful  and deadly policy moves,” Asia Russell, Executive Director of the Health Gap advocacy organization, told IPS.

But it is far from just efforts to fight HIV/AIDS in the region that have been affected by the pause on US aid.

In many countries, foreign funding is essential to the survival of independent media, keeping a check on autocracies and serving audiences living under repressive regimes.

Press freedom watchdogs say the aid freeze has created confusion, chaos, and uncertainty among media organizations and outlets that rely heavily, or completely, on American funds.

Exiled media reporting for audiences in countries such as Russia, Belarus, and others from outside those states are particularly vulnerable.

“This is very bad news for exiled media that relocated to democratic countries after crackdowns. Some newsrooms from Belarus have reported a complete lack of funding due to the current [US aid] freeze, which may lead to a complete cessation of these projects due to the inability to pay employees. Others have been forced to cut their staff, which is very worrying since they have so far managed to keep their audience in their country, despite being forced into exile. Their efforts made it possible to effectively counter official Belarusian and Kremlin propaganda,” Jeanne Cavelier, Head of Eastern Europe & Central Asia Desk at Reporters Without Borders (RSF), told IPS.

Meanwhile, in Ukraine, where nine out of ten outlets rely on subsidies and USAID is the primary donor, a survey after the aid freeze showed that almost 60% of media professionals surveyed believe that the suspension of US media support programmes could have ‘catastrophic consequences and lead to the closure or significant reduction in the work of many independent media outlets,’ according to RSF.

“Projects funded by American aid, such as USAID, were mostly intended to enable the media to investigate corruption and public spending. This is critical for reliable information, as well as for small media outlets reporting from the frontline,” said Cavelier.

“The freeze has already led a number of newsrooms to cut back on content, lower salaries, increase part-time working and reduce staff numbers,” she added.

Editors at local independent media outlets fear the suspension could lead to publications turning to other sources of funding, which could then look to change editorial stances, influence the independence of these media and, potentially, become tools for Russian propaganda.

There are similar fears in other parts of the region.

“The independent media here relies very much on foreign funding because otherwise they would not be economically viable in a country that is poor and in a market where some media are financed by shady Russian money,” Valeriu Pasha, Programme Manager at Moldovan think tank WatchDog.Md, told IPS.

“I think we could definitely see some deals where some media that are now struggling with funding could be bought by, or would start to be funded through, Russian sources in some way,” he added.

However, he pointed out that it was not just independent media that had been affected by the US aid freeze.

“This will have quite an effect on civil society here; plenty of organizations will feel its impact,” he said, pointing out that groups involved in everything from local election observation to healthcare, rights defense, and even working with the government on judicial reform were reliant to some extent on US aid.

“Even our organization, which has not really been affected by this so far, could well be affected in the future. We don’t know,” he added.

The freezing of US funding may also have had an unexpected, although equally pernicious, effect on civil society in the region.

The US administration’s apparent efforts to effectively shutter USAID have been welcomed by authoritarian leaders who have already been cracking down on NGOs and others they see as critical of their regimes.

In Georgia, USAID is currently investing in scores of programmes across the country with a total value of USD 373 million, according to local media. These initiatives focus on, among others, strengthening democratic institutions and increasing public resilience to disinformation.

Much US funding to the country was stopped last year in response to increasingly authoritarian behavior by the ruling regime—including legislative crackdowns on civil society.

But Prime Minister Irakli Kobakhidze earlier this month told local journalists the stop on USAID activities proved his government’s previous claims that the organization’s funds were used not for humanitarian goals but to “stage revolutions, sow disorder, and destabilize countries, including Georgia.”

Lawmakers appear to have also taken it as confirmation of the hardline approach they have already taken to civil society and the media—including a controversial law on foreign funding of NGOs introduced last year, which forced many to close—and emboldened them to tighten restrictions even further. On February 5, a media regulation law was announced that would ban foreign funding of media, as well as an even more restrictive version of the law on foreign funding for NGOs.

Reports have suggested authorities in Russia, where a swathe of laws and repressive measures have already forced the closure of many key services provided by civil society groups in areas from HIV prevention and help for marginalized groups to rights organizations, may be planning to ask US Congress to share a list of Russian citizens who received US funding with Russia’s Federal Security Service (FSB).

Groups affected by the funding freeze are looking to find alternative sources of finance. Some have called for governments, particularly in Europe, to step in and fill the gap left by the withdrawal of American money.

In a statement, a group of European disability organizations and services called on the European Union and non-governmental donors to provide emergency and long-term funding to disability organizations affected by the cuts in US funding.

They highlighted that organizations were implementing lifesaving programs in countries such as Ukraine, Moldova, Georgia and Albania and that the loss of funding will put at risk organizations and persons with disabilities in the Balkans, Eastern Europe and South Caucasus, leaving hundreds of thousands without support.

While there are hopes that US funding will, sooner or later, resume once the Trump administration finishes its review, whatever US foreign aid is resumed, it is unlikely to be disbursed in the same way as it was previously, said Pasha.

“I expect that some aid will resume in some form after the 90-day freeze, but it will reflect the priorities of the new US administration—in the future it will likely be less connected to values and more to economics,” he said.

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Flashback to 2020 protests against a rigged election. Credit: Andrew Keymaster/Unsplash

By Ed Holt
BRATISLAVA, Feb 10 2025 (IPS)

In the months leading up to presidential elections at the end of January, Belarus’s authoritarian leader Alexander Lukashenko ordered the release of hundreds of political prisoners. Some observers saw this as a sign that the man who had led the former Soviet state for the last three decades could be planning a relaxation of his regime’s brutal repressions in return for a lessening of Western sanctions.

But having secured an inevitable further term in office, human rights groups and Belarusians who have survived persecution under his regime say they see no signs he is preparing to loosen his iron grip on the state.

“If we have learned anything from the last four years, it is that repression in Belarus is not lessening, despite the fact that Lukashenko has everything under his power. There are no protests, people have been forced into exile, there are no legal ways for rights groups to do their work, yet the repression continues,” Anastasiia Kruope, Assistant Researcher, Europe and Central Asia, at Human Rights Watch (HRW), told IPS.

In August 2020, hundreds of thousands of people took to the streets in Belarus to protest against what they saw as the rigged result of an election which had just returned Lukashenko, who has ruled the country since 1994, to power.

Security forces launched a violent crackdown on those involved. Over the next six months, tens of thousands were detained and at least 11 people were killed.

Although the protests eventually stopped, repression has continued, with any form of dissent severely punished. There have been mass arrests, imprisonment, and torture for those deemed to be opposing the regime, while secret police and party loyalists have been installed in institutions as official ideological gatekeepers to ensure people toe the government line.

Independent media has been muzzled—almost 400 journalists have been arrested in the last four years—and much of the NGO sector has been effectively shuttered through repressive legislation on foreign funding and authorities’ misuse of anti-terror and anti-extremism laws. The closures of these groups have impacted everything from human rights work to vital healthcare services.

But while the wider international community largely sees Belarus as a pariah state—Lukashenko has the explicit political support of Moscow, and China maintains close ties with the country—and the West has imposed sanctions on individuals in Belarus, there has been no let-up in government efforts to bring the population to heel.

However, the slew of releases of political prisoners, which began last summer and went right up to the elections, had prompted speculation that Lukashenko may be looking to repair relations with the West, especially as the conflict in Ukraine—Lukashenko has backed Russia and allowed Moscow to use Belarus to launch assaults on Ukraine—appears to be heading towards some kind of, at least temporary, end, and he looks to extract his country from ever-increasing dependence on Moscow.

But people who live in Belarus, and some who have fled into exile, told IPS they are not expecting the pervasive climate of fear that Lukashenko has spread to cement his control in the country to lift any time soon.

“Usually the human rights situation in Belarus after elections becomes calmer, with fewer arrests. But it doesn’t look that way this time. We are still getting information about repressions,” Natallia Satsunkevich, a human rights defender with the Belarussian NGO Viasna, told IPS.

She said Lukashenko could even decide to intensify his crackdown on opponents of his regime.

“Of course [he could], the repressive machine is huge and works fast. Police are still looking for and arresting people that participated in protests in 2020,” Satsunkevich said.

Others who have suffered under Lukashenko agree.

“Any expectations that the repression will ease are just wishful thinking,” Lidziya Tarasenka, co-founder of The Belarussian Medical Solidarity Foundation (Bymedsol), which operates outside Belarus helping doctors who have left the country, told IPS.

Tarasenka, who worked in healthcare in the capital, Minsk, before fleeing the country after the 2020 protests, said she saw no sign that repression in Belarus was easing off.

“First of all, the number of political prisoners that have been released is less than the number of those newly imprisoned. The government has learned their lessons and is trying to make new prosecutions as unnoticeable as possible, but the process is in full swing. Secondly, there is a whole army of different police/secret services and so on, their number is growing and they have to be doing something. [Repression] cannot be stopped that easily,” she said.

Some Belarussians who spoke to IPS gave some insight into the regime’s persecutions.

Sviatlana (NOT REAL NAME) fled Belarus last year after she feared she was about to be arrested. Her work in healthcare had brought her into contact with former political prisoners, some of whom had been tortured in prison, and she had given some money for treatment to help their recovery. She managed to escape, but she fears now that her former colleagues will be targeted by the security services simply for having worked with her.

“I’m expecting there will be repressions against the staff and management at my work now,” she told IPS.

Kruope added that while Belarusians not actively opposing the regime could try to adopt a “keep your head down and don’t make any trouble” approach to ensuring they avoid any repressions, even that carried no guarantees.

“One thing people have to watch out for is that you never know what might suddenly become a problem. You may have, in the past, liked a social media comment or followed someone, not even for their political views, or simply followed a media outlet that is then declared a terrorist group or something, and now find yourself in trouble. It is difficult to know what activity might suddenly become a criminal offense,” she said.

So far, it is unclear what Lukashenko may be planning as he begins his latest term in office. But the initial signs suggest he is not planning any kind of rapprochement with the West in the immediate future.

In a press conference immediately after his election win and as western leaders threatened more sanctions and dismissed the elections as a “sham,” he pointedly said, “I don’t give a damn about the West.”

However, even if repressions continue, rights defenders have not given up hope that things will improve in the future.

“I personally believe that one day Belarusians will live in a free and democratic country,” said Satsunkevich.
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Israeli drones targeted a clearly marked World Central Kitchen aid killing seven aid convoy in the Gaza Strip killing seven aid workers. Credit: Tasnim News Agency

By Ed Holt
BRATISLAVA, Jan 14 2025 (IPS)

Humanitarian aid operations in some places may become impossible in the future, experts have warned, as a new report shows a dramatic rise in the use of armed drones in conflict zones.

The report Hovering Threats The Challenges of Armed Drones in Humanitarian Contexts by Insecurity Insight, released on January 14, shows that recorded incidents directly affecting aid and health care programmes in conflict zones rose almost four-fold in the last year and that the share of drone-delivered explosives among all incidents where explosive weapons impacted aid or health care doubled.

It also warns that given that it is considerably cheaper to deliver explosive munitions with drones compared to piloted aircraft and that drone use carries minimal risk to operators, coupled with the increasing availability of components on both military and commercial markets, the frequency of drone use in conflict and with it the number of incidents where aid operations are affected is likely to rise in the coming years—both in scale and in the number of affected countries and territories.

“There could be some time where aid organizations will not be able to work in some conflict zones [because of the risks associated with drones],” Christina Wille, Director of Insecurity Insight, told IPS.

The report highlights how the use of drones in conflict zones has expanded exponentially in the last two decades, and especially in the last few years. This is increasingly impacting aid and healthcare in those areas, killing and injuring health and aid workers and destroying aid infrastructure, including warehouses, IDP or refugee camps, and health facilities and ambulances.

Insecurity Insight’s research shows that armed actors’ use of drones has been a factor in conflict dynamics since 2001, but the first recorded instances of drone-delivered explosives impacting health care services were not until 2016. Until 2022, the number of recorded incidents directly affecting aid and health care programmes remained below ten per year.

By 2023, however, 84 incidents of drone use directly impacting aid operations or health services were recorded, and this figure surged to 308 incidents in 2024. Additionally, the geographic spread of drone-related incidents directly affecting aid or health services expanded from five countries or territories in 2022 to twelve in 2024. The share of drone-delivered explosives among all incidents where explosive weapons impacted aid or health care in conflict zones increased from 6 percent in 2023 to 12 percent in 2024.

The report also says that during this period, for the first time, explosive weapons were the most commonly recorded form of violence directly affecting aid or health operations.

The organization says that between 2016 and 2024, at least 21 aid workers and 73 health workers, six of whom worked for health NGOs, were reportedly killed in drone attacks.

Aid operations or health care services in conflict zones were directly impacted by drone-delivered explosive weapons in at least 426 documented incidents.

The majority of incidents of drone-delivered explosives that affected aid operations or health care in conflict-affected areas documented by Insecurity Insight involved Russian and Israeli forces, and the impact of drone use on aid organizations operating in conflict zones in Ukraine and Gaza has been stark.

In Gaza, since the beginning of Israeli forces’ offensive against Hamas following the group’s attack on Israel on October 7, 2023, aid organizations in the region say healthcare and humanitarian operations have been devastated by Israeli strikes, some of which have involved the use of drones.

In Ukraine, the situation is similar.

Pavlo Smyrnov, Deputy Executive Director of the Ukrainian healthcare NGO Alliance for Public Health (APH), which has been running aid and healthcare programmes in Ukraine, including in front-line areas, since Russia’s full-scale invasion of the country, said the risks to aid workers from drones were now so great that some areas had become off-limits to them.

“Because of drones, it is difficult to work in some places and impossible to work in others. In some places there are just so many drones we can’t work, and in other areas we can still work, but that work is much more limited,” he told IPS.

However, the report points out that the use of drones is rising in other conflicts around the world. In 2023, the use of drone-delivered explosives affecting aid or health operations was reported for the first time in Burkina Faso, Lebanon and Sudan. In 2024, incidents involving drone-delivered explosives that impacted aid or health care were reported from more countries and territories, including for the first time in Chechnya, Colombia, Mali, Niger and Russia.

Experts say this proliferation of drone use is not just dangerous in itself—proliferation of any weapon increases risk—but because their specific nature means their use threatens to create bloodier conflicts where previously accepted humanitarian laws and rules of war will be more frequently broken.

“What is particularly worrying is how these weapons change the way combat is carried out. When you have people directly confronting each other, who knows what will drive people to make decisions [on weapons use] in these circumstances? But these drones are being used remotely, often by people a long way away, in rooms. It’s almost like playing a video game,” said Wille.

“What we can expect drone operators to do may be very different from what happens in a situation where someone feels their own life under threat because they are in a combat situation with a direct adversary. To some extent, the use of drones has led to prescribed norms being more frequently ignored by conflict parties and also because using drones to deliver explosives is so much cheaper. If you have to spend half a million dollars to hit a target, you will self-restrain because of the cost, but if it costs much less, it is easier to just say, ‘OK, we’ll hit a target now because we feel like it’. The drones have removed a lot of the cost barriers [that led to conflict parties using some restraint in their attacks],” she added.

Experts have also linked these rising attacks with a lack of meaningful global action over deadly military strikes on health and humanitarian operations in war zones, particularly those seen in Ukraine and Gaza.

“In the past, many conflict parties may have felt constrained in what they could do because they would fear some serious reprimand, even from allied states, but that seems to have disappeared now. Other regimes see states getting away [with attacking humanitarian groups] and are emboldened to do the same themselves,” said Wille.

She said this was making it much harder for aid agencies to know where they can safely operate.

“They cannot rely on parties to conflicts to regulate their actions to ensure they stay within prescribed norms,” she said.

Another problem related to drone attacks is that civilian populations in areas of conflict have begun to associate all drones with nefarious or lethal operations against them.

“One of the key challenges with the multiplication of drones in conflict and humanitarian contexts is their psychological and ‘chilling’ effect: a lot of people/civilians in those contexts associate drones with possible attacks or surveillance. The more drones there are, the more worried and ‘paranoid’ people become,” Pierrick Devidal, Senior Policy Advisor at the International Committee of the Red Cross (ICRC), told IPS.

“Because it is virtually impossible for people to distinguish drones used for civilian/humanitarian and military purposes, this lack of distinction compounds the problem and deepens an atmosphere of fear and anxiety. These perceptions and psychological issues are likely to create problems for humanitarian organizations wanting to use drones for humanitarian/operational purposes, as those uses may be (mis)perceived as related to military/security objectives,” Devidal added.

The Insight Insecurity report has a list of recommendations for measures aid agencies can take to mitigate the risks posed by the use of armed drones, including not just practical operative measures to ensure safety if drones are in an area but also the use of humanitarian diplomacy and deconfliction to avoid being targeted.

However, experts say with parties in conflicts appearing to be uninterested, or unable, to observe deconfliction agreements and the costs of implementing safety measures increasingly prohibitive—for example, in some places here you cannot operate anywhere in a vehicle without having a drone jamming device on your car—this is a requirement set by the police. These are expensive though,” said Smyrnov—many groups will struggle to keep operations going in areas where drones are frequently used.

“If the risks [of operating in a conflict zone] increase so too do the costs for the aid agencies,” said Wille.

“Security risks from the use of drones, e.g., mistargeting, drones failing and falling, etc., represent an additional security risk—a source of risks that did not exist before—in conflict and humanitarian settings to which civilians and humanitarian organizations will have to adjust and adapt. This will require more resources, time and energy that will not be spent in delivering aid. In short, it is not good news,” added Devidal.

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Big families are promoted on billboards in Russia. Credit: Sky News screengrab

By Ed Holt
BRATISLAVA, Jan 6 2025 (IPS)

“A lot of people are very scared,” says Zalina Marshenkulova. “This is obviously another tool of repression. The state is waging war on the remnants of free-thinking people in Russia and trying to suppress all dissent and freedom,” the Russian feminist activist tells IPS.

The warning from Marshenkulova, who left Russia soon after the country’s full-scale invasion of Ukraine in 2022 and now lives in Germany, comes just days after new legislation came into force in her home country banning “child-free propaganda.”

Under the law, any person, organisation or government official deemed to be promoting a “child-free” lifestyle or encouraging people, either in person or online, not to have children can face huge fines and, in some cases, may be deported.

While MPs have stressed the legislation would not infringe on the right of individuals not to have children, critics fear it will be used in what some have described as an ongoing “crusade” by the Kremlin to promote a deeply conservative ideology centred around ‘traditional values’ and rejecting decadent Western ways of life—even at the expense of women’s reproductive rights.

“Women are already buying up all sorts of contraceptive pills [fearing they may not be able to get them in the future]. Abortions are already hard to get and that’s only going to get even harder now,” says Marshenkulova.

The legislation, which came into effect on December 4, introduces fines for individuals spreading “child-free propaganda” in broadcast media or online of up to 400,000 rubles (€3,840), while companies doing so can be fined up to 5 million rubles (€48,000) for the same offence. Foreign citizens who fall foul of the legislation will face deportation.

Its supporters have said the legislation is essential to protect Russia against a harmful Western ideology that could have devastating consequences for a country struggling with worrying negative demographic trends.

“We are talking about protecting citizens, primarily the younger generation, from information disseminated in the media space that has a negative impact on the formation of people’s personalities,” Vyacheslav Volodin, chairman of the lower house of parliament, said ahead of the vote. “Everything must be done to ensure that new generations of our citizens grow up centred on traditional family values.”

But human rights groups and activists say they have grave concerns about it. They point out that it has similarly vague language to other repressive laws passed in Russia in recent years that have been used to persecute minorities, such as LGBT+ people, and government critics, including civil society groups, as well as opponents of the invasion of Ukraine.

The relative novelty of the legislation means it is hard to gauge how strictly it will be implemented and what exactly authorities will see as ‘childfree propaganda’.

But it has already had some effect.

“The law is vague and broadly formulated so we can’t predict what things will be considered punishable—no one knows,” Anastasiia Zakharova, a lawyer at the Memorial Human Rights Defence Centre, told IPS.

“For example, a situation where women share publicly things like how hard it can be as a mother, how difficult it can be raising kids—will that be considered childfree propaganda? We have already seen that groups on social media where women talk about how hard it is raising children and being a mother have closed down to avoid potentially being fined. This law will have a chilling effect on what people will say,” she added.

Others say experience with Russian laws such as those introduced in the last decade banning “LGBT+ propaganda” provides a guide for how this legislation could impact women’s lives.

“This is another part of the Kremlin’s harmful ‘traditional values’ crusade. It will limit women’s freedom, their reproductive freedoms, and will stifle freedom generally,” Tanya Lokshina, Europe and Central Asia associate director at Human Rights Watch (HRW), told IPS.

“We can predict what the effects of this law will be because it is similar to the anti-LGBT+ propaganda law in Russia and we have seen the effects of that. It’s not so much that this kind of law targets individuals; it’s about purging the cultural arena of anything that could be even vaguely interpreted as propaganda,” she added.

She said while this could see a vast amount of films, shows and books disappearing from shop shelves, TV schedules, and online streaming services—”for example, a ‘romcom’ film in which you see a woman in her thirties with no children pursuing her career—anything like that is going to be outlawed. Can you imagine how many films, TV shows, books, etc. might have to be banned because of that? It’s mind-boggling,” she said—it could also significantly impact reproductive health.

“Will children be able to get information about abortion and birth control? We saw what happened with the anti-LGBT+ law when teachers and others who should have been helping them could not, or would not, talk about [LGBT+ sexual health issues]. If children needed help, they couldn’t get it,” she said.

Other rights activists agreed.

“There will be problems for women to get information about abortions, contraception, and other reproductive health matters and it will be particularly difficult for young people who already might already be struggling with getting hold of information on these things and now won’t have any way at all to access it,” Natalia Morozova, Head of the Eastern Europe/Central Asia Desk at the International Federation for Human Rights (FIDH), told IPS.

This comes at a time when women’s access to abortion is already being curtailed.

Elective abortion is legal in Russia up to the 12^th week of pregnancy, and in some exceptional cases, such as rape, up to the 22^nd week. However, in recent years there have been moves to limit access to the procedure.

Laws have been introduced in some regions outlawing “coercing” women—the legislation defines this as persuading, bribing, or deceiving a woman into undergoing the procedure—to have an abortion, while hundreds of private clinics across the country have followed a ‘voluntarily initiative’ supported by the Health Ministry and have stopped offering abortions.

The state has also introduced guidelines for doctors to encourage female patients to have children, but also to dissuade them from abortions.

“Already in state clinics in Russia, doctors put pressure on women to have children. There are women who have gone to a clinic and been questioned by doctors on why they have no children and why they don’t want to have them yet,” said Lokshina.

Health experts have already pointed to the dangers of restricting abortions, with World Health Organisation (WHO) officials previously warning that bans on private clinics performing abortions would force more women in Russia into having surgical abortions rather than medical abortions. Private clinics mainly offer medical abortions, whereas state hospitals perform surgical abortions, which carry higher risks of complications, side effects and injuries.

The WHO also raised concerns that tightening access to legal abortions could lead to a spike in dangerous illegal procedures.

This tightening of access to abortion and the passing of the ‘childfree propaganda’ law come as the Kremlin battles a demographic crisis amid rising mortality as Russia’s brutal war in Ukraine grinds on and the country’s birth rate falls.

Data from statistics service Rosstat showed 599,600 children were born in Russia in the first half of 2024, which is 16,000 fewer births year-on-year and the lowest figure since 1999. Meanwhile, the number of newborns fell 6 percent in June to 98,600, which is the first time the number fell below 100,000. There were 325,100 deaths recorded between January and June, which is 49,000 more than in the same period of 2023.

The Kremlin has called the demographic situation a “catastrophe” for the nation and lawmakers who backed the ‘childfree propaganda’ legislation see it as a way to help halt population decline.

But Morozova said the Kremlin’s main motive was bolstering its armed forces to continue fighting in Ukraine.

“They want a population that produces soldiers, women that produce soldiers. The only goal of this regime is to produce as many soldiers as possible,” she said.

According to Lokshina, the law will also give the Kremlin an extra tool in its fight against a group that many experts see as potentially the biggest threat to President Putin’s hold on power.

“The most notable protests [against the Russian regime] since the start of the full-scale invasion of Ukraine have been women’s protests. The Kremlin sees women as being problematic and wants to silence them,” she said.

While it remains to be seen how the law will be implemented and interpreted by authorities in the future, some activists have already left the country in response to its passage, fearing it could be used against them.

But there are doubts the legislation will have any effect on the birth rate.

Some Russian women who spoke to western media ahead of the legislation’s approval said women’s decisions on whether to have children or not are largely rooted in financial concerns at a time when the economy is struggling, rather than anyone else’s opinion on their right to have children or not.

And research carried out by the All-Russian Public Opinion Research Center (VTsIOM) in October showed that 66 percent of Russians doubted fines for promoting childfree ideology would be effective.

“The law has no potential to influence the birth rate,” said Lokshina. “It is aimed at stifling dissent—in this case, the rejection of so-called traditional family values.”

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Ahead of World AIDS Day (1 December), a new report by UNAIDS released its report, 'Take the rights path to end AIDS.' Credit: UN AIDS

By Ed Holt
BRATISLAVA, Nov 26 2024 (IPS)

Gaps in realising human rights could stop AIDS being ended as a public health threat by 2030, UNAIDS has warned in a report to mark World AIDS Day.

In the report, entitled Take the Rights Path, the group says the global HIV response is at an inflection point and that decisions taken now by governments will determine whether the AIDS pandemic is no longer a public health threat by the end of the decade, a commitment in the UN Sustainable Development Goals (SDGs).

It highlights that a litany of widespread rights abuses, including girls being denied education, impunity for gender-based violence, arrests of people for who they are or who they love, and other barriers to accessing HIV services simply because of the community a person is from, are endangering efforts to end the pandemic.

The group has called on world leaders to ensure rights are upheld so that everyone that needs to can reach lifesaving programmes and AIDS can be ended, or risk “a future of needless illness, death, and unending costs.”

“It is entirely possible to end AIDS—the path is clear. Leaders must only choose to follow it,” Winnie Byanyima, UNAIDS Executive Director, told IPS.

HIV/AIDS activists and public health experts have in recent years increasingly pointed to the effects of repression of human rights on efforts to fight HIV/AIDS.

They have highlighted a growing marginalization and stigmatization of key populations, including LGBT+ people, and drug users, in a number of countries, including the introduction of legislation directly discriminating against those communities. Meanwhile, women’s rights continue to be repressed or not fully upheld in many parts of the world.

The UNAIDS report points out that currently, only three countries report no prosecutions over the past 10 years for HIV non-disclosure, exposure, or transmission and have no laws in place criminalizing sex work, same-sex relations, possession of small amounts of drugs, transgender people, or HIV nondisclosure, exposure, or transmission. It also shows that 44 percent of all new HIV infections worldwide are among women and girls.

Activists say it is essential that criminal and other laws that harm people’s rights must be removed, and at the same time laws and policies that uphold the rights of everyone impacted by HIV and AIDS are enacted.

“The science couldn’t be more clear—criminalization is prolonging the HIV epidemic and erodes the trust in the health system that is necessary not only for an effective HIV response but also for strong pandemic responses more broadly. But these gaps can be overcome—what’s missing is political will,” Asia Russell, Executive Director of campaign group Health GAP, told IPS.

There is concern, though, that against a backdrop of growing authoritarianism and a pushback against rights in many countries, this will be challenging.

“Scapegoating and criminalizing communities is a tool dictators and autocrats are turning to more frequently, driving people away from life-saving health services and making all communities less safe,” said Russell.

Ganna Dovbakh, Executive Director at the Eurasian Harm Reduction Network (EHRA), went even further, suggesting widespread criminalisation meant that achieving the end of AIDS as a public health threat increasingly appeared to be “wishful thinking.”

“It sounds unrealistic. Taking into account anti-gender and anti-human rights movements across the globe, it sounds too ambitious,” she told IPS.

However, while the report raises concerns about how the failure to ensure human rights is impacting efforts to fight HIV/AIDS and the potential for inaction on the matter to halt or even reverse progress in battling the disease, UNAIDS points out that there has been success in countries where people-centred approaches to fighting HIV have been adopted.

“Seven countries in Africa (Botswana, Eswatini, Kenya, Malawi, Rwanda, Zambia, and Zimbabwe) have already reached UNAIDS testing and treatment targets (95-95-95) for the general population.

“This is a testament to global solidarity, African political leadership, and the strong collaboration between governments, communities, civil society, science, and the private sector,” said Byanyima.

“While there are rising threats from anti-LGBTQ fundamentalists in the US, Russia, Uganda, Kenya, Tanzania, and elsewhere, not all countries are blindly embracing criminalization,” said Russell. “Some governments, however, have recently rejected this approach—such as Namibia, pointing to the racist and colonial origin of such laws and their destabilizing effect not on the HIV response but on society as a whole.”

However, the report lays bare the scale of the global challenge to end AIDS by the end of the decade.

In 2023, 9.3 million [7.4 million–10.8 million] people living with HIV were still not receiving antiretroviral therapy, and 1.3 million [1.0 million–1.7 million] people newly acquired HIV. In the regions where numbers of new HIV infections are growing the fastest, only very slow progress is being made in scaling up pre-exposure prophylaxis (PrEP). These regions also lag behind sub-Saharan Africa in progress towards meeting the 95–95–95 HIV testing and treatment targets, according to the report.

It also said that coverage of prevention services among the populations at greatest risk of HIV is very low—typically at less than 50 percent—and that HIV infections are rising in at least 28 countries around the world.

“These countries need to look at their policies and programmes and build a rights-based approach to turn their epidemics around,” said Byanyima.

Despite this, the group remains optimistic that the disease can be ended as a public health threat by the end of the decade—if governments take action now.

“It is still possible, but leaders must act now to dismantle barriers to health. I remain hopeful, but it will only happen if countries with expanding epidemics change course and protect everyone’s rights to protect everyone’s health,” said Byanyima.

Some others agree, but say it is likely governments will need to be pushed into taking the action necessary to end AIDS.

“We have the interventions that can deliver the defeat of the AIDS crisis—if deployed at scale, with the people most in need at the front of the line rather than pushed to the back. What’s missing is equitable access to the advances of science and human rights and the political will,” said Russell.

“The case for closing the HIV funding gap, reversing criminalizing laws, and accelerating deployment of superior prevention technologies could not be stronger. Unfortunately. Many governments are not, on their own, showing the leadership we need… pressure is needed now to compel government action—political will in response to the AIDS crisis rarely happens because of benevolence; it emerges in response to the pressure of accountability from communities,” she added.

Mark Harrington, Executive Director of the Treatment Action Group campaign organisation, said decades of advances in medical science meant “the toolkit we have to prevent and treat HIV, and to ensure that people can live healthy long lives regardless of HIV status, is better than it’s ever been,” but that governments must be pushed to ensure they are “responsive to the health needs of their people to fulfill the promise of all these results of decades of research and activism.”

“Political will has to be continually created and strengthened. As activists, that is our job. Over the past four decades, scientists and activists have made unbelievable progress against a once untreatable disease. We need to keep on reminding policymakers of their duties and communities of their rights to health,” he told IPS.

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An amendment to Bulgaria’s education law, passed last month, bans the "propaganda, promotion, or incitement in any way, directly or indirectly, in the education system of ideas and views related to non-traditional sexual orientation and/or gender identity other than the biological one."

By Ed Holt
BRATISLAVA, Sep 4 2024 (IPS)

A law banning the portrayal of LGBT+ identities in Bulgarian educational institutions is just the latest piece of repressive legislation in a wider assault on minorities and marginalized communities across parts of Europe and Central Asia, rights groups have warned.

The law, passed in a fast-track procedure last month, is similar to legislation passed or proposed in many countries across the region in recent years that restricts LGBT+ rights. 

And while the Bulgarian law is expected to have a harmful impact on children and adolescents in the country, it is also likely to be followed by legislation aimed at repressing other groups in society, following a pattern implemented by autocratic rulers across the region, activists say.

“Often anti-LGBT laws go hand in hand with other [repressive] legislation. One will come soon after the other. What this is all about is for certain political parties to concentrate and gain ultimate power for themselves. LGBT+ people and other marginalized groups are just scapegoats,” Belinda Dear, Senior Advocacy Officer at LGBT+ organisation ILGA Europe, told IPS.

An amendment to Bulgaria’s education law, passed on August 7, 2024 with a huge majority in parliament, bans the “propaganda, promotion, or incitement in any way, directly or indirectly, in the education system of ideas and views related to non-traditional sexual orientation and/or gender identity other than the biological one”.

Kostadin Kostadinov, chairman of the far-right Vazrazhdane (Revival) party that introduced the legislation, said that “LGBT propaganda is anti-human and won’t be accepted in Bulgaria.”

Critics say the law will have a terrible impact on LGBT+ children in a country where LGBT+ people already face struggles for their rights. In its most recent Rainbow Map, which analyses the state of LGBTQ+ rights and freedoms across the continent, ILGA Europe ranked Bulgaria 38 out of 48 countries.

“The teachers we have spoken to are really afraid of what is going to happen now. We are expecting to see a sharp increase in attacks and abuse of schoolchildren over gender and sexual orientation,” Denitsa Lyubenova, Legal Program & Projects Director at Deystvie, one of Bulgaria’s largest LGBT+ organizations, told IPS.

“The law has just been passed so we cannot be sure of its specific impacts just yet, but what we know from elsewhere is that laws like this in schools will impact children and adolescents, it will increase bullying and legitimize discrimination by other students, and even teachers,” added Dear.

Like other rights campaigners, Lyubenova pointed out the similarities between the Bulgarian law and similar legislation passed in other countries in Europe and Central Asia in recent years.

So-called ‘anti-LGBT+ propaganda’ laws were passed in Hungary in 2021 and Kyrgyzstan last year. These were in turn inspired by Russian legislation passed almost a decade earlier, which has since been expanded to the entire LGBT+ community and followed by laws essentially banning any positive expression of LGBT+ people.

Reports from rights groups have shown the harmful consequences of such legislation.

But while these laws have been roundly condemned by local and international rights bodies, political parties in some countries continue to attempt to push them through.

On the same day the Bulgarian law was passed, the far-right Slovak National Party (SNS) said it was planning to put forward a bill restricting discussion and teaching of LGBT+ themes in schools at the next parliamentary session in September.

Meanwhile, in June, the ruling Georgian Dream party in Georgia proposed legislation which would, among others, outlaw any LGBT+ gatherings, ban same-sex marriages, gender transition and the adoption of children by same-sex couples.

It will also prohibit LGBT+ ‘propaganda’ in schools and broadcasters and advertisers will have to remove any content featuring same-sex relationships before broadcast, regardless of the age of the intended audience.

In both countries, the proposed legislation comes soon after the implementation of so-called ‘foreign agent laws’ which put restrictions and onerous obligations on certain NGOs which receive foreign funding. Critics say such laws can have a devastating effect on civil society, pointing to a similar law introduced in Russia in 2012 as part of a Kremlin crackdown on civil society. The legislation, which led to affected NGOs being forced to declare themselves as ‘foreign agents’ has resulted in many civil society organisations in fields from human rights to healthcare being effectively shuttered.

Campaigners say it is no coincidence that anti-LGBT+ legislation and ‘foreign agent’ laws are being introduced closely together.

“[The anti-LGBT+ legislation] is likely to be the first in a series of laws that will discriminate against not just LGBT+ people, but other marginalized groups, which are seen as a ‘problem’ by far right organizations in Bulgaria,” said Lyubenova.

“This anti-LGBT+ law came from the Revival party, which has previously put forward bills for a ‘foreign agent law’ in Bulgaria. We are expecting a bill for foreign agent legislation to be introduced to Bulgaria’s parliament soon,” she added.

In Georgia, where legislation restricting LGBT+ rights will be debated in a final reading this month in parliament, civil society activists say the government is using one law to fuel support for the other.

“Both laws are part of the same, great evil [the government is pushing],” Paata Sabelashvili, a board member with the Equality Movement NGO in Georgia, told IPS.

Dear said the passing of ‘foreign agent’ laws was part of a template used by autocratic regimes to hold onto power “by dismantling civil society, which keeps a watch on politicians”.

The other parts of the template, she said, were to also “dismantle the independence of the judiciary, and the media”. Russia, Hungary, Georgia and Slovakia regularly score poorly in international press freedom indexes, and concerns have been raised about threats to media independence in Kyrgyzstan. Meanwhile, Russia is widely seen as no longer having an independent judiciary and concerns have been raised about government influence in the judicial systems in Slovakia, Georgia and Hungary.

Governments that have introduced these laws have said they are essential to preserve their countries’ traditional values and to limit foreign regimes—usually specifically western—influencing internal politics and destabilizing the country. These claims have been repeatedly rejected by the civil society and minority groups the laws are aimed at.

Some rights campaigners see the introduction of these laws as part of a coordinated international effort to not just spread specific ideologies but also entrench autocratic regimes.

While ostensibly the introduction of such legislation are the acts of independent sovereign regimes, campaigners say the politicians behind these laws are not necessarily acting entirely on their own initiative.

Activists in Slovakia and Georgia who have spoken to IPS highlight the strongly pro-Russian sentiments expressed by governing parties in their countries, while Hungarian prime minister Viktor Orban has been heavily criticized even among European Union officials for his closeness to the Kremlin and criticism of help for Ukraine since the start of Russia’s full-scale invasion of its neighbour. Meanwhile, Russia—as it does with many other central Asian countries—and Kyrgyzstan have historic ties dating back to the Soviet Union.

“These parties [behind these laws] have links to Russia. [Pushing through this kind of legislation] is strategically coordinated; it’s very well-planned,” said Dear.

“I believe this is all part of a wider trend linked to far right governments and/or parties,” Tamar Jakeli, LGBT+ activist and Director of Tbilisi Pride in Tbilisi, Georgia, told IPS.

Forbidden Colours, a Brussels-based LGBT+ advocacy group, linked the Bulgarian law directly to the Kremlin’s repression of rights in Russia.

“It is deeply troubling to see Bulgaria adopting tactics from Russia’s anti-human rights playbook,” the group said in a statement.

Meanwhile, international and Bulgarian rights groups have called on the EU to act to force the Bulgarian government to repeal the anti-LGBT+ law, while Bulgarian civil society organisations are getting ready to fight its implementation. There have been street protests against it in the capital, Sofia, and Lyubenova said her organisation was also preparing legal challenges to the law.

“What these far-right groups are doing with this law is they are testing our ability to stand up to hateful actions. We have to challenge it,” said Lyubenova.

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Activists protest during the 25th International AIDS Conference (AIDS2024) in Munich over a affordable pricing for a drug currently sold by pharmaceutical firm Gilead. Credit: Ed Holt/IPS

By Ed Holt
MUNICH, Aug 2 2024 (IPS)

Campaigners and experts have demanded a breakthrough HIV intervention hailed as “the closest thing to an HIV vaccine” must be made available as soon and as cheaply as possible to all who need it as its manufacturer faces protests over its pricing.

Activists led a massive protest during the 25th International AIDS Conference (AIDS2024) in Munich last week as a study was presented showing lenacapavir—a drug currently sold by pharmaceutical firm Gilead for more than USD 40,000 per year as an HIV treatment—could be sold for USD 40 per year as a form of pre-exposure prophylaxis (PrEP) to help prevent HIV infection.

Community groups working in prevention, as well as experts and senior figures at international organizations fighting HIV, called on the company to ensure it will be priced so it is affordable for low- and middle-income countries (LMICs), which account for 95 percent of HIV infections.

“It is no exaggeration to call lenacapavir a game changer. It could be life-changing for some populations. We need to see it produced generically and supplied to all low- and middle-income countries to the people who need it,” said Dr. Helen Bygrave, chronic disease advisor at Medecins sans Frontiere’s (MSF) Access Campaign.

During the event, data from a trial of lenacapavir, a twice-yearly injectable, were presented. The results of the trial were announced by pharmaceutical firm Gilead last month and showed the drug offered 100% protection to more than 5,000 women in South Africa and Uganda.

Many experts and community leaders helping deliver HIV interventions who spoke to IPS described the drug as a real “game changer,” offering not just spectacular efficacy but relative ease and discretion in delivery—the latter key in combating stigma connected with HIV prevention intervention in some societies—compared to other interventions, such as oral PrEP.

But they warned there were likely to be challenges to access, with cost expected to be the main barrier.

Lenacapavir is currently approved only as a form of HIV treatment at a price of USD 42,000 per person per year.

While as a PrEP intervention it would be expected to be sold at a much lower price, an abstract presented at the conference showed that it could cost just USD 40 a year for every patient.

In a statement put out following the protests, Gilead said it was developing “a strategy to enable broad, sustainable access globally” but that it was too early to give details on pricing.

Critics claimed Gilead was not being transparent in its statement—the company talked of being committed to access pricing for high-incidence, resource-limited countries rather than specifically low- and middle-income countries—and there are fears that the price at which it is eventually made available as PrEP will be so high as to put it out of reach of the countries that are struggling most with the HIV epidemic.

“Cabotegravir, a two-month injectable form of PrEP, is currently being procured by MSF for low-income countries for USD 210 per person per year. We would not expect [the price for lenacapavir] to be higher than that, and we would hope it would be more ‘in the ballpark’ of  USD 100 per person per year,” said Bygrave.

She added that “questions have been asked of Gilead about its pricing for lenacapavir, and the company has been pretty vague in its answers.”

“Civil society needs to put continued pressure on Gilead about this issue because, without that pressure, I do not trust Gilead to do the right thing,” Bygrave, who took part in protests at the conference against Gilead’s pricing, said.

Some speakers at the conference set out a series of demands for the firm.

Winnie Byanyima, Executive Director of UNAIDS, called on Gilead to license generic manufacturers to produce it more affordably through mechanisms such as the Medicines Patent Pool (MPP), a UN-backed programme negotiating generics agreements between originators and generic pharmaceutical companies.

Others, such as keynote speaker Helen Clark, Chair of the Global Commission on Drug Policy, said such interventions must be seen as “common global goods, and ways must be found to make them accessible to all.”

“The pharmaceutical industry has been the beneficiary of much public research investment. With respect to HIV/AIDS, it has benefited from the mobilization of scientists and engaged communities who have advocated for investment in R&D and treatments. Prima facie, the notion that the companies can then make great profits from and not share the intellectual property created is wrong,” she said.

Others went even further, accusing some pharmaceutical firms of being parties to the creation of a de facto global two-tier system for medicine supply.

“Companies must share their medicines. We cannot accept an apartheid in access to medicine in which the lives of those living in the Global South are not regarded as having the same value as the lives in the North,” Archbishop Dr Thabo Makgoba, Archbishop of the Anglican Church of Cape Town and HIV advocate, said at a UNAIDS press event during the conference.

Some of those who work with key populations stressed the need to push through all necessary approvals and set lenacapavir’s price at an accessible level as quickly as possible to save lives.

“It’s great to have innovation and get important new tools in the fight against HIV. But the question is: how long will it take to get them to the people who need them? Until then, they are just a great announcement—like a beautiful picture hanging up there that you can see but cannot actually touch. We need to give communities the funding and the tools they need to do their vital work,” Anton Basenko, Chair of the Board of the International Network of People who Use Drugs (INPUD), told IPS.

The calls came as campaigners stressed the exceptional potential of lenacapavir. It is not only its astonishing efficacy, but also its relative ease and discretion of delivery, which experts are excited about.

Stigma around HIV prevention, such as oral PrEP, which involves taking daily tablets, has been identified as a major barrier to the uptake of HIV interventions in some regions.

Some HIV healthcare specialists at the conference told IPS they had seen cases of women leaving clinics with bottles of tablets and, as soon as they heard them rattling in the bottle, threw them into the bin outside the clinic because the noise would tell others they were taking the tablets and leave them open to potential discrimination, or even gender-based violence.

“The lack of oral PrEP uptake and adherence among women and girls is due to a number of factors, such as stigma and worries about being seen with a huge bottle of pills. What about if you are in a relationship and your partner sees the bottle and starts asking whether you are cheating on them or something?

“A woman could go and get a lenacapavir injection a couple of times a year and no one would have to even know and she wouldn’t have to think about taking pills every day and just get on with her life. This drug could change lives completely. I would definitely take it if it was available,” Sinetlantla Gogela, an HIV prevention advocate from Cape Town, South Africa, told IPS.

The concerns around access to lenacapavir at an affordable price for low and middle income countries come against a background of record debt levels among poor countries, which experts say could have a severe negative impact on the HIV epidemic.

A recent report from the campaign group Debt Relief International showed that more than 100 countries are struggling to service their debts, resulting in them cutting back on investment in health, education, social protection and climate change measures.

Speakers at the conference repeatedly warned these debts had to be addressed to ensure HIV programmes, whether they include lenacapavir or not, continue. Many called for immediate debt relief in countries.

“African debt needs to be restructured to let countries get hold of the medicines they need,” said Byanyima.

“Drop the debt; it is choking global south countries, denying us what we need for health. Please let us breathe,” said Makgoba.

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Jay Mulucha speaks at the 25th International AIDS Conference in Munich. Credit: Steve Forrest/IAS

By Ed Holt
MUNICH, Jul 31 2024 (IPS)

Jay Mulucha, Executive Director of FEM Alliance Uganda, gave an impassioned plea to governments around the world to push lawmakers in his home country to reverse punitive new legislation criminalizing the LGBT+ community.

He became the first trans man to speak at the opening ceremony when he addressed the 25th International AIDS Conference in Munich last week (July 22)—the world’s largest conference on HIV and AIDS, attended by an estimated 10,000 people.

Mulucha spoke about how he and other members of the LGBT+ community in Uganda live in constant fear, and the impact of Uganda’s 2023 Anti-Homosexuality Act, which outlaws sexual relations among members of the same sex and imposes the death penalty for “serious homosexual acts.”

IPS spoke to Mulucha at the conference about how he and other activists refuse to give up their fight for acceptance and their determination to help others despite the dangers and challenges they face on a daily basis.

Jay Mulucha, Executive Director of FEM Alliance Uganda. Courtesy: Jay Mulucha

IPS: Were you surprised at the reception you got today when you spoke?

Jay Mulucha (JM): I was very surprised because this is a really big conference that brings together a lot of people. But at the same time, I am very pleased that I am here.

IPS: Today, we heard you talk about the repression that you and other members of the LGBT community face in Uganda. But of course, Uganda is not the only place where there are such laws. Do you think that your activities and what you are doing can be an inspiration for other LGBT+ people facing repression in other countries?

JM: Yes, it can. What I have achieved today by telling the world about what we are going through is going to make a change. That’s because I have made sure that we are getting opportunities (to speak out). This is the first time that a trans person has been part of the opening ceremony at [the annual IAS AIDS Conference] and it is very important that these opportunities be given to us so that they can hear our voices. You see, it’s not only in Uganda—people in other countries are suffering. Our voices are being trodden on, so if we are given the chance to speak, it gives us a greater opportunity to let the world know that things are not going well for people like us.

We work with different people in different countries to get out the message of what we are doing to counter the anti-gender movements that are rising up. This movement is really hurting us and we are doing what we can to try and stop them from spreading their hate.

IPS: Do you see any hope that the situation in Uganda for LGBT+ people will change any time soon?

JM: I joined the LGBTQI activist movement in Uganda more than ten years ago. When I joined, the situation was worse than it is today. Today, we are doing a lot of advocacy work, helping different people, and I can say that though the situation is not good, I am happy to say that there are some people who used to be homophobic and transphobic, and their minds and narratives have been changed through the advocacy work that we have done. Compared to ten years ago, at least now people know about the LGBT community. Back then, no one would even say it because people thought it was a sin to even mention the LGBT+ community. Right now, they are talking about us, the health service providers, and the government knows about LGBT—they are saying it. Even if it’s negative, at least they are saying it; they know that we exist and that we need services. So, I have a feeling that if we keep on doing our work, our advocacy, and we keep on talking about all these issues in different forums, at some point things will change. I can give an example of countries that have better laws, but those laws didn’t come about suddenly; it’s not like everyone woke up one morning and they were suddenly in place. People had to fight [for these laws] and go through a lot until things were better. I have a feeling that one day things in Uganda are going to change. We’re not going to give up; we’re going to continue the fight until we get what we want. We call upon different missions, different countries, in Europe, and the whole world to stand with us in this fight until we get what we want.

IPS: What impact are these laws going to have, or are already having, on the HIV situation in Uganda?

JM: These laws are making things worse. Different government officials are on record castigating and telling health service providers not to attend to any LGBT people, meaning that access to services is a challenge. The LGBT community is kept from accessing health services. This is because they know that once they try to access these services, they are going to be arrested, that they are not going to get these services, that they are going to be tortured, that they are going to be discriminated against, and (that they will be) told lots of homophobic things. These laws have really impacted health service provision for LGBT+ people. It’s so bad that some people are resorting to self-medication, which, of course, is bad and very dangerous.

IPS: How does someone in Uganda from the LGBT+ community who has HIV access the HIV care they need?

JM: There are drop-in centres that are being funded by international organizations. We also educate some health service providers. Some healthcare providers are welcoming; they welcome us and give us the services we need. The pop-up centres have supported the community. The community feels safe accessing services in places where they feel comfortable. Finding a doctor is done by word of mouth. There are some physicians that are welcoming [of LGBT+ people] but those doctors also have challenges; they have to give us services sometimes secretly because they don’t want to be seen supporting us.

IPS: Do you think that homophobia and transphobia are very prevalent in Uganda, or is it really the case that there is just a very visible and very vocal minority that thinks like that and is spreading anti-LGBT+ hate, and most other people are just silent on the issue?

JM: Homophobia and transphobia were very prevalent in Uganda even before LGBT+ people were as open as they are now. But with the anti-rights movement, it has just increased. There was already hate, but this movement that has come up has increased the hate, transphobia and homophobia. The anti-gender and anti-gay movements have just increased and fueled everything. The rise of those movements among the politicians and the ‘evangelicos’—like the religious leaders and the cultural leaders—has fired up everything. Nowadays, they are so vocal because they are being funded. They have these huge donors and people are bribed to support them. This is just increasing the hate.

Another thing—the reason these people are silent is because these anti-gay and anti-gender movements are being funded and they are bribing people to stand with them and for people to be silent about the whole situation. People are not standing with us because some of them have been bribed to do so. That is why the LGBT community in Uganda asked different governments in different countries to speak up about these repressive laws in Uganda and other places. But instead, some countries, especially European countries, have been silent on it, including Germany. They are welcoming parliamentarians from Uganda, like the vice speaker of parliament, who was welcomed with open arms by the German government recently. And Germany is still funding our government. Why is that happening?  They are hiding behind the US, which put sanctions on the government figures who were involved in the passing of the [anti-homosexuality] laws. Germany just put out statements on this. We don’t want statements; we want Germany to put sanctions on these people. And they should stop funding them. Instead, Germany should fund the LGBT+ organizations that are struggling. And they’re doing all this thinking that we won’t, or don’t, know about it. We call on the German government to stop this.

IPS: You spoke about waking up every day and wondering whether you were going to be safe. How do you and other activists function and do your jobs when you have to worry all the time about your safety?

JM: We are trying to do our work in hiding because we need to continue the struggle; we need to continue to stand with the LGBT community here. We find ways to operate safely. We try our best to make sure we aren’t discovered because the moment the government finds out about our work, they will close the organization, arrest us, or cancel our permission to work. So we do our work in hiding. The second thing we do is look out for each other and each other’s security and try to find new ways to keep ourselves safe. Safety is a major concern for us. The situation is not good, but we are not giving up. We tried to also make sure that we advocate and that we also help educate people in institutions, like the police for example. We speak to people and we try to make them understand who we are and why they should not be violent towards us. We are going through a lot of challenges at the moment, but we go on because we know that at some point this is going to change and everything is going to be okay with us.

IPS: What message would you like to give to people from this conference?

JM: I would like to say thank you to the conference organizers for allowing me to be a speaker here and hope people like me continue to get opportunities like this to speak, because whenever we do, it takes things to another level. Every time we get the chance to speak out, it allows our voices to be heard, and it is through our voices being heard that we get support.

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Irene Khan, Special Rapporteur for freedom of expression and opinion, briefs reporters at UN Headquarters. Credit: Manuel Elías/UN

By Ed Holt
BRATISLAVA, Jul 19 2024 (IPS)

Rights groups have called for governments to do more to combat transnational repression as a series of recent reports show growing numbers of exiled journalists, political dissidents and rights defenders are being targeted by autocratic regimes in an attempt to silence them.

They say governments must do more to deal with the repression, which takes the form of online harassment, surveillance, enforced disappearances, physical attacks and sometimes even killings, to protect the safety of these people.

“We have seen an increase in transnational repression, tied into the rise in authoritarianism around the world in general. Generally, there is a growing awareness of this complex problem among host countries and a willingness to do something about it.

“But more work needs to be done in some areas and governments need to support exiled journalists and understand the vital importance of the work they do,” Fiona O’Brien, UK Bureau Director at Reporters Without Borders (RSF), told IPS.

The scale of the problem has been laid bare in a number of reports in recent months.

In February, rights group Freedom House released a report documenting scores of attacks, including assassinations, abductions and assaults, carried out by governments against people outside their borders in 2023.

Naming Russia, Cambodia, Myanmar, Turkmenistan and China as the biggest perpetrators, it also reported on the first known cases of transitional repression sanctioned by a number of governments, including the regimes of Cuba, the Democratic Republic of the Congo, El Salvador, Myanmar, Sierra Leone and Yemen.

The group said that 44 countries—more than a fifth of the world’s national governments—have attempted to silence dissidents, activists, political opponents and members of ethnic or religious minorities beyond their own borders in the last ten years, with 1,034 recorded direct, physical incidents of transnational repression.

Meanwhile, at the end of June, while presenting a report on transnational repression, the United Nations special rapporteur on freedom of opinion and expression, Irene Khan, raised concerns not just about increasing incidents of transnational repression, but host countries’ responses to it.

“Too often, states are either unwilling for political reasons or unable for lack of capacity or resources to protect and support journalists in exile. Journalists should not be treated as political pawns but as human beings in distress who, at great cost to themselves, are contributing to the realization of our human right to information,” Khan said.

Following the report, scores of governments issued a joint statement condemning the repression and committing to coordinated action to help people being targeted and to hold accountable those behind any attacks. But it did not spell out any specific measures that should be implemented to do this.

Rights groups say that concrete steps must be taken by host governments to address the problem both in their own countries, and to confront those regimes perpetrating such acts.

Phil Lynch, Executive Director at the non-profit organisation International Service for Human Rights, said such action should involve host states not only providing comprehensive protection and support to those at risk of acts of transnational repression, but also measures, to undermine the capabilities of regimes to target people abroad.

He said host states must ensure they do not support or acquiesce in acts of transnational repression, such as through extradition or refoulement to states engaged in the persecution of human rights defenders; do not provide or export the tools or technologies of transnational repression, such as spyware and arms, to repressive states; must build awareness and law enforcement capabilities to respond to acts of transnational repression; and publicly denounce, investigate and pursue accountability for acts of transnational repression, including through sanctions and diplomatic repercussions.

“They should also prioritise human rights in foreign policy and relations both at bilateral and multilateral levels, adopting a principled and consistent approach to human rights in all situations, without selectivity and without discrimination,” he told IPS.

The lack of any serious consequences for regimes using transnational repression is helping perpetuate its widescale use, experts say.

“Governments don’t seem to be shying away from using transnational repression. This is likely because there has been very little accountability even in the most well-publicized cases, like the assassination of [Saudi dissident writer] Jamal Khashoggi. Since governments aren’t paying a price for targeting dissidents abroad, there’s little reason for them not to attempt it,” Yana Gorokhovskaia, Research Director, Strategy and Design, at Freedom House, told IPS.

But it is not just host country governments that could do more, experts say.

“Most of the harassment and attacks are online. Big tech have been totally absent from [efforts to fight transnational repression]. Governments have to hold big tech to account on this,” said O’Brien.

“Increasingly, acts of transnational repression occur online or are technology-facilitated. Technology providers have a duty to conduct due diligence to ensure their technologies and tools are not used, directly or indirectly, to restrict or violate human rights, including through acts of transnational repression. Governments should also legislate to mandate that human rights due diligence is undertaken by companies,” added Lynch.

It appears that some countries are becoming increasingly aware of the issue and willing to improve how they tackle it.

O’Brien said this following an RSF report on harassment of Iranian journalists in the UK released earlier this year. British authorities have “shown a lot of interest in how to tackle this problem better,”  while Freedom House has highlighted how President Joe Biden’s administration has made addressing the issue a priority across law enforcement and security agencies.

Gorokhovskaia also pointed out that over the last four years various countries have adopted policies to mitigate the threat posed by transnational repression, including improved training for police and security agencies and more outreach to communities that can be targeted.

“Countries have also become more aware of how international organizations, like Interpol, can be misused for transnational repression and taken steps to address this (by examining Interpol notices from certain perpetrator countries),” she said.

But research from other groups shows a much less reassuring picture.

A report from Human Rights Watch (HRW) said some host country governments were not only failing to ensure adequate protective measures for those at risk but were even actively facilitating transnational repression.

UN special rapporteur Khan also warned of host states becoming enablers “of transnational repression, for instance, by colluding in abductions instigated by the home state.”

Some alleged cases of such facilitation involve ostensibly stable, democratic, western states.

Abdulrahman Al-Khalidi, a political activist and a known dissident, arrived in Bulgaria in October 2021.

A campaigner for human rights and advocate for democratic reforms, he had fled his home country in the wake of mass arrests following the Arab Spring.

But since crossing into Bulgaria and claiming asylum, he has faced a complicated and, he says, at times incomprehensible legal battle over authorities’ continued refusal to grant him asylum and release him from detention at the migration centre despite court rulings in his favour.

He is facing deportation to Saudi Arabia, where, he told IPS, he will almost certainly be killed.

Al-Khalidi believes the Saudi secret service is behind the Bulgarian authorities’ blocking of his asylum. He says that during questioning by agency officials, he was told they were working with Saudi authorities on his case and that Saudi officials wanted him returned to Saudi Arabia. The Bulgarian state security agency has repeatedly said Al-Khalidi is a threat to national security, thereby blocking his asylum and release from detention.

Speaking to IPS in early July as he began a hunger strike while at a migrant detention centre near the Bulgarian capital, Sofia, where he has been held for the last three years, Al-Khalidi had a warning for governments hosting exiled dissidents and journalists.

“We live in a time full of international turmoil in which younger generations believe in anarchism more than they believe in democratic principles. This is very dangerous. The blame for this is fully borne by politicians who benefit from this and whose actions contradict the principles of the state, subsequently raising generations who lose their faith in both,” he said.

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Organizers decided to cancel physical Pride events this year for fear of a repeat of violence that marred the 2023 event when far-right groups attacked festival goers. The organizers and Georgia's president said anti-LGBT hate speech from government officials had incited violence ahead of the event in Tbilisi.

By Ed Holt
BRATISLAVA, Jun 26 2024 (IPS)

“If this legislation passes, LGBT+ people simply aren’t going to be able to live here.” The warning from Tamar Jakeli, an LGBT+ activist and Director of Tbilisi Pride in Tbilisi, Georgia, is stark, but others in the country’s LGBT+ community agree, accurate.

Jakeli is talking to IPS in early June, soon after the ruling government party, Georgian Dream, proposed a bill in parliament that would, among others, outlaw any LGBT+ gatherings, ban same-sex marriages, gender transition and the adoption of children by same-sex couples. 

It will also prohibit LGBT+ ‘propaganda’ in schools and broadcasters and advertisers will also have to remove any content featuring same-sex relationships before broadcast, regardless of the age of the intended audience.

Strikingly similar to various legislation passed over the last decade in Russia, where the regime has looked to crack down on any open LGBT+ expression, critics say it could, if passed, have a devastating effect on Georgia’s queer community.

They fear it will lead to violent attacks on LGBT+ people and an increase in stigmatization, marginalization, and repression of the community.

“This legislation will give the green light to anyone who already has very conservative opinions to unleash violence on the LGBT community,” says Jakeli.

Experience from other countries where similar legislation has been introduced suggests this is a very likely outcome.

“The experiences of Russia and other countries that have passed such legislation show a clear pattern: state-sanctioned discrimination tends to foster an environment of hostility and violence against LGBTI communities,” Katrin Hugendubel, Advocacy Director at LGBT+ rights group ILGA-Europe, told IPS.

“This legislative move in Georgia could embolden extremist groups and individuals, leading to an increase in hate crimes and violence. The societal message that LGBTI people are less deserving of rights and protections can have severe and dangerous consequences,” she added.

Rights groups say that while the law would have an immediate negative effect on many aspects of LGBT+ people’s lives, it is also likely to reverse what has been a growing acceptance of the community in the country, albeit a slow one.

Although recent research suggests prejudice against LGBT+ people runs deep among what is a traditionally conservative population, activists say attitudes have become more tolerant towards the community in the last few years.

“There is still a conservative society here, and transphobia, homophobia and prejudice exist, [but] in recent years, surveys have shown people being less homophobic, especially in big cities and among the young. The dynamic has been positive,” Beka Gabadadze, an LGBT+ activist and Chairperson of the Board at Queer Association Temida in Tbilisi, told IPS.

But this could now all be under threat.

“The introduction of this legislation has the potential to undo much of the progress that has been made in recent years,” Hugendubel warned.

“Improvements in the situation for LGBTI individuals in Georgia have been fragile and often driven by the efforts of activists and supportive segments of society. This law, by contrast, represents a significant setback that could negate the positive changes achieved. It could lead to increased fear, discourage public expressions of identity, and drive LGBTI people and their allies back into hiding,” she said.

The bill must pass three readings in parliament before it becomes law, and the last of those is expected for September, a few weeks before planned parliamentary elections.

Activists say they expect it to be passed, pointing to the government’s willingness to push through legislation regardless of how unpopular it might be. a law requiring civil society groups that receive a certain amount of funding from abroad to register as “pursuing the interests of a foreign power” was passed earlier this year, despite massive street protests and overwhelming public opposition to it.

Over the next few months as the Bill is debated, Jakeli says she is expecting rising repression against the community.

She says her organization’s offices have already been attacked—she believes by people connected to the government. A Georgian Dream MP appeared to claim responsibility for a series of attacks against the offices of civil society organizations in May this year.

She also expects many LGBT+ people to start, if they have not already, planning a new life abroad.

While Georgian Dream has said the bill has been introduced as a necessary measure to stop the spread of “pseudo-liberal” values that undermine traditional family relationships, critics see it as the latest cynical attempt by a government turning away from the West to increase stigmatisation of certain groups, particularly the LGBT+ community, for political gain ahead of elections.

Georgian Dream also linked its foreign influence legislation to protecting the country from NGOs promoting LGBT+ rights, among others.

“The timing and nature of these legislative moves suggest that they are part of a broader strategy to appeal to homophobic and anti-minority sentiments among certain voter bases,” said Hugendubel. “This tactic has been used in other countries to consolidate power by stoking fears and prejudices,” she added.

Following the implementation of the foreign agent law, the US slapped sanctions on Georgian officials and the EU is currently considering similar action. There have been calls for similar moves to deter the government from pursuing its anti-LGBT+ legislation.

“International pressure, such as sanctions or diplomatic measures, can be effective in signalling to the Georgian government that these actions have severe repercussions. Additionally, domestic protests and sustained public opposition can also play a crucial role in pushing back against these laws,” said Hugendubel.

But Jakeli said the government might try to use any mass protests to further push their own repressive political narrative.

“What Georgian Dream wants is for LGBT+ activists to go out on the streets now and protest and then they can turn around to voters and say, ‘Look, these are radicals trying to overthrow the government who want to spread their decadent western morals through Georgian society’,” she says.

Activists say they are holding out hope that the elections in October will bring about a change of government. Although Jakeli admits the “odds of that happening are not great” with opposition parties, she points out, “facing almost as much repression from the government as the LGBT+ community does.”

But even if Georgian Dream do remain in power after the October vote, Jakeli believes its efforts to further stigmatize the LGBT+ community may actually have already backfired.

“The protests against the ‘foreign agent’ law united different sections of society and more and more people see anti-LGBT+ laws as another ‘Russian’ method of polarizing and dividing society.

“When I was on the front lines of the foreign agent law protests, for the first time I felt as if I was part of the majority, not minority, in Georgia. I think that people have realized that everyone should have human rights, including LGBT+ people,” she says.

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Saudi dissident Abdulrahman Al-Khalidi says he is being kept in appalling conditions as he waits for the Bulgarian courts to confirm his asylum application. Credit: Supplied

By Ed Holt
BRATISLAVA, Jun 4 2024 (IPS)

When Abdulrahman Al-Khalidi fled Turkey for Bulgaria after his fellow Saudi dissident Jamal Khashoggi was murdered, he thought he was heading for safety and sanctuary in the European Union.

But, he says, he instead would end up facing the exact opposite.

“When I came to Bulgaria, I thought I was going into a European asylum system, but what I signed up to was actually a slavery contract. Where I am now, they can just treat you like animals,” he tells IPS.

Al-Khalidi is speaking from the Busmantsi migrant detention center outside the Bulgarian capital, Sofia, where he has been held since November 2021.

He says that since arriving there, he has been subjected to a “nightmare” of inexplicable detention in appalling conditions and numerous breaches of his rights, including a police beating. He has tried to take his own life and says his mental health has suffered dramatically during his time there.

“I am being treated unfairly and illegally. What is happening to me doesn’t make sense to me or to anyone else. It has been very difficult for me mentally here. Every day I wait for someone to come and tell me I am free to go, but it never happens,” he says.

Al-Khalidi, a political activist and a known dissident, arrived in Bulgaria in October 2021.

A campaigner for human rights and advocate for democratic reforms, along with prominent Saudi figures such as Khashoggi, he left his home country in the wake of mass arrests following the Arab Spring. He sought refuge abroad, first traveling to Egypt, then staying in Qatar and Turkey, where he worked as a journalist writing critical articles about the Saudi regime, before heading to the EU to apply for asylum.

He was detained crossing the border into Bulgaria and claimed asylum. But it was denied by Bulgaria’s Refugee Agency, which decided Saudi authorities had taken steps to democratize society and rejected his claim of asylum on humanitarian grounds.

This was despite Al-Khalidi’s protests, and warnings from human rights groups that he would be in serious danger if he were to be returned to Saudi Arabia.

“If I get sent back to Saudi Arabia, I will 100 percent be killed or will be ‘disappeared’ in prison,” he says.

He launched an appeal against the decision but this was rejected by a lower court. He then took his case to the Supreme Court, which last month (APR) ruled that the State Refugee Agency must reconsider his asylum request. It said the reason given for initially rejecting it—a recommendation from Bulgaria’s National Security Agency that Al-Khalidi posed a security risk to Bulgaria—had not been substantiated.

A decision from the State Refugee Agency on his asylum is expected within months.

Human rights campaigners say they see no reason why it should not be granted.

“I have never come across a case of a refugee that is as clear as that of Abdulrahman’s,” Victor Lilov, member of the Bulgarian Helsinki Committee, told IPS.

Al-Khalidi himself says that he has lost faith in the asylum process in Bulgaria.

“I don’t trust the authorities anymore,” he says.

His mistrust comes after spending the last two and a half years fighting not just to have his asylum request properly dealt with, but also against what he and rights activists believe is his unfair and, following a recent court ruling, unlawful continued detention at the Busmantsi centre.

Under Bulgarian migration regulations, asylum seekers should only be put in closed centers, such as the Busmantsi facility, as a temporary measure while their identity and the facts around their asylum application are established. They should not be held there solely on the grounds that they have claimed asylum. There is, however, a provision under which a migrant can be held in closed facilities if they are deemed a threat to national security.

Al-Khalidi has been in the Busmantsi centre since just a few weeks after his initial arrest.

He initially lodged a legal complaint over his detention in 2022, but that was rejected by a lower court and he was ordered to remain detained at the centre.

He describes conditions there as appalling, with inadequate medical care, a lack of basic hygiene facilities, insect infestations causing infections and diseases, and that it is run “like a prison” with strict restrictions on movements and freedoms for those housed there.

He also claims that at the end of March, security officers at the facility attacked him after he offered food to others detained at the centre. He was taken to the toilets, where there are no cameras and repeatedly beaten and choked for an hour before being taken back to his room, where he was handcuffed to his bed for another two and a half hours.

He says his ordeal over the last few years has taken a huge mental and physical toll on him, which has only been worsened by what he says have been inexplicable decisions by Bulgarian authorities in his case.

In January of this year, the Supreme Court overturned the 2022 lower court ruling on his continued detention and ordered his immediate release. But it was blocked by the National Security Agency, again on the grounds that he presented a threat to national security.

Al-Khalidi denies posing any threat to national security and says he cannot understand why he remains at the detention centre.

“I don’t know what to do anymore. I can’t see how they can still keep me here,” he says.

Lilov said his continued detention was unlawful.

“The Supreme Court decision of January 18 to release Abdulrahman was immediate and non-appealable. The State Refugee Agency and the National Security Agency have so far refused to implement this decision, making his detention unlawful,” he said.

“This ‘accommodation’ centre for migrants is generally intended for those who have fully exhausted all procedures and have extradition orders and are waiting there for the appropriate transport. Only in exceptional cases does the law allow asylum seekers to be accommodated in closed places until the circumstances requiring their detention are no longer present.

“In the case of Abdulrahman, we have decisions of last resort from the Supreme Court saying that he should be released and that the State Refugee Agency should grant him asylum status. I really don’t understand the reasons behind the Bulgarian authorities’ persistence [to continue to detain him],” added Lilov.

Meanwhile, Al-Khalidi continues to face the threat of deportation to Saudi Arabia, despite the Supreme Court ruling.

On February 5, Al-Khalidi was served with a deportation order by the National Security Agency. He has appealed against this.

In response to questions from rights groups and local media about Al-Khalidi’s situation, the Interior Ministry has confirmed this order should not be enforced until a final ruling on his asylum status is made.

Human rights organisations campaigning for his release say Al-Khalidi’s deportation is likely to be in breach of international refugee conventions and Bulgaria’s international obligations on non-refoulement, given Saudi Arabia’s human rights record and documented treatment of political dissidents.

They say he would be at risk of arrest, torture, and potentially the death penalty for his political views and activism.

“The Saudi regime treats political dissidents in a very harsh way. If he is sent back, Abdulrahman will also face very harsh treatment,” said Lilov. “Bulgaria must give him asylum.”

The Bulgarian Interior Ministry did not respond to requests from IPS for comment.

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