A child grimaces as he receives a measles vaccination at a school in Charsarda District in Pakistan's northwestern Khyber-Pakhtunkhwa Province in 2010. Credit: UN Photo/UNICEF/ZAK

By Lindsey Walker
UNITED NATIONS, Oct 9 2012 (IPS)

Pakistan, where some 126,000 children under five years old die from pneumonia every year, launched a new pneumococcal vaccine Tuesday, making it the first South Asian country to do so.

Pneumonia is the most common killer of children under five, and 99 percent of these deaths occur in developing countries, according to the World Health Organization (WHO).

Some 1.4 million children under the age of five die each year of pneumonia – more than child deaths by HIV/AIDS, tuburculosis, and malaria combined. And 550,000 of these deaths occur in South Asia alone, according to the United Nations children’s agency UNICEF.

The Global Alliance for Vaccines and Immunisation (GAVI), of which UNICEF and WHO are members, will bear 95 percent of the immunisation costs in order to bring the pneumococcal vaccine into Pakistan’s Expanded Progamme on Immunisation (EPI).

The EPI already includes several vaccinations, including those against polio, meningitis, and childhood tuberculosis, but has until now lacked the badly needed pneumococcal vaccine due to its considerable expense.

In an interview with IPS, Dr. Seth Berkley, CEO of the GAVI Alliance, said, “Historically, the delay between a vaccine being made available in the West and its availability in the east is 10, 15, (or possibly) 20 years.”

Pneumococcal, a vaccine that has been in existence for many years, is only recently conjugated into an inoculation safe for infants.

“When it came out of the West it was expensive,” Berkley said, “and the reason is that it is actually a collection of 10 or 13 vaccines (depending on which of the two products that are being used now) and it was a very complex, difficult to manufacture vaccine.”

The developing world was introduced to the vaccine only one and a half years after its introduction to the Western world, closing the usual gap by at least a decade. This is due to GAVI’s innovative Advance Market Commitment (AMC), an initiative that offered incentive to the vaccine manufacturers to produce large quantities of the pneumococcal at lower costs.

“AMC basically put out a programme to encourage manufacturers to make a vaccine that would contain the appropriate strains for the developing world,” said Berkley, “as well as having a better price point. That was the big innovation that occurred.”

AMC raised 1.5 billion dollars and offered a top up to the companies for the vaccines produced until the money ran dry. In this way, the price of each dose was reduced a staggering 90 percent from the price of each dose originally sold in the West.

In most countries, the poorest and most deprived children are likely to die before their fifth birthday.

“Coverage of key prevention should be higher among these children,” said UNICEF in a report published in early June of this year, “but too often the opposite occurs.”

In developing countries such as Pakistan, air and water pollution, overcrowding, and most importantly, lack of access to medical facilities all contribute to the enormous death toll by treatable and preventable illnesses.

The GAVI Alliance has called for “equity approach”. The concept is to treat children under the age of five in the lowest 20 percent of the economy in the same way as the top 20 percent of households are treated.

“Our long-term goal is to get it (the vaccination) to every child possible, especially because we know that the children who are stigmatised or who are in the poorer districts not only have higher incidence of disease because of living conditions, but also have less access to treatment,” Berkley told IPS.

He explained the strategy to accomplish this is to continue working with governments, NGOs and others to distribute the vaccine as widely as possible, despite the challenge of Pakistan’s wide gap between the rich and poor districts.

“It’s unlikely that the coverage in those places are as good as the places that have easy access,” said Berkley, “but on the other hand we don’t ignore them either. We try to do everything we can to get vaccines to them.”

GAVI’s financial support in the developing world comes in two parts: the financial backing to provide the vaccines themselves and the training needed to administer them, and the funding to improve the actual health system of the country in order to increase the functioning of the immunisation programmes.

Berkley explained that, in order for this these programmes to sustain themselves, there must be a visible price drop of vaccination costs, and the countries getting support from GAVI must begin to increase their payments as the economy improves.

Pakistan, for example, currently pays 20 cents per dose. Over time, as the economy begins to support itself, it will increase its payment to the full 3.50 dollars per dose, unless the price per dose has dropped by that time, as GAVI hopes and expects. AMC has already established that the price of each dose will not increase from 3.50 dollars.

“Above all, we must not lose sight of the heavy infant and child mortality burden facing Pakistan’s families,” said Dr. Guido Sabatinelli, WHO representative in Pakistan. “The introduction of the pneumococcal vaccine represents an important milestone in the fight to reduce this burden.”

Human rights groups reacted with condemnation following a ruling by Bahrain’s highest court Monday rejecting the last appeals and upholding the convictions of nine medics for their role in the 2011 uprising in the capital  Manama.

“Large numbers of Bahrainis have aired their criticisms of the government through peaceful protests. While some protesters have used violence, the overarching climate has been one of nonviolent criticism of the government of Bahrain,” Sanjeev Bery, Amnesty International USA advocacy director for Middle East/North Africa affairs, told IPS.

“Unfortunately, the government of Bahrain has responded with torture, violence, and arrests. It is time for Bahraini government officials to stop attempting to silence political speech through the repression of the state,” he said. The medics were arrested after tending to wounded pro-democracy protesters.

The upheld sentences, announced in mid-June of this year, range from one month to five years in prison. The verdict includes plotting to overthrow the monarchy and gathering illegally, charges that have been strongly denounced by many human rights groups, which said the rulings “violate basic rights such as free assembly” and dismissed them as politically aimed.

“It’s a black day for Bahrain when it imprisons physicians and other medical professionals whose only ‘crime’ was to carry out their ethical duty to care for sick and wounded people,” Richard Sollom, Physicians for Human Rights’ deputy director, said in a statement Tuesday.

“Sadly, these medics have now joined the ranks of other prisoners of conscience unjustly locked up in Bahrain and elsewhere around the world.”

Many human rights organisations view the verdict as a signal to the populace that dissent will not be tolerated. Two of the convicted are missing and believed to be in hiding.

The June verdict is actually a reduction in severity of the sentences originally imposed by a military court in September 2011, in which 20 doctors and nurses were arrested, imprisoned and sentenced to five to 15 years. The arrests followed a government siege of the Salmaniya Medical Complex in Manama, a hospital that was considered an opposition site in the uprising. The medics were among thousands of arrested protesters and are believed to have been targeted solely for their role as medical professionals.

“The organisation believes the real reason why the medics were arrested and tried is because they publicly denounced the excessive force used against protesters during pro-reform demonstrations last year in interviews with international media,” Amnesty International said.

Many of the medics gave reports of abuse, torture, and forced false confession during their imprisonment. The trial of two Bahraini police officers accused of torturing the medics was postponed Monday, as they both failed to appear in court. The next hearing is set for Oct. 18.

“It is important to keep in mind that so far, the government of Bahrain is not known to have investigated any senior government officials for the potential ordering of the many acts of repression that have occurred in Bahrain,” Bery told IPS.

“While lower level police officers should be investigated in cases of torture or other violence, it is not enough to stop there. Full accountability requires that senior government officials also be investigated on the question of whether or not they ordered political repression against critics,” he added.

The retrial and subsequent dropped charges for nine of the 20 medics was a result of the public uproar generated around the world for what was widely viewed as an unfair and politically motivated trial. U.N. Secretary-General Ban Ki-moon also publically criticised the ruling.

The United States’ ties to the Bahraini government have also been under the spotlight. Although Washington postponed he sale of 53 million dollars worth of weaponry to Bahrain upon news of September’s military court hearing, the same deal has been back under review for some months despite appeals from groups like Physicians for Human Rights and Human Rights Watch to hold off.

Bahrain is a small island between Iran and Saudi Arabia and hosts a United States naval base for the Fifth Fleet. It is considered a critical strategic ally by the Barack Obama administration, particularly for its simultaneous geographical proximity to one of Washington’s greatest enemies and one of its greatest political allies.

The 2011 Bahraini uprising was quashed with help from Saudi Arabia, a Sunni majority kingdom that is sympathetic to the ruling Sunni minority of Bahrain.

Seventy percent of the Kingdom of Bahrain consists of Shi’ite Muslims, who have been marginalised by the minority Sunni regime. The uprising was inspired by Egyptian and Tunisian rebel victories, yet it was the only Arab uprising that was successfully quashed through governmental tactical force.

The degree of that force is considered excessive by many human rights organisations and by U.N. Secretary-General Ban Ki-moon himself.

An investigation by Physicians for Human Rights describes Bahrain’s extreme and unprecedented approach to the use of tear gas as a means of crowd control, which it said caused an increase in miscarriages, respiratory complications, and other illnesses among the Shi’ite population. Thousands have been wounded during the uprising, though the exact number is impossible to determine, as citizens fear to take refuge in hospitals after the raids and arrests of doctors and protesters.

The report by Physicians for Human Rights documented several accounts of injured protesters, including that of an asthmatic man named Mohammed.

“Muhammad’s family reported that he was routinely exposed to tear gas and sought medical care in private hospitals, but never told doctors about his severe adverse reactions to the gas for fear of being reported to authorities and sent to prison,” it said.
Investigations by Amnesty International found no use of violence on the part of the nine convicted medics, all of whom were Shi’ites.

“The fact that all these convictions have been upheld while prisoners of conscience remain behind bars highlights the lack of real commitment from the Bahraini government to fully meet the promises made less than two weeks ago before the Human Rights Council in Geneva,” Ann Harrison, Amnesty International’s Middle East and North Africa deputy programme director, said in a statement Monday.

The root cause of hunger and malnutrition for millions of people worldwide lies in the severely skewed and unfairly structured hierarchy of policymakers, not in natural disasters or food shortages, according to the Right to Food and Nutrition Watch 2012 (RTFN Watch) released Tuesday.

Jorge Medina practices integrated, diversified farming on land near Havana. Credit: Ivet González /IPS

The report entitled “Who Decides About Global Food and Nutrition: Strategies to Regain Control” describes marginalised people, such as peasants and the indigenous, who continue to suffer hunger despite their efforts to farm and cultivate their own food, as “victims of selfish interests”.

The report outlines how ineffective policies surrounding food security and agricultural development breed hunger and malnutrition globally.

Martin Wolpold-Bosien, a founder of the Watch, told IPS, “Food and power are related,” he said. “This is very clear. As long as we do not empower the people, more are affected by hunger and nutrition.”

Wolpold-Bosien is a the coordinator of the Right to Food Accountability at Food First Information and Action Network (FIAN), which annually publishes the globally respected publication, RTFN Watch.

According to the Watch, there is a direct correlation between power and food, in that those with power never hunger, and those without any voice in decision-making have lost individual sovereignty over their own nutrition.

The report defines food sovereignty as “the right of Peoples to define their own policies and strategies for the sustainable production, distribution, and consumption of food, with respect for their own cultures and their own systems of managing natural resources and rural areas, and is considered to be a precondition for Food Security.”

There is an emphasis on the idea that chronic hunger, food riots, and other complications following natural disasters and emergency situations are not direct results of the situations themselves, but rather of the serious gap which exists between decision makers and the effect of those decisions on the livelihoods and daily needs of civilians.

The main reason for this growing gap is that governments and multilateral organisations are relying ever more heavily on public-private partnerships as stakeholders in the path to end hunger, including the Global Alliance for Improved Nutrition (GAIN) and the Scaling Up Nutrition Initiative (SUN).

According to the Watch, public-private partnerships seek a solution through short-term intervention strategies, as opposed to the holistic approach designed to cut the cause of hunger at its roots.

Wolpold-Bosien expressed to IPS his concern in the role of Public-Private Partnerships in the Private Sector. “You cannot expect the private sector to be the best actor for public interest,” he said. “The private sector by definition is constituted to serve the private interest and their business.”

The RTFN Watch argues that, although Public-Private Partnerships are often considered a necessity in the funding of development work, deeper analysis of these partnerships unveils the contradictory agendas involved. The underlying causes of nutritional deficiencies are rarely addressed while very selective programmes are targeted, thereby overlooking locally derived causes and needs.

The RTFMN Watch outlined seven case studies of individual countries, one from each continent, in which the right to food and nutrition are violated due to ineffective legal structures. It also made the direct connection between these violations and the states’ unethical seizures of natural resources and land grabbing, as seen in the case studies of Mexico and the Arab Spring.

“It is impossible to combat the causes of hunger while keeping existing power relations untouched,” stated civil society representatives in an official statement.

The solution to hunger, they argue, is in citizen action, social movement, and the redirection of control from the companies and severely compromised, and often corrupt, chain of power back to the civilians themselves.

The proposed plan of action is to occupy political space, or “Occupy the Food System,” a social movement to include the voice of all people, rich or poor, in the decisions regarding their own food and nutrition.

“Human rights are perhaps the most efficient weapon for the combat against hunger,” Wolpold-Bosien told IPS. If we do not open political space and occupy political space for them and their voices, it’s very difficult to do something against the structural courses of hunger.”

An important step was made toward achieving the goal with the reform of the Committee on World Food Security (CFS) in 2009. According to the U.N. Food and Agriculture Organization (FAO), the CFS aims to be “the most inclusive international and intergovernmental platform for all relevant stakeholders to work together to ensure food security and nutrition for all.”

“So this is the point—we have to use those instruments that help people affected by hunger and malnutrition to raise their voices and to be more powerful.” Wolpold-Bosien told IPs. “And human rights is absolutely a strong tool because it is an obligation of states.”

The report is the fifth annual RTFN Watch. It was published by 15 civil society organisations and their partners with the intention of creating a platform for activists, media, and scholars to promote, advocate, and lobby for the right to food and nutrition.

It is also a tool to pressure national and international policymakers into prioritising the human rights of the civilian, especially because the RTFN Watch is the first and only of its kind.

“This report is human rights based and helps people to visualise their struggle at a global level,” said Wolpold-Bosien.

By Lindsey Walker
NEW YORK, Sep 19 2012 (IPS)

The Global Civil Society Network CIVICUS: World Alliance for Citizen Participation has a new secretary general – Dhananjayan (Danny) Sriskandarajah, who was appointed Monday by the board of directors following the CIVICUS World Assembly in Montreal.

Dhananjayan (Danny) Sriskandarajah

CIVICUS is a global alliance of organisations and individuals that strives to strengthen citizen action and civil society, particularly in regions of the world where freedom of association is limited or threatened.

Danny Sriskandarajah, previously the director general of the Royal Commonwealth Society, is the youngest ever leader of CIVICUS. He replaces Ingrid Srinath as the outgoing secretary general.

Sriskandarajah spoke with IPS correspondent, Lindsey Walker, about his hopes and intentions for his upcoming term as SG.

Q: What do you offer CIVICUS as its new secretary general?

A: I hope I can bring a real sense of commitment to supporting and nurturing citizen action or civil society throughout the world. That is a fundamental purpose of an organisation like CIVICUS.

Q: Amid a long-term financial crisis and government crackdowns on NGOs and countries across the world, how do you see the influence of civil society evolving in the next years?

A: I think we’re at a low point in public confidence in traditional economic and political institutions. With the Arab Spring, with the “Occupy” movement, with a new sense of the need for accountability in global development issues, I can’t think of a more important time for citizen action. Governments and the multilateral system seem to have failed the public and people of the world and I think civil society will be at the heart of that project.

I get the sense that there will also be a realisation amongst some of those countries that see civil society as a threat that, actually, healthy and vibrant civil society is good for the long-term future of their country. There are regimes around the world which have done all sorts of things to curb the freedom of association and the freedom of expression. But I think we’re seeing some countries realise that’s a short-term strategy that will inevitably backfire. What a demonstration of the power of citizen voice than what happened in the Middle East and North Africa over the last 18 months.

So, if I look ahead, I think the role of citizen action and civil society more generally is going to be at the heart of political and economic development over the next few years.

Q: With governments’ failure to tackle global issues such as climate change, do you believe civil society can step in and have a game changing impact?

A: Absolutely. Look, I can’t see how the current system is going to deliver tangible outcomes on climate change, on global economic equality, on accountability in our financial institutions – no, the list is endless. And something has got to give. To me, what we’re feeling in some of these social movements, including online social mobilisation, is a growth of a new era of citizen action. And I think that it’s never been easier to mobilise across the world. And yet, member states and nation states act as if they have some clear control of these defined boundaries around these nation states.

What I think we’re starting to see is the global citizen action can be truly global and incredibly effective at large-scale change in economic and political institutions.

Q: Is there anything specifically that you are going to focus most of your efforts on, or is there a certain issue that you find most important in this upcoming year?

A: In the last few years we’ve seen this growth of online campaigning and amazing things that various organisations have been able to achieve. My focus is going to be about trying to deepen that mobilisation so that, beyond the click of an internet campaign or a petition, there are civil society institutions that can see through those campaigns.

We have global mobilisation on any particular issue, but we also have these robust and strong civil society organisations within countries across regions that are there doing this sort of every day work of promoting democracy and development long after the viral video has faded away.

My focus is going to be that support of civil society champions who are running the everyday fight or the everyday struggle to promote democracy and development.

Excerpt:

Startling new evidence of the torture, unlawful rendition, and other abuse of Libyan anti-Gaddafi rebels in U.S. detention facilities during the George W. Bush administration was revealed Wednesday by Human Rights Watch (HRW).

The groundbreaking report, “Delivered into Enemy Hands: U.S.-Led Abuse and Rendition of Opponents to Gaddafi’s Libya”, was made public one week after Attorney General Eric Holder announced the Justice Department’s decision to cease investigations of Central Intelligence Agency (CIA) officials who may have been responsible for the deaths of two prisoners.

The investigation, which initially began with the examination of 101 prisoner cases, was reduced to that of only two already dead prisoners. Additionally, the investigation only encompassed the abuses which were unauthorised by Bush.

Thus, the investigations did not include alleged waterboarding and other forms of torture which were approved by the president, according to Laura Pitter, counter-terrorism advisor at HRW and author of the report.

Pitter told IPS, “The investigation needs to be reopened, it needs to be broadened, and the U.S. needs to make a full accounting of what went on at these sites.”

Pitter’s report unveiled, for the first time, secret service documents recovered from Tripoli, as well as many personal testimonies of former detainees who were released after the fall of Muammar Gaddafi a year ago. These documents and testimonies shed light on unlawful and unethical practices of detention programmes and CIA investigation tactics that had been kept in the dark for years following the Sep. 11, 2001 attacks.

Fourteen former detainees were interviewed, all of whom reported being transported back to Libya after their capture outside of the country, in what is known as rendition. Most of these detainees who had worked to overthrow Gaddafi were involved in the Libyan Islamist Fighting Group (LIFG).

All persons interviewed report having been returned to Libya by the U.S. or other collaborating countries at a time when it was clear they would be tortured by the Libyan government.

International law strictly forbids this sort of rendition, as well as all acts of torture and ill-treatment. Other countries in collaboration with Gaddafi’s regime and the renditions were the United Kingdom, Afghanistan, Chad, China and Hong Kong, Malaysia, Mali, Mauritania, Morocco, the Netherlands, Pakistan, Sudan, and Thailand.

In addition to these reports of renditions, five detainees described various methods of torture and cruel treatment by the CIA secret prisons in Afghanistan prior to their transport. Two men described experiences of water torture tactics, and one accurately described what is known as waterboarding.

Pitter wrote, “The allegations cast serious doubts on prior assertions from U.S. government officials that only three people were waterboarded in U.S. custody. They also reflect just how little the public still knows about what went on in the U.S. secret detention program.”

Other reports of physical abuse include being forced into cramped spaces and denied the ability to bathe for nearly five months, being denied food and sleep, and being chained to walls naked. One man, Majid Mokhtar Sasy al-Maghrebi, described a time when he was chained and abused.

According to Pitter’s report, al-Maghrebi said, “I was there for 15 days, hanging from my arms, another chain from the ground. They put a diaper on me but it overflowed so there was every type of stool everywhere, the temperature was freezing.”

Pitter’s 154-page report brings to light never before seen evidence of what could be a very serious offence against International Law. The Tripoli Documents highlighted in the report show how the United States may have tried to side-step the law against rendition through extracted promises from Libya that the prisoners would not be ill-treated.

The Third and Fourth Geneva Conventions set down protections against unfair rendition and ill-treatment, and HRW claims that the United States “violated its international legal obligations”.

Pitter told IPS, “Failure to account for past abuses undermines the United States’ credibility when trying to argue for human rights in other places.”

“It’s in National Security’s interest, really, to acknowledge past mistakes so they can make clear this was a mistake and it’s never going to happen again.”