Charlie Weimers with EU flag and the Sweden Democrat’s party symbol, a bluebell.

By Jan Lundius
STOCKHOLM, Sweden, Sep 19 2025 (IPS)

On September 11, Charlie Weimers, a Swedish Member of the European Parliament and active within the European Conservatives and Reformists Group, rose up during a Parliamentary session and asked for a minute of silence to honour the memory of Charlie Kirk, who the day before had been shot and killed during a political meeting at the Utah Valley University in the U.S.

“Madam President, dear colleagues, the murder of political activist Charlie Kirk, a husband, loving father and patriot has shocked the world. We must strongly condemn political violence and rhetoric that incites violence. Will you stand with me in reflection and prayer in his honour, and I yield the rest of my time for a moment of silence.”

Charlie Weimers began his political career as a member of the Swedish Chrisitan Democrat Party, but later switched to the Sweden Democrats, a nationalist, right-wing populist party, which in spite of efforts to tune it down finds its roots in Neo-Nazi fringe organizations. It is now Sweden’s second largest political party with more than 20 percent of the electorate behind it.

There is nothing wrong in condemning murder political violence and defend freedom of speech, but this cannot hinder us from scrutinizing who is canonized as a victim of radical aggression. Charlie Kirk was 33 years old when he was murdered, leaving a wife and two small children behind. He had admitted that when he in 2012 started Turning Point USA, which eventually would become a rich and powerful organization, he had “no money, no connections and no idea of what I was doing.” At that time, Kirk had dropped out of college and been rejected by The U.S. West Point Military Academy. Nevertheless, he had rhetorical gifts for countering progressive ideas, being sensitive about cultural tensions, and endowed with an aptitude for making provocative declarations that resonated with frustrated college audiences, who followed and agreed with his web postings. Kirk’s frequent college rallies eventually attracted tens of thousands of young voters, as well as the attention and financial support of conservative leaders. President Trump was not wrong when he declared that:

The Great, and even Legendary, Charlie Kirk, is dead. No one understood or had the Heart of the Youth in the United States of America better than Charlie.

After his death Kirk has been praised for showing up at campuses where he talked with anyone who would approach him. Conservative journalists have declared him to be one of the era’s most effective practitioners of persuasion. Kirk’s message was readily embraced by youngsters who accepted his view that Democrats had spent hundreds of billions of dollars on illegal immigrants and foreign nations, while the young “lost generation” of the U.S. had to pinch their pennies, but would not be able to own a home, never marry, and even be forced to work until they died, abused and childless. However, he also gave them hope, telling these unfortunate youngsters that they did not have to stay poor and accept being worse off than their parents. They just had to avoid supporting corrupt political leaders, who were lying to them only to take advantage of their votes. Kirk assured his young audience that it is an undeniable fact that cultural identity is disappearing, while sexual anarchy, crime and decadence reign unabated, private property is a thing of the past, and a ruling “liberal” class controls everything. The White House press secretary, Karoline Leavitt, was probably right when she said that Kirk had inspired millions of young people “to get involved in politics and fight for our nation’s conservative values.”

Kirk allied his Turning Point USA not to any poor radical fringe groups, but to conservative, wealthy donors and influencers. He preached a “Christian Message” well adapted to several members of such groups, declaring that Turning Point USA was dedicated to “recruiting pastors and other church leaders to be active in local and national political issues.”

Kirk fervently defended the 2nd Amendment of the U.S. Constitution, i.e. “The right of the people to keep and bear Arms, shall not be infringed “, declaring that it was worth “a cost of, unfortunately, some gun deaths every single year so that we can keep a Second Amendment which protect our other God-given rights”.

However, Kirk was not happy about the Civil Rights Act of 1964, which outlawed “discrimination based on race, colour, religion, sex, or national origin in employment, education, and public accommodations.” He stated that the Civil Rights Act was a “huge mistake” and declared that if the majority of Americans were asked if they respected the Civil Rights Act the answer would have been a “no”. Adding the caveat that “I could be wrong, but I think I’m right.”

Undoubtedly, there was a racist ingredient in Kirk’s ideology. He did for example state that the concept of white privilege was a myth and a “racist lie”. In October 2021, he launched an Exposing Critical Racism Tour to numerous campuses and other institutions, to “combat racist theories”, by which he meant the propagation of an understanding of the relationships between social conceptions of race and ethnicity, social and political laws and mass media, all of which Kirk considered to be propaganda and an unfounded brainchild of liberal Democrats. He blamed the DEI (Diversity, Equity, and Inclusion) programmes for threatening U.S. competitiveness and security, even claiming that upon sitting in a plane and realising that the pilot was “Black”, he could not help thinking “’Hey, I hope he’s qualified”.

Like most populist, “patriotic”, European right-wing political parties, not the least the Sweden Democrats, though they nowadays try to hide it more carefully than before, Kirk endorsed the so-called “great replacement theory”. This way of thinking assumes that powerful, nefarious actors, for some obscure reason, are trying to replace an upright indigenous, generally white-skinned population with immigrants of “doubtful” origin. Kirk did not even hesitate to state that Democrats supposedly wanted to make the U.S. “less white”.

Kirk also argued that humans have no significant effect on global climate change and joined antivax activists by, among other statements, calling the mandatory requirements for students to get the COVID-19 vaccine “medical apartheid”. Kirk was outspoken when it came to claim that Trump’s loss in the president elections of 2022 was due to fraud, supported the “stop the steal” movement and denied that the violent attacks on the Capitol were an insurrection.

Opposing political violence and supporting free speech does not mean that you have to sanctify a victim like Charlie Kirik, who after all was a racist and an incendiary agitator against underprivileged groups, as well as he degraded scientists who warned against climate change and vaccine denial. It is not defensible that such a voice, no matter how despicable it might be, is silenced by violence and murder. However, we cannot refrain from pointing out the great harm the kind of agitation Kirk devoted himself to can cause. As an educator, I have often been forced to experience how children suffer from racism and bigotry preached and condoned by influencers like Charlie Kirk. Accordingly, to sanctify such persons and tolerate their prejudiced ideology is hurtful and dangerous.

Furthermore, let us not be fooled by deceitful propaganda trying to convince us that Charlie Kirk’s so called “debates” were neither aggressive, nor mendacious. They were brutally provocative; opponents were shouted down, or belittled. The rhetoric was hateful, contempt was poured out over women, Black people, immigrants and Muslims, queer and trans people. Liberals were branded as enemies, science demeaned. And, yes – Charlie Kirk turned to young people, who felt frustrated, marginalized and despised, telling them that he wanted to give them hope and a will to fight injustice. But at what price? Based on what truth? Incitement to violence and contempt for humanity might be safeguarded in the name of free speech, but it should never be accepted and defended. It must be attacked through an unconstrained press based on facts, a well-founded science, and an unfaltering respect for human rights.

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The origin of COVID-19 remains a mystery, hampered by secrecy, stalled research and global inaction.

By Shreya Komar
UNITED NATIONS, Aug 14 2025 (IPS)

More than four years since Covid-19 upended the world, the question of how it began remains unanswered. Did SARS-CoV-2 originate from animals to humans naturally, or did it accidentally escape from a laboratory? The World Health Organization’s latest report offers little new clarity and raises serious concerns about international cooperation and scientific transparency. On June 27, 2025, the WHO Scientific Advisory Group for the Origins of Novel Pathogens (SAGO) released its second report examining how the virus emerged. Despite years of work and renewed international focus, the findings have been widely criticized for failing to break new ground. Much of the blame lies in what wasn’t included. Critical data requested from China was never provided, leaving glaring holes in the investigation.

“The report adds almost nothing to what a few talented independent investigators found several years ago,” said Viscount Ridley, co-author of Viral: The Search for the Origin of Covid-19.

“That it has taken five years and 23 people to produce this ‘all but useless’ addition to the literature on the origin of Covid-19 is frankly a disgrace.”

The search for COVID-19’s origin is not simply an academic exercise. Understanding how this virus entered the human population is crucial for preventing the next pandemic. Scientists agree that future coronavirus outbreaks are not only possible but also likely. Knowing whether SARS-CoV-2 came from a wildlife market or a laboratory accident informs how humanity prepares for the next spillover.

While the SAGO report acknowledges both the zoonotic spillover and lab-leak theories as plausible, it stresses the need for further evidence. That evidence remains frustratingly out of reach.

“If China had been transparent all along, we would have been able to pinpoint what happened,” said Dr. Deborah Birx, who served as the White House Coronavirus Response Coordinator from 2020 to 2021.

Most virologists continue to believe that the virus has a natural origin, a view reinforced in a new documentary titled “Unmasking COVID-19’s True Origins” released by Real Stories on July 15. “The vast majority of virologists understand the virus had a natural origin,” one expert says in the film. Still, without access to early samples and full records, both theories remain scientifically viable, and political tensions continue to cloud the inquiry.

This latest WHO report comes just weeks after a major development in global health policy. On May 20, 2025, the World Health Assembly adopted the long-anticipated WHO Pandemic Agreement, a legally binding treaty intended to strengthen preparedness for future outbreaks. The agreement aims to fix the deep weaknesses revealed by the COVID-19 pandemic: sluggish coordination, delayed data sharing, and unequal access to vaccines and treatments.

The treaty commits countries to share information on emerging pathogens faster, to improve cooperation on disease surveillance, and to distribute medical tools like vaccines more equitably. It also respects national sovereignty, meaning that countries will not be forced to relinquish control of their public health decisions. Still, some provisions, particularly those concerning the sharing of pathogen samples and related benefits, remain under negotiation and are expected to be finalized in 2026.

The WHO’s first SAGO report, released on June 9, 2022, also found that both leading origin theories were possible and called for further data from Chinese authorities. The absence of transparency since then has only hardened frustration among scientists. The call for cooperation is not just about this virus but about preparing for what comes next.

Meanwhile, research vital to fighting COVID-19 and future respiratory diseases has quietly stalled. In 2024, Ohio State University was awarded USD 15 million to study new treatments for SARS-CoV-2 and long COVID. One promising clinical trial focused on a drug to treat hypoxemic respiratory failure, a leading cause of death among hospitalized patients. But halfway through, the National Institutes of Health abruptly terminated the funding.

The cancellation saved USD 500,000 but came after USD 1.5 million had already been spent. As a result, researchers were forced to abandon the trial entirely, delaying possible treatments that could have helped the nearly one million people hospitalized annually for respiratory failure caused by COVID, flu, and other infections. “This is a disaster for all of us,” said a veteran scientist at Ohio State.

“We’re all depressed and living on a knife-edge, because we know we could lose the rest of our grants any day. These people really hate us, yet all we’ve done is work hard to make people’s health better. A flu pandemic is coming for us; what’s happening in cattle is truly scary and all we have is oxygen and hope for people.”

Scientific leaders argue that the world must do the opposite of what is currently happening: invest more, not less, in pandemic-related science. Research that has languished or been underfunded must be revived and expanded. More international partnerships are needed, especially with researchers in hotspot regions such as China, to ensure the global community is better equipped to face the next threat.

As the WHO itself notes, “The work to understand the origins of SARS-CoV-2 remains unfinished.”

But without transparency, funding, and political will, it may remain that way for years to come. And if that happens, the world could be left just as vulnerable when the next pandemic emerges.
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Credit: WHO/Christopher Black

By Samuel King
BRUSSELS, Belgium, Jun 11 2025 (IPS)

When the next pandemic strikes, the world should be better prepared. At least, that’s the promise states made at the World Health Organization’s (WHO) World Health Assembly on 19 May when they adopted the first global pandemic treaty. This milestone in international health cooperation emerged from three years of difficult negotiations, informed by the harsh lessons learned from COVID-19’s devastating global impacts.

Yet this step forward in multilateralism comes at a deeply difficult moment. The WHO, as the organisation tasked with implementing the agreement, faces its starkest ever financial crisis following the withdrawal of the USA, its biggest donor. Meanwhile, disagreements between states threaten to undermine the treaty’s aspirations. Some of the big decisions that would make the experience of the next pandemic a more equitable one for the world’s majority are still to be negotiated.

A treaty born from COVID-19’s failures

Processes to negotiate the Pandemic Agreement came as a response to the disjointed international reaction to the COVID-19 pandemic. When the virus spread across borders, global north countries hoarded vaccines for their populations but left much of the world unprotected – an approach that as well as being manifestly unfair enabled the virus to further mutate. The treaty’s text emphasises the need for proper pandemic prevention, preparedness and response in all states, with the potential to enhance multilateral cooperation during health crises.

With 124 countries voting in favour, 11 abstaining and none voting against, many diplomats presented the agreement’s finalisation as a victory for global cooperation. It comes at a time when multilateralism is being severely tested, with powerful governments tearing up international rules, pulling out of international bodies and slashing funding. The window of opportunity to reach some kind of agreement was rapidly closing.

A major absence loomed large over the final negotiations. Upon his inauguration in January, President Trump announced the USA would withdraw from the WHO and halt all funding. The withdrawal of a superpower like the USA harms the WHO’s legitimacy and sends a signal to other populist governments that withdrawal is an option. Argentina is following its lead and Hungary may too.

Funding crisis

US withdrawal will leave an enormous funding gap. In the pre-Trump era, the USA was the WHO’s biggest contributor: it provided US$1.28 billion in 2022-2023, amounting to 12 per cent of the WHO’s approved budget and roughly 15 per cent of its actual budget.

As the treaty was agreed, WHO Director-General Tedros Adhanom Ghebreyesus painted a disturbing picture of the organisation’s financial situation. Its 2022-2023 budget showed a US$2 billion shortfall and its current salary gap is over US$500 million. The proposed budget for 2026-2027 has already been slashed by 21 per cent, and this reduced budget is expected to receive only around 60 per cent of the funding needed. The WHO will likely have to cut staff and close offices in many countries.

This reflects a lack of political will: states are making the choice of cutting down on global cooperation while boosting their defence spending. The current WHO funding gap of US$2.1 billion is the equivalent of just eight hours of global military expenditure.

Big issues kicked down the road

Deteriorating political realities made it crucial to reach an agreement as soon as possible, even if this meant kicking some difficult decisions down the road. As a result, the text of the agreement has severe weaknesses.

The treaty lacks dedicated funding and robust enforcement mechanisms, which means the blatant inequalities that defined the global response to COVID-19 are likely to remain unconfronted. It doesn’t tackle the most critical and contested issues, including the international sharing of pathogens and vaccine access.

The treaty will open for ratification following the negotiation of an annex on a pathogen access and benefit-sharing system, a process that could take a further two years. This means implementation is likely still a long way away.

The current impasse reflects an enduring faultline between global south states that need better access to affordable health products and technologies, and global north states siding with powerful pharmaceutical corporations that want their assets protected. Wealthy governments are making their decisions safe in the knowledge they’ll be at the front of the line when the next pandemic starts, while the world’s poorest people will again face the brunt of the devastation.

Political will needed

The Pandemic Agreement is a step forward at a time when international cooperation faces increasing attacks. That 124 countries demonstrated their commitment to multilateral action on global health threats offers hope. But substantial work remains if the treaty is to enable a truly global and fair response to the next health crisis.

For that to happen, the world’s wealthiest states need to put narrow self-interest calculations aside. States also need to address the issue of long-term funding. Right now, global leaders have agreed on the need for coordinated pandemic preparedness, but the institution meant to lead this doesn’t have the resources needed to put goals into action.

The next pandemic will test not just scientific capabilities, but also collective commitment to the shared global values the treaty is supposed to represent. Political will and funding are needed to turn lofty aspirations into meaningful action.

Samuel King is a researcher with the Horizon Europe-funded research project ENSURED: Shaping Cooperation for a World in Transition at CIVICUS: World Alliance for Citizen Participation.

For interviews or more information, please contact research@civicus.org

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On his first day in office, President Donald Trump signed an executive order withdrawing the U.S. from the World Health Organization (WHO) – a move experts say makes the U.S. and other countries less safe from infectious diseases and other public-health threats. It might thus be opportune to return to the global COVID 19 pandemic. Has the threat really gone away? Can something similar not erupt again?

Around the world, numerous scientific institutions store and experiment with deadly microbes and viruses. This is done for the benefit of humanity, but it might also have more macabre aspects. It has happened that deadly material leaked from laboratories; perhaps not too often, but the risk is always there. On 2 April, 1979, the city of Sverdlovsk (now Yekaterinburg), at the time with a population of over a million, was struck by an accidental release of anthrax bacteria, which officially killed at least 68 people (as in similar cases, this figure is likely to be a low estimate). Nevertheless, Soviet/Russian research on the development of chemical and biological weapons continued and, evidently, still does. The use of the radioactive nerve agent Novichok has drawn significant attention. Developed between 1971 and 1993, Novichok has reportedly been used on several occasions to poison and kill Russian dissidents.

A great amount of material from the infamous Japanese Unit 731 was after World War II brought to both the Soviet Union and the U.S. In the USSR it became the basis for the development of the Sverdlovsk facilities and in the U.S. it were brought to the Army Biological Warfare Laboratories at Fort Detrick in Frederick, Maryland, where it, just as in the USSR, were further developed. Strangely enough, the facilities at Fort Detrick were shut down in August 2019, only three months before the first cases of SARS-CoV-2 were reported from China. The reason for the closure was cited as “a risk of severe threats to public, animal, or plant health, as well as animal or plant products.” No further details were provided.

Unit 731 was a secret biological and chemical warfare research and development unit of the Imperial Japanese Army, where horrific human experimentation occurred – no one survived these experiments, which nevertheless was meticulously recorded by the researchers who performed them, leaving behind a vast documentation. Between 1936 and 1945, approximately 14,000 victims were murdered in Unit 731, established in occupied Manchuria, while at least 300,000 individuals died due to infectious illnesses originating from Unit 731 and spread across China.

So, what is currently happening within intensely guarded and well protected microbiological facilities around the world? First and foremost, vaccines and drugs are being developed to eradicate and cure a variety of often life-threatening diseases. However, like all research, this can also have its downsides. Ron Fouchier is known for his research on respiratory viruses; how they can mutate, and through zoonosis spread from animals to humans. His research is also evidence of how viruses and microbes can be manipulated and altered within a laboratory environment. In 2003, at the annual meeting of the European Scientific Working Group on Influenza, assembled microbiologists listened as Fouchier described how he had transferred avian (bird) influenza from one animal to another, thus making the virus significantly more contagious.

He mutated the genetic sequence of the avian virus in many different ways, until, as he later put it, “someone convinced me to do something really, really stupid.” He spread the virus by allowing it to mutate in the nose of a ferret and then implanted the animal’s nasal fluid into the nose of another ferret. After ten such manipulations, from one ferret to another, the virus spread by itself among the animals and within a few days killed most of them. Fouchier found five new mutations of the virus and then managed to combine them into a single super-virus, turning out to be far more deadly than the original avian virus. He had thus achieved something that could probably happen in nature, where a virus mutates when transferred from one animal to another and thus become increasingly deadly. What happens in nature can be done much faster and more efficiently in a laboratory. Fouchier’s virus is now securely stored in an underground facility in Rotterdam.

China is the country that so far suffered the most from biological warfare. When Unit 731 had been destroyed and some of its researchers captured by Russians and Americans, the Chinese might not have had much interest, or time, to focus on the scientific results of the Japanese Biological – and Chemical warfare programmes. The country was torn apart by violent fighting between Chiang Kai-shek’s republican forces and Mao Zedong’s communists. However, there were branches of Unit 731 in Chinese-controlled areas. Unit 731’s largest auxiliary facilities had been established in Beijing, Nanjing, and Guangzhou, and it is likely that Chinese forces succeeded in securing some of the material from these installations

After the war and the Communists’ victory, the Chinese Academy of Sciences’ facilities in Beijing became the centre for the country’s microbiological research and branches were soon established throughout China. Wuhan’s microbiological laboratory was founded in 1956 and initially focused on research concerning zoonotic transmission of viral diseases.

The so-called Hong Kong flu struck China in the summer of 1968 and spread to Hong Kong, where half a million people fell ill, and after the disease had spread worldwide more than a million people died. This served as a warning for the Chinese authorities, who, despite the general chaos reigning in the country, discreetly began cooperating with international epidemiologists. This cooperation deepened over the years. Wuhan’s laboratory developed an intimate collaboration and exchange with researchers from Galveston National Laboratory at the University of Texas, Canada’s National Microbiology Laboratory, and Centre international de recherche en infectiologie in Lyon, France.

The SARS virus, a group to which the deadly coronavirus belongs, first appeared in November 2002, causing a relatively mild epidemic, with about 8,500 cases, of which 800 died. It was a group of researchers from Wuhan’s Institute of Virology who found that China’s horseshoe bats were natural reservoirs for the SARS-like coronavirus. Wuhan’s researchers collected samples from thousands of horseshoe bats across China and isolated over 300 bat coronavirus sequences. In 2015, an international team, including two researchers from the Wuhan Institute, published their research results concerning the probability that a bat’s coronavirus could infect a human cell line. They had constructed a hybrid virus by combining a bat coronavirus with a SARS virus, which was then adapted to grow in mice and subsequently replicate human diseases. It was found that this hybrid virus could infect human cells.

We are still stuck with the question – where did SARS-CoV-2 originate? Can it be traced all the way back to Unit 731? Probably not. Did it come from a bat? It is very possible. Did it leak from Wuhan’s Institute of Virology? This continues to be an open question. The prestigious British scientific weekly journal Nature, stated in 4 December 2024 that most researchers now agree that SARS-CoV-2 finds its origins in animals. However, since the virus’ definitive origin has not yet been traced to any animal, some researchers continue to claim that the virus may have been developed in and then leaked – either by accident or intentionally – from Wuhan’s Institute of Virology.

In August of the same year, an editorial in the equally prestigious British medical journal The Lancet did in its monthly issue Lancet Microbe call for an end to all unscientific conspiracy theories about the virus leaking from Wuhan’s research laboratory, stating that “SARS-CoV-2 is a natural virus that found its way into humans through mundane contact with infected wildlife that went on to cause the most consequential pandemic for over a century. While it is scholarly to entertain alternative hypotheses, particularly when evidence is scarce, alternative hypotheses have been implausible for a long time and have only become more-so with increasing scrutiny. Those who eagerly peddle suggestions of laboratory involvement have consistently failed to present credible arguments to support their positions.”

The Lancet’s editorial writer continued to state that zealous attacks from amateurs might intimidate and even scare scientists, who are trying to objectively pursue their research.

“A worrying potential consequence of this saga is that it might have a chilling effect on the pursuit of answers in the future on both COVID-19 and new potential threats. With researchers unwilling to ask questions freely for fear of being persecuted when facts lead to inevitable refinement or revision of earlier conclusions.”

Accordingly, we have to let science continue to work undisturbed, though under supervision. However, this does not mean that we have to yield to unfounded conspiracy theories and leave global scientific cooperation. By leaving WHO, the U.S. is taking a first step on a dangerous road. This becomes even more worrisome while considering President Trump’s decision to nominate Robert F Kennedy Jr, a man without medical expertise and prone to believe in conspiracy theories, to become U.S. health secretary, overseeing everything from medical research to food safety and public welfare programmes. One of the mandates Trump will provide Kennedy with is to remove “corruption” from health agencies, whatever he might mean by that?

Main sources: Harris, Sheldon H. (2002) Factories of Death: Japanese Biological Warfare 1932-1945, and The American Cover-up. New York: Routledge, and Specter, Michael (2012) “The deadliest Virus”, The New Yorker, March 4.

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Lillian Mworeko of ICWL with UNAIDS Executive Director, Winnie Byanyima, at the launch of the Choice Manifesto. Credit: Wambi Michael/IPS

By Wambi Michael
MBALE, WAKISO, KAMPALA, Uganda, Nov 26 2024 (IPS)

In Uganda, women and girls are more affected by HIV. Out of 1.4 million people living with the disease, 860 000 are women and girls.

According to UNAIDS, every week, 4,000 adolescent girls and young women aged 15–24 years became infected with HIV globally in 2023, with 3,100 of these infections occurring in sub-Saharan Africa.

In 2023, in sub-Saharan Africa, women and girls accounted for 62 percent of all new HIV infections.

As part of the efforts to prevent new infections and death among the adolescents and women, Uganda adopted oral PrEP in 2017, or pre-exposure prophylaxis. PrEP, or pre-exposure prophylaxis, is medicine people at risk for HIV take to prevent getting HIV from sex or injection drug use.

In January 2021, the World Health Organization (WHO) recommended that the dapivirine vaginal ring (DPV-VR) may be offered as an additional prevention choice for women at substantial risk of HIV infection as part of combination prevention approaches.

Dr. Daniel Byamukama, the head of HIV prevention at the Uganda Aids Commission, revealed that HIV prevalence remains high among key populations. Credit: Wambi Michael/IPS

Because Uganda largely depends on donor support for HIV/AIDS treatment and prevention, PrEP tools like the dapivirine vaginal ring (DPV-VR) and a twice-yearly injection known as lenacapavira are rolled out in a phased-funded approach, and therefore more women and adolescent girls continue to be infected despite the efficacy of these medications and tools.

A bio-behavioral survey conducted in 12 of Uganda’s regional towns found that 54 percent (over half of the sex workers aged 35-49 years) were living with HIV. The results of the survey released in October indicated that one in three commercial sex workers missed taking their ARVS at least once.

Dr. Geoffrey Musinguzi, the principal investigator, said each female sex worker had had a sexual encounter with at least four men. He suggested HIV pre-exposure prophylaxis (PrEP) could stop the majority of HIV transmissions that still happen in Uganda and most of the sub-Saharan countries.

Lynette Nangoma (not her real name) is one of the lucky female Ugandan women who have had the chance to have access to oral pre-exposure prophylaxis as well as the vaginal dapivirine vaginal ring. She told IPS that there are times when she forgets to take her PrEP pills. Nyangoma usually engages in multiple sexual relationships. ”Thank God I’m still alive and HIV-free. I think those tablets helped a lot. As you may know, this job of ours can be risky,” she narrates.

Dr. Diana Atwine, the Permanent Secretary at Uganda’s Health Ministry, said the dapivirine vaginal ring is only available in seven districts funded by USAID under PEPFAR.

Dr. Daniel Byamukama, the head of HIV prevention at the Uganda Aids Commission, revealed that HIV prevalence remains high among key populations, at 33 percent among sex workers, 15 percent among prisoners, and 17 percent among people who inject and use drugs.

Nangoma told IPS that she has been using the dapivirine vaginal ring for the last four months.

“I feared it at first when a health worker was brought in to teach us about it. It looked too big. But I decided to try it. I can tell that for me, I find very convenient.”

The dapivirine vaginal ring is a female-initiated option to reduce the risk of HIV infection. It must be worn inside the vagina for 28 days, after which it should be replaced by a new ring. The ring works by releasing the antiretroviral drug dapivirine from the ring into the vagina slowly over 28 days.

Nangoma told IPS that some of her colleagues have been hesitant to use it, fearing discomfort.

Dr. Carolyne A. Akello, who has spent over 10 years in HIV/AIDS research with a focus on HIV prevention among women of reproductive age, including adolescent girls and young women, told IPS: “Yes, it looks big, but actually the vagina is a very accommodating organ. The ring is inserted into the vagina, and it is held up by the muscles. The ring was well researched. It is one size fits all. So whether small, big, or short, it fits every woman. It usually goes to the back of the vagina. There is where it sits for all the 28 days.”

“For a woman to use it consistently, we ask her to leave it there even during sex and menstrual periods. And many women, once they fix it, actually say, ‘Wow. The ring seems to have disappeared; I don’t feel it any more.’ And also, many men don’t feel it during sex. Seven out of ten men did not know that their partner was using the ring,” said Akello.

Unlike daily oral PrEP, dapivirine vaginal ring does not rely on remembering to take a pill each day and is also discreet as it stays inside the vagina throughout the month.

HIV/AIDS activist and access to medicine campaigner who leads the International Community of Women Living with HIV in Eastern Africa (ICWEA), Lillian Mworeko, told IPS that one of the advantages of the dapivirine vaginal ring is that it is discreet.

“It gives power to the woman in terms of control. They are able to fix it themselves. They are in charge. You are giving power to the woman to take care of their prevention. We strongly advocate for it,” Mworeko said. “So that women, especially adolescent girls and young women who are not able to negotiate for safer sex, have a tool that is in their control without seeking permission.”

Uganda was among the first countries in sub-Saharan Africa to approve dapivirine ring. Others included Namibia, South Africa, Kenya, Zimbabwe, Zambia, Malawi, Rwanda, Eswatini, Lesotho, and Botswana. The ring was designed for women to use in countries that still carry a high level of stigma around HIV. In 2023, South Africa announced a national rollout of the ring. Eswatini, Zambia, Rwanda, and Kenya have embarked on similar efforts.

Dr. Diana Atwine, the Permanent Secretary at Uganda’s Ministry of Health, said the dapivirine vaginal ring is only available in seven districts funded by USAID under PEPFAR. Less than three hundred women had accessed the vaginal ring through that initiative by the end of August 2024.

While Atwine says lenacapavir will be a game-changer in terms of reducing the burden of daily pills and minimizing stigma and stigmatization, her ministry’s budget cannot afford the high cost of such tools.

As Uganda joins the rest of the world to mark World AIDS Day, Mworeko used the occasion to express her frustration that so many women in Africa cannot access these tools because their governments say they cannot afford them. Gilead Sciences, the company behind lenacapavir, reportedly charges the one-month ring, which currently costs USD 12.8 per month.

“When we talk about life and the lives of people, we need to put it into the context that nothing can compare with a person who is going to live with HIV for the rest of their life. We cannot compare the price of prevention with treating a person for life,” argues Mworeko.

She suggests that other than waiting for donations that delay or never arrive, the leaders of Africa must set part of their national budgets to ensure that women and girls have access to the new prevention tools and methods.

“What is the cost of preventing a young girl from getting HIV, and they are going to live the rest of their life free of HIV? They are going to deliver babies free of HIV, and they are going to contribute to the economy of their country. Compared to not acting now in the name of the cost, we are going to have this young person infected with HIV, and we must treat them,” Mworeko asked.

When asked about the facts that Uganda and other countries in Africa lacked money to make their own purchases of the prevention measures, Mworeko said, “What are our priorities? Who prioritizes what? We must prioritize where our hearts are. We cannot continue talking about new HIV infections when tools are here.”

Part of Mworeko’s frustration was partly directed towards researchers and the manufacturers of these medicines and preventive measures.

“I think the most disturbing situation is that most of the research is done here in our country. We are slow at rolling them out. Yet other countries pick up and fund these interventions. So we contribute to research, but we don’t benefit as a country. Because there is no one who would want to see their children infected with HIV,” says Mworeko, one of the activists behind the HIV Prevention Choice Manifesto for Women and Girls in Africa.

Uganda was among the countries where clinical trials for Gilead’s PURPOSE 1 were conducted. The results showed the high prevention effectiveness of the six-monthly long-acting injectable drug lenacapavir for cisgender adolescent girls and women, cisgender men, and transgender women.

The Global HIV Prevention Coalition (GPC), UNAIDS, and other partners called on Gilead Sciences to accelerate their efforts in ensuring that it is made available, accessible, and cost-effective, especially to low- and middle-income countries. It said the company’s approach must reflect the urgency of their needs.

“We urge Gilead to act swiftly in ensuring equitable, sustainable, broad access, particularly in markets with the highest need,” said GPC.

Gilead promised in early October that it will prioritize providing lenacapavir to Rwanda, South Africa, Tanzania, Thailand, Uganda, Vietnam, Zambia, and Zimbabwe until generic versions are available.

Dr. Flavia Matovu Kiweewa, one of the researchers on Gilead Sciences’ PURPOSE program in trials in Uganda, said: “I know Gilead Sciences has committed to providing licenses to generic manufacturers to make this product. But countries need to advocate so that we can be the first beneficiaries of lencapvir because we have significantly contributed to the study. But not only that, we are seeing lots of infections in young women.”

Dr. Herbert Kadama, the PrEP coordinator at the Ministry of Health, said Uganda plans to adopt lenacapvir and dapivirine vaginal ring are part of the efforts to address the challenges women also face with HIV/AIDS. He noted that 63 percent of new infections in Uganda, like the rest of Africa, are in women and girls.

According to Dr. Flavia Matovu Kiweewa, lencapvir prevents HIV acquisition by HIV-negative women by 100% compared to other preventive measures, but it is not a vaccine.

”We are glad that for the first time ever in history, we have an intervention that can give 100% protection against acquiring HIV. For us who have been in the PrEP field for quite some time, we faced lots of disappointments, especially for women trials. Because women are not able to adhere to daily interventions and they are influenced by their partners and friends,” said Matovu Kiweewa.

“Lenacapvir is going to be a game changer in the HIV prevention landscape. We are very excited that if we can access lanacapvir in Uganda and other high-burden settings in Africa, we will reduce the incidence of HIV significantly,” she added.

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For some time, most multilateral financial institutions have urged developing countries to borrow commercially, but not from China. Now, borrowers are stuck in debt traps with little prospect of escape.

Jomo Kwame Sundaram

The 2008 global financial crisis and Great Recession have recently been worsened by the Covid-19 pandemic, US Federal Reserve Bank-led interest rate hikes and escalating geopolitical economic warfare.

Following Reagan-inspired tax cuts, ostensibly to induce more private investments, budget deficits have loomed larger. Instead of enabling rapid recovery, greater fiscal austerity is now demanded, as in the 1980s.

After fiscal expansion averted the worst in 2009, unconventional monetary policies, mainly ‘quantitative easing’ (QE), took over. The European Central Bank (ECB) followed the US Fed’s QE lead for over a decade.

QE’s lower interest rates encouraged more borrowing as more credit became available and affordable. With rich nations offering less concessional finance, developing countries had little choice but to turn to markets for loans.

Spending counter-cyclically in a downturn requires government borrowing, which QE made more accessible and cheaper. The resulting borrowing surge has since returned to haunt these economies since 2022-23, when interest rates spiked.

Pushing debt
World Bank slogans, such as ‘from billions to trillions’, urged developing country governments to borrow more on market terms to meet their funding needs for the SDGs, climate and the pandemic.

With capital accounts open, many private investors have long sought ‘safety’ abroad. But when lucrative direct investment opportunities beckoned, e.g., in India, some ‘capital flight’ returned as foreign investments, typically privileged and protected by host governments and international treaties.

Easier credit availability on almost concessional terms, thanks to QE, enabled more, often innovative, financialization. Blended finance and other such innovations promised to ‘de-risk’ private investments, especially from abroad.

Despite less bank borrowing than in the 1970s, indebtedness increased with more market-based debt. However, such indebtedness did not grow the real economy much despite much private technological innovation.

Borrowing sours
The US Fed started raising interest rates from early 2022, blaming inflation on the tight labour market. As interest rates rose sharply, debt became more burdensome.

Thus, government borrowing worldwide became more constrained when more needed. Raising interest rates has dampened demand, including private and government spending for investment and consumption.

But recent economic contractions have been mainly due to supply-side disruptions. The second Cold War, the COVID-19 pandemic, and geo-political economic aggression have disrupted supply lines and logistics.

Raising interest rates dampens demand but does not address supply-side disruptions. Inappropriate policies have not helped, as such anti-inflationary measures have cut jobs, incomes, spending and demand worldwide.

Worse for some
Following the 2008 global financial crisis, successive US presidents have successfully maintained full employment. All central banks are committed to ensuring financial stability, but the US Fed also has an almost unique second mandate to maintain full employment.

Developing countries now face many more constraints on what they can do. Most are heavily indebted with little policy space for manoeuvre. With more financing from markets, the pro-cyclical bias is more pronounced.

Vulnerable developing countries believe they have little choice but to surrender to the market. Poverty in the poorest countries has not declined for almost a decade, while food security has not improved for even longer.

Worse, geopolitics has put much pressure on the Global South to spend more on the military. But most recent food price increases were due to speculation and ‘artificial’ rather than real shortages.

Poor worst off
The likelihood of distress increases with debt burdens. Debt stress has grown tremendously in the last two years, especially for developing countries heavily borrowing in major Western currencies.

Although the apparent reasons for central banks raising interest rates are rarely cited anymore, interest rates have not fallen, and funds have not flowed back to developing countries.

For at least a decade, the US has increasingly warned developing countries against borrowing from China despite its low interest rates compared to most other credit sources except Japan.

Consequently, China’s lending to developing countries, particularly in Sub-Saharan Africa, has fallen since 2016. By 2022, poorer countries had borrowed much more from commercial sources. But such private capital has since fled to the US and other Western markets offering high returns with more security.

Capital flight from developing countries, especially the poorest, followed as much less money went to the poorest developing countries via markets. With fewer funding options, the poorest countries have been the most vulnerable.

Negotiating with varied private creditors in markets, rather than via intergovernmental arrangements, has proved much more difficult. With much more private market funding, such financiers will not take instructions from governments unless compelled to do so.

Hence, little on the horizon offers any real hope of significant debt relief, let alone strong recovery and improved prospects for sustainable development in the Global South.

IPS UN Bureau

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By Jewel Fraser
PORT-of-SPAIN, Trinidad , Jul 3 2024 (IPS)

Global South countries did get one benefit from the COVID-19 pandemic. A professor at St. George’s University in Grenada describes it as the pandemic’s “silver lining.” He was referring to the widespread use of next-generation genomic sequencing technology to identify, track, and trace the numerous variants of the Sars Cov-2 virus. Researchers and scientists in the Caribbean, Africa, and elsewhere have been eagerly harnessing genomic sequencing technology to develop resilience and greater self-sufficiency in numerous fields, ranging from health surveillance to agriculture and beyond.

In this podcast, IPS Caribbean correspondent Jewel Fraser speaks with Professor Dr. Martin Forde at St. George’s University in Grenada about a research paper published in The Lancet that he coauthored looking at the Caribbean’s use of genomic sequencing technology.

To be fully transparent, we recorded this interview in early 2023, and it’s possible that new developments have occurred since then. Also, Forde and his colleagues’ paper relied solely on the data available in the GISAID database.

Music credit: https://www.fesliyanstudios.com/

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Jane Salanda holding some sorghum, the only crop that survived the drought.

By Simplex Chithyola Banda
LILONGWE, Malawi, Jun 21 2024 (IPS)

After El Niño-induced floods and devastating drought, roughly two in five people in Malawi – a country of some 20 million people – are now facing the looming prospect of acute hunger by the end of the year.

At particular risk is the progress Malawi has made to improve maternal and infant nutrition, especially during the critical window of a child’s first 1,000 days.

Yet, facing similar challenges in the past, I have seen with my own eyes how international development aid can uplift and build the resilience of even the most vulnerable communities.

Concessional finance from the World Bank’s International Development Association (IDA), for instance, has previously helped millions of Malawians access food, improve nutrition, and rebuild agricultural livelihoods in the aftermath of shocks. With its focus on addressing the most urgent long- and short-term challenges, the IDA is one of the greatest allies of low-income, climate-vulnerable countries.

However, conditions not of our own making are exacerbating the hunger challenges in Malawi and across the African continent, while simultaneously holding back governments from responding effectively.

Malawi’s external debt servicing alone, for example, will take up an estimated US$ 147 million this year, just over five percent of total government spending. This is money that would better serve the country in the long run as investments into building the resilience of smallholder farmers to safeguard food and income security against rising climate shocks.

In light of these compounding challenges, we urgently need donor governments to double their contributions to the IDA in its upcoming replenishment, without which countries like Malawi will simply lack the resources to break the cycle of crises.

Food systems in the countries receiving support from the IDA, where infrastructure and national resilience is already precarious, have been more acutely affected by recent shocks than elsewhere.

We already know that one in three IDA nations are now poorer than before the Covid-19 pandemic, while the cost of recent climate disasters has doubled over the past decade, and will continue to rise. These shocks are devastating setbacks to attempts to develop long-term resilience and foster agricultural development for food and nutrition security and rural livelihoods.

Yet, just as these countries are facing arguably greater challenges than ever before, the amount of funding provided via the IDA has stalled – and in some cases, begun to decline.

For almost a decade, contributions to the IDA have flatlined, which means financial support from the wealthiest countries in real terms has fallen as many countries have cut aid budgets.

And the results of this downturn in funding are now playing out on the ground. Over the past two replenishment cycles, for example, the number of food insecure people in IDA countries has doubled – a clear sign that donor countries must rapidly reverse course to save lives and economies worldwide.

In the face of mounting challenges, the IDA can still be a driver for positive change in many of the world’s most vulnerable contexts, but only with the enhanced support of the foremost donor countries.

Momentum for tackling the hunger crisis – which ultimately spans borders, cultures, and economies – is already growing, with the formation of a Global Alliance Against Hunger and Poverty ahead of the G20 meetings in Brazil this year.

Donor governments must now make up ground, rising to the scale and urgency of the food security challenge ahead of us by doubling their funding for one of the most potent solutions against hunger and poverty.

The IDA is one of the most proven and effective aid providers the world possesses today and will be vital in delivering the vision of a hunger- and poverty-free world.

With greater funding, the IDA can support the long-term investments needed to strengthen national food systems, while also breaking the cycle of crises that currently hold back the most vulnerable nations.

At the same time, adequately replenishing the IDA will be critical in achieving both the UN Sustainable Development Goals (SDGs), and the World Bank’s own mission to end poverty – both of which rely on sustainable agricultural development that allows for healthy people and planet.

Therefore, as the IDA meets in Nepal, Malawi and other IDA countries urgently need donor governments to step up both financially and strategically, directing more funding towards nutrition and food security.

The return on this investment is a world with less hunger, poverty and inequality, the toll of which is ultimately borne by all of us.

Hon. Simplex Chithyola Banda is Minister of Finance & Economic Affairs, Malawi

IPS UN Bureau

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The coastal village of Scotts Head, Dominica: The 2023 State of the Climate in Latin America and the Caribbean report is calling for robust early warning systems to safeguard small island developing states from rising sea levels and other impacts of climate change. Credit: Alison Kentish/IPS

By Alison Kentish
DOMINICA, May 10 2024 (IPS)

Every year for the last four years, a collaborative effort involving scientists and other experts has assessed the state of the climate in Latin America and the Caribbean. The findings have revealed increasingly alarming trends for the world’s second-most disaster-prone region.

The latest report by the World Meteorological Organization published on May 8, confirmed that 2023 was the hottest year on record. The Atlantic region experienced a rapid rise in sea levels, surpassing the global average and threatening the coastlines of several small island developing states. The spike in temperatures hit agriculture hard, worsening food insecurity, while wildlife populations suffered. Meanwhile, heavy rainfall triggered floods and landslides, with significant fatalities and economic losses across the region. 

“In all types of climatic and environmental variables, records were broken during the year 2023. In terms of the amount of heat in the ocean, sea level rise, ice loss in the Antarctic Sea and the retreat of  glaciers, Latin America and the Caribbean have been seriously affected by the effects of El Niño, which are of course added to those of climate change induced by human presence,” said Professor Celeste Saulo, WMO Secretary General.

The report highlighted Category 5 Hurricane Otis, which hit near Acapulco, Mexico, as one of the strongest hurricanes on record in the Eastern Pacific. It also underscored the impacts of heavy rainfall, such as the deadly landslide in Sao Sebastiao, Brazil, and noted that the Negro River in the Amazon hit record low levels, while low water levels restricted shop traffic in the Panama Canal.

“In 2023, around 11 million people in the region were affected by disasters. Out of all these, climate-related disasters were the majority, resulting in over 20 billion US dollars in economic losses,” Acting Special Representative of the UN Secretary-General for Disaster Risk Reduction, Paola Albrito, told the report’s launch.

“We are unfortunately seeing this play out now in Brazil, where devastating floods have taken almost 100 lives and displaced over 160,000 people to date.”

Albrito told the launch that in order to meet their commitments to the Sustainable Development Goals, countries must reduce the burden of disasters.

“This starts by accelerating the implementation of the Sendai Framework for Disaster Risk Reduction, in line with the agreed Regional Action Plan, which was updated last year,” she stated.

The UN Disaster risk official is calling for integrated disaster risk reduction into development financing to close funding gaps. Presently, just 1% of official development assistance in Latin America and the Caribbean goes towards disaster prevention.

She urged countries in this Region to take advantage of the opportunity presented by the UN Secretary General’s Early Warnings for All Initiative to enhance multi-hazard warning systems and emphasized the importance of heightened collaboration in disaster preparedness and risk management between the European Union and Latin American and Caribbean intergovernmental organizations to improve response mechanisms and enhance resilience to natural disasters.

The report acknowledges progress made in using meteorological data for health surveillance, particularly in disease monitoring, citing it as a “move towards stronger public health strategies.” The COVID-19 pandemic underscored the importance of this area and the need to address gaps in disease surveillance.

“Climate change is a threat to global health that directly and indirectly affects health, well-being, and health equity. It exacerbates existing public health challenges in the Americas, such as food and water insecurity, air pollution, and the transmission of vector-borne diseases,” said Dr. Jarba Barbosa, Director of the Pan American Health Organization.

One of Barbosa’s first actions as PAHO Director was the relaunch of an initiative for the elimination of more than 30 diseases and health conditions from countries in the Americas. He says social and environmental conditions contribute significantly to elimination efforts, but climate change continues to challenge experts’ understanding of the epidemiology of many of those diseases.

“This is why member states have asked PAHO to develop a new policy to strengthen action of the health sector to respond to climate change with equity. This will be presented to our governing bodies in 2024, so that the Region of the Americas can have climate resilient and low carbon health systems, adopting a climate justice approach to increase equity in health,” he said.

The collaborative effort behind the 4th State of the Climate report involved over 30 national meteorological and hydrological services and regional climate centres, 60 scientists and experts and the support of organizations like the Food and Agriculture Organization and the Pan American Health Organization.

Partners say the report is a valuable resource to enhance regional risk knowledge and provides critical benchmarks for countries to better understand and address the growing climate risks they face.

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Excerpt:

Credit: UNICEF/Abdulazeem Mohamed
 
War in Sudan is putting the future of its 24 million youngest citizens at risk, the Representative of the UN Children’s Fund (UNICEF) warned. January 2024
 
Meanwhile geopolitical and geoeconomic fragmentation threaten the development and survival of children across the globe. But a more hopeful path exists.

By Jasmina Byrne
UNITED NATIONS, Feb 23 2024 (IPS)

At the start of 2024, we stand at a critical juncture: Geopolitical tensions are escalating, economic integration is unravelling, and multilateral cooperation is faltering. This global fragmentation threatens to undermine decades of progress made for children worldwide.

The choices we make today – whether to continue on this path or whether we should bolster global cooperation – will have a profound impact on generations to come.

Children are always the most vulnerable in times of crisis – a reality highlighted by the COVID-19 pandemic, when school closures, economic hardship and disrupted health services jeopardized children’s rights and wellbeing.

Almost four years since that pandemic was declared, our new report, Prospects for Children in 2024: Cooperation in a Fragmented World, paints a concerning picture for children’s future development and welfare.

Tensions among major powers are rising and the threat of new conflicts emerging is high. Beyond the immediate physical dangers, children can experience lasting psychological trauma and violations of their basic rights.

If military spending continues increasing at the expense of investments in healthcare, education and social protections, children’s development will be further compromised.

Meanwhile, economic fragmentation is widening disparities between countries. Restrictive trade policies and supply chain disruptions are leading to rising energy and food prices, reducing access to essential goods and negatively impacting child nutrition and household incomes.

Competition for critical minerals essential for the green economy is increasing the risks of trade fragmentation while threatening the pace of the green energy transition. At the same time, the drive to expand mining for minerals puts mining communities and children at risk of exploitative practices.

Despite continued global economic growth, the lukewarm and uneven recovery is diminishing prospects for reducing child poverty. From now until 2030, 15 million more children a year will be living in poverty than would have otherwise, due to the unequal post-COVID recovery.

This gloomy picture is compounded by the weakening of multilateral institutions, which is further undermining the potential for progress for children. Why?

Because a fragmented multilateral system that is hamstrung by competing interests will struggle to deliver on conflict prevention, climate change, effective digital governance, debt relief and enforcing child rights standards, fuelling dissatisfaction in the Global South with rising inequalities.

Children in the poorest nations also face continued barriers to financing for basic services. Crippling debt, high remittance fees and lack of voice in global economic governance restrict investments in healthcare, education and social protections – investments vital to children’s survival and development.

But amid all these concerning trends, we see still signs of hope. Alternative alliances are emerging in the developing world to advance cooperation, bringing novel policy solutions, more nimble policymaking and effective results.

Despite expressing discontent with current democratic political structures, young people remain optimistic that opportunities exist to reform and resolve deficiencies in the political system, whether at the national or international level. They are engaging as change-makers, breathing new life into civic participation and democratic renewal.

In addition, technological innovations are unlocking new opportunities to empower children and enhance their rights. Green transition, if carried out in a just and sustainable way – one that prioritizes young people’s needs, skills and access to jobs in emerging sectors (such as the digital and green economy) – can benefit younger generations.

Reforms and modernization of global governance and financing arrangements could still deliver greater justice for developing countries. This more hopeful path will not unfold on its own. It requires global leaders to make an active choice – to double down on solidarity, inclusion and cooperation despite tensions and instability.

Prioritizing children and their rights must be at the centre of this choice.

Jasmina Byrne is Chief, Foresight & Policy, UNICEF Innocenti – Global Office of Research and Foresight.

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A gathering ‘perfect storm’ – due to various developments, several quite deliberate – now threatens much devastation in the global South, likely to most hurt the poorest and most vulnerable.

Globalisation’s protracted decline
The age of globalization had mixed consequences, unevenly incorporating national markets for labour, goods and even some services. It ended gradually, with the trend far more pronounced following the protracted worldwide stagnation since the 2008 global financial crisis.

Jomo Kwame Sundaram

But the end of the era of globalization did not mean a simple return to the status quo ante. Most economies had been transformed irreversibly by economic liberalization, both nationally and internationally, with dire lasting consequences.

Market pressures for fiscal austerity were strengthened by conditionalities and advice from international financial institutions. This inevitably led to deep cuts in government spending, leaving little for public investments, which might contribute to the recovery of the real economy.

Interest rate hikes accelerate stagnation
The 2008 Wolfowitz doctrine, from late in the Bush Jr presidency, was revised by the Obama administration to launch the second Cold War. The COVID-19 pandemic and the last two years of war and sanctions have worsened supply-side disruptions exacerbating ‘cost-push’ inflation.

Some prices spiked due to opportunistic market manipulation by investors and speculators as well as deliberate disruptive interventions for political advantage. The rule of law – even once sacred property rights – has been sacrificed for political expediency, undermining trust, especially in states.

Hence, concerted interest rate hikes by influential Western central banks have proved to be an unnecessary, inappropriate and blunt demand-side tool to address contemporary inflation driven primarily by supply-side factors!

Instead of addressing inflation due to supply disruptions, higher interest rates have cut both private and government spending, resulting in less demand, jobs and incomes in much of the world.

In the US, successive presidents maintained full employment since Obama inherited the 2008 global financial crisis. Uniquely, its central bank, the US Fed, has a dual mandate to maintain full employment and financial stability.

All over the world, the deliberate and concerted interest rate hikes of 2022 and 2023 have proved to be both contractionary and biased against labour and jobs.

Global South’s hands tied
Policymakers in the Global South are greatly constrained by their circumstances. Exposed to global markets and with limited fiscal and monetary policy instruments at their disposal, they are captive to pro-cyclical policy biases.

The International Monetary Fund and other international financial institutions tend to demand fiscal austerity conditionalities in return for any credit relief provided.

Thus, recipient governments are subject to spending constraints instead of providing relief. Worse, many legislatures have imposed unnecessary spending constraints on themselves, supposedly to enhance government fiscal credibility.

Supposedly independent central banks have further compounded monetary policy constraints. Such central banks are primarily responsive to international and national financial interests rather than national policy priorities.

Following monetary and financial liberalisation in recent decades, developing countries are much more exposed to debt crises worse than those experienced in the 1980s.

Then, governments in Latin America, Sub-Saharan Africa and elsewhere had borrowed heavily, mainly from US and UK commercial banks. After US Fed chair Paul Volcker raised interest rates sharply from 1980, severe fiscal and debt crises paralysed many of these governments for over a decade.

The debt exposure level is much higher and borrowed from varied sources, significantly more market-based and non-bank. Governments have also provided guarantees for state-owned enterprises to borrow heavily, but less accountably than with sovereign debt.

New divides in post-unipolar world
The unipolar world moment after the end of the first Cold War briefly saw unchallenged US hegemony. The Organization for Economic Cooperation and Development developed policies for the global North in trade, investment, technology, finance, tax and other vital areas, typically at the expense of the South.

More recently, the ‘new Cold War’ or geopolitical policies, including illegal sanctions, have frustrated developing countries’ aspirations to reach the Sustainable Development Goals, adapt to global warming and its effects, and retrieve a fairer share of global corporate income tax revenue.

With most economies barely growing, and efforts by many governments to reduce imports, export opportunities have become more uncertain and constrained, ending a crucial premise for globalisation. With higher interest rates, even finance has abandoned developing countries in ‘flights to safety’ to the US.

Lacking the ‘exorbitant privilege’ of issuing the US dollar, still the world’s reserve currency, most developing countries lack monetary, fiscal and policy space. Unlike rich nations which borrow in their own currencies, most developing countries remain vulnerable to foreign exchange rate vagaries.

Poorest getting poorer
With Obama’s ‘Pivot to Asia’ launching US efforts to check China, its lending to developing countries, including in Sub-Saharan Africa, fell from around 2016.

Despite higher borrowing costs, many of the poorest countries turned to private creditors. But private market lending to poor nations dried up from 2022 as the US Fed raised interest rates sharply for almost two years.

As debt service costs soared, distress risks have risen sharply, especially in the poorest nations. While not obviously due to a conspiracy against the global South, there is little concern for the predicament of the worst off in the poorest countries.

Meanwhile, poverty in the poorest countries has not declined for over a decade.

With international disparities growing at the expense of the poorest people in the poorest nations, the desire to emigrate continues to rise although mainly unaffordable to the poorest.

IPS UN Bureau

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Contractionary economic trends since 2008 and ‘geopolitical’ conflicts subverting international cooperation have worsened world conditions, especially in the poorest countries, mainly in Africa, leaving their poor worse off.

Jomo Kwame Sundaram

Deepening stagnation
Following tepid growth after the 2008 global financial crisis, Covid-19 disrupted supply chains worldwide. Then, post-pandemic recovery was disrupted by wars in Ukraine and then Gaza.

Food and energy prices soared briefly, largely due to market manipulation by opportunistic investors. Invoking the price hikes as a pretext, the US Fed and European Central Bank raised interest rates, deepening economic stagnation worldwide.

Countries which borrowed heavily during the earlier decade of unconventional monetary policies – especially ‘quantitative easing’, offering easy credit – now have to cope with increasingly unbearable debt burdens, particularly in the global South.

Earlier modest progress in reducing poverty – now termed ‘extreme poverty’ – and food insecurity has slowed sharply, if not worse. For many of the world’s poorest, progress has not only stopped but even been reversed.

The World Bank currently defines the poor as those with daily per capita incomes under US$2.15 in 2017 prices. It estimated those deemed poor fell from 1.87bn – 31% of the world’s population – in 1998 to a forecast of 690mn (9%) in 2023.

The rate of decline of poverty has slowed sharply: global poverty is forecast to fall by a little over three percentage points during 2013-23 – very much less than the 14 percentage points in the decade before 2013.

Poorest mainly in poor countries
The pace of poverty decline has slowed most in the world’s poorest nations. Wolf defines these countries as those deemed eligible for concessional loans from the World Bank Group’s soft-lending arm, the International Development Association (IDA).

Seventy-five countries are now considered eligible for IDA resources, including 39 in Africa. Some – e.g., Bangladesh, Nigeria and Pakistan – can also borrow on costlier terms from financial markets and the Group’s International Bank for Reconstruction and Development.

In IDA-eligible countries, those in extreme poverty fell from 48% in 1998 to 26% in 2023. But this only involved a single percentage point decline over 2013-23, compared to 14 percentage points in the decade before.

Extreme poverty has mainly declined in better-off middle-income countries, with 497 million poor in IDA-eligible countries. With 72% of the world’s total of 691 million poor in IDA-eligible nations, the remaining 193 million were in other countries.

The population share in extreme poverty in countries not IDA-eligible fell from a fifth in 1998 to 3% in 2023, falling by only four percentage points during 2013-23. Expecting modest overall growth, Wolf expects this 3% share will be largely eliminated by 2030.

Hence, he argues that extreme poverty can only end if attention and resources are focused on the world’s poorest countries, where poverty is most concentrated and deeply entrenched.

Unequal debt burdens
Government debt is widespread, but especially debilitating in countries where the poor are most concentrated. The World Bank’s last International Debt Report notes such countries depend too much on unreliable and expensive funding.

The report acknowledges, “For the poorest countries, debt has become a nearly paralysing burden: 28 countries eligible to borrow from [IDA] are now at high risk of debt distress. Eleven are in distress.”

During 2012-21, the external debt share of IDA-eligible countries owed to private creditors jumped from 11.2% to 28.0%! Their debt service payments more than tripled from $26bn in 2012 to $89bn in 2022, as interest due jumped from $6.4bn to $23.6bn!

Meanwhile, the share of bondholders and other private lenders in total government debt fell from 37% in 2021 to 14% in 2022! As the US Fed raised interest rates sharply during 2022-23, investors dumped ‘high-risk’ poor borrowers, lending much less to those in most need.

With this ‘perfect storm’, debt distress should come as no surprise. The 2023 International Debt Report found 56% – over half – of IDA-eligible countries at risk of such distress.

Distress of the poorest
Wolf argues it is in rich nations’ interest and their obligation to provide poor countries with far more concessional finance. But such funding has actually declined in recent decades, especially with the end of the first Cold War over three decades ago.

The IDA is using its 20th replenishment for July 2022 to June 2025 to provide financing on concessional terms. The World Bank president has argued for a much bigger new replenishment ostensibly to accelerate growth, reduce poverty and address other challenges in the poorest countries.

IDA-eligible countries include many of the world’s worst-managed nations, often very fragile, vulnerable to shocks, and stuck in “hard to escape” poverty. But their problems have become pretexts to withhold or withdraw concessional finance from those most in need.

Much more concessional finance and other resources are needed for poor nations to develop sustainably. But reducing sustainable development to simply eliminating poverty, nowadays with climate action, will condemn the poorest developing countries to backwardness.

World financial arrangements have been crucial in undermining fair, sustainable development in poor countries. While it will be critical to enable these nations to overcome their current and imminent predicaments, far more fundamental reforms must quickly follow.

As the poorest developing countries are both weak and vulnerable, needed reforms are nowhere on the horizon. Instead, the ‘international community’ continues to kick the can down the road instead of undertaking bold reforms for the short and medium term.

IPS UN Bureau

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Men on camels and donkeys travel through a dust storm in the desert near the western city of Mao, in the Kanem Region of Chad. Credit: UNICEF/UNI82205/Holt

By Sudip Ranjan Basu, Chen Wang and Monica Das
BANGKOK, Thailand, Jan 17 2024 (IPS)

As the world is still gearing up to welcome 2024, let us find a moment to reflect on some of the key trends of the past year and pursue now to embrace the path towards hope and promise for everyone, everywhere.

Deepening global inequalities are having enormous socio-economic implications across countries. Increasing income and social disparities are spreading around regions. Growing intensities of climate induced natural disasters, the uneven speed of post-pandemic recoveries, and cost-of-living crises from conflicts and geopolitical tensions are exacerbating inequalities and poverty traps globally.

The changing distribution of economic benefits vis-à-vis the rising prices of food and fuel are causing social unrest and protests. Citizens are voicing their frustration not only in the streets of capitals but through exponential engagement on social media platforms.

With the intensification of various external shocks, and the lack of economic opportunities for accelerating growth and productivity surges, multidimensional poverty indices are on rise. The inequality-poverty nexus is contributing to a new form of uncertainty for disadvantaged households.

A family displaced by prolonged drought in Ethiopia now live in a makeshift tent in Mogadishu, Somalia. June 2023. Credit: IOM/Muse Mohammed

Intensifying course of climate change

Intensifying hazards caused by climate change, such as floods, tropical cyclones, heatwaves, droughts and earthquakes, have impacted agricultural outputs and industrial sectors, especially through decreasing productivity growth and falling real wages. The widening gap between rich and poor in rural and urban areas has also been linked to extreme weather events due to the increasing frequency of natural disasters.

These inequalities are further aggravating extreme poverty, creating the vicious nexus of climate-disaster-inequalities among vulnerable groups.

Evidence from around the world indicates that climate change is likely to impact more severely on vulnerable groups and coastal communities, because they are more exposed to the uncertainties of weather patterns. Lack of adaptive capacity are often constraining the ability of these communities to build resilience and cope with the severity of these environmental shocks.

Widespread incidence of climate migration from low- to high-latitude areas and social mobility are increasingly impacting the social fabric of small island developing States and other developing economies.

With the exodus of young and skilled labour force, transfers of income and the wealth gap will further worsen inequalities in communities, raising concerns of greater socio-economic uncertainties.

From Fiji to Ethiopia, Bangladesh to Brazil, the exacerbation of inequalities due to climate change has been impacting socio-economic prosperity. Growth uncertainties are causing extreme poverty to increase, while causing hardship and hunger for households in rural areas.

Varying scales of COVID-19 pandemic

Socio-economic polarization has been on the rise since the global outbreak of the COVID-19 pandemic. Due to differentiated impacts of national lockdowns, pandemic restrictions and vaccination measures have had adverse impacts on the existing inequalities and multidimensional poverty indices.

As economic development stagnation persists, rural areas have seen rising impacts of extreme poverty and income divergence across households, leading to new episodes of income divergence within countries.

The post-COVID 19 recoveries are uneven. Rising levels of unemployment and stagnating real wages remain major indicators of corresponding economic growth deceleration. The differentiated policy measures to stabilize labour market distortions, social protection systems and sectoral productivity surges have not always achieved the desired outcomes in developing countries.

According to the labour force surveys in various countries, the majority of workers have been engaged in less paid work due to lack of dynamism in the labour market. Evidence suggests that the changes in work style and availability of types of jobs as well as their skills and profiles aggravate the income disparity within urban centres.

From several Latin American to African countries, the pandemic-induced policy measures have differently elevated the risk of vulnerability for the manual labor force. Similarly, the studies have shown that young, low-income and self-employed workers including women with limited education, have suffered greater job losses and earnings reductions than other groups in the workforce in the UK, USA, China and India, among others.

Changing forms of conflicts

Conflicts also go beyond borders, causing immeasurable human suffering on the global scale. With the volatility and uncertainties around supply chains, food and fuel prices spiral. Cost-of-living crisis spreads around countries as governments lose fiscal space for developmental expenditure, while debt burden mounts.

Conflicts cause people to lose hope and opportunities from East to West, North to Southern countries. With the lack of rule of law and property rights, households and communities fall into poverty traps, changing the face of socio-economic disparity.

As these conflicts are prolonged, countries often fail to overcome the existing structural constraints, maintain production streams, and improve lackluster infrastructure. A higher risk of falling into poverty traps and increasing scale of disparities is then the inevitable outcome. The polarization fears and lack of trust are now a reality.

Looking ahead

Today, as we look back at 2023, there is no doubt that in the end, common aspirations and outlooks remain our best hope to chart a new course to advance the Sustainable Development Goals. Evidence of successful policy coherence will provide valuable opportunities for policymakers to unite their priorities and lay the foundations for breakthroughs.

Sudip Ranjan Basu is Deputy Head and Senior Economic Affairs Officer; Chen Wang is Professor, Institute of Finance and Economics, Shanghai University of Finance and Economics, China; Monica Das is Associate Professor, Economics Department, Skidmore College, New York

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BioNTainers, facilities equipped to manufacture a range of mRNA-based vaccines have been inaugurated in Rwanda in December 2023. Credit: Aimable Twahirwa/IPS

By Aimable Twahirwa
KIGALI, Jan 8 2024 (IPS)

An agreement signed between the Rwandan government and the Africa Pharmaceutical Technology Foundation (APTF) gives impetus to Africa’s domestic industry with the hope of helping the continent tackle vaccine inequity and fill the critical gap in vaccine manufacturing.

The agreement to operationalize the foundation was signed in Kigali, Rwanda, in late 2023.

What is important, according to stakeholders, is to focus efforts on building a resilient and self-reliant pharmaceutical industry for the continent. This became apparent during COVID-19, when, for example, COVAX, a multilateral mechanism for equitable global access to COVID-19 vaccines, helped lower-income economies achieve two-dose coverage of 57 percent, compared to the global average of 67 percent.

Both officials and scientists take delight in pointing out that the benefit of having such an initiative is to close the vaccine equity gap between African countries and the world’s developed nations.

During the implementation phase, the African Development Bank (ADB) has committed to investing up to USD 3 billion over the next decade in the development of pharmaceutical products.

The foundation, which is ready to hit the ground running in January 2024, will dedicate its core mandate to addressing some of the common challenges facing African indigenous pharmaceutical companies, including weak human and institutional capacities and low technical capacity for using and applying new technologies.

“The Foundation was a pledge that Africa will have what it needs to build its own health defense system, which must include a thriving African pharmaceutical industry and a quality healthcare infrastructure, ADB President Dr Akinwumi Adesina said.

These solutions, according to experts, aim to close technical capacity gaps in their use and lack the ability to focus on the production of basic active pharmaceutical ingredients for drugs or antigens for vaccines.

Professor Padmashree Gehl Sampath, Chief Executive Officer of the APTF, told IPS that access to know-how, technologies, and processes for manufacturing pharmaceutical products is clearly needed on the continent to ensure the sustainability of financial investments.

She, however, points out that, with the current move to ensure the sustainability and reliability of the domestic pharmaceutical industry in Africa, it is not enough just to have financial, infrastructural, strategic, and regulatory support.

“There is a need for a clear and coherent focus on technology transfer and knowledge sharing for capacity building and diversification within the pharmaceutical value chain,” she said in an exclusive interview.

While technology is described as the main transformative tool that will enable the development of a competitive pharmaceutical industry in Africa, Sampath stresses the need to build policy capacity to facilitate the sector.

According to her, this can be done by implementing the flexibilities contained in the Agreement on Trade-Related Aspects of Intellectual Property and then also enabling local companies to access domestic markets.

In a move to overcome these challenges, the foundation’s work received a major boost with a memorandum of understanding signed in December 2023 in Kigali, Rwanda, to partner with the European Investment Bank.

The European Investment Bank will be a partner in the foundation’s “regional biosimilars program for the production and innovation of relevant biosimilars in Africa and to facilitate the creation of common active pharmaceutical ingredients parks in any chosen specific sub-region of Africa,” the organization said in a press release.

According to Sampath, there is a need to remove barriers to domestic innovation in Africa.

“We need to work with our universities and public research institutions to transform them into centers of excellence,” she said.

During the implementation phase, the first modular elements of the German company’s factory, BioNTech, based on shipping containers, were delivered to the Kigali construction site in March and were then assembled to form the so-called BioNTainers that were inaugurated in December 2023.

The company, which developed the most widely used COVID-19 vaccine in the Western world with its U.S. partner Pfizer, developed a plan in 2022 to allow African countries to produce its Comirnaty-branded vaccine under the supervision of BioNTech.

BioNTech said the initial vaccine factory could, over the next few years, be part of a wider supply network spanning several African countries, including Senegal and South Africa.

At the time BioNTech announced plans to expand into Africa, the shipment of coronavirus vaccine doses manufactured in the West to the continent had been delayed, which had been the subject of much criticism.

“The African Union has come together to make a firm commitment not to find ourselves in this situation again,” Rwandan President Paul Kagame said at the inauguration ceremony of the plant site located in Masoro, a suburb of Kigali.

The company, which developed the most widely used COVID-19 vaccine in the Western world with its U.S. partner Pfizer, developed a plan in 2022 to allow African countries to produce its Comirnaty-branded vaccine under the supervision of BioNTech.

“What BionTech’s partnership with Africa demonstrates is that vaccine technology can be democratized, but we could not have reached this point without a wider set of partnerships.” Kagame said.

Gelsomina Vigliotti, Vice President at the European Investment Bank, said that the bank is committed to working with its partners to strengthen public health and health innovation across Africa.

“Strengthening access to finance is essential to scaling up pharmaceutical investment and innovation across Africa,” Vigliotti said.

An important manifestation of Africa’s scientific and technological innovation capability, according to experts, is the application of innovations to its pharmaceutical industry development.

The newly-established plant, located in the suburb of Rwanda’s capital city, Kigali, is expected to start by producing 50 million vaccines, but production will increase depending on the demand for mRNA-based vaccine candidates to address malaria and tuberculosis.

But researchers and policymakers argue that trust and cooperation are critical for the successful implementation of this innovation.

The latest estimates by the World Health Organization (WHO) show that industrial development should be combined with national policy for universal health coverage so that local vaccine production can address local health needs.

Before the inauguration of the BionTech factory in Rwanda, there were fewer than 10 African manufacturers with vaccine production, which are based in five countries: Egypt, Morocco, Senegal, South Africa, and Tunisia.

The capability to produce vaccines in Africa, according to the UN agency, requires a fully integrated approach, pulling together some key elements including finance, skills development, regulatory facilities, and technology know-how.

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With the US Fed raising interest rates, the world economy is slowing as debt distress spreads across the global South, increasing poverty worldwide to pre-pandemic levels, with the poorest countries faring worst.

Extreme poverty continues to be high and is now worse than before the pandemic in low-income countries (LICs) and among those affected by fragility, violence and conflict. The promise of eradicating poverty worldwide by 2030 has become unachievable.

Jomo Kwame Sundaram

Instead of fostering cooperation to address the causes and effects of the contemporary catastrophe, neither the International Monetary Fund nor the World Bank governors could agree on joint communiques due to the greater politicisation of multilateral fora.

Indebtedness immobilises governments
Indebtedness and restrictive creditor rules prevent governments from spending more counter-cyclically to overcome the many contractionary tendencies of recent times, besides preventing them from addressing looming social and environmental crises.

The G20’s largest twenty economies have urged strengthening “multilateral coordination by official bilateral and private creditors … to address the deteriorating debt situation and facilitate coordinated debt treatment for debt-distressed countries”.

But its Common Framework to restructure debt has been roundly criticised by civil society, think tanks and even the World Bank on many grounds, including the paltry concessional credit relief offered to a few of the very poorest countries.

In contrast, the G24 caucus of developing countries at the BWIs has emphasised the need for “durable debt resolution measures while collaborating on resolving the structural issues leading to such vulnerabilities.”

But all those advocating purported solutions are not even trying to ensure fiscal space and public spending capacity for counter-cyclical efforts, let alone achieve the Sustainable Development Goals and national development objectives.

Surcharges
The IMF currently imposes additional charges on countries that do not quickly clear their debts to the Fund. Besides the usual fees and interest, borrowing countries paid over $4 billion in such surcharges in 2020-22, during the COVID-19 pandemic.

Surcharges will cost debt-distressed countries about $7.9 billion over six years. The G24 has emphasised that surcharges are pro-cyclical and regressive, especially with monetary tightening.

Governments have undertaken contractionary policies and cut imports for lack of foreign exchange. This deepens the problems of heavily indebted poor countries who cannot but count on the Fund for relief and solutions.

At Marrakech, the governing International Monetary and Financial Committee decided to “consider a review of surcharge policies”. The G24 called for “a suspension of surcharges while the review – which we hope will lead to substantial permanent reduction or complete elimination – is being conducted.”

Rich nations have been divided over surcharges. With Ukraine now among the top surcharge payers, following civil society criticisms, the Biden administration’s refusal to review surcharges in 2022 was heavily criticised by the US Congress.

Deepening austerity
IMF fiscal austerity measures of the 1980s returned with a vengeance after the 2008 global financial crisis, and then again during the Covid-19 pandemic from 2020. Most Fund loans require cutting the public sector wage bill (PSWB), the budget line to pay employees.

Most wage earners in many LICs, including nurses, teachers and other social service workers, work for the state, directly or indirectly. Although much needed, these employees have been more likely to be targeted by such budget cuts.

PSWB cuts may involve hiring or wage freezes, or limiting, or even cutting wages. These inevitably undermine government capacities and services. Fiscal consolidation has also involved raising more indirect, consumption taxes, and tax exemptions, e.g., for essential goods such as food.

In 38 countries with over a billion people, loan conditionalities during 2020-22, the three years of the Covid-19 pandemic, meant regressive tax reforms and public spending cuts. PSWB and fuel or electricity subsidy cuts are also common demands worsening economic contractions.

Austerity bound to fail
But the IMF’s own research suggests such austerity policies are generally ineffective in reducing debt, their ostensible purpose. The April 2023 IMF World Economic Outlook acknowledged austerity programmes and fiscal consolidations “do not reduce debt ratios, on average”. Yet, its Fiscal Monitor still demands “fiscal tightening” of most developing countries.

The new IMF-World Bank debt sustainability framework sets the LICs’ external debt-to-GDP ratio limit at 30% or 40%. It insists debt-distressed economies must have lower ratios than ‘strong’ countries, effectively further penalising the weak and vulnerable.

Instead of enabling consistently counter-cyclical macroeconomic frameworks, the IMF’s current short-termist approach is mainly preoccupied with annual, or worse, quarterly balances, mimicking corporate reporting practices.

Such short-termism further limits fiscal space, effectively preventing or deterring public sector investments requiring longer-term macroeconomic frameworks to realise benefits. This discourages ‘patient’ medium- to long-term investments required for national economic planning and transformation, essential for sustainable development.

Restrictive debt and fiscal targets have meant even less public investment. This is typically required of borrowing countries as a credit conditionality. Annual IMF Article IV consultations cause other countries to also accept similar constraints to avoid Fund disapproval.

While a few better-off economies enjoy full employment, most countries face further economic contraction, not least due to interest rate hikes led by the US Fed and their many effects. Instead of being part of the problem, the IMF should be part of the solution.

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Keithlin Caroo speaks to young Saint Lucian on International Rural Women’s Day. Education is an important part of advocacy on behalf of women and girls. Credit: Alison Kentish/IPS

By Alison Kentish
SAINT LUCIA, Nov 3 2023 (IPS)

On August 22, 2023, Women’s Affairs Ministers from the Commonwealth huddled in a room at the Atlantis Resort in the Bahamas. For the first time since the COVID-19 pandemic, they were meeting in person.

The 13th Commonwealth Women’s Affairs Ministers Meeting was being held under the theme, Equality Towards a Common Future. It was taking place amid the acknowledgement by policymakers that issues like accelerating climate change, economic turmoil, political upheaval in some parts of the world, and the COVID-19 pandemic have taken a debilitating toll on progress toward the empowerment of women and girls.

Bahamian Prime Minister Philip Davis vowed that the gathering would be solutions-oriented.

“The time is now for our Commonwealth community to be unabashedly ambitious in our goals and plans. We need more than slogans – we need commitments,” he said.

As Dr Anne Gallagher, Director General of the Commonwealth Foundation, addressed the high-level forum, images of a recent online civil society gathering organized by the Foundation flashed on screens across the room. The key outcome of that event was a list of ten recommendations that civil society groups from across the Commonwealth want women’s affairs ministers to consider.

Recommendation number seven, “Measure better to target better,” appeared on the screen. It was one of the recommendations that drew animated discussion among delegates. It came from a young woman dedicated to helping women farmers in her part of the world.

The journey of a recommendation from an online forum to the Commonwealth’s highest decision-making body for women’s affairs is serving as an example of the importance of not just giving a voice to those who are on the ground, working with women and girls but ensuring that their concerns are heard by those charged with gender equality policy action.

A Virtual Roundtable

Keithlin Caroo was a panellist on the Commonwealth Foundation’s Critical Conversations series, a virtual discussion that seeks to find sustainable solutions to the most pressing issues for the 2.5 billion citizens of the Commonwealth.

For years, Caroo has been on a mission to help rural women in her home country, Saint Lucia, and has extended that support to the neighboring islands of St. Vincent and the Grenadines and St. Kitts and Nevis. She is the founder and executive director of Helen’s Daughters, a non-profit organization that she refers to as a ‘community,’ which has been changing the narrative on women in agriculture. Helen’s Daughters is built on the premise that while in small states, everyone is connected to agriculture, women are not sufficiently supported despite their pivotal role in the sector.

The organization helps rural women with market access and forges linkages for farmers with supermarkets, restaurants, hotels, and the public through a FarmHers Market. It runs a free Rural Women’s ‘Ag-cademy’ on the islands of Saint Lucia, St. Kitts and Nevis and St. Vincent and the Grenadines, which focuses on sustainable agriculture and entrepreneurship. It is the first all-women agri-apprenticeship programme in the Caribbean. The organization operates a structured care system that focuses on the holistic development of women, hosting training on trauma-informed care to peer-to-peer support and wellness retreats.

Before the virtual event, the Commonwealth Foundation had made it clear – recommendations from the forum would be put before decision-makers. When Caroo spoke, she did so on behalf of the women farmers who toil daily in a sector fraught with gender biases.

“This engagement was important because it shows that the voices of grassroots organizations are important to Commonwealth’s policymaking; however, what’s important for me is seeing to it that the recommendations translate from policy to actions on the ground,” she said in an interview with IPS.

“We recognized the lack of sex-disaggregated early on, and aside from our interventions, data collection, monitoring, and evaluation are key to our work. Lack of data places further burden on us because aside from crafting interventions relevant to our beneficiaries, we are also responsible for primary data collection, which takes more time and resources; however, we must craft interventions according to the current state of play rather than what is imagined. As I said during the roundtable- “We can only target better if we measure better.”

Voices like Caroo’s played an important role in ensuring a commonwealth-wide response to gender inequality.

The Process

With its theme Gender, climate change and health: how can we do better for women and girls? the virtual roundtable stoked discussion on cross-cutting issues such as violence against women, investing in women and access to education.

“The event was deliberately outcome-oriented: it included not just a debate and discussion but also a highly focused working session where all participants were charged with coming up with specific recommendations to present to this body. Not a shopping list of blue-sky ideas but practical steps that they felt reflect what Commonwealth civil society – what the 2.5 billion citizens of the Commonwealth, want their countries to do for women and girls when it comes to health and climate change,” said Gallagher.

She reminded the gathering that the Foundation is a link between Commonwealth Member States and the people they all serve. She urged the ministers to reflect on the ‘clear and urgent’ recommendations from civil society.

“For me, the clarity and simplicity of the ten recommendations signals an important truth: we all understand the challenges we are up against in relation to women’s rights and well-being, and also in relation to climate change. We all appreciate what must be done. But shifting the current trajectory in ways that make a real difference will require much more. It will require courage, commitment, and true solidarity within and between countries of the Commonwealth,” she said.

The Recommendations

Recommendation seven, “Measure better to target better,” might have struck a chord with attendees, but the other nine recommendations were also well received.

They are:

• Acknowledge that the impacts of the climate crisis are not gender-neutral,
• Empower women through gender-responsive climate policies and actions,
• Improve access to education and training for women and girls,
• Improve climate finance and bring women forward as leaders and decision-makers,
• Value and promote women and girls as adaptation educators and agents of change,
• Promote gender equality in access to healthcare
• Act to reduce gender-based violence
• Enhance women’s economic empowerment.

The meeting’s official outcome statement notes that the recommendations were welcomed and endorsed.

Their journey is not over – they are now part of the women’s affairs ministerial meeting recommendations that will be brought before Commonwealth Heads of Government at their 2024 meeting in Samoa.

“I thought this engagement was of particular importance because I had never been to a panel at this level that spoke on the intersection of gender, climate change and health or intersectionality in general. Far too often, we focus on these themes in silos,” Caroo said.

“We do not consider Helen’s Daughters an agricultural organization because we deal with gender, climate change, gender-based violence, health, economic empowerment, climate and environmental justice, several areas that contribute to the overall development of our FarmHers. I thought the roundtable was timely because our policymaking needs to take an intersectional approach.”

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Excerpt:

Tacugama Chimpanzee Sanctuary – a conservation center dedicated to rescuing, rehabilitating, and protecting Sierra Leone’s national chimpanzee. Credit: Stella Paul/IPS

By Stella Paul
FREETOWN, Nov 3 2023 (IPS)

Thirty-three years ago, Bala Amerasekaran – a Sri Lankan by birth – visited Freetown, Sierra Leone. Since then, the West African nation has been his home, where Amerasekaran has dedicated his life to conserving the chimpanzee – Sierra Leone’s national animal.

In 1995, with support from the national government, he founded Tacugama Chimpanzee Sanctuary – the country’s first conservation center that rescues, rehabilitates, and protects chimpanzees, often hunted, traded, and killed for their meat. Currently home to 100 chimpanzees, the conservation works of the sanctuary also help prevent the spread of any possible diseases transmitted from primates to humans.

However, 20 years later, Amerasekaran’s enthusiasm is declining as he has witnessed massive encroachment within the sanctuary, destroying its forest cover and threatening the sustainability of the conservation program itself.

“I am beginning to feel that I have wasted my life for 28 years because there is no safety for this place,” says a visibly upset Amerasekaran.

Wildlife Connection to Africa’s Zoonotic Disease Trail

“At least 75 percent of emerging and re-emerging infectious diseases of humans—including Ebola, Marburg, Henipavirus, and zoonotic avian flu—have an animal origin, according to Hellen Amuguni – Associate Professor in the Department of Infectious Disease and Global Health at the Cummings School of Veterinary Medicine at Tufts University. “Chances are that when the next illness like COVID-19 emerges to threaten global health, it will originate in animals before it passes to humans, a process known as spillover,” Amuguni says.

West Africa has a long history of recurring zoonotic disease spillovers, the biggest of which occurred in 2014 when the region witnessed a devastating Ebola virus outbreak. The outbreak spread quickly across the entire region, including Guinea, Liberia, and Sierra Leone, where about 11,000 people died.

A 2018 study led by Caroline Huber of Precision Health Economics estimated that the disease outbreak also caused an economic and social burden worth over USD50 billion. Researchers later traced the origin to a spillover event: a two-year-old boy in Guinea likely infected while playing near a tree where bats roosted.

Since then, the conservation of biodiversity, especially the natural habitats of wildlife, has gained attention in the region to prevent any quick transmission of a zoonotic pathogen from animals to humans. But almost all the major forests and key wildlife habitats also face increasing stress from loggers, hunters, traders, and illegal builders.

An example is the Upper Guinean Forest, which covers the lowland forests of West Africa from Guinea to Togo. This forest is a global biodiversity hotspot and contains the world’s second-largest rainforest, the Congo Basin. However, studies have found that the forest has lost 84 percent of its original area, mostly due to agricultural expansion, commercial logging, charcoal burning, and human settlement.

Within the borders of Guinea – where the 2014 Ebola outbreak occurred first – 17.1-kilo hectares of humid primary forest disappeared between 2002 -2022, according to Global Forest Watch (GFW). To put it in perspective, this is the loss of a forest area as big as the city of Washington, DC.

GFW has also tracked large-scale deforestation in Equatorial Guinea –the country that reported the first cases of Marburg – a deadly viral zoonotic disease in May this year that claimed 12 lives. According to GFW’s estimates, in 2010, Equatorial Guinea had 2.63 mega hectares (Mha) of tree cover, extending over 98 percent of its land area, but by 2022, it lost 7.76 thousand hectares (kha) of tree cover, which is roughly the size of Paris.

Sierra Leone’s Vulnerable Forests

In Sierra Leone, several dense forests are habitats of many endangered wildlife species, including 6000 chimpanzees. These include Kangari Hills and Nimini Hills forests, Outamba-Kilimi National Park, and the Gola Rainforest – one of the largest remaining West African tracts extending to neighboring Liberia.

While deforestation has occurred in all these forests owing to illegal logging, unsustainable land use, infrastructural development, and charcoal production, it is particularly high in Gola Forest. According to a 2017 Purdue University research, the Gola forest has been losing its green cover at an annual rate of 4.18 percent. These losses are largely due to the expansion of rice farms within the forest area, says John Christian Abu-Kpawoh, who conducted the research.

In comparison, Tacugama Sanctuary is a tiny patch of forest of only about 40 hectares. Yet its proximity to the national capital, Freetown, a 40-minute drive away, makes it a prime target for encroachers. About 30 percent of the sanctuary has been encroached upon by builders, many of whom are powerful and well-connected.

“Last year, the Ministry of Lands deployed soldiers here (to protect the chimpanzee sanctuary). Yet every name that is coming up in the recent encroachments is of a soldier,” Amerasekaran reveals, indicating deep-rooted corruption in the government.

Worrying News for One Health

Since the COVID-19 pandemic, the One Health Approach to prevent a future zoonotic disease spillover has gained traction. The One Health approach recognizes the interconnection between human, animal, and environmental health and emphasizes an integrated approach to prevent any health crisis, especially related to infections transmitted from animals to humans.

Across West Africa, several large projects are already being implemented where multidisciplinary experts, including veterinarians, zoologists, epidemiologists, social behavior scientists, and risk communicators, are working together to prevent a new spillover.

The USAID-funded STOP Spillover, PREDICT and RESPOND, the Eco Health Alliance projects, and the West African One Health actions for understanding, preventing, and mitigating outbreaks are some examples.

These projects, among others, are engaged in studying and monitoring animal-human interaction, assessing risks of a possible disease breakout, putting surveillance measures in place to detect the early warning of spillover, and raising awareness among locals about the importance of conserving forest and wildlife to prevent a disease outbreak.

Tacugama Chimpanzee Sanctuary is also working with local communities to address some of the threats being faced by the rainforest-dwelling species. For example, the sanctuary is helping to establish livestock rearing projects, setting up swamp rice plantations, improving fuel efficiency of cooking, setting up tree nurseries for sustainable harvesting of wood and food products, and running education programs for school children.

But the uncontrolled development and encroachment on the forest land pose serious threats to the success of these activities, the biggest of them being the shrinking of space between humans and animals.

Although the 2014 Ebola virus outbreak and spillover were attributed to bats, chimpanzees can also be responsible for a new Ebola outbreak as they can contract and succumb to the virus. Ebola has been a major reason for the declining chimpanzee population across Africa. Once humans come in contact with an infected chimpanzee or its body fluids, the deadly disease can be transmitted to humans – leading to a viral spillover.

This means every unmonitored handling of a chimpanzee, including its capture, to sell it as a pet or kill for meat poses a risk of a disease breakout simply because the hunter or the capturer cannot know whether the animal has contracted Ebola virus. On the other hand, protecting a chimpanzee’s natural habitat and ensuring it stays within that habitat not only leads to its conservation but also prevents it from passing on any deadly pathogen, such as Ebola, to humans.

‘Learn from East Africa’

Considering the spillover risks, conserving the habitats of key wildlife species, especially those known to transmit viral zoonotic diseases to humans, is vital. Many feel West Africa can learn from its East African neighbors who have set examples of protecting their wildlife reserves by creating a safe distance between the wildlife and humans.

“Look at countries like Rwanda or Kenya, then you will see that where there is a wild reserve, they create a buffer zone of 2-3 kilometers,’’ says the founder of Tacugama Chimpanzee Sanctuary.

The failure to maintain this distance can pose serious risks to the region’s One Health goal, says Frederick Jobo Moseray, Assistant Conservation Manager at the sanctuary.

“When the forest goes, the animals become homeless. They then come to human colonies. Here, we are talking about chimpanzees. They are hunted, killed, and also kept as pets. All of this is dangerous. We are talking about preventing a zoonotic disease spillover, but first, we must stop the shrinking of safe space between humans and chimpanzees,” Moseray concludes.

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Aradhiya Khan, 25, a transwoman, got her vaccination in the middle of the night in July 2021, when the centre was less crowded, and stood in the women's line as there was none for her gender.

By Zofeen Ebrahim
KARACHI, Oct 31 2023 (IPS)

After months of warding off appeals from his employers to get vaccinated for the COVID-19 disease, Mohammad Yusuf, 24, working as a live-in domestic worker in Karachi’s Clifton area, finally relented and got his first shot.

“I believed that anyone who took the vaccine would die within two years,” he told IPS. He said he got this information from social media.

The people who finally convinced him were his parents living in the village of Rahil, in Sindh’s province of Umerkot district, where, according to Yusuf, “not a single case of COVID-19 has to date been found.” But because Karachi was rife with the virus then, his parents explained that he might catch the infection if he remained unvaccinated.

The other reason for his hesitancy was the fear that if he got COVID-19 and was hospitalized, he may die without saying goodbye to his family and be buried unceremoniously by strangers. “You either got well within ten days, or you’d die a very difficult and painful death with breathlessness, high fever, and then death,” is how he explained the disease and its symptoms.

Rakhi Matan, 40, a caretaker for the elderly, had heard, “If someone got COVID-19, the government would come and pick them up from their home and take them to a center, inject poison into you after which you died”. It was this fear that got her to vaccinate herself. But since the shot, she often falls sick and attributes it to the vaccine.

The country began its COVID-19 vaccination campaign first by inoculating health workers on February 2, 2021, a year after the first case was reported in February 2020. This was followed closely by senior citizens and gradually to everyone over 18 years of age.

According to data from the Ministry of National Health Services Regulations and Coordination (MoNHSR&C), by March 2022, of the total eligible population of a little over 143 million, more than 125 million had received their first jab.

Dr Rana Imran Sikander, executive director at the Pakistan Institute of Medical Sciences and who was then heading the COVID-19 ward there, was the first person in Pakistan to receive the shot from the batch of 500,000 Sinopharm vaccines received from China.

It was also the time when “myths and conspiracies abounded,” leading to hesitancy and fear of side effects. The more far-fetched conspiracy theories circulating in his hospital included ‘Bill Gates wants to reduce the world’s population,’ ‘the United States is injecting microchips into humans to make them their slaves,’ ‘Gates wants to alter their DNA.’

“Seeing me well and alive gave a huge boost to my co-workers,” said Sikander, who luckily has not caught COVID-19 even once. It could also be because he had also volunteered a dose six months prior to the official shot for the vaccine trial, he said.

Gallup Pakistan carried out 13 surveys (from March 2020 to January 2022) to understand people’s attitudes towards the pandemic. It also recorded the change in their perception towards the disease and the vaccine over a two-year period.

“The most alarming finding was that for close to 60 percent of health professionals, social media was a key source of information, and as high as one in five doctors were not willing to take the vaccine,” Bilal I. Gilani, executive director at Gallup Pakistan, told IPS. A consistent perception among Pakistanis in general, during all these months, he said, was “that COVID-19 was a foreign conspiracy.”

Like epidemiologists study viruses and find solutions on how to control the spread of diseases, anthropologist Dr Heidi Larson studies misinformation and tries to contain it before it spreads like wildfire. She is, therefore, not surprised as to why Sikander’s colleagues were “hesitant or losing confidence in vaccines.”

She has been studying the trend of how rumors start, flourish, and then taper, for 13 years under her Vaccine Confidence Project that she started in 2010.

At a recent Global Media Dialogue, held earlier this month, organized by the Internews, Larson spoke to a group of journalists about how important it was for health workers and policymakers to “listen” to what people are saying and why and “even listen to the rumors,” and they will “reveal that they [people] are not being heard”.

“That’s the cue to address the rumors,” she said. Already the findings say there is a drop in confidence around basic childhood vaccines, which she finds “pretty significant” and worrying as “we’ve never seen such a drop,” she said.

But how did the Pakistan government manage to get 130 million (above the age of 15) of the 250 million Pakistanis vaccinated for at least two doses in two years (by May 2022) after the pandemic? Given that the polio virus has continued to be found in Pakistan with communities refusing to get their children administered the oral vaccine, there was a fear among government officials it may face the same challenge with the COVID-19 vaccine.

Looking back to the two years of the pandemic, when he was the federal minister for planning and headed the National Command and Control Centre (NCOC) that had been set up to plan and contain the pandemic, Asad Umar said the two most important ingredients — “transparency and sharing of real-time data with the media when COVID-19 struck” was how they managed to dispel misinformation.

“By the time we were ready to vaccinate the people, the media had become our allies and played a huge role in supporting us in fighting misinformation and even disinformation.”

The other reason was that “for a change, all political parties were on board, and there was across-the-board consensus and confidence on the decisions made by the NCOC,” he said. The center disbanded as quickly as it was formed. “It’s a good model and needs to be institutionalized if we are to fight any future catastrophes, natural or health,” said Umar.

In July 2021, 76 percent of Pakistanis claimed that the government was controlling the COVID-19 situation well, according to a Gallup survey, although it diminished to just 41 percent by 2022.

It was “the oneness of message and consistency, coupled with an efficient vaccine delivery, which helped fight vaccine hesitancy,” said Dr Zaeem Ul Haq, a health and risk communication (real-time exchange of information, advice and opinions between experts and people who face a health hazard) expert who led communication and community engagement part of Pakistan’s response to the pandemic.

But to understand how the country succeeded in vaccinating millions of people, Haq said it was important to differentiate between vaccine-resistant (due to vested interests and political or religious beliefs difficult to convert) and vaccine-hesitant (if their questions around vaccines are appropriately answered can be converted) groups to be able to continue fighting misinformation. Unfortunately, in Pakistan, he said, these terms were used interchangeably and erroneously by the Pakistani media, which must be avoided, especially in the case of childhood immunization.

He shared that with simple and consistent messaging, combined with an age-appropriate, systematic administration of a vaccine, this reason-specific hesitancy declined in subsequent surveys.”

Dr Zafar Mirza, former special advisor to the prime minister for health, the government’s use of innovative approaches helped reach diverse and underserved populations.

“We put out pro-vaccination messages replacing the ringtones for nearly 150 million mobile phones, which made a huge impact,” he said. The Gallup survey found that by 2022, 84 percent of adult Pakistanis with mobile phone access had received at least one dose of the COVID-19 vaccine.

Another task carried out successfully was by the brigade of female community health workers and vaccinators, who convinced people to get vaccinated.

“Through the over 8,000 vaccinators and health workers and 300,000 community leaders, we managed to reach a population of 35 million in the remotest parts of Pakistan,” said Mirza.

A toll-free helpline, the Sehat Tahaffuz-1166, launched just before the pandemic in November 2019 to provide guidance for polio and its vaccine, was used to disseminate information about COVID-19.

“At one point, we had 500 call agents and 30 doctors daily assuaging the apprehensions and concerns about the infection and later the vaccine itself,” Mirza told IPS. From approximately 300 calls per day in 2019, it reached to 25,000, although the agents have attended as many as 70,000 calls in a day, too, he added.

For its part, UNICEF helped the government in battling vaccine hesitancy on social media platforms. “Through regular static posts and short videos, we communicated verified information about the vaccine’s efficacy. We posted messages from doctors, religious leaders, youth representatives, celebrities, community leaders, and even vaccinated individuals on our social media accounts,” UNICEF’s communications specialist, A. Sami Malik, told IPS. In addition, it regularly organized live interactive sessions on FB, Twitter Space, and Instagram, with experts providing responses to people’s questions and concerns.

This is not the last of the pandemics. Scientists are already warning of the possibility of a COVID-19-like pandemic at the scale of 2.5 percent to 3.3 percent yearly and 47 percent to 57 percent in the next 25 years. While vaccine hesitancy may have lowered, it has not ended after the pandemic. In fact, it gets fueled every time there is a reemergence of measles and polio in Pakistan. While vaccines must be delivered to the public in a coherent and effective manner to ensure public confidence in them, it will pay dividends if, as Dr Larson says, countries in general and Pakistan in particular, can recognize “the importance of emotions in people’s decision-making and in their willingness to cooperate.”

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Credit: Fiona Goodall/Getty Images

By Andrew Firmin
LONDON, Oct 20 2023 (IPS)

It’s a rapid reversal for New Zealand’s Labour Party, in power for six years. At the last election in 2020 it won an outright majority, the first party to do so under the current voting system. But three years on, it’s finished a distant second in the election held on 14 October. The result speaks to a broader pattern seen amid economic strife in many countries – of intense political volatility and the rejection of incumbents.

Jacindamania fades

Former Labour leader Jacinda Ardern captured the public imagination when she took the helm of her party in August 2017. Labour had been floundering but went on to gain seats at the election the following month, unexpectedly forming a coalition government.

Aged 37, Ardern was her country’s youngest-ever prime minister by some margin, and the world’s youngest female government leader. Many saw her as a breath of fresh air, offering an approachable and empathetic brand of politics. Ardern enjoyed an international profile unprecedented for a New Zealand prime minister.

The 2020 election saw Ardern and her party rewarded for what was widely seen as an effective pandemic response, credited with saving around 20,000 lives. The opportunity seemed on to pursue an ambitious agenda. The government could point to progress in decriminalising abortion, tightening gun control laws and introducing stronger workplace rights. But many saw the government as having an overcrowded legislative agenda, failing to make headway on headline policies such as child poverty, while voters increasingly became preoccupied with high inflation.

Ardern announced her resignation in January 2023. Her popularity and that of her party had declined amid the soaring cost of living, which some blamed on long pandemic lockdowns.

Ardern had been the target of a bombardment of online abuse, much of it vilely misogynist in nature. Last year New Zealand police reported that threats against Ardern had almost tripled over two years, as anti-vaccine disinformation and conspiracy theories accumulated extremist adherents. In 2022, anti-vaccine protesters camped for weeks outside parliament. The protests, which ended in violence, were a magnet for far-right extremists. Levels of vitriol previously unseen in New Zealand were again present during the election campaign, in which women and Māori candidates in particular were subjected to intimidation and instances of violence.

Ardern’s replacement as prime minister, Chris Hipkins, promised to focus on bread-and-butter issues. He cut many progressive policies and pitched squarely for the centre. But his strategy failed. Labour was the only major party to shed votes. It lost support to the centre-right National Party – New Zealand’s other party of government – along with the right-wing Act and the nationalist and populist NZ First. But it also shed more progressive voters, with the Green party and Te Pāti Māori, which advocates for Indigenous rights, picking up support.

Fractious coalition ahead

Quite what government will form isn’t yet clear. Results are provisional and won’t be finalised until 3 November, with over half a million ‘special votes’ still to be counted – many from New Zealanders living overseas. Due to the death of a candidate a by-election will also be held.

The National party has 50 seats in the 121-seat single-chamber parliament; the workings of the electoral system mean parliament will expand to 122 seats once all votes are counted. This total means it’s clear the National party will head a coalition government, with Christopher Luxon as prime minister. But a National-Act alliance might not be enough to command a majority. NZ First may need to be part of the coalition too.

NZ First is the creation of maverick opportunist Winston Peters. Over the course of a long career, Peters has pulled off the trick of positioning as anti-establishment while working with both main parties in coalition governments, including Ardern’s first administration, and serving as deputy prime minister twice. This time he was able to capitalise on anti-government sentiment developed under the pandemic, including by opposing vaccine mandates.

Among his campaign targets were Māori rights, with Peters – himself Māori – pledging to withdraw support for the United Nations Declaration on the Rights of Indigenous Peoples. Another focus was trans rights, tapping into the same currents of manufactured outrage seen in Europe and North America, with a law proposed to restrict access to toilets for transgender people.

The numbers may mean that the National party finds it easier to govern with Peters than without, even though the three parties disagree on key policies, including on the economy and housing. It could be a rocky road ahead.

Advances reversed?

For New Zealand’s civil society, the question could now become how best to defend gains made and keep on the agenda vital issues such as climate change. The climate crisis was barely mentioned during the campaign even though the country is experiencing extreme weather along with the rest of Oceania. Hipkins scrapped a series of transport reforms intended to cut greenhouse gas emissions. Act, certain to be part of government, wants to get rid of New Zealand’s Climate Change Commission and Zero Carbon Act, which mandates an emissions reduction plan and cap.

The last government’s experiments in ‘co-governance’ – essentially collaborative management, mostly of environmental resources, between government and Māori representatives, based in New Zealand’s foundational Treaty of Waitangi – seem sure to end. All parties likely to be involved in the new government attacked these moves with a flurry of hyperbolic claims. Act and NZ First characterise efforts to challenge the exclusion of Māori people as privileging them over other population groups. The danger is that those strongly opposed to Māori rights will feel emboldened, signalling increasing division and polarisation ahead.

New Zealand offers a lesson on the political consequences of the impacts of the pandemic and the cost-of-living crisis intensified by Russia’s war on Ukraine. In just three years, overwhelming political support evaporated. Progress may be temporary and subject to rapid reversal. Civil society must be able to switch strategies just as quickly, from advocating for more to defending gains already made.

Andrew Firmin isCIVICUS Editor-in-Chief, co-director and writer for CIVICUS Lens and co-author of the State of Civil Society Report.

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Cities across Asia and the Pacific in the 21st century have undergone extraordinary transformation and economic growth. They are places of immense opportunities for upward mobility to improve quality of life, dynamic innovations for transforming global technologies, and manufacturing hubs to meet the increasing demands for industrialization, consumerism and prosperity. The eighth Asia-Pacific Urban Forum (APUF-8), which is being held next week (23-25 October) in Suwon, Republic of Korea, is a key platform to share urban solutions and enhance partnerships to address the multitude of challenges. Credit: ESCAP

By Armida Salsiah Alisjahbana
BANGKOK, Thailand, Oct 20 2023 (IPS)

Cities have always been dynamic hubs of culture, education, economic growth and opportunity, and most importantly, centres of social interaction attracting residents and visitors alike.

It is no surprise then, that Asia and the Pacific has in recent years become predominantly urban as people seek greater opportunities and services in cities of all sizes, from coastal communities in the Pacific to mega-cities such as Bangkok, Hong Kong and Tokyo, and in smaller towns and emerging urban centres, each with unique characteristics reflecting our region’s diversity.

The megatrend of urbanization, however, has not been free of difficulties, with many of the global crises, including the COVID-19 pandemic, the increasing effects of climate change, biodiversity loss and various forms of pollution, all converging in our cities. These challenges have made more visible long-standing issues such as inequalities and urban poverty, access to affordable housing and an infrastructure gap.

Our most vulnerable communities often are those most affected. This is clear in our cities where climate-related disasters disproportionately impact the poor, and women and children are unable to access essential urban services.

Meanwhile, a lack of affordable housing hinders the poor and middle classes alike, and inadequate infrastructure too frequently results in persons with disabilities being left behind. Collectively, these challenges not only can harm cities and their residents but will hinder progress toward the 2030 Agenda for Sustainable Development and its goals, many of which intersect in cities.

When cities shuttered during the pandemic, economic activity, tourism, education and urban services all suffered seemingly irreparable harm. Yet, in the aftermath of the global pandemic, we realize that a sustainable future for Asia and the Pacific runs through our cities, and we must take the necessary steps to address existing urban challenges and plan urbanization to be inclusive and resilient to future shocks and crises.

And we know how to get there. ESCAP, UN-Habitat and partners have developed a new flagship report, Crisis Resilient Urban Futures: The Future of Asian & Pacific Cities 2023. Through analysis of the crises and their effects, the report offers practical guidance across four key thematic areas for inclusive urban policies, partnerships, and innovations:

First, urban and territorial planning remains the foundation of how all cities manage their growth and plan urban services. Having seen how crises can disrupt these systems, we know that holistic urban planning that prioritizes multi-use, compact development, low-carbon transportation and mobility, affordable housing and efficient delivery of services are essential for creating safe, sustainable and livable cities for all citizens.

Next, as we are all too frequently reminded by the number of climate-induced disasters in our region, effectively responding to the climate emergency must be a priority, and cities are well positioned to lead innovation and new practices for low-carbon and resilient pathways. A resilient city engages all stakeholders, from the most vulnerable communities to civil society and policy makers from the local to national level, all working to co-develop solutions.

We also live in a more digitally connected world, where urban digital transformations and smart city technologies, if managed effectively, can improve operational efficiencies, bridge the digital divide and ensure access for all. The pandemic underlined the need to include everyone in shaping our digitally transformed future.

Finally, the multiple crises highlighted the urgency to safeguard urban finances. Expanding, diversifying, and increasing municipal revenue should be a key strategy for cities to stimulate local economic recoveries. And as no city can go it alone, robust multi-level governance, supported by transparent public frameworks for intergovernmental transfers, is needed, while more stable policies and incentives can open doors to private sector investment.

Recovery from any shock or crisis takes time and collective action. We must ensure that our urban areas guard against future risks while building safe, sustainable and livable communities and putting us back on track to achieve the 2030 Agenda.

The eighth Asia-Pacific Urban Forum (APUF-8), which is being held next week (23-25 October) in Suwon, Republic of Korea, is a key platform to share urban solutions and enhance partnerships to address the multitude of challenges. Though the task is formidable, with the right policies, innovations, cooperation and the engagement of citizens, we can ensure that our region’s cities remain vibrant hubs.

Armida Salsiah Alisjahbana is Under-Secretary-General of the United Nations, and Executive Secretary of the Economic and Social Commission for Asia and the Pacific (ESCAP).

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With decisive leadership and the support of civil society Kerala was able to the spread of COVID-19 down. Picture Supplied

By Ranjit Devraj
NEW DELHI , Oct 6 2023 (IPS)

When COVID-19 claimed millions of lives across India, Kerala state at the southern tip of the subcontinent stood apart for low mortality rates that experts attribute to good governance, a robust public health delivery system and strong civil society support.

Kerala, a state of 35 million people, has consistently ranked above the rest of India on the Human Development Index (0.84), with literacy, life expectancy, and human rights records comparable to that of developed countries. It enjoys an infant mortality rate of 12 per thousand live births and a female literacy rate of 92.07 percent.

One reason for Kerala’s high development indices is its remittance economy, with large numbers of its people finding work abroad — an estimated four million are known to be working in the oil-rich Middle Eastern countries alone. Remittances to Kerala averaged 715,789,912 million US dollars annually during the 2004—2023 period.

However, the same expatriate workers became a liability during the pandemic. As they streamed back home, the state government mounted tight monitoring at its four international airports at Kannur, Calicut, Kochi, and Thiruvananthapuram while following up with quarantine, source tracing and tracking to prevent the virus from spreading in the densely populated state (860 people per square kilometre).

“There are many layers to the measures ordered by the state government, extending to individuals, community, public health systems and private hospitals,” said Jaideep C Menon, professor of adult cardiology and public health at the Amrita Institute of Medical Sciences, Kochi.

Voluntary Agencies

“Everybody pulled together. Community kitchens run by panchayats ensured essential supplies of grains, vegetables, fruits, petroleum products or drugs,” said Jaideep Menon. Additionally, he said, there were awareness creation programmes run by government-backed self-help groups like ASHA and the women’s voluntary agency Kudumbasree.

“There were instances of essential drugs like Factor VIII for haemophilia, cancer care medicines, etc., being sent through the police networks to remote public health centres (PHCs) during lockdowns. Radioisotopes — supplied to hospitals solely by the Babha Atomic Research Centre — were flown in on specially chartered flights and moved to recipients with police help,” Jaideep C said.

According to Jaideep Menon, the police force proved to be an effective arm of the government’s COVID-19 response, not only for facilitating the movement of essentials but also for providing effective policing that was needed to implement contact tracing and quarantine during the first wave of the pandemic that ran from March to November 2020.

Groups such as the Distress Management Collective India networked influential Malayalis (as Kerala natives are called) living around the world to source medicines, vaccines, and equipment such as oxygen concentrators for COVID-19 patients in dire need.

“On receiving the oxygen concentrators, we delivered them to people with breathing difficulties in remote places of Kerala,” says Anil Jabbar, a local coordinator in the state for the DMCI. “The instructions on how to calibrate and use the equipment were then provided over smartphone videos to protect ourselves from getting infected.”

Coordination expertise came from Vinod Chandra Menon, a founder member of the National Disaster Management Authority (NDMA) and former Asia regional director of the International Emergency Management Society, Oslo.

“The odds in Kerala were tremendous because of a moving population – in fact, the first recorded Covid case in India was that of a female medical student in Wuhan who flew back home to Kerala on 23 January 2020,” said Vinod Menon.

“What was instructive was the professional way in which the authorities handled the case,” said Vinod Menon. “She had no symptoms but based on her travel history in China, she was placed in an isolation room, and her throat swab and blood samples were flown to the National Institute of Virology in Pune, where the samples tested positive for COVID-19.”

“It was clear from the start that early detection and early response was the way to go, and Kerala averted a major disaster by simply following the standard operating procedure that was laid down from the start,” said Vinod Menon.

“Unlike in most of India, Kerala’s interdepartmental coordination was excellent and meshed together with voluntary agencies and women’s help groups thanks to backing from the highest levels of government right down to the villages.”

While the number of COVID-19 fatalities in India remains contentious, with some estimates placing it above 5 million, calculations based on National Survey Data indicate that between 1 June 2020 and 1 July 2021 alone, there were 3.2 million deaths from the virus.

In contrast, Kerala’s data, even after the second wave between April and March 2021, suggested “relatively limited spread, fairly effective mitigation and better surveillance of both infections and deaths than in most parts of the country,” according to Murad Banaji a lecturer in applied mathematics at the University Oxford with an interest in analysing the pandemic in India.

It helped that Kerala had been primed up for community participation, interdepartmental coordination, participation of local self-governments and social mobilisation by voluntary agencies through the experience of responding to a massive flood that devastated the state in 2018 and a Nipah virus epidemic in 2018—2019.

Said Sandhya Raveendran, who is both a surveillance officer for Kollam as well as the deputy medical officer for the district: “We hit the ground running. Even before the first case was identified, we were ready with mock drills and rapid response teams, thanks to the legacy of handling a Nipah virus outbreak.”

Sample collection teams, consisting of a medical officer, a nurse or laboratory technician and a driver, all equipped with PPE kits, fanned out daily along predetermined routes after prior intimation to sites that were due to be visited, said Sandhya Raveendran.

“Key to containment was the early setting up of sentinel surveillance using RT PCR tests followed by the setting up of laboratories capable of performing accurate tests,” said Raveendran. “What became clear after four rounds of tests was that most of the cases were imported and that there was no community transmission.”

The laboratories were linked to an ‘integrated health information platform’ for real-time reporting of detailed results so that action could be rapidly taken at the field level and epidemiological investigations could be carried out by special rapid response teams.

By early March 2020, the state had the highest number of active cases in India, but using the trace, quarantine, test, isolate and treat strategy, by June 2020, Kerala managed to keep the basic reproduction number (transmission per primary infected person to the secondarily infected persons) at 0.454 against the India average of 1.225.

Decisive leadership

“What worked was decisive leadership from the top in setting up command centres in various districts under the district collector (chief administrator), following directives from the chief minister and the state health department,” said Jaideep Menon. “This led to health taking centre-stage for a prolonged period in both print and audio-visual media.”

“In sum, Kerala’s proactive approach to quarantine, infection prevention and control, the state’s strong public health system that could reach every household, and an empowered and literate community pulled together to combat the pandemic.”

He says the key lesson for the rest of India is that a robust disaster management plan must be instituted with clarity on who does what, adding that while all the states had voluntary agencies and local self-governments, they were not harnessed towards quick and effective intervention in the way Kerala did.

“Pandemics like COVID-19 are a distinct possibility in the future, and that’s why it is important to clearly define the role and mandate of each implementing agency by governments.”

Note: This article was supported by the Sabin Vaccine Institute and Internews.

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Women share nutritious diverse local crop varieties at 2022 Djimini seed fair in Senegal. The Alliance for a Green Revolution in Africa is helping rewrite African laws and policies to favor conversion to hybrid and GMO maize seeds. Credit: AFSA or Alliance for Food Sovereignty in Africa (AFSA)

By Timothy A. Wise
CAMBRIDGE, MA., Aug 29 2023 (IPS)

As the adage goes, when you find yourself stuck in a hole, stop digging. As African leaders and their philanthropic and bilateral sponsors prepare for another glitzy African Green Revolution Forum, convening September 5-8 in Dar es Salaam, Tanzania, they are instead handing out new shovels to dig the continent deeper into a hunger crisis caused in part by their failing obsession with corporate-led industrialized agriculture.

Instead of cutting food insecurity in half, as the Alliance for a Green Revolution in Africa (AGRA) promised at its founding in 2006, the continent has spiraled in the opposite direction. The number of chronically “undernourished” people in AGRA’s 13 focus countries has increased nearly 50%, not decreased, according to recent hunger data from the United Nations.

AGRA’s corporate cheerleaders will try to blame the continent’s deepening cavern of hunger on disruptions from the COVID pandemic and the Russia-Ukraine war, but chronic hunger had already risen 31% by 2018 in AGRA countries, as I documented in my 2020 Tufts University study. The hole was already getting deeper.

Summit host Tanzania is a case in point. As the government readies another Green Revolution festival of self-congratulation, refusing to allow Tanzanian farm groups to offer a more critical perspective and more effective solutions, UN figures show a 34% increase in number of undernourished Tanzanians since 2006. An estimated 59% of Tanzanians suffer moderate or severe levels of food insecurity, according to survey data from the UN Food and Agriculture Organization.

African farmers: “Put down the Green Revolution shovels”

Once again, African farmer organizations are calling on African leaders and the donors who support them to put down the Green Revolution shovels, climb out of the hole, survey the damage their failing agricultural development model has wrought, and change course to more farmer-centered and sustainable ecological agriculture.

The Alliance for Food Sovereignty in Africa concluded its recent continental meeting on seed rights denouncing “AGRA and other corporate actors’ continued pressure to influence African government seed policies and biosafety regulations to increase corporate capture and control of seed on the continent.” They have scheduled a virtual press conference August 30, demanding “No Decisions About Us Without Us!”

In calling for a strategic reset, they are not ignoring the complex causes of hunger on the continent – climate change, conflict and corruption exacerbated by pandemic disruptions and rising costs of fertilizers and food imports from Russia and Ukraine. They are recognizing that the Green Revolution’s corporate-driven, technology-based strategy for rural uplift has proven unfit to help small-scale farmers cope with such challenges.

In 2006, AGRA offered a coherent strategy and admirably ambitious goals. Its aggressive promotion of commercial seeds and synthetic fertilizers would catalyze a virtuous cycle of agricultural development. Rising yields would feed the hungry and stimulate further investments in productivity-enhancing farm technologies. AGRA’s self-proclaimed “theory of change” would double food-crop productivity and incomes for 30 million small-scale farming households by 2020 while cutting hunger in half.

Seventeen years – and more than one billion dollars – later, the evidence shows that AGRA’s theory of change was flawed at every turn. Those seeds and fertilizers did not produce a productivity revolution. Yields rose only 18% over 14 years, barely faster than before the new Green Revolution push. Maize yields grew only 29% despite billions of dollars in government subsidies to allow farmers to buy – and corporations to sell – the inputs. Meanwhile, more nutritious and climate-resilient traditional crops such as millet and sorghum saw yields stagnate or decline as farmers planted more subsidized maize.

With limited yield improvements, farmers didn’t see more food or higher incomes from sales of their promised new surplus production. They saw a losing proposition, with the costs of seeds and fertilizers outpacing the expected returns from crop sales. When the subsidies were cut as government budgets were squeezed, farmers stopped buying the seeds and fertilizers and went back to their old seeds, if they had managed to save any. Many found themselves in debt after input purchases failed to pay off their investment.

Most found farmland that was now less fertile than before, the nutrients drained by monocultures of maize. The fertilizers fed the maize, not the soil, which continued to lose fertility, starved for the organic matter provided by more ecological methods such as intercropping and manure applications.

So no one should be surprised to find hunger on the rise. Farmers were not growing much more food. What food they were growing – mostly starchy staples like maize and rice – were less nutritious than the mix of crops they used to grow. And they had little new cash income to purchase more food, never mind a diverse and nutritious diet. Many had less cash as they tried to pay off debts from their failed investments in commercial seeds and fertilizers.

Cosmetic changes, less transparency

International donors have failed to heed African farmers’ calls to change course. Instead, AGRA rolls out new corporate branding, a facelift not the full makeover Africa needs.

At last year’s Green Revolution Forum, attendees were treated to a slick set of videos announcing that the forum was removing the term “green revolution” from its name. Indeed, this year’s gathering calls itself the African Food Systems Summit. And AGRA itself dropped “green revolution” from its name, declaring with no real explanation that it would now just go by its acronym, AGRA.

AGRA literally stands for nothing at this point. Calling its new five-year strategy “AGRA 3.0,” leaders refuse to acknowledge the failures of their Green Revolution model. They keep promoting new versions of the same failed approaches. AGRA continues to foster pro-business policy changes within African governments, like the one it has helped push in Zambia this year. It promotes “agro-poles” – 250,000 acre “farm blocks,” often located on land grabbed from local communities so corporate investors can establish industrial-scale farms.

Like many tech upgrades, AGRA 3.0 gives African farmers less of what they really need, not more.

This year, AGRA’s cosmetic changes include a newly redesigned web site, replete with AGRA’s new logo but missing even the rudimentary progress reports it used to make available to the public. Scrubbed from the site – or conveniently buried in it – is last year’s damning donor-commissioned evaluation, which highlighted AGRA’s many failures to deliver on its promises.

African farmers have a different vision. They want donors and governments to stop supporting the failing Green Revolution initiative and instead shift their support to lower cost, farmer-centered, ecological agriculture. Farmers are producing their own organic fertilizers and pesticides from local materials, with excellent results. The simple and low-cost innovation of “green manure-cover-cropping” has scientists working with some 15 million small-scale maize farmers in Africa to plant local varieties of trees and nitrogen-fixing food crops in their maize fields, tripling maize yields at no cost to the farmer.

The solutions are at hand. It is past time for Green Revolution promoters to put down the shovels and stop digging Africa deeper into hunger.

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Anti-government protest in Sri Lanka on April 13, 2022. Credit: Wikipedia

By Asoka Bandarage
WASHINGTON DC, Aug 25 2023 (IPS)

Sri Lanka has been faced with an unprecedented political and economic crisis since the beginning of 2022.

The dominant narrative attributes the crisis to the confluence of the COVID-19 pandemic, the Ukraine conflict, China’s ‘debt trap diplomacy’ and – most importantly – the corruption and mismanagement of the ruling Rajapaksa family.

Western mainstream media celebrated the so-called aragalaya (struggle, in Sinhala) protest movement that led to the ouster of the Rajapaksas and upholds the IMF bail-out as the only solution to the dire economic situation.

The aragalaya protests emerged from genuine economic grievances, but failed to develop an analysis beyond the ‘Gota, Go Home’ demand for Gotabaya Rajapaksa to resign. Influenced by local and external interests with their own agendas, the protestors exhibited little-to-no awareness or critique of the global political economy and the financial system at the root of the country’s crisis.

In 2022, the United Nations Conference on Trade and Development (UNCTAD) reported that 60 percent of low-income countries and 30 percent of emerging market economies are ‘in or near debt distress.’ While the details differ from country to country, the historical patterns of subordination that have given rise to global crises are the same.

The Sri Lankan crisis is an illustrative example of convergent global debt, food, fuel and energy crises facing much of the world. It is corporate media bias and narrative control that deflects from this analysis.

The island’s severe debt and economic crisis must be seen in a broader global context as the culmination of several centuries of colonial and neo-colonial developments, and the disastrous and inevitably self-destructive capitalist paradigm of endless growth and profit. Debt is not “a straightforward number but a social relation embedded in unequal power relations, discourses and moralities…and…institutionalized power.”.

Colonialism and Neocolonialism

The development of export agriculture and the import of food and other essentials under British colonialism turned Sri Lanka into a dependent ‘peripheral’ unit of the global capitalist economy.

Adopting ideologies of modernization and development and theories of comparative advantage, the capitalist imperative integrated self-sustaining indigenous, peasant, and regional economies into the growing global economy, through the appropriation of land, natural resources, and labor for export production.

Monocultural agriculture, mining, and other export-based production disturbed traditional patterns of crop rotation and small-scale subsistence production that were more harmonious with the regional ecosystems and cycles of nature.

Plantation development contributed to deforestation, loss of biodiversity and animal habitats. While a small local elite prospered through their collaboration with colonialism, most people became poor, indebted, and dependent on the vagaries of the global market for their sustenance.

Although colonized countries including Sri Lanka gained political independence following World War II, unequal exchange continued under neo-colonialism. Terms of trade disadvantaged the ‘Third World’ with their labor, resources and exports grossly undervalued and imports overvalued.

The dynamic is better understood as poorer countries being over-exploited rather than under-developed. Rising populations combined with corruption and inefficiency of local governments gave rise to endemic foreign exchange shortages and economic crises in Sri Lanka and many other countries.

The debt relief and aid given by the IMF, the World Bank and bilateral institutions from the Global North have been mere band-aids to keep the ex-colonial countries tethered to the global financial and economic structures. Post-independent Sri Lanka went to the IMF 16 times before the current 2023 bail-out which seeks to further perpetuate the county’s cycle of debt dependence.

The transfer of financial and resource wealth from poor countries in the global South to the rich countries in the North is not a new phenomenon. It has been an enduring feature throughout centuries of both classical and neo-colonialism. Between 1980 and 2017, developing countries paid out over $4.2 trillion solely in interest payments, dwarfing the financial aid they received from the developed countries during that period.

Currently, international financial institutions – notably the IMF and the World Bank – remain outside political and legal control without even ‘elementary accountability’. As critics from the Global South point out, “The overwhelming power of financial institutions makes a mockery of any serious effort for democratization and addressing the deteriorating socioeconomic living conditions of the people in Sri Lanka and elsewhere in the Global South.”

Financialization and Debt

Corporate and financial deregulation which accompanied the rise of neoliberalism starting in the 1970s has given rise to financialization, and the increasing importance of finance capital. As more and more aspects of social and planetary life are commoditized and subjected to digitalization and financial speculation, the real value of nature and human activity are further lost.

As a 2022 United Nations Report points out; food prices are soaring today not due to a problem with supply and demand but due to price speculation in highly financialized commodity markets.

A handful of the largest asset management companies, notably BlackRock (currently worth USD $ 10 trillion) control very large shares in companies operating in practically all the major sectors of the global economy: banking, technology, media, defense, energy, pharmaceuticals, food, agribusiness including seeds, and agrochemicals.

Financial liberalization advanced when interest rates dropped in the richer countries after the global 2008 financial crisis. Developing countries were encouraged to borrow from private international capital markets through International Sovereign Bonds (ISBs) which come with high interest rates and short maturation periods.

Although details are not available to the public, BlackRock is reportedly the biggest ISB creditor of Sri Lanka. Most of Sri Lanka’s foreign debt is ISBs, with over 80% of Sri Lanka’s debt owed to western creditors, and not – as projected in the mainstream narrative – to China.

IMF debt financing requires countries to meet its familiar structural adjustment conditions: privatization of state-owned enterprises (SOEs), cutbacks of social safety nets and labor rights, increased export production, decreased import substitution and alignment of local economic policy with US and other Western interests.

These are the same aims as classical colonialism, they are just better hidden in the more complex modern system and language of global finance, diplomacy and aid.

A vast array of policies exacting these aims are well under way in Sri Lanka, including the sale of state-owned energy, telecommunications and transportation enterprises to foreign owners, with grave implications for Sri Lanka’s economic independence, sovereignty, national security and the wellbeing of her people and the environment.

The IMF approach does not address long-term needs for bioregionalism, sustainable development, local autonomy and welfare. A small vulnerable country such as Sri Lanka cannot change the trajectory of global capitalist development on its own.

Regional and global solidarity and social movements are necessary to challenge the deranged global financial and economic system that is at the root of the current crisis.

Global South Resistance

Since the 1970s, major collaborative projects have been initiated by developing countries and the UNCTAD to develop a multilateral legal framework for sovereign debt restructuring. Yet they are futile in the face of the powerful opposition of creditors and the protection given to them by wealthy countries and their multilateral institutions, and the UN has failed to uphold commitment and implement a debt restructuring mechanism.

Sri Lanka was a global leader in efforts to create a New International Economic Order, the Non-Aligned Movement and the Indian Ocean as a Zone of Peace in the 1960s and 70s. In the early years of their political independence, countries throughout Asia, Africa and Latin America sought to forge their own paths of economic and political development, independent of both capitalism and communism and the Cold War.

These included African socialist projects such as Tanzania’s Ujamma, import substitution programs in Latin America and left-wing nationalism and decolonization efforts in Sri Lanka and many other countries.

Almost without exception, these nationalist efforts failed, not only due to internal corruption and mismanagement but also due to persistent external pressure and intervention. Massive efforts have been taken by the Global North to stop the Global South from moving out of the established world order.

A case in point is the nationalization of oil companies owned by western countries in Sri Lanka in 1961 and the backlash against the left-nationalist Sri Lankan government which dared to take such a bold move.

The western response included the 1962 Hickenlooper Amendment passed in the U.S. Senate stopping foreign aid to Sri Lanka and to “any country expropriating American property without compensation.” As a result, Sri Lanka lost its credit worthiness, the domestic economic situation worsened, and the left-nationalist government lost the 1965 elections (with some covert US election support).

Observing those developments, political economist Richard Stuart Olsen wrote: “…the coerciveness of economic sanctions against a dependent, vulnerable country resides in the fact that an economic downturn can be induced and intensified from the outside, with the resulting development of politically explosive ‘relative deprivation’…”

These observations resonate with Sri Lanka’s current repetition of the same vicious cycle: an externally dependent export-import economy; worsening terms of trade; foreign exchange shortage; policy mismanagement; external political pressure; debt crisis; shortages of food, fuel and other essentials; mass suffering; and political turmoil.

Geopolitical Rivalry

Sri Lanka’s present economic crisis – the worst since the country’s political independence from the British – must be seen in the context of the accelerating neocolonial geopolitical conflict between China and the USA in the Indian Ocean. Many other countries across the world are also caught in the neocolonial superpower competition to control their natural resources and strategic locations.

There is much speculation as to whether the debt default on April 12, 2022 and political destabilization in Sri Lanka were ‘staged’ or intentionally precipitated to further the US’s ‘Pivot to Asia’ policy, the Indo-Pacific Strategy and the Quadrilateral Alliance (USA, India, Australia and Japan) in its competition to confront China’s $1 trillion Belt and Road Initiative and counter China’s presence in Sri Lanka.

It is widely recognized in Sri Lanka that ‘The policy of neutrality is the best defence Sri Lanka has to deter global powers from attempting to get control of Sri Lanka because of its strategic location.’ Although President Gotabaya Rajapaksa claimed to pursue a ‘neutral’ foreign policy, the Rajapaksas were seen as closer to China than the west. After Prime Minister Mahinda Rajapaksa and President Gotabaya Rajapaksa were forced to resign, Ranil Wickramasinghe – a politician who was resoundingly rejected in the previous elections by the electorate but is a close ally of the west – was appointed as President in an undemocratic transition of power.

To what extent were Sri Lanka and her people victims of an externally manipulated ‘shock doctrine’ and a regime change operation, sold to the world as internal disintegration caused by local corruption and incapability?

While it is not possible to provide definitive answers to these issues, it is necessary to consider the available credible evidence and the geopolitics of debt and economic crises in Sri Lanka and the world at large.

Paradigm Shift

As the locus of global power shifts from the west and a multipolar world arises, new multilateral partnerships are emerging for development financing, such as the New Development Bank (NDB) – formerly referred to as the BRICS (Brazil, Russia, India, China and South Africa) Development Bank – as alternatives to the Bretton Woods and other western dominated institutions.

However, given controversial projects, such as China’s Port City and India’s Adani Company investments in Sri Lanka as well as their projects elsewhere, it is necessary to ask if the BRICS represent a genuine alternative to the prevailing political-economic model based on domination, profit and power?

Dominant political power in our era is about propaganda, control of narratives and exploiting ignorance and fear. In the face of worsening environmental and social collapse across the world, there is a practical need for a fundamental questioning of the values, assumptions and misrepresentations of the dominant neoliberal model and its manifestations in Sri Lanka and the world.

At the root of the crisis, we face is a disconnect between the exponential growth of the profit-driven economy and a lack of development in human consciousness, i.e., in morality, empathy, and wisdom.

Ultimately, dualism, domination and the unregulated market paradigm need to be questioned to find a balanced path of human development, based on interdependence, partnership and ecological consciousness. Such a path of development would uphold the ethical principles necessary for long-term survival: rational use of natural resources, appropriate use of technology, balanced consumption, equitable distribution of wealth, and livelihoods for all.

This article is derived from the author’s new book: Asoka Bandarage, CRISIS IN SRI LANKA AND THE WORLD: COLONIAL AND NEOLIBERAL ORIGINS: ECOLOGICAL AND COLLECTIVE ALTERNATIVES (Berlin: De Gruyter,2023) https://www.degruyter.com/document/isbn/9783111203454/html?lang=en]

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Coimbatore, Tamil Nadu, India, December 15, 2021: Community members in Sowripalayam outside of Coimbatore stand in line to receive a nutritious meal from No Food Waste. Credit: The Global FoodBanking Network / Narayana Swamy Subbaraman

By Lisa Moon
CHICAGO, USA, Aug 8 2023 (IPS)

With the ongoing global food crisis—triggered by the COVID pandemic, disasters, supply chain disruptions, and conflict in Ukraine—food security should be at the top of the G20 agenda when countries gather in India in September 2023.

Food security and national security are closely intertwined. Throughout history, countries that have suffered from extreme hunger and malnutrition have been vulnerable to civil unrest, along with diminished economic productivity and exacerbated inequity.

Having a robust and resilient food system is critical for G20 countries, which together represent around 85 percent of global gross domestic product and are home to two-thirds of the world’s population. In addition, G20 countries produce as much as 80 percent of the world’s cereals and account for a similar proportion of global agricultural exports.

Indian Prime Minister Narendra Modi has recognized this imperative, recently saying in a message to G20 Agricultural Ministers: “I urge you to deliberate on how to undertake collective action to achieve global food security.”

Yet, with more than 735 million people facing food insecurity in 2022, about half of whom are in G20 countries, the food system clearly needs repair.

While a multi-dimensional approach is essential, there is a solution that brings immediate benefit to people, while reducing food waste and helping address climate change. That solution is food banking.

Food banks collect surplus food in large volumes, often donated or purchased from food manufacturers, retailers or farmers, and get it to those who need it most. Working in concert with other community-led organizations to reduce hunger and food insecurity, food banks help address the paradox at the heart of the global food system: the unconscionable amount of food that is lost or wasted that could – and should – instead be used to feed people.

Tiruppur, Tamil Nadu, India, December 17, 2021: No Food Waste (NFW) staff serve a nutritious meal to community members in Eswaran Koil Street. Credit: The Global FoodBanking Network / Narayana Swamy Subbaraman

Food banks are already present in every G20 market, providing nutritious meals to people who need them most. They often complement the work of governments to get food to people who are underfed or undernourished. And they can reach those who are often left out of other forms of social protection. Food bankers are embedded in their communities and can respond quickly when disasters strike.

Last year, members of The Global FoodBanking Network in nearly 50 countries helped feed 32 million people, distributing more than 650 million kilograms of food and groceries and mitigating 1.5 billion kilograms of CO2e through avoided food loss and waste. Many of these countries faced civil unrest and disasters caused by climate change and conflict.

India is already setting a strong example in mobilizing food banks as part of its efforts to address food waste. Having implemented Surplus Food Regulations in 2019 to ensure unused food could be donated, India saw a 250 percent increase in the volume of food distributed through food banks last year compared to pre-pandemic levels.

The food banks No Food Waste, India FoodBanking Network and Feeding India provided 13.5 million kilograms of food to 6.4 million people in 2022. These food banks provide nutrition to school children, migrant workers and other vulnerable populations. With supportive government policies and financing, these efforts have the potential to expand rapidly in the coming years.

A growing number of G20 countries, such as Brazil and Indonesia, are also adopting food banks to strengthen their food security and reduce hunger. Last year, Brazil’s national network of nearly 100 food banks served 2.5 million people in the country. And food banks in Indonesia provided food to about 1.2 million people in 2022, an increase of nearly 40 percent compared to 2021.

By working with food producers, retailers and farmers, food banks bridge public and private sectors, providing a vital service that complements social welfare programs and helps minimize food waste and the associated emissions, contributing to multiple human development goals.

When G20 leaders come to the table to discuss the urgency of food security, they will look for solutions that are already available and have proven track records. India has already made it clear that food security is a priority for its G20 presidency. The government now has the opportunity to leverage its experiences and insights to build effective collaboration among countries on this issue.

By developing comprehensive food security strategies, G20 countries can make a sound investment to create a stronger future.

IPS UN Bureau

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Excerpt:

In 2015, almost all heads of government in the world committed to the United Nations’ Sustainable Development Goals (SDGs), including universal health coverage (UHC). This was consistent with the World Health Organization’s commitment to Health for All.

The COVID-19 pandemic exposed most countries’ under-investment in public healthcare provisioning and other weaknesses. Clearly, health system reforms and appropriate financing are needed to improve populations’ wellbeing.

Jomo Kwame Sundaram

Health inequalities growing
Recent decades have seen healthcare in many developing countries trending towards a perceived two-tier system – a higher quality private sector, and lower quality public services. Many doctors, especially specialists, have been leaving public service for much more lucrative private practice.

This ‘brain drain’ has worsened already deteriorating public service quality, increasing waiting times. Hence, more of those with means have been turning to private facilities. As private medical charges are high in developing countries, many who can afford private health insurance, buy it.

If unchecked, the gap – in charges and quality – between private and public health services will grow, increasing disparities between haves and have-nots. Social solidarity implies cross-subsidization in health financing – with the healthy financing the ill, and the rich subsidizing the poor. Social solidarity also enables universal coverage and equitable access.

Better healthcare for all
Most governments need to strengthen public provisioning of comprehensive health protection with adequate financing. Meanwhile, healthcare costs have gone up due to more ill health, the rising costs of new medical technologies, privatization and less public procurement.

Everyone – nations as well as families – faces more unexpected health threats, worsened by rising catastrophic and other medical expenses, more economic vulnerability, greater income insecurity, declining public provisioning, and costlier coping strategies.

Nazihah Noor

Spending and outcomes
Most countries, including in the developing world, have seen rising healthcare spending. But there is no direct relationship between health expenditure and wellbeing. Hence, more spending does not ensure better outcomes, whereas appropriate public healthcare provisioning does.

Although health spending has been rising in many developing countries, it has generally remained low in relation to income. Government health services were already facing fiscal constraints before the pandemic. To cope with COVID-19, public health expenditure in many middle-income countries spiked.

Chronic underinvestment in public services has undermined healthcare overall. Many underfunded systems have nonetheless improved health conditions, reducing morbidity and mortality. Decent health outcomes, despite relatively low health spending, imply greater public expenditure ‘cost-effectiveness’ or efficiency.

Nonetheless, much more could be achieved with better policies, increased spending and more appropriate priorities. Thus, reducing child and maternal mortality, besides improving sanitation and water supplies, have significantly raised life expectancy in developing countries.

Improving policy
To enhance wellbeing, health systems must better protect people from current and future threats and challenges. Better public healthcare financing – with absolutely and relatively more, but also more appropriate funding – seems most important.

Developing country governments are often fed oft-repeated, but doubtful claims that current government healthcare spending is too high, and health insurance is necessary to fill the funding gap. Instead, official revenue should mainly fund health budgets to ensure efficiency and equity.

Health promotion should involve more preventive efforts. By mainly focusing on curative interventions, most government spending and policy priorities neglect determinants of wellbeing, including inequities. Some WHO recommended policies deemed most cost-effective target tobacco products, harmful alcohol use and unhealthy diets.

Policy coherence
To better address overall wellbeing, a more comprehensive and integrated approach should integrate health with related public policies. Affordable healthier food options, physical exercise and healthier lifestyles deserve far greater emphases.

For example, a cheap, but nutritious, safe and healthy daily school feeding programme in Japan – introduced a century ago, when it was still quite poor – has ensured life expectancy in the archipelagic nation has been the world’s highest for decades.

An ‘all-of-government’ approach should ensure meals planned by dieticians, mindful not only of good nutrition, but also of local food cultures, costs, safety and micronutrient deficiencies. With a ‘whole-of-society’ approach, involved parents can ensure schoolchildren are fed safe food from farmers not using toxic pesticides.

This can be ensured with the food or agriculture ministry’s participation. Farmer organizations can be contracted to supply needed foodstuff with initial support from government agricultural extension services, not corporate salesmen. This, in turn, improves the safety of all farm produce, ensuring healthy food for all.

Health reform recommendations should prioritize governments’ major commitments – to the people and the international community – of ‘universal health coverage’ to ensure ‘health for all’.

Nazihah Noor is a public health policy researcher. She led two reports on health system issues in Malaysia, Social Inequalities and Health in Malaysia and Health and Social Protection: Continuing Universal Health Coverage. She is currently pursuing a PhD in public health in Switzerland.

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Persons with disabilities have been disproportionately affected by the events of recent years, including the COVID-19 pandemic. Credit: UNDP Honduras

By Ulrika Modéer and Jose Viera
NEW YORK, Jul 10 2023 (IPS)

This year marks halfway towards the Sustainable Development Goals (SDGs), an ambitious agenda which set out to transform our world.

We have always known that the goals cannot be realized without the inclusion of persons with disabilities. From poverty to inequality, climate to health the promise to leave no-one behind is the bedrock of the SDG call to action.

Unfortunately, the midway indicators should give us all cause for concern. The UN Secretary-General recently announced that progress on 50 percent is weak and insufficient and we have stalled or gone into reverse on more than 30 percent of the goals.

And what can this lack of SDG progress tell us about disability inclusion?

Worryingly, very little. While the SDGs include persons with disabilities, this does not fully extend into the monitoring. Only seven out of 169 targets specifically address disability inclusion and only 10 of their 231 indicators explicitly require disability data disaggregation.

However even without specific SDG data, the extent of progress must be called into question when we see that, in 2023, the 1.3 billion people worldwide who experience significant disability, still face a range of barriers to inclusion.

While specific actions to progress disability inclusion undoubtedly need reinvigorating, it is also important to remember that we are living in unprecedented, testing times.

The COVID-19 pandemic, the largest cost of living crisis this generation has ever seen, climate change and increasing conflicts are placing pressure on communities all over the world at a ferocity and speed which we have rarely seen before.

And while everyone may be affected by these interconnected crises, they are not affected equally. The most vulnerable always bear the greatest burden and persons with disabilities have been disproportionately affected by the events of recent years.

Yet despite these challenges, across the world, disability inclusion has been gathering greater momentum. Even in the most challenging of crisis settings, such as the war in Ukraine, we have seen that early assessments such as the one UNDP carried out – looking at how to improve the accessibility of information and notifications in crises, and the specific difficulties persons with disabilities face during evacuations – have brought together persons with disabilities, civil society and government partners to help bring about change.

These joint efforts also give recognition to the importance of not only taking into account the needs of persons with disabilities as beneficiaries of aid, but also their engagement as key actors in humanitarian response planning.

An increased understanding of intersectionality and recognition of the multiple factors which affect people’s lived experience is also taking hold, and it is awe-inspiring to see the extent to which organizations of persons with disabilities are driving forward this change.

But it is time for global and country level policy commitments to catch up. At a global level monitoring of the SDGs must include greater involvement of organizations of persons with disabilities, and this should be matched with investment for these groups, to ensure capacity building programmes around the SDGs can scale up.

Without this, the disability community and underrepresented groups will continue to struggle to take part in national SDG plans.

The collection of disability-specific SDG data is also a priority. Persons with disabilities are often excluded from participating in data collection processes, leading to an under-representation of their perspectives.

Data collection mechanisms designed by and with persons with disabilities and their respective organizations, including disaggregated data on disability types, age and gender, are vital yet currently missing.

At a national level, we must fast track implementation of the UN Convention on the Rights of Persons with Disabilities, which sets out to promote, protect and ensure the human rights of persons with disabilities.

Significant progress has been made since 2008, when the convention came into force, but more must be done to develop policies and legislative frameworks in close consultation with persons with disabilities and their respective organizations, and to couple this with strong political will and the necessary resources.

UNDP and the International Disability Alliance (IDA) are working together with global partners to advance this work, recognizing that it is a prerequisite to achieving the SDGs.

But much more remains to be done. Because we cannot truly claim progress when in large parts of the world, persons with disabilities are still unable to equally and meaningfully participate in the world around them.

When they remain unheard and unseen in programmes designed to meet their needs, and when systemic barriers to their full inclusion and participation in society still exist.

This year offers an important moment for reflection, to take stock of what has been achieved but also – critically – to course correct. Persons with disabilities are some of the most marginalized and excluded in the world.

Righting this wrong is one of the ways that we can get the SDGs and the 2030 Agenda back on track. This is not a task for one group or one country. It will require cooperation across the board, political will and perhaps most importantly – real collaboration with persons with disabilities and their representative organizations – recognizing that they are the ones who stand to benefit or lose the most from the progress being made.

Ulrika Modeer is UN Assistant Secretary-General and Director of the Bureau of External Relations and Advocacy, UNDP; Jose Viera is Advocacy Director, International Disability Alliance.

SOURCE: UNDP

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Caura Hospital, in the east of Trinidad, was designated an acute care facility for patients with COVID-19 during the pandemic. Often developing countries are forced to wait for vaccines leaving their populations vulnerable. Credit: Jewel Fraser/IPS

By Jewel Fraser
Port of Spain, Trinidad, Jun 29 2023 (IPS)

The reasons that led to inequitable distribution of COVID vaccines during the pandemic have been inherent in the global pharmaceutical supply chain for decades and contributed to serious adverse consequences for global south countries, as was evident with HIV and Ebola. Further, those issues will likely contribute to inequities with regard to vital medicines in the future. This story by IPS Correspondent and IWMF Fellow Jewel Fraser highlights that the inequity issue is definitely not due just to the pandemic but an ongoing one.

Music for this podcast courtesy of Fesliyan Studios.

This report was supported by the International Women’s Media Foundation’s Global Health Reporting Initiative: Vaccines and Immunization in the Caribbean.

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Thembeni Mkingofa, a woman living with HIV, visits the PMTCT section of the Makhume District Hospital, Zimbabwe. She has three children - 14, 10 and 2 who are all HIV negative. This is her fourth pregnancy. Her husband is also on HIV treatment. Here she is pictured with her two-year-old daughter, Hilda Chakiryizira. 5 November 2019. Credit: UNAIDS/C. Matonhodze

By Winnie Byanyima and Sir Michael Marmot
BRASILIA, Brazil, Jun 5 2023 (IPS)

The COVID-19 crisis has shone a light on the danger of pandemics; social crises have shone a light on the danger of inequalities. And the reality is that outbreaks become the pandemics they do because of inequality. The good news is that both can be overcome – if they are confronted as one.

Scientific and medical breakthroughs in the treatment and prevention of HIV should have brought us to the point of ending AIDS. Tragically, however, although the number of new HIV infections is falling fast in many countries, it is still rising in dozens of countries and the goal of ending AIDS by 2030 is in danger.

The reason: economic and social inequalities within countries and between them increase people’s risk of acquiring disease and block access to life-saving services.

Letting inequality grow is driving pandemics and prolonging emergencies that drain economies and health systems. This makes all of us vulnerable to the next pandemic, while placing entire countries and communities of people in harm’s way.

In too much of the world we see policy approaches which leave inequalities to widen, and even, in some cases, deliberately exacerbate inequalities.

On a global level when wealthy countries quickly invest billions in their own medical and social response, while leaving other countries so burdened by debt they have no fiscal space to do so, that undermines the world’s capacity to fight AIDS and pandemics.

During COVID-19 while wealthy countries poured in billions to protect their economies, reduce economic and social hardship and fight the pandemic, almost half of all developing countries cut health spending and about 70% cut spending on education.

Shanenire Ndiweni, has a consultation to receive pre-exposure prophylaxis at the Centre for Sexual Health and HIV/AIDS Research Zimbabwe (CeSHHAR Zimbabwe) clinic, Mutare, Zimbabwe, 6 November 2019. Credit: UNAIDS/C. Matonhodze

Viruses do not respect borders, so when the vaccines, drugs, and tests intended to stop those viruses go to powerful countries in excess, while other countries have little or nothing and are held back from producing medicines themselves, that perpetuates pandemics everywhere.

Similarly, social and economic conditions that perpetuate pandemics in low- and middle-income countries present a global threat. Much as with COVID-19 the same has happened with the MPox virus.

In recent years twice as many people have died of MPox in the Democratic Republic of Congo as the entire rest of the world combined but, as of today, zero vaccines for MPox had been delivered to the DRC.

Social and legal determinants that make people vulnerable to pandemics must be tackled. Globally almost 5,000 young women and girls become infected with HIV every week. Dismantling barriers to sexual and reproductive health and rights services, investing in girls’ education, and combating gender-based violence to remove gender inequity is key to ending the AIDS pandemic and protecting women’s health.

Laws that criminalize and marginalize LGBT communities, sex workers and people who use drugs weaken public health approaches and prolong pandemics such as HIV. In sub-Saharan African countries where same sex relations are criminalized, HIV prevalence is five times higher among gay men and men who have sex with men than in countries where same sex relations are not criminalized.

Even within countries that are making substantial progress against HIV, advances may not be shared equally. Here in Brazil for example, HIV infections are falling dramatically among the white population as access to treatment is widened and new prevention tools such as PrEP are rolled out.

That shows what can be achieved; but HIV infections among the black population in Brazil are still on the rise. A similar story runs in the United States where gay white people are more likely to have access to good health care than gay black people.

We emphasize that it is not only access to health care that perpetuates these inequalities, but the social determinants that increase the risk of infection.

To overcome inequalities in accessing essential services, communities must be empowered to demand their rights. The AIDS movement is one of the best examples of how groups of people experiencing intersecting inequalities can unite to overcome them, leading to millions of lives being saved.

Successive Commissions on Social Determinants of Health have brought together evidence on how the conditions in which people are born, grow, live, work and age are powerful influences on health equity.

To bring together these two strands of knowledge over the coming months we will be convening global experts from academia, government, civil society, international development and the creative arts to build a Global Council to advance evidence-based solutions to the inequalities which drive AIDS and other pandemics.

The council will unite experts from disparate fields of economics, epidemiology, law, and politics and will include ministers, mayors, and former heads of state, researchers and clinicians, health security experts, community leaders and human rights activists.

The work of the Global Council will harness essential evidence for policymakers. It will elevate political attention to the need for action. Most crucially, it will help equip the advocacy of the frontline communities fighting for their lives, with what they need to shift policies and power.

Appropriately, the Global Council is launching in Brazil. Whilst Brazil has exemplified the challenges of intersecting inequalities, Brazil’s social movements have been pioneers in confronting them, and Brazil’s new government under President Lula has committed to tackle inequalities in Brazil and worldwide.

To fight tomorrow’s pandemics, we need inequality-busting approaches to today’s pandemics. The world’s leaders now face a clear choice: stand by whilst the dangers mount or come together to tackle inequalities for a world that is not only fairer, but safer too.

Winnie Byanyima is the Executive Director of UNAIDS and an Under-Secretary-General of the United Nations. Before joining UNAIDS, she served as Executive Director of Oxfam International, a confederation of 20 civil society organizations working in more than 90 countries worldwide, empowering people to create a future that is secure, just and free from poverty.

They will launch the Global Council on Inequalities, HIV and pandemics in Brazil on June 5. The authors are founder members of the Global Council on Inequality, AIDS and Pandemics and are in Brazil for its announcement.

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Young girls chat while sitting under a mosquito net in Bienythiang, South Sudan. Credit: UNICEF/Mark Naftalin
 
World Malaria Day, April 25, is an occasion to highlight the need for continued investment and sustained political commitment for malaria prevention and control. It was instituted by WHO Member States during the World Health Assembly of 2007.

By Arthur Ng'etich Kipkemoi Saitabau
KUALA LUMPUR, Malaysia, Apr 24 2023 (IPS)

For centuries, malaria has remained one of the deadliest diseases, inflicting great suffering on families and perpetuating the cycle of poverty in many communities and nations. The African region currently accounts for 95% of malaria cases and 96% of malaria deaths globally, with women and girls disproportionately affected by the disease.

Women are at higher risk of malaria due to biological, social, economic, and gender factors. They have limited access to healthcare, less decision-making power and control over household resources, which increases their susceptibility.

Gender-based economic disparities further worsen the situation by limiting women’s access to malaria prevention and treatment.

While significant progress has been made in the past decades in combatting malaria through the development of life-saving treatment regimens and the implementation of cutting-edge technologies to accelerate the discovery and development of new malaria vaccines, deaths due to malaria remain high.

In 2021 alone, an estimated 619,000 deaths were caused by malaria, highlighting the need for continued efforts to combat this disease.

In addition, COVID-related disruptions in the delivery of malaria curative and preventive services during the two peak years of the pandemic (2020-2021), led to approximately 13 million more cases of malaria and an additional 63,000 deaths caused by the disease compared to the pre-COVID-19 year of 2019.

To date, malaria cases and deaths have primarily been reduced through disease-focused approaches that tend to be reactive rather than proactive often initiated in response to malaria outbreaks.

This narrow focus on treating individual cases of malaria overlooks broader social, economic, environmental risk factors including gender-based inequalities.

As Member States work towards ambitious goals set during the 2015 World Health Assembly of reducing the global malaria burden by 90% by 2030, efforts need to prioritise the underlying factors that drive transmission through a multifaceted approach, particularly recognising the social determinants like gender inequalities.

The concept of people-centred health care is based on fundamental principles that prioritize human rights, dignity, participation, equity, and partnerships.

This approach aims to create a health care system where individuals, families, and communities receive humane and holistic care, while also having the opportunity to actively engage with the health care system.

As we work towards leaving no one behind and achieving the last mile, developing and adopting more people-centred approaches, that address gender and intersectionality concerns through an analysis of power dynamics, will be critical to make significant strides towards eradicating malaria for good.

This can involve engaging with communities and stakeholders to identify their needs and develop evidence-based malaria control strategies that promote equity and inclusion.

Additionally, promoting participation of marginalized groups in decision-making and ensuring malaria interventions respect human rights and promote social justice.

Not only will this help advance Sustainable Development Goals towards gender equality but importantly will also contribute to decolonising global health and empowering communities that remain most impacted by the disease.

Unpacking the Gendered Dimensions

A people-centred approach to malaria prevention aims to prioritize the well-being of individuals and communities by establishing reliable health systems. However, power dynamics must be taken into account to prevent the perpetuation of power imbalances, hierarchies, and inequalities.

This means engaging with communities and other stakeholders to identify their needs and priorities and working together to develop evidence-based malaria control strategies.

The Community Directed Intervention (CDI) approach exemplifies the importance of extensive community engagement to identify local needs and priorities for malaria control. This includes community meetings, involving leaders and women groups, and conducting surveys on malaria burden and risk factors.

Developing evidence-based strategies through community engagement results in increased community ownership and participation, leading to higher uptake of interventions and reducing malaria transmission.

Addressing the power dynamics associated with malaria prevention requires acknowledging and tackling gendered dimensions linked with malaria prevention.

Women in some communities may lack access to education, employment, and decision-making power, which can limit their ability to protect themselves from malaria.

Additionally, cultural beliefs and practices may contribute to the unequal distribution of resources for malaria prevention and control, with men accessing more resources than women.

This underscores the importance of addressing gender roles in malaria control initiatives and empowering women to take an active role in protecting themselves and their families.

Intersectionality also has important implications for malaria control as gender intersects with other social categories to create specific vulnerabilities and challenges. For instance, women from lowest income groups are least likely to get access to healthcare.

To address these challenges, it is important for more malaria control programs to conduct systematic social and gender analysis, hearing from those affected, to better understand the subtle nuances of gendered and intersectional dimensions of power both within households and communities.

This approach can then help to identify the specific barriers and opportunities for women’s participation in malaria control initiatives. By unpacking the gendered dimensions in communities, public health officials can design targeted interventions that promote women’s empowerment, address gender inequalities, and increase women’s involvement in malaria control programs.

Confronting not Reinforcing Power Dynamics

A people-centred approach to malaria control can empower individuals by providing education and training on malaria prevention and control. It can emphasize inclusivity and centre the experiences and knowledge of those who have been historically excluded or marginalized due to factors such as racism, sexism, classism, and other systems of power.

To avoid reinforcing power dynamics in malaria control, it is crucial to involve and empower marginalized groups in decision-making. This involves consulting communities to identify their needs and priorities, promoting participation of women and marginalized groups, and designing interventions that promote equity and inclusion.

The foundation for improving community dialogue and community-led actions towards malaria elimination has been established over the years.

A case in point is the successful elimination of malaria in Cambodia’s last mile, which relied on communities in high-risk areas agreeing to increased testing, regular fever screening, and in some cases, taking preventive antimalarial medication.

A people-centred approach recognizes the significance of communities in designing and implementing malaria control programs, considering their unique social, cultural, and environmental contexts that can impact malaria transmission and control.

One illustration is the use of local languages and cultural practices to build trust and improve communication on malaria prevention and control measures through empowerment of community health workers who understand and can tailor interventions to their specific contexts.

On the other hand, a people-centred approach, which does not consider power dynamics, can unintentionally reinforce social hierarchies and exclude vulnerable populations from accessing preventative and curative treatment for malaria.

For instance, a malaria control program that only involves male community leaders and village chiefs in decision-making when distributing bed nets reinforces patriarchal power and favour wealthier households, while excluding marginalized groups such as women and those from lower socio-economic backgrounds.

In conclusion, achieving malaria elimination through people-centred approaches requires a holistic approach that actively considers issues of gender, intersectionality, and balance of power. It is crucial to ensure that these approaches do not perpetuate existing inequalities, but instead centre the experiences and knowledge of marginalized groups.

By acknowledging and addressing the ways in which different forms of oppression intersect and compound to create experiences of marginalization and exclusion, we can make meaningful strides towards malaria elimination.

To achieve this, sustaining a commitment to inclusivity, equity, and social justice is imperative in all efforts aimed at eradicating malaria and improving the health and well-being of communities affected by this disease.

This includes actively involving marginalized groups in decision-making processes, addressing social determinants of health, tailoring interventions to specific cultural and contextual factors, and promoting gender equality and women’s empowerment.

By taking a proactive and inclusive approach, we can ensure that malaria control efforts are effective, equitable, and sustainable, leading to more just and healthier communities.

Arthur Ng’etich Kipkemoi Saitabau is Post-Doctoral Fellow of the United Nations University – International Institute for Global Health.

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The removal of Mughal history from textbooks is seen as a political move which downplays the rich diversity of the Indian subcontinent. This artwork stems from this period. Credit: Govardhan. Jahangir Visiting the Ascetic Jadrup. ca. 1616-20, Musee Guimet, Paris

By Ranjit Devraj
NEW DELHI, Apr 20 2023 (IPS)

The removal from school textbooks of chapters covering the Mughal period of Indian history spanning three centuries has raised a storm of protests from academics.

The Mughals, who ruled much of the Indian sub-continent between the 16^th and 19^th centuries, left behind an indelible stamp on science, art, culture, and overall development. Their legacy is visible today mainly in a number of monuments recognised as UNESCO World Heritage Sites, including the Agra Fort, Fatehpur Sikri, Red Fort, Humayun’s Tomb, Lahore Fort, Shalamar Gardens, and the Taj Mahal.

UNESCO’s India representative, Hezekiel Damani, said the organisation advises that the curriculum represents a conscious and systematic selection of knowledge, skills and values that shape the way teaching, learning and assessment processes are organised by addressing questions such as what, why, when and how students should learn.

“Therefore, a quality curriculum must pave the way to the effective implementation of inclusive and equitable quality education,” Damani says. “Subject-specific curriculum development, reform and revision are entirely the decision of member states; they must be conscious of today’s curriculum, and future needs while making any intervention.”

“The issue here is that Mughal rule does not align well with present-day politics — it is no surprise that chapters that refer to that period are being deleted by the National Council for Education Research and Training (NCERT),” says Ruchika Sharma, who teaches history at the Delhi University.

Sharma says that from an academic point of view, the Mughal period presents a well-researched part of Indian history because of the rich documentation they left behind. “Removing an entire chapter dealing with such an important period of history from class XII textbooks would certainly affect students’ career choices — they will see a mismatch between visible legacy and the curriculum.”

Sharma referred in particular to the chapter titled ‘Kings and Chronicles, the Mughal Courts,’ from the NCERT history book Themes of Indian History-Part II, which describes how the Mughals encouraged peasants to cultivate cash crops such as cotton grown over a “great swathe of territory that spread over central India and the Deccan plateau.”

The Mughal period saw India becoming the world’s biggest exporter of cotton as well as cotton manufactures such as calico and fine muslins that were shipped to the European markets by the Dutch and English East India Companies that were allowed to set up ‘factories’ or fortified trading posts along the Indian coasts.

Other revenue-generating crops included sugarcane and oilseeds such as mustard and lentil that were grown alongside staples like rice, wheat and millets, the deleted chapter said. The section on ‘Irrigation and Technology’ noted that under the Mughals, cultivation rapidly expanded with the help of artificial irrigation systems and the introduction of crops from the new world, such as tomatoes, potatoes and chilli.

Swapna Liddle, historian and author, says that much of India’s built heritage, language, arts, agriculture and land tenure systems are a legacy of the Mughal period. “It is important to study how India was also progressing in the scientific fields during that period,” says Liddle.

The Mughal period saw a flowering of the sciences, especially astronomy, mathematics, medicine, architecture and engineering, that had an impact long after the dynasty ended in 1857. Akbar’s reign (1556—1605), for example, saw the establishment of medical schools and dispensaries, while his successor, Jehangir, patronised the study of mathematics and astronomy.

On April 7, a group of ‘Concerned Historians’ issued a statement saying: “We are appalled by the decision of the NCERT to remove chapters and statements from history textbooks and demand that the deletions from the textbooks be immediately withdrawn.”

“The decision of the NCERT is guided by divisive motives. It is a decision that goes against the constitutional ethos and composite culture of the Indian subcontinent. As such, it must be rescinded at the earliest,” said the statement, which has been endorsed by hundreds of academics.

According to the statement, the textbooks were designed to be inclusive and provide a sense of the rich diversity of the human past both within the subcontinent as well as the wider world. “As such, removing chapters/sections of chapters is highly problematic not only in terms of depriving learners of valuable content but also in terms of the pedagogical values required to equip them to meet present and future challenges.”

The director of the NCERT, Dinesh Kumar Saklani, has stated that the chapters were removed as part of “rationalisation aimed at reducing the burden on schoolchildren following the COVID-19 pandemic.” He claimed that the rationalisation was vetted by experts and denied that there was any political agenda behind the move.

Says Ajay K. Mehra, a political scientist currently attached to the independent think tank, the Observer Research Foundation: “It would have been far better to modify the chapters on the Mughal and Islamic periods than delete them altogether — this way a very large and important period of mediaeval Indian history is going to be lost to impressionable young students and to future generations.”

The changes to the textbooks, says Mehra, are deliberate and part of a larger, declared political agenda to restore the past glory of Hindu dynasties that existed before the arrival of Islam in India. This can be seen in the renaming of roads and cities, he said, citing the renaming of Allahabad city in 2018 to Prayagraj to reflect its importance as a Hindu pilgrimage site at the confluence of the sacred Yamuna and Ganges rivers.

“What is lost here is the fact that Mughal rule saw enormous economic advancement that lasted three centuries because of a compact with Hindu Rajput (princely) feudatories. “Rajput princes not only led Mughal armies but also entered into marital alliances — two of the important Mughal emperors, Jehangir and Shah Jahan, were born of Rajput princesses, for example,” Mehra said.

Makkhan Lal, distinguished fellow at the Vivekananda International Foundation, a think tank considered close to the government, says that there is a case for the Mughal period getting “disproportionate description and allotment of space” in history textbooks and this needed to be rectified.

Lal, who has taught history at the Banaras Hindu University and worked with the NCERT, said the “correction being made now is a step in the right direction and should have been taken earlier.”

Apart from academics, leaders of opposition parties have also denounced the changes to the textbooks. Sitaram Yechury, general secretary of the Communist Party of India, said the changes made to class textbooks were regrettable because of India’s diversity.

“The lands of India have always been the churning crucible of civilisational advances through cultural confluences,” Yechury says.

Pinarayi Vijayan, who leads a communist party government in the southern Kerala state, Tweeted: “They resort to rewriting history and masking it with lies. So, we must strongly protest the decision of the BJP government to delete certain sections from NCERT textbooks. Let the truth prevail.”

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A woman with tuberculosis in Pakistan went undiagnosed for five years because she could not afford the $2 transportation cost from her village to the Civil Hospital in Tharparkar. Credit: OCHA/Zinnia Bukhari
 
Each year, the UN commemorates World TB Day—March 24-- to raise public awareness about the devastating health, social and economic consequences of tuberculosis (TB) and to step up efforts to end the global TB epidemic. The date marks the day in 1882 when Dr. Robert Koch announced that he had discovered the bacterium that causes TB, which opened the way towards diagnosing and curing this disease.

By Nyuma Mbewe and Swati Krishna
LUSAKA / PUNE, Mar 22 2023 (IPS)

Despite being both curable and preventable, the TB pandemic is a global health crisis and a leading cause of death worldwide. COVID-19 brought into sharp focus how women bear the brunt of pandemics. In 2021, over three million women and girls fell ill with TB, resulting in 450,000 needless deaths.

As women leaders in global health, on this 2023 World TB Day, we believe that systematic and sustained investment to tackle gender-related barriers is essential to get the world back on course and end TB by 2030.

We must confront the root causes of gender inequality and reshape the power dynamics across health systems, promoting the voice of women in their own care, to reach our global goals, for a safer, healthier world for all.

To better understand how gender norms and inequalities increase the burden, stigma and discrimination on women resulting in the failure to prevent, detect and treat TB infection, adopting an intersectional lens is a necessary step.

Differentiating the impact of TB based on the intersection of different determinants such as sex, gender, ethnicity, age, location and socioeconomic status can improve health planning, along with confronting legal, cultural and social barriers that are preventing improved health outcomes.

Using evidence-based knowledge, we can tailor interventions and care strategies for populations with increased vulnerabilities and curb the spread of the disease.

The Global Fund data has shown that women often face additional barriers to accessing TB diagnosis and treatment in countries with high rates of TB. Women generally wait longer than men for diagnosis and treatment, and may be discouraged from seeking care by a lack of privacy or child-care facilities in health services.

In some contexts, women have been less likely to undergo sputum smear examinations due to cultural norms and perceptions about femininity as well as gender dynamics of service provision. Young women in high HIV burden settings face increased TB risk.

The stigma, discrimination and exclusion associated with HIV amplifies and is amplified by TB-related stigma, especially for key populations. This impacts TB detection, access to reliable health services and treatment adherence.

It is past time to prioritize measures that emphasize women’s fundamental role in building resilient health systems and workforce. Globally, women are 90% of frontline health workers, and 70% of the overall health workforce.

Despite challenging working conditions, and lack of formal representation, women continue to show outstanding leadership across the health sector. Evidence shows that community-based and ambulatory care results in better TB outcomes compared to hospital-based or inpatient care. Yet their contribution is often undervalued, underpaid, and they occupy less than one quarter of management roles.

Women are the vast majority of nurses and community health workers (CHW) that play a vital role in the delivery of TB care and people-centered approaches to treatment, yet their voices are more often than not absent from decision-making fora. Valuing women, working at all levels of health, including CHWs is essential for the prevention, detection and treatment success of TB.

Making health systems fit for purpose means promoting gender parity in management, leadership, and governance. Mechanisms that harness the talent and expertise of women in the health workforce will result in better health systems, and support improved health governance.

Women in Global Health is committed to work with global health institutions to ensure that structural gender barriers are addressed and promote accountability for resilient health systems that improve health at every level.

Recent history has taught us that pandemic responses have often overlooked the specific needs of diverse women. Health leaders must promote and create opportunities for gender transformative leadership to strengthen health systems and ensure quality services. It is urgent to both recognize and include women and people of all gender identities for more impactful health interventions.

As we commemorate World TB Day, we appeal for increased efforts and stronger commitments to promote gender parity in decision-making across the health sector. This must be matched with sustained investments in gender transformative policies and programs to build resilient health systems and a workforce that adequately represents the diverse communities it serves.

Dr Nyuma Mbewe, a member of the Women in Global Health, Zambia Chapter, is an Infectious Diseases Physician with Zambia’s National Public Health Institute and is based in Lusaka, Zambia.

Dr Swati Krishna, a member of the Women in Global Health, India Chapter, is Young Investigator at KEM Hospital Research Centre and consultant to the iDEFEAT TB project of the International Union Against Tuberculosis and Lung Disease. She is based in Pune, India.

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The Asia-Pacific SDG Progress Report will be launched on Wednesday, 22 March 2023, 11:00-12:00 hours (Bangkok time, UTC+7), at the Foreign Correspondent’s Club of Thailand, and Online via Zoom.

By Armida Salsiah Alisjahbana
BANGKOK, Thailand, Mar 20 2023 (IPS)

As we reach the midpoint of the 2030 Agenda for Sustainable Development, it is an opportune moment to reflect on the Asia-Pacific region’s progress and accelerate efforts to achieve our goals.

This year’s Asia-Pacific SDG Progress Report published by ESCAP features pace-leaders of the region who have successfully implemented evidence-based policies to accelerate progress. For instance, Pakistan has made great strides in increasing the number of skilled birth attendants. India has taken concrete steps to reduce child marriages.

Timor-Leste has implemented a national remittance mobilization strategy to leverage remittances as an innovative financial diversification tool, and Cambodia is implementing an evidence-informed clean air plan.

These national achievements across the 17 Sustainable Development Goals are grounded in evidence-based approaches and provide hope and valuable lessons for other countries in the region to follow. By learning from one another’s successes and building on them, the region can collectively accelerate its progress towards achieving the SDGs.

However, the report presents a sobering reminder of how much work remains. While a few nations have made remarkable strides in achieving some of the targets, none of the countries in Asia and the Pacific are on course.

The region has achieved less than 15 per cent of the necessary progress, which puts us several decades away from accomplishing our SDG ambitions. In the absence of increased efforts, the region will miss 90 per cent of the 118 measurable SDG targets.

It is unsettling to observe that progress towards climate action (Goal 13) is slipping away. The region is both a victim of the effects of climate change and a perpetrator of climate change.

Countries are not on track to achieve greenhouse gas emissions reduction targets, and more countries must report emission levels for all sectors to properly monitor their contribution towards global climate agendas.

Goals 5 (Gender equality) and 16 (Peace, justice, and strong institutions) also require urgent attention from all countries to fill the persistent data gaps. Unfortunately, the report shows that since 2017 there has been almost no progress in the region in the availability of data for these two goals with the most significant data gaps.

Investment in data systems is crucial to closing this gap, but more is needed. A data-driven approach to implementing the SDGs is critical to measure progress accurately. To progress towards SDG 5, collecting gender-disaggregated data and investing in education, promoting participation in decision-making, and ensuring access to essential services is crucial.

To achieve SDG 16, countries need to strengthen the rule of law, promote human rights and good governance, and foster civic participation.

As we face a multitude of challenges, including climate change, human-made disasters, military conflicts, and economic difficulties, progress towards the SDGs becomes increasingly critical. Governments must act quickly, invest wisely, enhance partnerships and prioritize populations in the most vulnerable situation.

We must renew our commitment to producing high-quality data and use every means available to ensure sustainability across social, economic, and environmental dimensions. National plans must align with the 2030 Agenda to guide development at the national level.

Despite significant challenges, we must not give up the ambition to achieve the SDGs. There are many inspiring examples of national achievements in carrying out data-informed actions in the region.

These successes give hope for Asia and the Pacific, and there is a need to leverage them more effectively for change. Our collective commitment to the SDGs will serve as a compass towards achieving a sustainable, prosperous and inclusive future for all.

Produced by the United Nations Economic and Social Commission for Asia and the Pacific (ESCAP), the Asia-Pacific SDG Progress Report 2023 will shine a spotlight on countries that have demonstrated commitment and progress towards the 17 global goals. Their strong performance deserves recognition, and their experiences provide important lessons and illuminate pathways for progress in the years ahead.

Unfortunately, this year’s report also reveals that the Asia-Pacific region has achieved less than 15 per cent of the necessary progress, which could result in substantial delays in accomplishing our 2030 ambitions. While the full impact of COVID-19 has yet to be quantified, data on a limited number of indicators are beginning to reveal impacts on people, planet and prosperity.

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Excerpt:

Benson Musyoka rides his motorcycle from Kamboo health centre to transport vaccines to Yindalani village. Photo Joyce Chimbi/IPS

By Joyce Chimbi
NAIROBI, Mar 13 2023 (IPS)

Up until 2019, nurses in three health facilities located in the semi-arid south-eastern Kenya region of Makueni County struggled to bring critical health services closer to a hard-to-reach population scattered across three remote, far-flung villages.

“Kamboo, Yindalani and Yiuma Mavui villages are located 17 and 28 kilometres away from Makindu sub-county hospital, and 10 and 22 kilometres away from the nearest electricity grid,” Benson Musyoka, the nurse in charge of Ndalani dispensary in Yindalani village tells IPS.

Without a cold chain capacity to store vital vaccines and drugs, health facilities records show vaccination coverage across these villages was well below 25 percent.

Babies were delivered at home because mothers could not raise 6 to 12 USDs to hire a boda boda or motorbike taxi, which is the only means of transportation in the area. Others could not reach the hospital in time to deliver.

“Every morning, I would collect vaccines at Makindu sub-county hospital and transport them inside a vaccine carrier box to Ndalani dispensary. Once the vaccines are inside the carrier box, they are only viable for up to six hours, at which point whatever doses will have remained unused must be returned to storage at Makindu sub-county hospital for refrigeration or thrown away,” Musyoka expounds.

In February 2019, a groundbreaking donation of a solar-powered freezer to the Kamboo health centre significantly improved availability and access to vaccinations as well as maternal health services across the three villages and surrounding areas.

Francis Muli, the nurse in charge of Kamboo health centre, tells IPS that without a fridge or freezer, “you cannot stock Oxytocin, and without Oxytocin, you cannot provide labour and delivery services.”

He says it would be extremely dangerous to do so because Oxytocin is injected into all mothers immediately after delivery to prevent postpartum haemorrhage. Oxytocin is also used to induce labour.

As recommended by the World Health Organization, Oxytocin is the gold standard for preventing postpartum haemorrhage and is central to Kenya’s ambitious goal to achieve zero preventable maternal deaths.

In 2017, the Ministry of Health identified sub-standard care in 9 out of 10 maternal deaths owing to postpartum haemorrhage. Overall, postpartum haemorrhage accounts for 25 percent of maternal deaths in this East African nation.

Usungu dispensary and Ndalani dispensary are each located 10 kilometres away from Kamboo health centre in different directions. Nurses in charge of the facilities no longer make the long journey of 28 kilometres to and another 28 kilometres from Makindu to collect and return unused vaccine doses on vaccination days.

“We collect vaccine doses from Makindu sub-county hospital at the beginning of the month and store them in the freezer at Kamboo health centre. The freezer is large enough to store thousands of various vaccine doses collected from the sub-county hospital for all three facilities,” says Antony Matali, the nurse in charge of Usungu dispensary in Yiuma Mavui village.

Two to three times a week, Matali and Musyoka collect doses of various vaccines, including all standard routine immunization vaccines, with the exception of Yellow Fever. The vaccines are transported to their respective dispensaries in a carrier box that can hold up to 500 doses of different vaccines, including the COVID-19 vaccines. All three facilities have recorded significant improvement in immunization coverage from a low of 25 percent.

At Kamboo health centre, where the freezer is domiciled, records show measles immunization rate has surpassed the target of 100 percent to include additional clients outside the catchment population area of 4,560 people. Overall immunization coverage is at 95 percent, well above the government target of 90 percent.

At Ndalani dispensary, the immunization rate for measles has also surpassed the target of 100 percent as additional patients, or transit patients from four surrounding villages and neighbouring Kitui County, receive services at the dispensary. The overall vaccination rate for all standard vaccines is 50 to 65 percent.

In the Usungu dispensary, the vaccination rate for measles is at 75 percent, and for other vaccines, coverage is hovering at the 50 percent mark.

“Usungu and Ndalani have not reached the 90 percent mark because we suffer from both missed opportunities and dropouts. Missed opportunities are patients who drop by a facility seeking a service and find that it is not available at that very moment. Dropouts are those who feel inconvenienced if they do not find what they need in their subsequent visits, so they drop out along the way,” Musyoka explains.

A cold chain or storage facility such as the solar-powered freezer, Muli says, is the cornerstone of any primary health unit in cash-strapped rural settings, and all services related to mother and child are the pillars of any health facility. Without these services, he emphasizes, all you have is brick and mortar.

“At Usungu and Ndalani, we are currently not offering labour and delivery services because we do not have Oxytocin in the facility at all times due to lack of storage, and we cannot carry it around in the hope that a delivery will materialize that day due to the six-hour time limit,” Musyoka expounds.

Still, pregnant women receive the standard tetanus jabs and all other prenatal services, but close to the delivery period, Ndalani and Usungu refer the women to the Kamboo health centre and follow-up to ensure that they receive referred services. Facility records show zero infant and maternal mortality.

Annually, the Ministry of Health targets to vaccinate at least 1.5 million children against vaccine-preventable diseases such as measles, polio, tuberculosis, diarrhoea and pneumonia. Currently, one in six children under one year does not complete their scheduled vaccines.

Only one in two children below two years have received the second jab of Measles-Rubella, and only one in three girls aged 10 have received two doses of the HPV vaccine which protects against cervical cancer.

Ongoing efforts are helping address these gaps. For instance, the HPV vaccine was introduced in Makueni in March 2021. Musyoka vaccinated 46 girls aged 10 years with the two doses of HPV vaccine in 2021, and another 17 girls received their first HPV dose in 2022 and are due for the second dose in November 2022.

Healthcare providers say the freezer has transformed the delivery of mother and child services in the area by bringing critical immunization services closer to a marginalized and highly vulnerable community.

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