Elongo, 12, washes her hands at Epo‑Ville Primary School in Bunia, Ituri Province, DR Congo, on 22 May 2026. She had just taken part in a handwashing demonstration led by UNICEF WASH Officer Ciza Nyalundja. Credit: UNICEF/Carmel Ndomba Mbikayi

By Oritro Karim
UNITED NATIONS, May 26 2026 (IPS)

Since May 16, there has been a significant increase in the number of laboratory-confirmed and suspected Ebola cases reported across the Democratic Republic of the Congo (DRC), primarily in Ituri Province, with additional unrelated cases identified in Kampala, Uganda. Although the outbreak has remained largely confined to that region, it has been heavily linked to areas affected by insecurity, civilian displacement, and mining-related migration, raising concerns among global health experts that the outbreak could spread without effective monitoring and response efforts.

As of May 17, the World Health Organization (WHO) has determined that the Ebola outbreak caused by the Bundibugyo virus in the DRC and Uganda constitutes a public health emergency of international concern (PHEIC), while the Centers for Disease Control and Prevention (CDC) has issued health alerts to healthcare workers and travelers regarding the spread in the region. Current projections of the virus spreading to other continents remain low at this time, with WHO stating that the outbreak does not meet the criteria of a pandemic, as defined in the 2005 International Health Regulations (IHR).

“We are now revising our risk assessment to very high at the national level, high at the regional level, and low at the global level,” said Tedros Adhanom Ghebreyesus, Director-General of WHO, on May 22 at a United Nations (UN) press briefing in Geneva, noting that there have been 82 confirmed Ebola cases and seven deaths in the DRC. However, these figures are expected to be far higher, with nearly 750 suspected cases and 177 reported suspected deaths.

Two additional confirmed cases linked with travel from the DRC have also been reported in Uganda, one of which ended in death. Furthermore, two American nationals have been transferred to Europe for treatment after being suspected of contracting the virus following prolonged “high-risk contact.”

Response efforts have been largely limited as a result of widespread civilian displacement and prolonged conflict. On May 21, the UN reported that a hospital in the Ituri province was set on fire by angry relatives after the local police refused to release the body of an infected individual to the family due to concerns of contamination.

Additionally, the outbreak has been most pronounced in the Ituri and North Kivu provinces, which have historically been the center of armed conflict and humanitarian suffering in the DRC. Over the past few months alone, there have been more than 100,000 civilians displaced in this region as a direct result of violence, which has severely constrained humanitarian response efforts.

“These are some of the most difficult operating environments in the world for our life-saving work,” said Tom Fletcher, UN Under Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, in a statement shared to X. “We face conflict and high population movement. We are working to secure safe and sustained access for frontline responders, including to areas controlled by armed groups. It is essential that there is no obstruction to our response. We must have access to all routes — air, land, and water — across the affected areas.”

According to Ghebreyesus, approximately four million people are in dire need of humanitarian intervention, two million are displaced, and ten million are facing acute food insecurity. Women will be disproportionately affected, as they often serve in caregiving roles, domestic labour, and frontline services, all of which increase their risk of infection. Pregnant women are particularly vulnerable, while quarantine measures have been linked with rising rates of gender based violence.

These risks have been exacerbated by the collapse of health systems in the North Kivu and Ituri provinces, where needs are most dire. In 2025, WHO recorded more than 1.5 million people across these provinces who lost access to primary healthcare facilities. Approximately 85 percent of healthcare centers face critical drug shortages.

“Even if people are sick, they may be suspected cases, they cannot access health services, and therefore they cannot be detected, they cannot be diagnosed,” said Teresa Zakaria, WHO’s Unit Head of Humanitarian Operations. “Within the outbreak response as well, we need to really make sure that essential health services for everyone in the two provinces are safeguarded, especially for those who have been forcibly displaced and extremely vulnerable.”

Humanitarian experts have stressed that restoring the public’s confidence in agencies’ capability to contain the outbreak will be crucial moving forward. Following the 2013-2016 Western Africa Ebola epidemic, many communities are still carrying trauma and have harbored a deep distrust in the humanitarian response.

Many residents across the region continue to seek treatment, while others believe that Ebola is “fabricated,” according to Gabriela Arenas of the International Federation of Red Cross and Red Crescent Societies (IFRC).

“They remember the fear. They remember the rumours spreading to villages. They remember neighbours disappearing into treatment centres,” said Arenas. “During an Ebola outbreak, trust and community acceptance can mean the difference between containment and wider transmission.”

Supplies handed over by UNICEF Chief Field Office Ibrahim Abdi Shire hands over supplies to the Provincial Health Directorate in Bukavu, South Kivu Province, DR Congo, on 20 May 2026. Credit: UNICEF/Christian Kalengera

On May 22, Fletcher announced that up to $60 million USD from the UN’s Central Emergency Response Fund will be allocated to support containment, treatment, and monitoring efforts in DRC and surrounding countries. WHO also announced that it has deployed 22 international staff to provide direct frontline assistance and released $3.9 million USD from its contingency fund. The agency, in collaboration with Africa’s CDC, has established a continental incident management team to support frontline responders and protect vulnerable communities.

“We are applying lessons from previous outbreaks,” said Fletcher. “Containment depends on fast, coordinated action at the community level. We need strong communication with governments and effective early warning and detection systems across affected countries. Community trust is essential: we will continue delivering wider humanitarian support to people affected, engage closely with them to understand their needs, preposition supplies where possible, and avoid militarised delivery of support.”

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Parliamentarians from Africa, Asia, and the Arab world gathered to assess pledges made at last year’s TICAD9 summit in Yokohama. Credit: APDA

By Hisham Allam
CAIRO, May 14 2026 (IPS)

The word heard most often at a two-day parliamentary forum in Cairo last week was not “commitment”; it was “follow-up.” And the difference mattered.

Parliamentarians from Africa, Asia, and the Arab world gathered 28–29 April not to renew pledges made at last year’s TICAD9 summit in Yokohama, but to ask what had actually been done. The answer was uneven, and delegates said so plainly.

The meeting, organised by the Asian Population and Development Association (APDA) and the Forum of Arab Parliamentarians on Population and Development (FAPPD) with support from UNFPA, the Japan Trust Fund, and IPPF, focused on sexual and reproductive health, universal health coverage, youth investment, and gender equality. It convened against a difficult backdrop: shrinking donor budgets, deepening demographic pressure across Africa, and a persistent gap between legislation and delivery.

Japan’s Makishima Karen, a member of the House of Representatives, Vice Chair of the Japan Parliamentarians Federation for Population, and former Minister for Digital Affairs, set the tone early. “Once a conference is finished, it’s no longer the finish – we should follow up the outcomes and the concrete actions,” she told IPS on the sidelines.

Makishima was direct about where progress begins. “Wherever you live or wherever you are born, the right to live healthily is a human right,” she said. “That is why I focus on the necessity of universal health coverage (UHC) for all.” She argued that UHC cannot be achieved without bringing finance ministries into the conversation: “The understanding of the Minister of Finance is necessary. We are encouraging ministries of finance to join the process.”

On what actually drives change at the community level, she was equally clear: “When mothers cannot read, it must be difficult for their communities to live healthily and safely. Education of women and girls is essential to protect the next generation.”

She also raised a dimension of the agenda that often goes unstated: the role of digital tools. Drawing on her background in digital governance, she argued that technology is not a separate track but integral to delivery: “With one smartphone, every person can access information, check their own data, and have the ability to control it. That is part of democracy.”

Meeting chairs set the tone, demanding asking for action, not new pledges, at a recent two-day forum in Cairo. Credit: APDA

On the wave of aid cuts hitting development programmes globally, she did not deflect. “I believe in the necessity of multilateral organisational frameworks; otherwise, it is very difficult to continue the necessary programmes in each region.” The longer-term answer, she said, is not to wait for donors to return. “Within five or ten years, each government should take on the responsibility to continue these programmes. We must have a very long-term perspective.”

Tanzania’s Jackson Kiswaga, MP, offered the clearest example of what domestic ownership can look like. His country, with 71.5 million people, 60 percent under 24, growing at nearly three percent a year, has been moving fast. In 2023, Tanzania passed the Universal Health Insurance Act, integrating reproductive health services into mandatory coverage spanning formal and informal sectors. A dedicated Youth Ministry was established under the President’s Office. A national scholarship programme has since supported over 400 girls in science education, with measurable reductions in early marriage and pregnancy.

“Institutional innovations are models for other countries,” Kiswaga said. “Strong partnerships in the health sector are key to ensuring sustainability.”

Morocco’s Soukaina Lahmouch, MP, offered a sharper warning. Her country enacted landmark legislation against gender-based violence in 2018, but seven years on, implementation has stalled. Procedural complexity, weak enforcement, and cultural resistance, particularly in domestic violence cases, have blunted the law’s impact.

“Women in Morocco still suffer discrimination and exclusion,” she said, “despite the progress made.” She called on TICAD to support not just the drafting of laws but their enforcement through court reform, rural health infrastructure, and access to financing for women.

Parliamentarians were reminded that the outcomes from Cairo would be reported to the Global Conference of Parliamentarians on Population and Development in Tokyo 2027. Credit: APDA

Two other delegates raised pressures that seldom receive equal billing. Tunisia’s Ezzeddine Tayeb, MP warned that his country’s rapidly ageing population is straining its pension system and called for a comprehensive law guaranteeing the rights of elderly citizens, including enforceable standards for long-term care. Algeria’s MP Khaled Bourenane placed the forum’s agenda inside Africa’s continental trajectory: a population heading toward 2.5 billion by 2050, with over 20 million people displaced by climate events annually. Demographic challenges at this scale, he argued, cannot be addressed in silos.

JICA representative Yo Ebisawa pointed to Egypt as a live test case. In 2017, Egypt ranked the third globally in out-of-pocket health spending as a share of household budgets.

Since passing its Universal Health Insurance Law, the country has been rolling out coverage across all 27 governorates, targeting completion by 2030. So far, six million people across six governorates have been enrolled. In Port Said, the share of households facing catastrophic health expenditure has fallen by 40 percent. Japan has backed the rollout with a $400 million development policy loan and an $8 million joint JICA-WHO project providing equipment and training, including for facilities serving Sudanese refugees and medical evacuees from Gaza.

APDA Vice Chair Prof. Kiyoko Ikegami closed the first day with a pointed reminder: the outcomes from Cairo will be reported to the Global Conference of Parliamentarians on Population and Development in Tokyo 2027. The chain of accountability, she said, must hold.

Whether the commitments made in Cairo translate into budget lines, legislation, and services – that is the only measure that counts.

Note: The meeting was organised by the Asian Population and Development Association (APDA) and the Forum of Arab Parliamentarians on Population and Development (FAPPD). It was supported by the Japan Trust Fund (JTF), the United Nations Population Fund (UNFPA) Arab States Regional Office (ASRO),  and the International Planned Parenthood Federation (IPPF), in collaboration with the African Parliamentary Forum on Population and Development (FPA).

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We must demand societal change that transforms harmful power structures. Only then can we secure healthier, more equal lives and sustainable futures. Credit: Duncan Shaffer/Unsplash

By Johanna Riha and Asha George
KUALA LUMPUR, Apr 23 2026 (IPS)

The world of 2026 is marked by overlapping crises that continue to expose the fragility of our systems and the persistence of inequality. Geopolitical conflicts enrich a few while devastating many, intensifying the already catastrophic impacts of climate change. These political choices are not neutral—they shrink civic spaces, reinforce political extremism, and unleash coordinated assaults on gender equality and human rights. These attacks are not incidental; they are deliberate strategies to undermine multilateralism and global solidarity, eroding the foundations of peace and planetary well-being.

Against this backdrop, the struggle for gender equality and human rights cannot be timid or reactive, it must be as ambitious and bold as the attacks themselves—if not bolder. It must be transformative, deeply rooted in dismantling the harmful power structures that oppress, exclude, and discriminate. It does not require loudness and spectacle, but it does demand depth, strength, and unwavering resolve.

The COVID-19 pandemic was a wake-up call. Even before the virus spread, commitments to gender equality and human rights were far from realized. The pandemic exposed complacency in global health and revealed the limitation of institutions that claimed authority but failed to deliver equity. Mistrust grew, funding evaporated, and self-interest prevailed. Bilateral agreements driven by commercial interests vastly outstripped development funding, fueling nationalist responses and shaping uneven outcomes.

The struggle for gender equality and human rights cannot be timid or reactive, it must be as ambitious and bold as the attacks themselves—if not bolder. It must be transformative, deeply rooted in dismantling the harmful power structures that oppress, exclude, and discriminate

Yet, amid this devastation, experts, reflecting on the pandemic and responses, offered insights that remain vital today. They challenged dominant narratives that frame health preparedness as merely technical or emergency-driven. Instead, they emphasized that vulnerability and resilience are shaped by political choices. At the heart of these choices lies the indispensable need to continually invest in gender equality—not as a token gesture, but as a non-negotiable priority.

Today, more evidence than ever supports the need for structural transformation. Research demonstrates how gender inequalities exacerbate health vulnerabilities, undermine resilience, and perpetuate cycles of poverty and exclusion. Evidence also shows that when women’s rights organizations and women-led organizations are empowered, societies become more resilient, equitable, and prosperous.

This evidence enables us to strategically address blind spots, confront deeply rooted structural challenges, and build a stronger foundation for gender equality and human rights as central health sector priorities. It underscores that change is not optional—it is urgent.

Transforming harmful power structures requires alliances that cut across regions, sectors, and movements. Feminist organizations must connect with climate justice advocates, disability rights groups, and grassroots activists and unions to build collective strength. Solidarity is not just a moral imperative; it is a strategic necessity.

These alliances must be grounded in trust, diversity, and shared vision. They must resist co-optation by market interests and remain steadfast in their commitment to justice. Only through such alliances can we counter the fragmentation that continues to weaken movements and confront the global forces that seek to divide and dominate.

The path forward is clear: we must demand societal change that dismantles harmful power structures. This requires personal development, legislative reform, representative leadership, and unwavering political commitment. It requires investment in feminist movements, particularly in regions where civic space is shrinking and pushback is intensifying.

Change will be uncomfortable. It will challenge entrenched interests and disrupt familiar patterns. But it is necessary. The alternative is a world where oppression deepens, exclusion widens, and discrimination becomes normalized.

The crises of 2026 reinforce that gender equality, and human rights are not peripheral concerns—they are central to health equity, economic and social justice, and sustainable development. Gender equality and human rights are under attack precisely because they challenge entrenched, exploitative power structures.

Their transformative potential threatens the preservation of existing systems of power, making them targets of deliberate and coordinated attacks. Our response must be equally bold, ambitious, and transformative. It is not enough to defend what has been achieved. We must reimagine and rebuild. We must demand societal change that transforms harmful power structures. Only then can we secure healthier, more equal lives and sustainable futures.

Many of these challenges will be addressed at the Women Deliver 2026 Conference, taking place from April 27 to 30 in Melbourne, a key platform to advance gender equality and strengthen collective action globally.

The event will bring together diverse stakeholders to foster strategic alliances, strengthen feminist leadership, and advance concrete solutions in areas such as sexual and reproductive health and rights, sustainable financing, and accountability. At a decisive moment for the global agenda, it offers an opportunity to translate dialogue into tangible action and measurable commitments.

Johanna Riha is Policy Research Lead, United Nations University International Institute for Global Health (UNU-IIGH)

Asha George is Professor, School of Public Health, University of the Western Cape, Cape Town

On 27 October, Omer, a Community Development Committee member, supports health workers at the UNICEF-supported mobile clinic in Al Jadab village in Atbara, River Nile State. Through this initiative, UNICEF is restoring lifesaving healthcare services, such as nutrition, immunization, antenatal and postnatal services, medical consultations, and essential medicines, closer to vulnerable communities. Credit: UNICEF/Mohamed Dawod

By Oritro Karim
UNITED NATIONS, Apr 2 2026 (IPS)

Global human migration is at record-high levels, as the World Health Organization (WHO) estimates that roughly 1 in 8 people—about one billion individuals—are on the move. Many of these migrants and refugees face harsh living conditions and heightened challenges, such as poverty, insecurity, and limited access to basic services. With the number of international migrants having doubled since 1990, new findings from WHO call for expanding health systems to meet the growing scale of needs.

“Refugees and migrants are not just recipients of care, they are also health workers, caregivers and community leaders,” said Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. “Health systems are only truly universal when they serve everyone. “Like anyone else, refugees and migrants need uninterrupted, affordable, and equitable access to health services wherever they are.”

WHO estimates that there are approximately 304 million international migrants worldwide, including 170 million migrant workers. Roughly 117 million of those are persons who have been forcibly displaced, 49 million are children, and 2.3 million have been born as refugees.

More than 71 percent of the world’s international migrants find refuge in low to middle-income countries, which often face the most severe resource constraints and protection challenges. Marginalized groups are disproportionately affected: women and girls are especially vulnerable to gender-based violence and often lack access to related services; unaccompanied children face heightened risks of exploitation, abuse, and neglect; and persons with disabilities face elevated barriers to accessibility and increased exposure to discrimination.

Refugees and migrants have been found to experience greater exposure to health risks, in part driven by conditions that restrict movement and access to care, as well as persistent discrimination and language and cultural barriers. These challenges are exacerbated by ongoing conflict and climate-related disasters, leaving millions around the world increasingly vulnerable to infectious and chronic diseases, mental health issues, and dangerous living and working conditions.

“We cannot talk about refugee and migrant health without also addressing emergencies,” said Dr Chikwe Ihekweazu, WHO’s executive director for health emergencies. “Whether it’s a conflict, a climate-related crisis, or an epidemic that forces movement, these crises expose the fragility of health systems and magnify the vulnerabilities of all those already at risk.”

On March 26, WHO launched its World Report on Promoting the Health of Refugees and Migrants: Monitoring Progress on the WHO Global Action Plan, establishing what it describes as the first global baseline for tracking progress toward inclusive, migrant-responsive health systems. Based on data from more than 93 Member States, the report highlights both a growing shift in national responses to migrant and refugee health needs and the persistent structural gaps that continue to hinder progress toward equitable access.

WHO found that out of the member states surveyed, only 42 percent reported having emergency preparedness and disaster reduction or response programs in place for migrant or refugee communities. Just 40 percent indicated that they provide training for health workers in culturally responsive care, while only 37 percent reported having systems to collect, monitor, and analyze migration-related health data—information that is rarely disseminated enough to support a more coordinated global response.

Discrimination remains widespread in low- and middle-income countries that host large numbers of refugees and migrants, with misinformation and disinformation continuing to fuel negative perceptions of these communities. Only 30 percent of surveyed countries reported having communication campaigns in place to counter these misconceptions and discriminatory language.

Anti-migrant sentiment remains particularly pronounced, with internally displaced persons, migrant workers, international students, and migrants under irregular circumstances being far less likely to access health services. Additionally, refugees and migrants are largely unrepresented in governance and decision-making processes that shape their access to health rights in most surveyed countries.

“The phenomena of displacement is unfortunately happening more frequently in countries with fragile systems, fragile economies and limited domestic resources,” said Dr Santino Severoni, head of WHO’s Special Initiative on Health and Migration and lead author of the report. “There is almost no mention of irregular migrants in those emergency plans and response or in disease risk reductions, there is no systematic approach in assessing the system to see how their system is really functioning, how efficient and effective it is. This is really a call for action to keep the promise of sharing a bit of responsibility in managing those emergencies.”

Over the past year, international support for refugee health has seen considerable declines. Figures from the United Nations High Commissioner for Refugees (UNHCR) show that their 2025 response plan has secured only 23 percent of its USD 10.6 billion goal. The agency projects that this could cause over 12.8 million displaced persons to lose access to lifesaving health interventions this year.

Global responses have been polarizing. Some countries have adopted inclusive policies that support migrant communities—such as Chile— which has supplied municipal health councils for migrants and refugees with community representatives. Other countries, such as the United States and Canada, have cut health insurance coverage for undocumented migrants, forcing them to pay out of pocket for lifesaving care and increasing protection risks.

Through the report, WHO called for greater inclusion of refugee and migrant voices in decision-making processes, as well as improved coordination between governments. With a smoother flow of data between Member States, WHO will be able to more effectively shape health, employment, housing, and protection services.

WHO emphasized that responses should be specifically tailored to the needs of different migrant subgroups, while remaining committed to countering misinformation and discrimination through “evidence-based action.” Investment in refugee and migrant health systems has been found to deliver significant returns, fostering improved social and economic cohesion, revitalizing fragile health systems, and boosting global security, all while reducing long-term costs by promoting these communities to contribute back to society.

“The health of refugees and migrants is not a marginal concern: it is a defining issue of our time,” said Severoni. “By acting now, countries can ensure that refugees and migrants are not left behind, and that health systems are stronger, fairer and more prepared for the future.”

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Artisanal miners work at a mercury-free processing site in Bushiangala, Ikolomani, Kakamega County, Kenya. Credit: Chemtai Kirui/IPS

By Chemtai Kirui
KAKAMEGA, Kenya, Apr 1 2026 (IPS)

They call this land Bushiangala. Gold has been mined here for nearly a century. In 1931, colonial prospectors arrived after traces were found in the nearby Yala River, setting off a rush that changed this quiet corner of western Kenya.

Colonial authorities quickly took control of the boom, introducing mining laws that restricted access, while companies like Rosterman Gold Mines dominated production, employing local labour even as profits flowed out of the region. When industrial operations collapsed in the 1950s, they left behind something more enduring: an informal mining economy that never disappeared.

For more than 70 years, artisanal miners, known locally as ‘wachimba migodi’, have worked these deposits by hand, digging, crushing and washing ore using techniques passed down through generations. Mercury came much later.

Josephine Liabule Mkhobi grew up around the pits. She remembers watching older miners process gold with water and pans.

“Our parents never used mercury,” Mkhobi says. “This method started around 2008.”

Introduced as a faster alternative, mercury quickly took hold, speeding up gold extraction – but leaving behind contamination that has not disappeared.

Over time, water sources across the Lake Victoria region became increasingly unsafe, with mercury in some wells reaching up to ten times the World Health Organization’s guidelines.

The contamination now stretches across a gold-rich belt that includes Kakamega — home to Bushiangala — as well as Vihiga, Siaya, Busia, and Kisumu, reaching toward Migori near the Tanzanian border.

A 2026 study published in Environmental Health found that the water and slurry used in these mining pits contain concentrations of arsenic, chromium, and mercury up to 100 times higher than local surface waters. The researchers warned that miners – and children living nearby – are in direct, frequent contact with these toxic mixtures, which eventually drain into the broader Lake Victoria ecosystem.

Mercury’s Slow Poison

Gladys Akitsa, an artisanal gold miner, mixes mercury with gold-bearing concentrate at the Bushiangala mining site in Ikolomani, Kakamega County, Kenya. Credit: Chemtai Kirui/IPS

For the miners on the ground, these toxins are no longer a matter of abstract data.

Timothy Mukoshi, a miner, remembers a colleague who slowly began to lose his memory. The man would withdraw money from the bank and later forget where he had put it.

Like many miners here, he often burnt mercury-gold amalgam to separate the metal – a process that releases toxic vapours. After he died, Mukoshi says the cause was clear: a post-mortem found traces of mercury in his brain.

“Mercury is what you call a slow poison,” Mukoshi says.

For years, the risks associated with using mercury in mining went largely unrecognised. Now, Bushiangala is trying something different.

In the same processing sites where women crush ore and wash gold by hand, miners are forming cooperatives and introducing methods that can recover gold without the toxic metal.

Miners say the shift gathered momentum after training initiatives reached the area through the planetGOLD programme — a global initiative backed by the Global Environment Facility (GEF) and led by the United Nations Environment Programme (UNEP), with country-level implementation in Kenya by the United Nations Development Programme (UNDP) to reduce mercury use in artisanal and small-scale gold mining.

“The planetGOLD programme stands as our leading initiative to tackle mercury use in artisanal and small-scale gold mining. By helping countries identify, test, and scale up mining and processing techniques, we not only support improved gold recovery but also empower miners to transition away from mercury use,” says Anil Bruce Sookdeo, Chemicals and Waste Coordinator and Senior Environmental Specialist at the GEF.

“Our approach is comprehensive – we facilitate sector formalisation, broaden access to financing for technology upgrades, and connect miners to formal and more reliable gold supply chains. When cleaner technologies are economically viable, financing is accessible, and there’s a dependable market for their gold, miners are much more likely to adopt mercury-free methods,” Sookdeo added.

Bringing Artisanal Miners Out of the Shadows

Women miners gather at a gold processing site in Bushiangala, Ikolomani, Kakamega County, Kenya. Credit: Chemtai Kirui/IPS

The planetGOLD Kenya project, locally known as IMKA, is partnering with the Ministry of Mining and the Ministry of Environment to tackle the root cause of the mercury crisis: informality. By bringing miners out of the shadows and into legal cooperatives, the project aims to replace toxic shortcuts with formal, mercury-free systems.

“At first, many miners were afraid of joining cooperatives,” says Mkhobi, the chairlady of the Bushiangala Women’s Mining Cooperative. “They thought it meant losing their money or being forced into something they didn’t understand. But after they understood the benefits, more people started joining.”

Kakamega currently has 24 registered mining cooperatives spread across several gold-producing sub-counties. Small welfare groups were brought together into registered cooperatives, creating a structure through which miners could access training, equipment, and formal recognition under the Mining Act of 2016.

A Capful of Mercury Replaced by Mechanical Processing

Miners stand at the entrance of a shaft at the Bushiangala mining site in Ikolomani, Kakamega County, Kenya. Credit: Chemtai Kirui/IPS

An artisanal miner uses a sluice box to separate gold from crushed ore at the Bushiangala mining site in Ikolomani, Kakamega County, Kenya. Credit: Chemtai Kirui/IPS

Women process crushed gold ore at the Bushiangala mining site in Ikolomani, Kakamega county, Kenya. Credit: Chemtai Kirui/IPS

Mechanical processing systems are replacing mercury inside the cooperatives. Miners who once relied on a capful of mercury are now learning to master gravity concentrators and shaking tables – mechanical systems that use physical force, rather than toxic chemicals, to pull gold from the dust.

At Bushiangala, a mercury-free demonstration plant now serves as a training ground for miners to practise using the new system under supervision. Technical manuals that once existed only as engineering documents are being translated into practical steps that can be applied directly in the pits.

Training sessions are conducted by technical staff from the planetGOLD programme alongside regional mining officers and cooperative leaders, combining engineering guidance with the practical knowledge miners already bring from the pits.

Oversight of the site is handled through a Joint Implementation Committee that brings together national regulators, county governments and representatives from mining communities.

By providing land and routine supervision, county governments are gradually assuming greater responsibility for the sector — an arrangement designed to ensure the effort continues even after international partners step back.

Convine Omondi, the project’s chief technical adviser, said in a 2025 planetGOLD report that involving local authorities directly helps turn what began as a donor-supported initiative into something managed and sustained at the local level.

The training materials and tools being tested here are part of a wider effort under the planetGOLD programme to share lessons between countries. Experiences from Kenya are being documented and adapted for use in other artisanal mining regions, rather than copied wholesale.

As of early 2026, Kenya had identified six demonstration sites across Kakamega, Vihiga, Migori and Narok. Fencing and sheds have already been completed, and the sites are now entering the commissioning phase. Delivery of heavy equipment and full operation are expected later this year.

Even so, progress is gradual. A site is only considered fully operational once the machinery is installed, utilities such as water and electricity are reliable, and certified cooperatives are actively using the facilities.

“First we were sensitised about how hazardous mercury is,” says Mukoshi, who has worked the Kakamega gold fields since the late 1990s and now chairs the Kakamega Miners Cooperative Union. “People realised it is dangerous. Now many sites keep registers, and miners are also learning that when you mine, you must rehabilitate the land.”

Healing the Land, Working Together

This focus on healing the land has spread beyond Kakamega. In neighbouring Vihiga County, the shift toward environmental restoration is being led by women who see the forest’s health as inseparable from their own.

“The training also introduced environmental rehabilitation, encouraging miners to restore excavated land once extraction ends,” says Shebby Kendi, chair of the Elwunza Women Cooperative Society.

But for Mkhobi, the change is not only about soil or chemicals. It is also about bargaining power. By moving from scattered pits to organised cooperatives, miners are beginning to act collectively in a trade where individuals have little influence.

“Now through the training we are learning how to organise ourselves, keep records and work as cooperatives,” Mkhobi says. “When we come together, we have more strength in the market.”

In a region where gold prices are often dictated by middlemen, that collective strength is beginning to shift how miners negotiate.

Giving Women Voice

A woman at the Bushiangala artisanal gold mine in western Kenya, where mercury is commonly used in gold processing, raises health concerns among workers. March 23, 2026. Photograph: Chemtai Kirui/IPS

“When you are one woman with a gram of gold, you have no voice,” she says. “When there are a hundred of you with a kilo, the buyers have to listen.”

For Anthony Munanga, Kakamega’s county director for environment, natural resources and climate change, that “kilo” also represents something else: control. At a recent media engagement, he said that without organised cooperatives, the gold economy remains largely invisible to regulators.

“Without organisation, there is no way to ensure compliance,” Munanga says. His department is now mapping mining areas across the county, an effort aimed at moving miners out of scattered pits and into designated zones where licensing and environmental oversight become possible.

“This process allows miners to operate safely and legally,” he says.

Changing Face of Financial Support

But legal recognition requires more than a map. It requires financing — and the local banking system is still reluctant to lend to a sector long defined by risk.

Changing how gold is produced also means rethinking how the trade is financed. In Bushiangala, this is where the constraints begin to show.

The planetGOLD programme in Kenya was launched with relatively modest public funding, despite ambitions that stretch far beyond its initial budget. At its core is a USD 4.24 million grant from the Global Environment Facility, much of which has already been allocated.

The grant has largely supported technical assistance — including miner training, policy development and institutional systems designed to formalise the sector — rather than directly financing mining equipment.

Project documents estimate the programme could mobilise up to USD 26 million in additional financing from commercial lenders and private investors to support new processing plants and upgraded mining infrastructure.

In practice, that funding has been slow to materialise.

Although the project was backed by USD 16.6 million in co-financing from government and local partners, a 2023 mid-term review found that much of this support existed on paper as in-kind contributions rather than cash available for day-to-day operations. It also pointed to delays within government financial systems and the lack of a risk-sharing mechanism to draw in private lenders, factors that have slowed implementation on the ground.

A final evaluation due in 2026 is expected to assess how far the programme has managed to address these gaps and whether it can sustain its operations over the long term.

Several structural constraints help explain the shortfall.

A government moratorium on new mining licences between 2019 and 2023 froze formalisation during a critical phase of the project. Without licences, miners could not meet standard lending requirements, and commercial banks have been reluctant to lend to what remains a largely informal sector.

Even where discussions with lenders progress, approval processes within banks can take more than a year, often outlasting key phases of the programme.

The absence of a dedicated risk-sharing mechanism has also limited participation. Without a first-loss guarantee to absorb potential defaults, lenders had little incentive to finance investments in artisanal mining.

The COVID-19 pandemic slowed procurement and field operations, but programme assessments suggest that the deeper barriers were structural — particularly the shortage of licensed miners eligible for credit and the lack of financial instruments tailored to the sector.

As a result, the programme has made measurable progress in training miners and organising them into cooperatives, but access to capital remains constrained.

Harry Kimtai, principal secretary at Kenya’s Ministry of Mining, describes the sequencing as deliberate, arguing that formalisation must come first before significant private investment can enter the sector.

Lag Between Training and Implementation

Sharon Ambale, an artisanal gold miner, holds a gold-mercury amalgam at the Bushiangala mining site in Ikolomani, Kakamega county, Kenya. Credit: Chemtai Kirui/IPS

For those on the front lines, that “deliberate sequencing” feels like a race against their own health. Merab Khamonya, a 28-year-old mother who joined the Bushiangala cooperative in 2024, is one of those caught in the lag between training and implementation.

Though she has attended planetGOLD sessions and understands the neurotoxicity of the metal she handles, her reality remains unchanged. To support her family, she still submerges her bare hands in basins of ore and mercury—a necessity for survival.

“I feel things moving inside my eyes,” she says, describing a persistent, painful irritation. “I know it harms me. I even see traces of it on my clothes when I go home to cook for my children.”

For Khamonya, the promise of a mercury-free mechanical system is a lifeline that has yet to arrive. “We are ready for the shift,” she says, “but for now, we have no other way to clean the gold. We are just waiting for the machines.”

Benefits of Mercury-Free Mechanical Systems

The economics behind the shift are straightforward. Kenya’s 2022 National Action Plan on artisanal and small-scale gold mining estimates that traditional manual methods recover only about 20 per cent of the gold in the ore. By comparison, data from planetGOLD Kenya shows that mercury-free mechanical systems can recover up to 90 per cent—potentially increasing the amount of gold recovered from each load of ore.

Miners involved in the programme say they are cautiously optimistic. They understand the problems and the solutions needed and feel best placed to judge what works on the ground.

“We have seen the difference and learned about mercury-free alternatives,” Mukoshi says. “We are ready to make the shift.”

But the obstacles, he adds, are basic.

“For these sites to work, you need water and electricity. Many of them don’t have either.”

For Mukoshi, Mkhobi, Kendi, Khamonya and their colleagues, the work has shifted to practicalities – securing water and electricity, preparing sites, and waiting on machines. The early experiments are over; what remains is making the system function.

On most days, that means clearing land, assembling equipment and negotiating with miners who are still uncertain about abandoning the mercury methods they have relied on for years.

The change taking shape in Bushiangala is small for now — one processing site, one cooperative, a handful of machines. But the model is already drawing attention beyond Kakamega.

planetGOLD’s Global Reach

In various places in Africa, governments and development agencies are searching for ways to formalise artisanal gold mining without destroying the environments where it takes place. In the Congo Basin’s Cuvette Centrale, UNEP and the planetGOLD programme are supporting a USD 10.5 million initiative aimed at protecting one of the world’s largest tropical peatland systems from mining damage.

The region spans about 167,600 square kilometres of peatlands and stores an estimated 29 billion tonnes of carbon — roughly three years of global emissions. GEF project data suggests the effort is designed to keep gold production from driving damage in a peat swamp that is crucial to climate stability.

In Zimbabwe, a parallel programme has begun introducing mercury-free processing technologies across dozens of mining sites. The effort here is more centralised, tied to the state-run Fidelity Gold Refinery and legislative reforms under the Mines and Minerals Bill.

Kenya’s system, by contrast, relies on cooperative structures at mine sites with county-level oversight through Joint Implementation Committees (JICs) and national regulation under the Mining Act — a model the African Development Bank is using as a reference point, particularly its JIC structure, for scaling mercury-free artisanal mining across the continent.

Kenya’s Experience Now a Guideline For Africa, World Expansion

According to Ludovic Bernaudat, head of the chemicals and green chemistry unit at UNEP, Kenya’s experience is now being used to guide the next phase of the programme as it expands across Africa.

He describes the country as one of the original eight members now completing its first implementation cycle – a milestone for the global initiative.

“New countries in Africa have recently joined the programme, and through the global project, UNEP will make sure that connection is made with Kenya,” Bernaudat said.

He added that the Kenyan model will be featured at the 2026 planetGOLD Global Forum in Panama, where nations share technical expertise and compare approaches to ending mercury use.

Since its launch, planetGOLD has expanded from nine to 27 countries across Latin America, Africa, and Asia.

“This growth demonstrates both the scale of the challenge and the value of a programme that integrates environmental action with support for livelihoods, inclusion, and market transformation,” says Anil Bruce Sookdeo, from the GEF.

But the final proof will depend less on policy design than on whether miners themselves decide it works.

Chasing Thin Seams of Gold Safely

Back in Bushiangala, that test is only beginning.

Miners still arrive at the pits each morning as they always have, chasing thin seams of gold buried in the red earth. What is changing — slowly — is what happens after the ore reaches the surface.

If the new system holds, the mercury that once flowed through these streams may eventually disappear. And the miners here, in this corner of western Kenya, will find a way to keep working the land without the risks that have defined it for years.

Note: This feature is published with the support of the GEF. IPS is solely responsible for the editorial content, and it does not necessarily reflect the views of the GEF.

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

By Ed Holt
BRATISLAVA, Mar 30 2026 (IPS)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Khomasuridze agreed.

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

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Credit: Ryan Brown/UN Women

By Inés M. Pousadela and Samuel King
MONTEVIDEO, Uruguay / BRUSSELS, Belgium, Mar 30 2026 (IPS)

On 19 March, the Commission on the Status of Women (CSW) did something unprecedented in its eight-decade history: it held a vote. The Trump administration, having spent two weeks attempting to defer, amend and ultimately block the session’s main outcome document, known as the agreed conclusions, cast the only vote against its adoption. That dissenting vote said a lot, as it came from the world’s most powerful government, backed by financial leverage, bilateral reach and a network of anti-rights states and organisations that are making inroads at many levels.

Established in 1946, the CSW brings together 45 states each year to negotiate commitments that, while not legally binding, shape domestic legislation, set international norms and signal the direction of political will. Civil society plays an important role in it: the NGO Committee on the Status of Women coordinates thousands of organisations, from large international bodies to grassroots groups, with the aim of ensuring those most affected by policy have a seat at the table. For several decades, this has been the closest thing the world has to a dedicated annual intergovernmental negotiation on women’s rights.

The assault on gender equality

The Trump administration arrived at CSW70 having withdrawn from UN Women in January and from its Executive Board in February, citing opposition to what it calls ‘gender ideology’. It submitted eight amendments targeting language on reproductive health. When these didn’t succeed, it attempted to defer or withdraw the conclusions entirely. When that too failed, it voted against adoption and tabled a separate resolution seeking to impose a restrictive definition of gender, effectively attempting to rewrite 30 years of carefully negotiated commitments. Its resolution was blocked.

At the Munich Security Conference in February, US Secretary of State Marco Rubio defined western civilisation as bound together by Christian faith, shared ancestry and cultural heritage, an ideological approach that treats women’s equality, reproductive rights and LGBTQI+ rights not as human rights but ideological impositions to be rejected. The Trump administration’s financial muscle is now the delivery mechanism for this worldview.

Defunding as a weapon

The immediate material crisis at CSW70 was the collapse of funding. The elimination of 90 per cent of USAID contracts wiped out US$60 billion in foreign aid. The USA is instead negotiating bilateral deals with 71 countries under its ‘America First’ global health strategy, extending its global gag rule not just to civil society organisations but to recipient governments. This means any institution that receives US health funding must certify that neither it nor any organisation it works with promotes or provides abortion.

Funding will now flow through faith-based groups, with ultra-conservative Christian organisations such as the Alliance Defending Freedom and Family Watch International set to benefit, having spent years building networks across Africa, Asia and Latin America. They use the language of family values, parental rights and national sovereignty to consolidate conservative influence over laws affecting women, LGBTQI+ people and young people. In many countries, they already have direct access to governments while progressive organisations are routinely excluded.

With threats intensifying, the UN is signalling retreat. A proposal under the UN80 cost-cutting initiative to merge UN Women with the UN Population Fund (UNFPA) has alarmed civil society worldwide. The stated rationale is efficiency, but there’s little overlap between the two agencies and their combined budgets make up a small part of the UN’s overall spending, suggesting savings would be modest. It’s hard to escape the conclusion that the targeting of these organisations reflects the increasing contestation of their rights-based mandates rather than any logic of organisational efficiency.

Over 500 civil society organisations signed an open letter to UN Secretary-General António Guterres warning that, when sexual and reproductive health rights are absorbed into broader mandates, they risk ‘being deprioritised, underfunded, or rendered politically invisible’. Some states have urged caution but so far none has committed to blocking the merger.

Civil society holds the line

In difficult times, over 4,600 civil society delegates attended CSW70 and made their presence count. They took the floor to name structural barriers and demand accountability: youth representatives challenged the normalisation of online violence, Pacific Island delegates described how geography compounds the denial of justice for survivors, and activists from Haiti documented the labour exploitation of migrant domestic workers. They all emphasised that when women’s rights organisations are restricted or defunded, survivors lose their primary pathway to justice.

The NGO CSW Forum hosted over 750 events alongside the official session. But not everyone could participate. US visa restrictions meant several women’s rights activists, particularly from the global south, couldn’t enter the country. This is a worsening problem that limits civil society’s ability to engage.

CIVICUS’s newly released 2026 State of Civil Society Report documents exactly what civil society has been up against: institutions built to protect women’s rights under sustained, coordinated attack, their funding cut, their mandates targeted and the human rights values they are built on reopened for revision. CSW70’s agreed conclusions offer hope, committing states to action on AI governance, discriminatory laws, digital justice, labour rights, legal aid and the formal recognition of care workers. But as the contest over them made plain, political will is running low and the anti-rights community is emboldened. Civil society left CSW70 without losing ground – and this seems to be the measure of success in the regressive times we live in.

Inés M. Pousadela is CIVICUS Head of Research and Analysis, co-director and writer for CIVICUS Lens and co-author of the State of Civil Society Report. She is also a Professor of Comparative Politics at Universidad ORT Uruguay.

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

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Sima Bahous, Executive Director of UN Women, addresses the opening of the Seventieth Session of the Commission on the Status of Women. Credit: UN Photo/Evan Schneider

By Oritro Karim
UNITED NATIONS, Mar 17 2026 (IPS)

The 70th session of the Commission on the Status of Women (CSW70) has brought together global leaders, gender equity advocates, and youth representatives at the United Nations (UN) Headquarters to advance efforts to strengthen mechanisms for justice, equality, and representation for women and girls worldwide. With challenges particularly pronounced in conflict zones, this year’s priority theme —“ensuring and strengthening access to justice for all women and girls — focuses on repealing discriminatory laws and addressing persistent structural barriers that prevent women and girls from being fully heard, represented, and treated equally.

At the opening of the session in March 9, the CSW adopted its Agreed Conclusions, which emphasized the need to improve access to justice for women and girls, following a week of spirited discussions among member states. During these discussions, several countries, including the United States, Argentina, Saudi Arabia, and Russia, proposed objections in which they sought to modify language that strongly supported these reforms and to revisit provisions from previous agreements.

These efforts elicited significant pushback from other member states, who argued that such objections would undermine years of progress in gender equity reforms. The Chair of the CSW ultimately decided to preserve some core elements of previous agreements while incorporating progressive changes.

As the Commission convened to adopt the outcome, efforts to halt these changes were brought forward by the U.S., which argued that the provisions included “controversial” and “ideological” issues. These efforts ultimately failed, gaining votes from only the U.S. Other states, including Egypt and Nigeria, called for a delay in the voting process to allow time for continued negotiations.

“At a time of severe backlash on human rights and multilateralism, the adoption of Agreed Conclusions that safeguard long-standing gender equality standards is a powerful signal that global commitments still matter and that attempts to turn back the clock will not go unchallenged,” said Agnès Callamard, Amnesty International’s Secretary General.

“While the loss of consensus is disappointing, a weakened text – or no outcome at all – would have sent an especially troubling signal to women and girls who continue to face barriers to access to justice, and multiple and intersecting forms of discrimination. In a climate marked by widespread impunity, Amnesty reiterates its calls on states to step up resistance to attacks on gender justice,” added Callamard.

Women currently hold only about 64 percent of the legal rights afforded to men, with “discriminatory laws and patriarchal norms” continuing to impede progress towards justice. These disparities are particularly pronounced in conflict settings, where women and girls face heightened risks of violence, displacement, and exclusion from justice, opportunities, and decision-making.

“We meet at a time of multiple global crises, peace eludes us, and the world is extremely and increasingly fragmented. And gender inequality is compounded by the evils of war and conflict, from Afghanistan to Haiti, to Iran, Myanmar, Palestine, South Sudan, Sudan, Syria, Ukraine, Yemen, and beyond,” said UN Women Executive Director Sima Bahous at the opening of the 70th session of the CSW. “When women and girls are denied justice, the damage goes far beyond any single case: it impacts the very fabric of our societies and good governance. Public trust erodes, institutions lose legitimacy, and the rule of law itself is weakened. A justice system that fails half the population cannot claim to uphold justice at all.”

Legal protections from discrimination and exploitation, and access to essential services are rapidly eroding, while female human rights defenders are increasingly under attack. Sexual and reproductive health rights are also being rolled back, and the UN has recorded an 87 percent increase in cases of conflict-related sexual violence over the past two years. Women and children in conflict zones continue to bear the heaviest burdens of violence and displacement. Currently, the number of women and girls living within 50 kilometers of deadly conflict is at its highest level in decades.

In commemoration of CSW70, IPS spoke with Anna, a 20 year-old Ukrainian activist and member of the UNICEF Global Girl Leaders Advisory Group. This initiative brings together 14 adolescent girl leaders from around the world who work to ensure that the perspectives of women and girls are represented in global decision-making, and present recommendations directly to the UNICEF Executive Board.

Anna was a teenager studying abroad when the conflict in Ukraine erupted, and was unable to return home to her family near the border. Since then, she has experienced significant challenges as a result of the war, compounded by limited access to essential services, such as education and psychosocial support, many of which have been disrupted or placed under strain by the war.

“When war begins, the changes in society are immediate and visible,” said Anna. “Frontlines move, cities are destroyed, and millions of people are forced to leave their homes. When many men go to the front, women often become the pillars holding communities together – running local initiatives, leading volunteer networks, managing businesses, and supporting families.”

Such shifts also bring structural struggles, as many women are forced to leave their homes and move with their children or elderly relatives. Such displacement can cause loneliness and uncertainty, Anna explained. While women take on more responsibility, inequality does not disappear. “Women still face salary gaps, stereotypes about leadership, and the expectation that they should both rebuild society and quietly carry the emotional labor of caring for everyone else. Stopping to fully process everything can feel impossible, because another responsibility, another task, or another crisis immediately takes its place.”

Anna speaking at a UNICEF-supported event dedicated to discussing the challenges and solutions for girls and young women in Ukraine who are not in education, employment or training. Credit: ISAR Ednannia /Serhii Piriev

In Ukraine today, roughly 32 percent of women aged 20-24 and nearly 49 percent of women aged 25-29 are left without access to education, employment, or training, compared to about 16.4 percent and 12.2 percent of men in the same age groups, respectively. In times of conflict, women are often the first to lose these opportunities and the last to regain them. Education for girls is often hardest-hit, as families are displaced and conflicts leave girls to take on added responsibilities to their families and support household incomes. Many are forced to drop out of school to keep their families afloat.

“My own educational journey has been deeply shaped by war. I was first displaced to Poland, and when I returned to Kharkiv for my senior year, continuing my studies was far from easy,” said Anna. “I consider myself incredibly privileged. I had a supportive family that believed in me and helped me keep going. But not every girl has that kind of support system – someone to catch her when she begins to fall behind.”

Additionally, the psychosocial strain of conflict and violence often leaves girls ill-equipped to engage in studies or training programs. With mechanisms for justice, healing, and empowerment for women and girls under attack, these challenges often go unheard, and impunity for sexual violence and abuse persists, leaving girls carrying significant amounts of trauma, anxiety, depression, and fear.

“Girls in crisis often carry a kind of psychological burden that is both invisible and personal – it is not only the direct exposure to violence, but the way war quietly settles into everyday life and into the body,” said Anna. “For many women and girls living near conflict zones, mental health is shaped by the constant proximity to violence. “You wake up, check the news, hear another siren, and feel what we call in Ukrainian a ‘ком в горлі’,’ or a lump in the throat.”

Sexual violence is particularly rampant near conflict zones, with Anna noting a persistent “climate of fear that reaches every woman who hears the story”. She added that many girls in Ukraine grow up with the knowledge that their bodies can become targets of violence. While girls are in school, studying for exams, or volunteering, many carry the awareness that women nearby have endured “unimaginable violence”.

According to a UN report, nearly 54 percent of surveyed countries reported having laws that do not correlate rape with the basis of consent, and roughly 75 percent of surveyed countries have laws that permit the forced marriage of a girl child. Additionally, 44 percent of countries lack laws that guarantee equal pay for women and girls. It is estimated that it could take 286 years to eliminate these gaps.

“The justice women and girls deserve, that is theirs by right, cannot wait. We must collectively pursue it, here at the United Nations, in our national laws and policies, in your court rooms and traditional justice mechanisms. In doing so, we must engage all of society, including men and boys and young people, to contribute to our collective effort for equality,” said Bahous.

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A street scene in Kabul.

By External Source
KABUL, Mar 12 2026 (IPS)

In the bone-chilling Afghanistan winter, a woman was dragged into a public square early this year and publicly lashed for a crime she may or not have committed. According to the ruling handed by the Taliban Supreme Court, the woman and the male culprit who was jointly accused of extra-marital affair received 30 lashes each and a one-year suspended prison sentence. The sentence was carried out in the presence of several local officials and residents in a province whose name is left out to protect the victim.

For Roya, (not her real name), a woman whose life has already been scarred by years of psychological and emotional distress, 30 blows of lashes in corporeal punishment amounts to an extra dose of salt into her wound. She lost her husband six years ago, in a traffic accident, leaving her to raise five children as a single mother.

Faced with crushing poverty Roya has worked as a farm laborer on other people’s land, but with the onset of the winter and agricultural work drying up, she migrated to the city where she cleaned houses, washed clothes and hand-stitched embroidered men’s collars under the dim light of a lamp at night. Naqeeba (also not her real name), a neighbor who has known Roya for years, speaks approvingly of her great sense of dignity. The money she earned through this work was little, but Roya never asked anyone for help, says Naqueeba.

She tried to cover the costs of living in whatever way she could and it was the constant need to create job-seeking opportunities by frequent daily travels, which rather became labeled as improper marital relations, bringing on her punishment rather than reward.

“She became a victim of circumstances, not a criminal,” Naqeeba, says, adding, “the charge was false.”

According to Naqeeba, Roya didn’t even get a chance to defend herself. She was on her way home and nearby her own house when she was seized “like a dangerous criminal,” thrown into a vehicle, and taken away without anyone knowing where she was taken to or what she had been accused of.

A Charge She Did Not Deserve

“This was not a simple blow. It was a strike that, as long as she lives, she will never be able to hold her head high again in this neighborhood”, Naqueeba explains further with her voice filled with anger and sorrow. She pauses and continues: “For a week, no one knew whether she was alive or what had happened to her until news of her public flogging emerged”.

The repeated public corporal punishments, especially against women, have not only instilled fear in society but also raised serious questions about justice, human dignity, and the status of women in today’s Afghanistan.

Roya’s story is not just the story of one individual; it reflects the suffering of thousands of women who live in silence under the weight of poverty, loneliness, and restrictions, and who are punished simply for being women. The day she was flogged marked the fourth public corporal punishment of women in that province in less than two months, during December and January a trend that has fueled waves of fear, anxiety, and silence, particularly among women in the region.

According to a report by Hasht e Subh Daily Media, in 2025, the Taliban publicly flogged 225 people in Kabul alone. This means that people were flogged at least every other day in the capital. Several other provinces carried out dozens of public floggings each.

The report reveals that confessions were often extracted under pressure. The accused were denied legal assistance and a fair trial. The Taliban rely on corporal punishment and public displays of force, which violate human rights and cause severe social and psychological consequences for the victims.

The Taliban abolished the Attorney General’s Office and shut down the Independent Bar Association of Afghanistan in November 2021, thus effectively blocking the path to legal defense.

In 2025, Richard Bennett, the UN Special Rapporteur along with other UN experts, on the situation of human rights in Afghanistan, consistently condemned the Taliban’s increased use of public flogging and other forms of corporal punishment, describing them as “inhuman and cruel”. Throughout the year, he highlighted the alarming rise in these practices, noting that they often occur without due process or fair trial standards.

“The Taliban must immediately end the death penalty and all corporal punishment that amounts to torture or other cruel and inhuman treatment, and respect the rights and dignity of all detainees,” Bennett and other experts stressed.

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Excerpt:

Credit: Marco Longari/AFP

By Inés M. Pousadela
MONTEVIDEO, Uruguay, Mar 9 2026 (IPS)

Consider what International Women’s Day looked like a few years ago, and what it looks like now: the same date, the same global moment of reflection, but a vastly changed global landscape. Gender rights are facing the most coordinated and wide-ranging attack in decades. Anti-rights forces are dismantling protections secured after generations of struggle, destroying infrastructure built to address gender-based violence and realise reproductive rights and rewriting legal frameworks to roll back rights, with a specific focus on excluding transgender people. This is the result of a deliberate, carefully crafted, handsomely funded and globally coordinated strategy.

Fortunately, resistance is proving harder to extinguish than those driving the backlash had expected. Another International Women’s Day of mobilisation is here to prove it.

A regressive template

While attacks have been building for years, the global landscape shifted quickly in January 2025, when a newly inaugurated Donald Trump signed executive orders imposing a rigid binary classification of sex across federal law, stripping non-discrimination protections for LGBTQI+ people in healthcare and housing, and banning diversity, equity and inclusion policies across the federal government. Because the USA had been the world’s largest bilateral donor, the simultaneous dismantling of USAID and expansion of the global gag rule — blocking US funding to organisations that provide abortions or advocate for abortion rights — had immediate effects on women and girls all over the world, with particularly deadly consequences in conflict zones, rural areas and the world’s poorest countries.

Elsewhere, regressive forces were already mobilising – and Trump’s example only emboldened them. Hungary banned Pride marches and authorised surveillance to enforce compliance. Slovakia and the UK redefined sex as exclusively biological, stripping legal recognition from non-binary and transgender people. Burkina Faso criminalised same-sex relations and their ‘promotion’. Trinidad and Tobago’s Court of Appeal reinstated colonial-era penalties for homosexuality of up to 25 years in prison. Kazakhstan introduced a Russian-style ban on positive LGBTQI+ representation in education, media and online platforms.

It’s striking how consistent the underlying logic is across different political and regional contexts: gender equality is framed as a dangerous ‘ideology’, feminism is demonised as a foreign imposition, LGBTQI+ visibility is portrayed as a threat to children. The similarities reflect a coordinated effort to manufacture cultural conflict to consolidate hierarchies, strengthen elite authority and deflect attention from economic and political failures.

The backlash has reached the international institutions that have long served feminist movements as key arenas for developing a common language, setting a shared agenda and coordinating action across borders. A milestone in anti-rights advances was observed at the United Nations Commission on the Status of Women’s 69th session last year, where a well-organised anti-rights bloc succeeded in stripping longstanding references to sexual and reproductive health and rights from the meeting’s Political Declaration.

What resistance looks like

Yet regression is not going uncontested: not in the streets, not in the courts and not even in the world’s most repressive settings.

In Hungary, tens of thousands defied the Pride ban in Budapest, risking prosecution to assert their right to be visible in public space. In South Africa, sustained civil society pressure, including over a million signatures demanding action, compelled the government to declare gender-based violence and femicide a national disaster. In St Lucia, the Eastern Caribbean Supreme Court struck down colonial-era laws criminalising same-sex relations. Courts in Malawi and Nigeria recognised the right to safe abortion for sexual violence survivors. The UK finally repealed a Victorian-era law that had continued to criminalise abortion in England and Wales. Denmark and Norway improved access to abortion services. Marriage equality came into force in both Liechtenstein and Thailand. At least three European Union member states — the Czech Republic, France and Poland — adopted consent-based definitions of rape.

Even in the most difficult of circumstances, under Afghanistan’s system of gender apartheid, women are maintaining underground schools, keeping solidarity networks alive and documenting abuses, setting their sights on future justice processes.

While the list of advances is impressive, some of the most important contemporary victories are invisible: stalled bills, softened provisions, laws not passed because civil society refused to stand aside. An attempt to repeal The Gambia’s ban on female genital mutilation was blocked. Kenya’s anti-LGBTQI+ Family Protection Bill remains stalled. In Latvia, when conservative forces moved in October 2025 to withdraw from the Istanbul Convention on violence against women, large-scale protests and a civil society petition won what could be a crucial delay. These defensive successes rarely make headlines, but they result from sustained, unglamorous advocacy and coalition work. Without them, the most extreme proposals would advance much further and faster.

Rising to the challenge

Recognition of rights is never permanent. It’s won through sustained struggle and can be reversed through organised opposition from those who perceive other people’s rights as a threat to their privilege. Backlash isn’t a historical anomaly but a predictable counter-mobilisation, and civil society has met it as such, by organising, mobilising, litigating and refusing to concede ground.

This is precisely what CIVICUS’s 2026 State of Civil Society Report, set for release on 12 March, sets out to document. The report examines the state of the world and civil society action throughout 2025 and early 2026 – including a dedicated chapter on women’s and LGBTQI+ people’s rights – and reveals strong patterns of resistance. Across regions and political contexts, it shows how civil society understands the scale of the attack and is responding in every possible way.

As this International Women’s Day will once again make clear, the backlash is organised and strong. But so is the resistance.

Inés M. Pousadela is CIVICUS Head of Research and Analysis, co-director and writer for CIVICUS Lens and co-author of the State of Civil Society Report. She is also a Professor of Comparative Politics at Universidad ORT Uruguay.

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

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Hawa Hussein Farah, a market trader in Garissa Town, Kenya, says extreme heat has shortened her working hours and reduced her daily earnings. Credit: Chemtai Kirui/IPS

By Chemtai Kirui
GARISSA, Kenya , Feb 16 2026 (IPS)

By 9 a.m. on a Wednesday, Hawa Hussein Farah is already watching the temperature climb. Awake since 6 a.m., she has prepared her three children for school before walking them to class and heading to Suuq Mugdi, an open-air market in Garissa town, to buy the fruit she will sell.

When she settles into her modest stall, built from wooden poles and covered with draped fabric, the heat is already intensifying beneath the canopy.

On a wooden table, yellow bananas rest in neat clusters beside green-striped watermelons. Mangoes, some blushed red, others golden, are stacked in small pyramids. The shade shields the fruits from direct sunlight, but the air beneath stays warm and dry.

“When it gets this hot, the customers disappear,” Farah says, lifting a bottle of water. “We have to close and go home to rest until it cools.”

Situated in Kenya’s arid northeast, Garissa is in its hottest season. Between January and March, daytime highs typically hover around 36°C (96.8°F).

In early February 2026, temperatures reached 38°C (100.4°F), with “feels-like” readings topping 41°C (107°F), according to Samuel Odhiambo, the county director of meteorological services.

While similar peaks have been recorded in previous years, Odhiambo said recent data show hot conditions are lasting longer, with more consecutive days above seasonal averages. The meteorological agency has issued a biometeorological advisory, warning residents that prolonged exposure increases the risk of heat stress, dehydration, and skin damage.

“If the current pattern continues, temperatures could exceed 40°C (104°F) in March,” he said.

For Farah, these degrees translate into a shorter workday. By noon, exhaustion sets in.

“My body feels weak and I sweat a lot. I drink two or three litres of water in the morning. I don’t even know if it helps.”

She now closes her stall roughly four hours earlier than in cooler months, cutting deeply into her already thin margins.

On cooler days, she brings in about 7,000 shillings (USD 54) in weekly sales. In prolonged heat, that falls to around 4,000 (USD 31), nearly half her usual takings.

Unsold fruit quickly softens, and after two days she lowers prices or sells it to nearby food kiosks for juice to avoid larger losses.

With no fixed salary or protections, each lost hour translates directly into lost income.

As the largest trade hub in northeastern Kenya, Garissa’s economy is anchored by its livestock markets. Data from the International Livestock Research Institute (ILRI)  indicate that this economic dependence makes the region uniquely vulnerable: when extreme heat degrades livestock health and keeps buyers away, the resulting financial contagion directly shrinks customer flow for small vendors like Farah.

Emily Ndung’e, a motorcycle taxi rider in Garissa Town, northeastern Kenya, says prolonged high
temperatures are affecting her income as fewer customers travel during the hottest hours. Credit: Chemtai Kirui/IPS

Emily Ndung’e, a motorcycle taxi rider, said she is facing similar losses.

Ndung’e says her daily income has plummeted from 1,500 shillings (USD 11.50) to just 500 (USD 3.80) during the heatwave.

Wearing  protective riding gear traps heat against her skin, and she often waits for hours between rides under the relentless sun.

“The heat gives me rashes and I sweat a lot,” Ndung’e says. “But I have to be out here. This is the work I depend on to feed my children.”

She describes the heat as devastating for both her income and her health. With few shaded areas along the roadside, she moves between scattered tree canopies, waiting for the next client.

Even after sunset, the heat lingers in Garissa’s concrete homes and corrugated roofs, offering little relief to those who have spent the day working outdoors.

Patricia Nying’uro, a climate scientist at the Kenya Meteorological Department who serves as the national focal point for the UN’s Intergovernmental Panel on Climate Change (IPCC), says that hotter nights strip away the body’s ability to recover between hot days.

“When temperatures approach 39°C, or even lower in humid conditions, the risk to outdoor workers increases sharply, particularly with prolonged exposure,” Nying’uro said.

Concerns over rising temperatures in Garissa have previously reached Parliament.

In 2022, Aden Duale, then the Garissa Township lawmaker, formally petitioned the Ministry of Environment regarding ‘public concerns’ over rising temperatures. The ministry acknowledged above-average temperatures linked to climate change. In Garissa’s markets, those shifts now translate into extreme heat events that disrupt daily survival.

Duale now serves as Cabinet Secretary for Health and in October 2025 presided over the launch of Kenya’s Climate Change and Health Strategy (2024–2029), marking the first time heat-related mortality is formally tracked at the national level.

Yet, responsibility for addressing the impacts of extreme heat remains limited.

Garissa has a County Climate Change Action Plan (2023–2028), but it focuses largely on drought, floods and livestock disease. Specific provisions for extreme heat, such as adjusted working hours, public cooling spaces or hydration points – are absent.

The National Drought Management Authority said its mandate centres on drought-related risks, adding that extreme heat on its own does not fall within its response frameworks. Officials directed heat-related enquiries to the Kenya Meteorological Department.

For Farah, that gap is tangible.

“We don’t get any help from the government. We need shade because we suffer in the heat,” she said. “I still pay taxes to the county, but the loss is mine to bear.”

Across Kenya, informal workers like Farah account for roughly 80 percent of the workforce. According to a July 2024 report by the International Labour Organization (ILO), Africa now faces the world’s highest heat exposure, affecting 92.9 percent of its workers.

The agency warns that labour capacity can decline by up to 50 percent under extreme heat—a productivity drain contributing to projected global losses of ISD 2.4 trillion by 2030.

Extreme heat poses a direct challenge to United Nations Sustainable Development Goal (SDG) 8.8, which mandates safe working environments for all.

Without safeguards against extreme heat, this promise remains unfulfilled, exposing a critical gap in Kenya’s climate strategy and undermining SDG 13’s call for national resilience.

The current National Climate Change Action Plan (NCCAP) prioritises large-scale agriculture and energy infrastructure. It offers few explicit protections for informal market labour.

While the heat is universal, its toll is gendered. Researchers say that women in Garissa face a “double exposure”, navigating extreme temperatures at the stall and then managing the unpaid care of children and seniors in overheated, unventilated homes, facing nearly a 24-hour cycle of stress.

A study by the The Atlantic Council’s Climate Resilience Center found that heat increases a woman’s total work burden by 260 percent when domestic labour is included.

“It’s a regressive tax,” says Kathy Baughman McLeod, CEO of Climate Resilience for All (CRA), citing research in cities like Freetown, Sierra Leone, where informal market women can lose up to 60% of their income during heat-driven disruptions.

“The body perpetually believes it’s under attack,” McLeod adds, “without tools like ‘heat insurance’, currently being piloted in India but absent in Kenya, the crisis erodes both income and physical recovery.”

Sierra Leone was the first country in Africa to adopt a national Heat Action Plan (HAP), which is a comprehensive policy framework designed to prepare for, respond to, and mitigate the health and economic impacts of extreme heat.

According to Dr Joyce Kimutai, who co-authored the State of the Climate Kenya 2024 report alongside Nying’uro, establishing localised Heat Action Plans is now the “most urgent task” for national adaptation.

“Heat continues to be a silent killer,” Kimutai said, adding that because the economic impacts remain poorly quantified, policy responses continue to lag behind the rising mercury.

Nairobi County is currently piloting a draft heat-response framework that would allow authorities to trigger adjusted working hours and open public cooling spaces during extreme conditions.

The proposal has not yet been formally adopted, but Kimutai says she hopes it could serve as a model for other counties.

As temperatures in Garissa edge toward 40°C, Farah’s adaptation strategy remains a solitary one. She packs her unsold, softening fruit, shutters her stall four hours early, and absorbs the financial blow.

For now, there is no policy to shield her livelihood, only the heat.

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

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

By Ed Holt
BRATISLAVA, Jan 14 2026 (IPS)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Malnutrition also remains a serious problem.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

IPS UN Bureau Report

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Donald Trump, President of the United States of America, addresses the general debate of the General Assembly’s eightieth session in 2025. Credit: UN Photo/Evan Schneider.

By Oritro Karim
UNITED NATIONS, Jan 8 2026 (IPS)

President Donald Trump’s executive order to stop United States support for 66 international organizations, including 31 United Nations (UN) groups, has faced strong opposition from these organizations, the global community, humanitarian experts, and climate advocates, who are concerned about the negative effects on global cooperation, sustainable development, and international peace and security.

This executive order follows earlier withdrawals from the World Health Organization (WHO), the United Nations Relief and Works Agency for Palestinian Refugees in the Near East (UNRWA), the United Nations Human Rights Council (UNHRC), and the United Nations Educational, Scientific, and Cultural Organization (UNESCO). The United States has recently reduced its funding for foreign aid organizations.

The majority of the affected bodies in this executive order are organizations that center around issues in climate change, labor, peacekeeping, migration, and civic space conditions. In a statement from the U.S. Department of State, it is confirmed that Trump’s review of these organizations found them to be “wasteful, ineffective, and harmful.”

The executive order primarily affects organizations that address climate change, labor rights, peacekeeping, migration, and civic space conditions. In a statement, the department described the organizations, calling them vehicles for “progressive ideologies” funded by American taxpayers and misaligned with United States’ national interests.

“The Trump Administration has found these institutions to be redundant in their scope, mismanaged, unnecessary, wasteful, poorly run, captured by the interests of actors advancing their agendas contrary to our own, or a threat to our nation’s sovereignty, freedoms, and general prosperity,” said United States Secretary of State Marco Rubio. “President Trump is clear: It is no longer acceptable to be sending these institutions the blood, sweat, and treasure of the American people, with little to nothing to show for it. The days of billions of dollars in taxpayer money flowing to foreign interests at the expense of our people are over.”

The order instructs all executive departments and agencies to begin implementing the withdrawals immediately. For the affected UN agencies, this entails ending United States participation and halting funding. Rubio also confirmed that the review of additional international organizations is still underway.

Humanitarian experts and spokespersons for many of the affected entities have voiced alarm and condemnation with President Trump’s order, warning of severe consequences for climate action, human rights, peacebuilding efforts, multilateral governance, and global crisis-response systems—particularly at a time of mounting international instability.

“Today, we are witnessing a complete shift from global cooperation towards transactional relations,” said Yamide Dagnet, Senior International Vice President at the Natural Resources Defense Council (NRDC).

“It is becoming less about shared principles, rule of law, and solidarity, thereby risking more global instability. By choosing to run away from addressing some of the biggest environmental, economic, health, and security threats on the planet, the United States of America stands to lose a lot. With diminishing credibility and competitiveness in the industries of the future, the United States will be missing out on job creation and innovation, ceding scientific and technological leadership to other countries,” Dagnet said.

She called on world leaders to commit to multilateralism.

“The world is bigger than the United States—and so are the solutions to our problems, which require global cooperation more than ever, including among states, provinces, and cities globally. This is the moment when world leaders need to resolutely commit to multilateral collaboration if we’re going to overcome these global threats to ensure a safe and sustainable future for all.”

Many have also criticized the United States’ à la carte approach to meeting its international obligations, only supporting the operations and agencies that align with President Trump’s priorities.

“I think what we’re seeing is the crystallization of the United States approach to multilateralism, which is ‘my way or the highway,’” said Daniel Forti, the head of UN affairs at the International Crisis Group. “It’s a very clear vision of wanting international cooperation on Washington’s own terms.”

The Intergovernmental Science Policy Platform on Biodiversity and Ecosystem Services (IPBES) said it regretted “the deeply disappointing news of the United States’ intention to withdraw its participation in IPBES, along with more than 60 other international organizations and bodies.”

Dr. David Obura, Chair of the Intergovernmental Platform on Biodiversity and Ecosystem Services (IPBES), said the U.S. was a founding member and “scientists, policymakers and stakeholders—including Indigenous Peoples and local communities—from the United States have been among the most engaged contributors to the work of IPBES since its establishment in 2012, making valuable contributions to objective science-based assessments of the state of the planet for people and nature.”

Apart from their contributions to IPBES, “decision-makers in the United States—at all levels and in all spheres of society—have also been among the most prolific users of the work produced by IPBES to help better inform policy, regulations, investments and future research.”

Obura thanked the United States for their contribution but noted that the withdrawal would have a massive impact on IPBES and the planet.

“Unfortunately, we cannot withdraw from the fact that more than 1 million species of plants and animals face extinction. Nor can we change the fact that the global economy is losing as much as USD 25 trillion per year in environmental impacts, or restore the missed opportunities of not acting now to generate more than USD 10 trillion in business opportunity value and 395 million jobs by 2030.”

Historically, the United States has been the largest financial contributor to the UN, providing approximately 22 percent of the organization’s regular budget and roughly 28 percent of all peacekeeping funds.

The withdrawal of United States support from 31 UN bodies is expected to trigger substantial budget shortfalls, cutbacks in humanitarian staffing, and the loss of critical technical expertise supplied by its personnel. These setbacks are likely to hinder progress toward the Sustainable Development Goals (SDGs), reduce food assistance and medical services for people in protracted crises, and embolden authoritarian governments to resist humanitarian oversight and intervention.

“The US decision to disengage from dozens of United Nations programs and agencies, along with other international bodies, is just President Trump’s latest assault on human rights protections and the global rule of law,” said Louis Charbonneau, UN director at Human Rights Watch (HRW).

“Whether withdrawing from the Human Rights Council or defunding the UN Population Fund, which helps millions of women and girls around the world, this administration has been trying to destroy the very same human rights institutions that the US helped build over the last 80 years. UN member countries should resist the US campaign to demolish tools they use to uphold human rights and ensure that vital UN programs have the funding and political support they need.”

At a press briefing at the UN Headquarters, Stéphane Dujarric, spokesperson for the UN Secretary-General António Guterres, informed reporters of the UN’s reaction to the United States withdrawal, emphasizing that the UN remains committed to assisting people in need regardless of United States participation

“As we have consistently underscored, assessed contributions to the United Nations regular budget and peacekeeping budget, as approved by the General Assembly, are a legal obligation under the UN Charter for all Member States, including the United States,” said Dujarric.

“All United Nations entities will go on with the implementation of their mandates as given by Member States. The United Nations has a responsibility to deliver for those who depend on us.  We will continue to carry out our mandates with determination.”

IPS UN Bureau Report

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

By Ed Holt
BRATISLAVA, Jan 7 2026 (IPS)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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A Community Health Worker in a door-to-door campaign to vaccinate people in communities in Nanyamba village, Mtwara Region, in southeastern Tanzania. Credit: Kizito Makoye/IPS

By Kizito Makoye
DAR ES SALAAM, Tanzania, Oct 28 2025 (IPS)

When COVID-19 hit Tanzania in 2020, Alfred Kisena’s life was torn apart. The 51-year-old teacher still remembers the night he learned that his wife, Maria, had succumbed to the virus at a hospital in Dar es Salaam. He wasn’t allowed to see her in her final moments.

“The doctors said it was too dangerous, and the virus was contagious,” Kisena said, gazing at a faded photo of her hanging on the wall.

Maria’s burial took place in eerie isolation. Municipal workers dressed in white protective gear lowered her body into a tomb at Ununio Cemetery on the city’s outskirts.

“Saying goodbye to a loved one is sacred, but I didn’t get a chance,” he said.

Across Tanzania, many families endured the same pain—losing loved ones and being denied the rituals that give meaning to loss. The government imposed strict measures: banning gatherings, restricting hospital visits, and prohibiting traditional burial rites. Schools shut down, and for three months, Kisena’s five children stayed home, their education abruptly halted.

“I was not working, so it was hard to meet the needs of my family,” he said. “We survived on the little savings I had.”

Five years later, as the scars of that crisis linger, Tanzania is charting a new path toward resilience. Earlier this month, the government launched its first-ever Pandemic Fund Project, aimed at strengthening the country’s capacity to prevent and respond to health crises.

Supported by a USD25 million grant from the global Pandemic Fund and USD13.7 million in co-financing, the initiative marks a shift from reactive crisis management to proactive preparedness. It unites local and international partners—including WHO, UNICEF, and FAO—under a “One Health” framework that recognizes the interconnectedness of human, animal, and environmental health.

Learning from the Past

The memories of COVID-19 and the more recent Marburg outbreak remain vivid. When the pandemic first struck, Tanzania’s laboratories were under-equipped, surveillance systems were weak, and community health workers were overwhelmed.

Tanzania’s Deputy Prime Minister, Doto Biteko, said during the launch that the lessons from those crises shaped the country’s new determination.

“For the past 20 years, the world has battled multiple health emergencies, and Tanzania is no exception,” he said. “We have seen how pandemics disrupt lives and economies. Strengthening our capacity to prepare and respond is not optional—it is a necessity.”

That necessity has only grown as Tanzania faces rising risks of zoonotic diseases linked to deforestation, wildlife trade, and climate change. The new project aims to address these vulnerabilities by upgrading laboratories, expanding disease surveillance, and training health workers across the country.

The Human Frontlines

In southern Kisarawe District, 38-year-old community health worker Ana Msechu walks along dusty roads with a backpack containing medicine, gloves, and health records.

“Sometimes I walk for three hours just to reach one family,” Msechu said. “During the pandemic, people stopped trusting us. They thought we were bringing the disease.”

With no protective gear or transport allowance, Msechu faced villagers’ suspicion head-on. At the height of the pandemic, she lost a colleague to the virus. Yet she continued, delivering messages about hygiene and vaccination.

“Sometimes we didn’t even have masks—we used pieces of cloth instead,” she recalled.

The new initiative, she believes, could change that. Implementing partners plan to supply personal protective equipment (PPE), digital tools for data collection, and regular training sessions.

“If we get proper support and respect, we can save many lives before diseases spread,” she said.

“Community health workers are the backbone of resilience,” said Patricia Safi Lombo, UNICEF’s Deputy Representative to Tanzania. “They are the first point of contact for families and play a critical role in delivering life-saving information and services.”

UNICEF’s role will focus on risk communication and community engagement—ensuring that people in rural and urban areas understand preventive measures, recognize early symptoms, and trust the health system.

Between Fear and Duty

Hamisi Mjema, a health volunteer in Kilosa District, remembers how fear became his biggest enemy.

When the Marburg virus hit last year, his job was to trace suspected cases and educate families about isolation.

“I was insulted many times, and some families wouldn’t even let me into their homes,” he said.

Without transport or communication tools, Hamisi walked from one remote village to another with his bicycle, often relying on farmers to share their phone airtime so he could report cases to district health officials.

Under the new initiative, local health officers say community health workers will receive field kits, digital disease-reporting tools, and risk communication materials in local languages.

“It will make our work safer and faster,” he said. “When we detect something early, the whole country benefits.”

Fighting Misinformation

In a lakeside village in Kigoma, volunteer health educator Fatuma Mfaume recalls how rumors once spread faster than the virus itself.

“People were afraid,” she said. “They said vaccines would make women barren. Others believed doctors were poisoning us.”

Armed with a megaphone, Mfaume moved through villages trying to dispel falsehoods—often facing insults. But her persistence paid off. Slowly, women began bringing their children for immunization again.

With the new project, she hopes community workers like her will gain formal recognition and training in communication skills.

“Many of us work without pay,” Mfaume said. “If this project can train us properly and give us materials, we can fight not just disease but fear and lies too.”

Animal-Borne Threats

At the same time, the Food and Agriculture Organization (FAO) is strengthening animal health systems, recognizing that most pandemics originate from animals.

“By improving coordination between veterinary and public health services, Tanzania is taking vital steps to prevent zoonotic diseases before they spill over to humans,” said Stella Kiambi, FAO’s Emergency Centre for Transboundary Animal Diseases Team Lead.

These measures include upgrading veterinary laboratories, improving disease surveillance in livestock markets, and training field officers to detect early signs of outbreaks.

The World Health Organization (WHO) is also supporting efforts to strengthen human health systems—from expanding testing capacity to developing rapid response teams.

“This project marks a bold step forward in health security,” said Dr. Galbert Fedjo, WHO Health Systems Coordinator. “It advances a One Health approach that links human, animal, and environmental health.”

Rebuilding Trust and Hope

For Priya Basu, Executive Head of the Pandemic Fund, Tanzania’s project represents “an important step in strengthening the country’s preparedness to prevent and respond to future health threats.”

Across Africa, the Fund—established in 2022—has supported 47 projects in 75 countries with USD 885 million in grants, catalyzing more than USD 6 billion in additional financing.

According to the World Bank, every USD 1 invested in pandemic preparedness can save up to USD 20 in economic losses during an outbreak.

For Tanzania—a nation that lost thousands of lives and suffered deep economic shocks during COVID-19—the stakes couldn’t be higher.

“Preparedness is about saving lives and livelihoods,” said Dr. Ali Mzige, a public health expert. “It’s about making sure families don’t suffer when a pandemic strikes.”

For Kisena, the government’s new initiative is a quiet promise that the lessons of loss have not been forgotten.

“Maria’s death taught me how precious life is,” he said. “If this project can protect even one family from that kind of pain, then it will mean her death was not in vain.

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In Hela Province, in the distant interior of the PNG mainland, rural women would need to travel considerable distances by road or air to reach a hospital that provides breast screening mammograms. Credit: Catherine Wilson/IPS

By Catherine Wilson
SYDNEY, Australia , Oct 24 2025 (IPS)

The burden of breast cancer, the most common cancer among women, is global, and the projected increase in cases in the coming decades will affect women in high- and low-income countries in every region.

That includes the Pacific Islands, where it is the top cause of female cancer mortality. Now, during Breast Cancer Awareness Month, islanders talk about tackling the disparities they face and reversing the trend.

“Breast cancer is a significant health concern in Madang Province,” Tabitha Waka of the Country Women’s Association in Madang Province on the northeast coast of Papua New Guinea told IPS. “Most of our women residing in urban centers have access to enough information and facts about cancer, but at least half who live in rural areas don’t.”

Current global trends indicate that new breast cancer cases could reach 3.2 million every year by 2050, reports the World Health Organization (WHO). In the Pacific Islands, which comprise 22 island nations and territories and 14 million people, more than 15,500 cases of cancer in general and 9,000 related deaths were recorded in 2022. But experts warn that the true numbers are unknown.

“It is currently not possible to accurately estimate the true burden of breast cancer in the Pacific Islands due to significant challenges in cancer data collection and the incomplete coverage of population-based cancer registries,” Dr. Berlin Kafoa, Director of the Pacific Community’s Public Health Division in Noumea, New Caledonia, told IPS, adding that it was an issue that countries were working to rectify.

Lack of cancer data is one sign of the funding and resource constraints experienced by national health services. And women are being affected, especially in rural communities where they have less access to knowledge about breast cancer and live far from urban-based health clinics and hospitals. These are major factors in global disparities, and while 83 percent of women in high-income countries are likely to survive following a breast cancer diagnosis, the likelihood of survival declines to 50 percent in low-income countries.

Breast cancer occurs when cells in the breast change, multiply and form tumors. Symptoms can include unusual lumps or physical changes in the breasts. If the cancer is detected early, the chances of successful surgery and treatment are high. At a more advanced stage, it can spread to other parts of the body. Risk of breast cancer increases after 40 years and with a family history of the disease, as well as lifestyle factors, such as tobacco and alcohol use and lack of physical exercise. However, this is not prescriptive and about half of all breast cancers are diagnosed in women with no significant risk criteria, apart from their age.

Importantly, being diagnosed with breast cancer today is not fatal and many women can enjoy long and productive lives. The key to this outcome is early detection, but one of the hurdles for women in the Pacific is that specialist services are centralized in main cities. In Papua New Guinea (PNG), women can seek mammograms, the main method of breast screening, in hospitals in the capital, Port Moresby, and the cities of Lae and Kimbe on the northeast coast of the mainland. But most of the 5.6 million women, who make up 47 percent of the population, live in rural areas, whether densely forested mountains or far-flung islands. And it could entail a long and costly journey by road, air or boat for many to reach a hospital with a mammogram machine.

But it is also not uncommon for women to hold back from seeking medical advice or proceeding with treatment because of cultural and community taboos.

“There is evidence to suggest that cultural and community taboos, personal inhibitions and fears surrounding medical examinations are significant factors contributing to the low levels of early breast cancer diagnosis and treatment among women in Pacific Island societies,” Kafoa said.

Modesty and privacy are important to many women in traditional Melanesian societies. In Palau, for example, a study published by Australia’s Griffith University in 2021 revealed that ‘low screening rates were, at least in part, explained as being due to women feeling uncomfortable during examinations due to its personal nature.’

There can also be pressure from families that may encourage or dissuade women from taking treatment. “If the family disagrees with the treatment, women might comply due to cultural norms,” and concerns about mastectomy and how it changes women’s bodies “can cause resistance to surgical procedures,” reports a breast cancer study in Fiji published last year.

Taking action now is imperative to save women’s lives across the region and, globally, achieve Sustainable Development Goal No. 3 of good health and well-being. The International Agency for Research on Cancer (IARC) predicts that breast cancer cases could increase globally by 38 percent and mortality by 68 percent by 2050. Experts project that cancer incidence in the Pacific Islands could rise by 84 percent between 2018 and 2040. Kafoa says that the “Pacific Island governments are not yet sufficiently prepared to confront the projected surge in breast cancer by mid-century.”

The PNG government’s national health plan includes strengthening health services to reduce cancer morbidity and mortality, but a population-wide breast screening program is yet to be rolled out. Waka says there is a need for more investment in breast cancer services. “One or two facilities is not enough to cater for the large numbers of women living with breast cancer,” she stressed.

But efforts to transform the quality and outreach of healthcare in the country, through the ‘glocal’ approach of combining global technology and local pathways to action, have begun. “This process is already underway,” Dr. Grant R. Muddle, ML, a global healthcare expert who has worked to assist health system transformation in Australia, the Pacific and other regions, told IPS. He is now working with health services in PNG.

Two years ago, a collaborative project was set up with an Australian health agency that “is providing PNG with proven cancer registry software and technical support, while local officials adapt it to PNG’s context. The result is a win-win: PNG quickly gains a modern data system and trained personnel, rather than building from scratch,” Muddle explained.

Mobile technology could also be used to help expand the recording of cancer cases. “Village health workers or clinic nurses, even in isolated areas, could be trained to input basic patient and tumor details into tablets or smartphones,” he continued.

A major step in improving rural health services occurred this year when a new public hospital opened in the remote Highlands province of Enga. It is expected to have an operational mammography unit by the end of this year. But there is also a need to “take the screening technology to women, rather than expecting women to travel to the technology,” Muddle emphasized. “Globally mobile mammography clinics in vans or portable units have been used to bring breast cancer screening to underserved communities…these could be truck-mounted clinics or portable equipment that can be flown by small plane or ferried by boat to regions with no road access.”

And telemedicine, another proven strategy, can link isolated clinics to specialist doctors at provincial hospitals via video consultations.

As PNG celebrates its 50^th anniversary of Independence this year, these initiatives support better outcomes for women’s breast cancer survival and the long journey ahead of meeting the nation’s healthcare goals.

“What needs to be done, we must do. Let us not compromise basic healthcare but at the same time provide specialist care. Together, let us secure a functioning health system for the 10 million people of PNG,” Prime Minister James Marape advocated to the Medical Society of PNG in September.
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Tsholofelo Msimango pictured at her home in Brakpan, near Johannesburg. Credit: TB Alliance/Jonathan Torgovnik

By Ed Holt
BRATISLAVA, Oct 20 2025 (IPS)

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

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

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

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

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

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

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

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

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

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

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

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

Tests showed she was free of TB.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Kamikawa Yoko, Chair of JPFP and of AFPPD addresses the Asian Parliamentarians’ Conference on Education for Life, Safety, and Human Dignity. Credit: APDA

By Cecilia Russell
TOKYO & JOHANNESBURG, Oct 13 2025 (IPS)

Vulnerable children are being targeted online faster than parliamentarians and law enforcers can act, a conference convened by the Asian Population and Development Association (APDA) heard. Yet, with international cooperation and sharing of ideas, lawmakers believe the scourge of online abuse can be addressed.

The Asian Parliamentarians’ Conference on Education for Life, Safety, and Human Dignity in Tokyo, Japan, on 7 October 2025 brought parliamentarians from Asian countries, ministry officials, practitioners, partner organizations, experts and media together to find solutions for the elimination of sexual crimes and violence against children and youth. It ended with a clear call for deeper international collaboration to tackle the protection of children in the digital age.

In her keynote address, Kamikawa Yoko, Chair of JPFP and of AFPPD, said, “Traditionally, in Japan, sexuality education was considered taboo; even the word ‘sexuality’ made discussion untouchable,” so she had proposed the concept of ‘Life Safety Education (LSE)’ so that it could be more readily accepted.

Lawmakers and other delegates at the Asian Parliamentarians’ Conference on Education for Life, Safety, and Human Dignity. Credit: APDA

Setting the scene for the discussion, she said young people come to major cities like Tokyo and Osaka and are exposed to a vast amount of information through the internet and social media—with some lured by promises of an “easy income” only to be deceived and become victims before “they realize it, they may be coerced into the sex industry, human trafficking, drug trafficking, or other criminal activities.”

LSE was more than just teaching children age-appropriate knowledge about the bodies; it empowers children to recognize their rights, develop self-determination and protect themselves, she said, emphasizing that the lawmakers are often approached by public institutions and civil society groups for support.

“Protecting children is not optional. It is our shared responsibility,” she reminded the lawmakers.

Nakazono Kazutaka from Japan’s Ministry of Education, Culture, Sports, Science and Technology elaborated on the country’s Life Safety Education program, saying it aims to prevent children from becoming perpetrators, victims, or bystanders, using age-appropriate content and social media guidance. The education is integrated into health and PE classes, with digital materials and teacher training. The initiative is expanding to more schools and regions, emphasizing human rights and dignity.

Makishima Karen, MP Japan, addresses the Asian Parliamentarians’ Conference on Education for Life, Safety, and Human Dignity. Credit: APDA

Makishima Karen, MP Japan, said the levels of incidences were worryingly high, with 2,783 cases related to child pornography involving 1,024 individuals reported. She also explained that many victims fell outside of the law enforcement and safety nets designed to assist them. Often the grooming starts innocently, with young people detailing hobbies and daily life; they often become entrapped by people who groom them, lure them in with promises, and then sexually assault and abuse them.

The worrying factor is that the abuse remains unreported or if reported, the children disappear, making follow-ups difficult. New laws criminalizing unauthorized filming have been passed, Makishima said but legal mandates need to be extended. She cited an example of how victims of non-consensual sexual images must request removal individually from each digital platform, irrespective of their age—unlike in the US, where the visuals need removal within 48 hours.

Chanlinda Mith, Director of Research of the General Department of Legislation and Research, National Assembly of the Kingdom of Cambodia, addresses the Asian Parliamentarians’ Conference on Education for Life, Safety, and Human Dignity. Credit: APDA

Makishima outlined measures the Ministry of Education was involved in, including the LSE, which emphasized the importance of “not becoming a bystander when witnessing harmful behaviors.”

“Children need to understand the impact of sexual violence and foster a mindset that respects oneself and others too,” she said, and this is done with different messaging for various ages, so, for example, early childhood education would include messages that “your body belongs to you, and parts covered by a swimsuit are private and should not be shown or touched.”

Teens and youth messaging is unambiguous, stating that any “sexual act that you do not want constitutes sexual violence,” and the perpetrator and not the child is blamed.

Yet there is a need for content ratings in online communication that are effective and enforceable, but the problem is international rather than national—and she called for a deeper collaboration.

“Platform operators are very often global; therefore, this would require international collaboration. On the ground, the teachers are trying to educate children, but we need international collaborations beyond the boundaries of countries.”

Among other solutions mooted by international delegates at the conference was the restriction on the use of social media for children and youth under 16.

Catherine Wedd, an MP from New Zealand, gave a remote presentation to the Asian Parliamentarians’ Conference on Education for Life, Safety, and Human Dignity. Credit: APDA

“Globally, the data is grim; 16 to 58 percent of girls in 30 countries have experienced cyber violence. These are our daughters, sisters and friends. The psychological toll is real. Cyberbullying destroys self-esteem and sparks anxiety and depression,” Catherine Wedd, an MP from New Zealand, said.

New Zealand, following the example of Australia, is moving to regulate social media for youth.

Wedd said she championed a bill that will “ensure that the onus is placed on the companies to create necessary age verification measures to prevent children from accessing social media platforms and to enforce a social media ban for users under 16.”

In Cambodia, social media in the form of a Youth Health mobile app has been developed to enhance health education and sexual and reproductive health for adolescents, Chanlinda Mith, Director of Research of the General Department of Legislation and Research, National Assembly of the Kingdom of Cambodia, told the conference.

Apart from crucial information designed to keep young people safe, the app, developed in collaboration with UNFPA, gives the youth anonymity should they need to discuss sensitive matters.

Both Yos Phanita, an MP from Cambodia and Dr. Abe Toshiko, Chair of the JPFP Project Team and MP Japan, reiterated the call for regional and international cooperation in their closing remarks

“We must continue to foster regional cooperations share best practice and advocate for comprehensive sexuality education (CSE) as a fundamental human right and a critical foundation for building healthy, equitable, sustainable societies across Asia,” said Phanita.

Abe agreed, saying that he hoped the discussion would serve as a “catalyst for concrete policy progress and for building greater understanding and support across our society.”

Note: The conference was organized by the Asian Population and Development Association (APDA) and Plan International Japan, in cooperation with the Japan Parliamentarians Federation for Population (JPFP) Project Team on LSE and the International Planned Parenthood Federation (IPPF).
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Participants at the Non-Governmental Organizations Forum meeting held in Huairou, China, as part of the United Nations Fourth World Conference on Women held in Beijing, China, on 4-15 september 1995. Credit: UN Photo/Milton Grant

By Naureen Hossain
UNITED NATIONS, Sep 30 2025 (IPS)

Thirty years since the UN Fourth World Conference on Women in Beijing, the resolve that defined and united the world toward a global agenda for gender equality make it just as relevant in 2025.

The Beijing Conference represents a turning point for the global movement in gender equality. It is marked by the adoption of the Beijing Declaration and Platform for Action, which is still held up as a landmark document in presenting a comprehensive blueprint to achieve gender equality.

The Beijing Conference was just “one stop in a long and continuing journey of feminist advocacy,” said Sia Nowrojee, a Kenyan women’s rights advocate with more than thirty years’ experience.

“Even though it’s thirty years later, it’s absolutely relevant. It was the culmination of twenty years of advocacy and gender equality.” Nowrojee is the UN Foundation’s Associate Vice President of their Girls and Women Strategy division.

The Beijing Conference was the first time that the international community integrated gender equality into the global development and rights agenda. It was recognition that securing the rights and dignities for all women and girls would be integral to achieving widespread development. This was key for the countries that had emerged in the post-colonial era.

Sia Nowrojee, UN Foundation’s Associate Vice President of Girls and Women Strategy. Credit: UN Foundation

The leadership of advocates from the Global South was instrumental to the Beijing PoA. Representatives from Africa, Asia, and Latin America pushed for the measures that make the framework as inclusive as it is. Nowrojee gave the example of girls’ rights being recognized thanks to the efforts of African feminists in the lead-up to Beijing.

Hibaaq Osman, a Somali human rights activist and founder of El-Karama, considers that the Global South activists had been uniquely prepared to participate as they had lived through their countries’ great political upheavals against colonialism and racism.

Osman attended Beijing 1995 as part of the Center of Strategic Initiatives of Women, a civil society network.

Hibaaq Osman, a Somali human rights activist and founder of El-Karama. Credit: UN Foundation

“For me, as a young woman, I was shocked by the things that I heard. I was raised to believe that everything was a privacy. But to hear a woman speaking for herself and sharing things that I never thought you could share with others, including violence against women… It absolutely opened my eyes and made me see, ‘Oh my god, I can actually share things with other women,’” Osman told IPS.

For Osman, the Beijing conference represented the possibilities of what could be achieved through a shared agenda and a shared sense of hope. The unique energy from that conference drove her advocacy work through groups like the Strategic Initiative for Women in the Horn of Africa (SIHA) and then El-Karama, which is working to end violence against women in the Arab region and South Sudan.

General view of the opening session of the Fourth World Conference on Women in Beijing. Credit: UN Photo/Milton Grant

Beijing 1995 also provided the expectation of accountability from governments and policy makers if they did not implement the PoA. “That had never happened before. There was a mechanism for the first time…,” said Osman. “You can hold governments and policymakers accountable. But you also have the connection with grassroots. That it was no longer the individual woman that could claim that she was the leader, but having accountability to your own people, I think that whole thing was fantastic.”

“I think the legacy of Beijing 1995 honestly, it gave us a legacy of getting out of our corners and just wide open to the rest of the women. And I think that vision, that framework is still working.”

Delegates working late into the night to draft the Beijing Declaration and Platform for Action. Credit: UNDP/Milton Grant

The success of the Women’s Conferences also demonstrated the UN’s role as a space to build up the gender equality movement, Nowrojee remarked. The UN has also served as a platform for emerging countries to raise their issues to the international community and to shape global agendas on their terms.

Prior to Beijing, the UN World Conference on Women had previously been held in Nairobi (1985), Copenhagen (1980) and Mexico City (1975). These were also key forums for people from all parts of the world to build relationships and for there to be a “cross-pollination of ideas and experiences”, laying down the groundwork for what was later achieved in Beijing.

Nowrojee was 18 years old when she attended the Nairobi 1985 Conference as part of a school/youth delegation. The experience was formative in listening to women’s activists from the region impart their wisdom and insights.

“To see the world’s women come to my home and talk about the fact that we mattered was life-changing for me,” Nowrojee said. “I made friends who I still work with and love and see today. And I think there is that sort of personal part, which is both personally sustaining, but it’s a critical part of feminist movement building.”

Each conference built up momentum that saw no sign of slowing down. Osman and Nowrojee explained that as gains were being made at local, national and global levels, this encouraged those in the movement to act with urgency and go further. This provided them the spaces to learn how to refine the messages for local contexts.

Delegates at the Fourth UN World Conference on Women in Beijing 1995. Credit: UNDPI /UN Women

The gains towards gender equality should be noted: the codification of women’s rights around the world, their increased participation in politics and in peace negotiations. Evidence has shown that investing in women’s participation in society through health, education and employment leads to economic growth and prosperity. More women in the workforce mean greater economic gains and stability. Increased social protections for women lead to more stability in communities.

And yet, there was backlash to the momentum. Recent years have seen the rise of anti-rights and anti-gender movements gain greater traction, combined with increasing attempts to strip women of their rights. UN Women has warned that one in four countries are reporting a backlash to women’s rights.

Nowrojee remarked that the autocratic leaders that champion these movements target women’s rights because it threatens their own agenda. “If you are silencing half the human family, and you are hampering their ability to make decisions about their bodies, to participate in political process… these are very, very effective ways of undermining democracy, development, peace and the achievement of all the goals and values that we hold dear.”

“They understand that if you bring women down, you are bringing society down, because women are the core of society,” Osman added.

The modern movements are also well-funded and well-organized. But there is an irony to it in that they use the same tactics that feminist movements have been using for decades by organizing at the grassroots level before moving their influence up to the national level and beyond. But this should not be where activists fall to despair. Instead they should understand, Osman and Nowrojee remarked, that women in this space already know what actions need to be taken to regain lost momentum.

“I’m sure that Sia and I and many, many others who were part of that are also thinking about today and what’s happening, and we know the space for civil society is shrinking,” Osman said. “The space for democracy, human rights, justice, reproductive rights, for all of that, there is absolutely a rollback, But it’s not going to delay us. We are just going to be more sophisticated and ask ourselves “Where are the blocks, how do we build… diverse constituencies?”… So it is hard, but we are not slowing down whatsoever.”

Today, it may seem the pursuit of gender equality is an ongoing struggle that faces the threat of autocratic movements that sow distrust and division. For the people who championed the women’s rights movement and can recall a time before the Beijing PoA, they are all too aware of what is at stake. The leaders in modern movements today need to look back to the past to take lessons, and to take courage.

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Delegates at a Ministerial event on climate and health organised by the CSO Climate and Health Cluster under the ACS2 organizing committee. Credit: Friday Phiri/Amref

By Friday Phiri
ADDIS ABABA, Sep 25 2025 (IPS)

At the Second Africa Climate Summit (ACS2) held in Addis Ababa, Ethiopia, from 8-10 September, African leaders committed to the climate and health nexus and their desire to advance climate-resilient and adaptive health systems on the continent.

According to available evidence , climate-induced extreme weather events—cyclones, droughts, floods and heatwaves, are leading to a surge in malaria cases including in regions previously unaffected as warming conditions provide conducive breeding ground for malaria carrying mosquitoes; overwhelming sanitation systems, creating a perfect storm for diarrheal diseases such as cholera; while climate-induced food shortages are driving malnutrition to dangerous levels, as droughts and floods disrupt agricultural productivity and production.

“We reaffirm our collective commitment to advancing Africa-led climate solutions that prioritise human health, environmental sustainability, and equitable development, as guided by the African Union’s Agenda 2063 and the principles of multilateralism, recognise the urgent need to address the intertwined crises of climate change and public health across the continent, and call for dedicated financial mechanisms for climate-related health and the resilience of African health systems, in particular, we highlight the growing threats of heatwaves and water scarcity, which severely affect public health, and call for early-warning systems linked to health services,” reads part of the ACS2 leaders’ declaration adopted at the close of the summit.

Amref Health Africa hosted delegates at the launch of the Climate and Health curriculum for African negotiators. Credit: Friday Phiri/Amref

The leaders thus committed to advancing climate-resilient and adaptive health systems across the continent and recognised the Belém Health Action Plan as a pivotal global framework that aligns with Africa’s aspirations for equitable, sustainable, and climate-smart healthcare.

Held under the theme, “Accelerating Global Climate Solutions: Financing for Africa’s resilient and green development,” the summit brought together African leaders, policymakers, youth, civil society, development partners, and the private sector to shape a unified African stance on the global climate agenda.

The summit served as a catalyst for bold commitments, transformative partnerships, and innovative solutions that address the continent’s most pressing climate challenges.

During the three-day summit, and at the 13^th Conference on Climate Change and Development in Africa (CCDA XIII), which served as a pre-session meeting to feed into the summit outcomes, experts discussed the clear linkages and the growing evidence of climate impacts on Africa’s health systems and delivery.

With limited, and in most cases, complete lack of climate-resilient infrastructure and well-trained health personnel to manage climate shocks affecting the sector, the discussions underscored that “health has become the human face of the climate crisis on the continent”, a reality that demands bold action from leaders.

“Health is the human face of climate change. Yet when you search for images of climate change, you only see the human face after page six. We must change that narrative,” remarked Naveen Rao, Senior Vice President of the Health Initiative at The Rockefeller Foundation, during the closing session of the launch of a Climate Change and Health Negotiators’ Curriculum by Amref Health Africa, a first-of-its-kind initiative to strengthen Africa’s voice in global climate negotiations.

A roundtable at the launch of the Climate and Health curriculum for African negotiators hosted by Amref Health Africa. Credit: Friday Phiri/Amref

With support from the Wellcome Trust, Amref Health Africa, working with its subsidiary, Amref International University (AMIU), and the African Group of Negotiators Expert Support (AGNES), has developed a curriculum which aims to equip African negotiators with the technical expertise, advocacy tools, and evidence to place health at the centre of climate negotiations and financing frameworks.

Dr Modi Mwatsama, Head of Capacity and Field Development for Climate and Health at Wellcome Trust, underscored the urgency of catalytic climate and health action, grounded in science.

“This is the moment to roll out training sessions, strengthen AGN’s leadership on climate and health, and ground Africa’s climate diplomacy in science and sustainability.”

In welcoming the curriculum, Dr Ama Essel, AGN Lead Coordinator on Climate and Health, who spoke on behalf of AGN Chair, Dr Richard Muyungi, emphasised the importance of unity and right framing.

“The science is there, but how we frame and communicate it is the value proposition. This curriculum is right on time, it will help Africa negotiate with a strong, common position,” said Dr. Essel, pointing out that the group is ready to support Africa’s agenda on climate and health, which should be rooted in the continent’s long-held priority of adaptation.

Dr Jeremiah Mushosho, WHO AFRO Regional Team Lead for Climate Change, emphasised the importance of aligning efforts with the Global Plan of Action on climate and health, while civil society voices, including the Pan-African Climate Justice Alliance, reinforced the need for advocacy “soldiers” to sustain pressure for health in climate talks, highlighting the Nairobi Summer School on Climate Justice as an important platform from which enthusiastic advocates could be recruited.

In summing up, Desta Lakew, Group Director of Partnerships and External Affairs at Amref Health Africa, refocused the discussions on the communities, emphasising their involvement at all stages of planning and implementation of climate action.

“Communities are the true front line of the climate crisis, as the health impacts of climate change are felt first in villages, towns, and cities. They are the first responders to shocks, witnessing floods, droughts, and outbreaks before national systems react. Resilience demands co-creation with communities at every stage, from surveillance and data generation to response. Leadership and coordinated action are critical to scaling an inclusive, African-led climate and health ecosystem. Climate resilience cannot be achieved from the top down. It must be built with and through communities, backed by integrated data systems, strong governance, and sustained investment. Thus, for Africa to build resilience, negotiators, governments, civil society, and scientists must work together to ensure health is firmly embedded in the UNFCCC processes and agendas.”

Other key climate and health sessions focused on the need to enhance climate information services for health resilience; pathways for integrating health into Africa’s climate change and adaption, mitigation and resilience strategies; unlocking climate and health financing; and ministerial dialogue on shaping a cohesive narrative for Africa’s climate and health agenda, among others.

• At the sessions, experts highlighted capacity building and training; research and evidence; and cross-sectoral partnerships, as key adaptation measures to support health sector’s resilience in the face of the climate crisis.
• The author is the Climate Change Health Advocacy Lead at Amref Health Africa.

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United Nations Special Rapporteur Reem Alsalem. Credit: UN Photo/Loey Felipe

By Jennifer Xin-Tsu Lin Levine
UNITED NATIONS, Sep 19 2025 (IPS)

A United Nations report calling for the global abolition of surrogacy has sparked intense debate among experts, with critics arguing that blanket bans could harm the very women the policy aims to protect.

Reem Alsalem, the United Nations Special Rapporteur on violence against women and girls, issued a report on violence against women and girls with a specific focus on surrogacy as a form of exploitation. The report, officially titled “The different manifestations of violence against women and girls in the context of surrogacy,” was published on July 14, 2025, and is slated for discussion at the upcoming UN General Assembly session in October.

The report calls surrogacy “direct and exploitative use of a woman’s bodily and reproductive functions for the benefit of others, often resulting in long-lasting harm and in exploitative circumstances.”

It further delves into the danger of surrogacy business models, in particular, which embrace the ambiguity of international law to churn a profit, often at the expense of both the surrogate and the prospective family. Alsalem recommends the abolition of surrogacy and asks member states to “work towards adopting an international legally binding instrument prohibiting all forms of surrogacy.”

One of the largest problems with surrogacy today, according to Senior Lecturer at Swinburne University Jutharat Attawet, is a lack of comprehensive education and legal standards around the practice. This results in social alienation and false conceptions, which worsen exploitation of people who participate in surrogacy—they are not provided adequate resources

Attawet, who specializes in surrogacy healthcare and domestic policy, considers surrogacy itself a beneficial tool for nontraditional family building. However, she acknowledges the steps it has to take to ensure autonomy and respect for surrogates.

Attawet’s research, cited in Alsalem’s report, shows that approximately 1 percent of babies born in Australia are from surrogates, so although the number has doubled over the past decade, doctors are not familiar with the process. Furthermore, legislation is primarily top-down rather than region- or area-specific. Since doctors in places like Australia are “intimidated by the language” surrounding surrogacy due to minimal education, they are less willing to openly engage with the procedures. This pushes families to seek surrogates elsewhere, where laws are less stringent and doctors more comfortable with the procedures.

Another incentive for overseas surrogacy, Attawet says, is lack of national support for surrogacy. Since it does not fulfill the criteria of most healthcare insurance plans, prospective parents often seek a more affordable surrogacy birth internationally. This further contributes to the exploitation both she and Alsalem note in their respective research—international surrogacy is much more difficult to regulate between different countries’ laws and often primarily harms the surrogate and the child, who is less likely to know their birth mother from an international surrogacy.

Alsalem criticized the practice of international surrogacy as an exploitative technique to perpetuate wealth inequality between different countries, but many experts argue that the job is one of the few accessible, well-paying jobs for child-bearing people who need to care for their family full-time. Polina Vlasenko, a researcher whose work was also cited in Alsalem’s report, explained to IPS that international surrogacy in Ukraine and the Republic of Georgia “is the type of job you can combine with being a full-time caretaker of your kid… it still benefits women.”

Vlasenko elaborated, saying that most workers in the surrogacy industry, including intermediaries and clinicians, were women who had some sort of pre-existing connection to the process—often being former surrogates. To ban surrogacy entirely, Vlasenko argues, would merely harm women in all facets of the industry rather than resolving wealth gaps. She said, “this inequality is much deeper than services of surrogacy.”

Social worker and professor at Ohio State University Sharvari Karandikar similarly opposes the Special Rapporteur’s recommendation of abolition. In an interview with IPS, Karandikar explained that “in countries like India, it’s really hard to implement policies in a uniform way, and I think that one needs to have proper oversight of medical professionals and how they’re engaging in surrogate arrangements and medical tourism. Blanket bans do not work.”

She emphasized the dangers of surrogacy without regulation, saying it would only do more harm.

Instead, Karandikar advocates for “the safety, the better communication, more education, more informed choice and decision, more safeguards, better treatment options, and long-term health coverage for women who engage in surrogacy” as “a wonderful way to speak about women’s choices, decisions and their health instead of penalizing anyone.”

However, in order for the global conversation surrounding surrogacy to center around female agency, experts like Vlasenko say the perception of surrogates needs to change. She said, “Reproductive work is not always seen as violence or exploitation when it’s done by women for free at home… surrogate mothers are taking the only work that, in their situation, allows them to fulfill certain responsibilities like childcare and income generation. They think that they’re agents in this process, but society sees them as victims.”

Ultimately, the surrogacy debate reflects broader questions about women’s autonomy, economic inequality and reproductive rights. As Vlasenko noted, addressing the “much deeper inequality” that pushes women to surrogacy may prove more effective than focusing solely on limiting the practice itself.

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Excerpt:

Wars and oppression leave behind not just rubble and graves. They leave behind invisible wounds, profound trauma carried by survivors. And most often, women carry the largest burden. They are targeted not only because of their gender, but because surviving and leading threaten structures based on patriarchy and domination.

Mozn Hassan

“Violence against women is never accidental,” Hassan explains. “It is systematic. It’s about control, silencing, and making sure women do not have the tools to stand up, to resist, to create alternative futures.”

In this report by the United Nations Department of Economic and Social Affairs, the percentage of women killed in armed conflict doubled in 2024, accounting for 40 percent of all civilian casualties. “Over 600 million women and girls live in conflict-affected areas, a 50 percent increase since 2017.” The report points out that nearly every person exposed to a humanitarian crisis suffers from psychological distress, and 1 in 5 people go on to develop long term mental health conditions like depression, anxiety, post-traumatic stress disorder (PTSD), bipolar disorder or schizophrenia. “Only 2 percent get the care they need”.

The matter of mental health and psychosocial support (MHPSS) has been brought up during the previous two reviews of the UN peacebuilding architecture (2020 and 2024) mentioned in this report of the International Peace Institute, “a peaceful society cannot exist if psychological impacts of war (such as grief, depression, stress and trauma) are left unaddressed in individuals, families and communities.”

Hassan has been a pioneer in the application of narrative exposure therapy (NET) among women in refugee camps and war zones. In contrast to other therapy models that concentrate on one-on-one psychological treatment, through NET she pushes for collective healing ans solidarity.

“Narrative exposure therapy is one of the tools of community psychology. It puts collective trauma-informed therapy higher than individual approaches,” she explains. “Being within collective spaces brings sharing of experiences, solidarities, and makes the community itself resilient. They can go through this afterward by themselves, they don’t need another, more educated person in a power dynamic over them.”

The approach, according to Mozn, has shown to be successful in dealing with Syrian, Palestinian, and Lebanese women in refugee camps in Lebanon and Turkey. Through five- or six-day workshops, participants narrate and re-narrate their stories, building strength on each other while creating knowledge and data on the realities of war.

Hassan remembers how women in camps, frequently from various ethnic or religious minorities, drew strength not just from sharing their own experiences but from hearing others. In this way, they developed resilience where there should have been none. “But when it’s collective, people are not left alone with their pain. They gain tools, they gain solidarity, and they gain resilience.”

Hassan points out that trauma is not a monolithic experience: “Studies show that only 20–25% of people who face trauma develop PTSD. One of the misconceptions has been that everyone who experiences trauma must have PTSD, it’s not true. Collective approaches make interventions more applicable and save resources, which are always limited for women.”

Above all, NET has given strength and mechanisms to these women to move forward. “Trauma doesn’t happen overnight, it’s an accumulation. Healing is the same. It’s not about saying: I was sick, and now I’m healed. Healing is a process. When you are triggered, you shouldn’t go back to the first point. You can have your own tools to say: I don’t want to be this version of myself while I was facing trauma,” she reflects.

For Hassan, one of the key questions of feminist peacebuilding is why women are so typically assaulted in war, revolution, and even in so-called peacetimes.

“We must stop thinking about peacebuilding only in the traditional way, only when there is open war,” she argues. “Patriarchy, militarization, securitization, and societal violence are all forms of violence that normalize abuse every day. Stability is not the same as peace.”

She points to Egypt as an example. While the country has not witnessed a civil war like Syria or Sudan, it does have systemic gender-based violence: “Egypt has more than 100 million people, half of them women. Official statistics say domestic violence is more than 60%, sexual harassment more than 98%. Femicide is rising. This is the production of collective trauma and acceptance of violence.”

The 2011 revolution, she remembers, brought these dynamics into sharp focus: “What we saw in Tahrir Square, the gang rapes, the mass assaults, was the production of societal violence. Years of harassment and normalization led to an explosion of gender-based violence that was then denied.”

Hassan’s warning is stark: the absence of bombs does not mean peace. “As long as you are not bombed by another country, people say you don’t need peace because you live in peace. But the absence of war is not peace.”

Healing, for Hassan, cannot be separated from politics and accountability. She rejects the idea that healing means forgetting.

“Forgiveness or letting go needs a process. Many people cannot sit at the same table with those who hurt them personally. But maybe it’s not our generation who will forgive. Maybe we can at least leave to others a better daily life than we lived,” she says.

Accountability, she argues, is a requirement for stability. “You couldn’t reach stability while people are thinking only about revenge. Collective healing in Egypt is important, but it also needs accountability, acceptance, and structural change.”

She also criticizes the tendency to depoliticize feminist movements: “Our definition of politics is not only about being in parliament. It is about feminist politics as tools for change everywhere. Too often feminists were pushed to say ‘we are not political.’ That sidelined many women who were engaging directly in politics.”

In spite of repression and trauma, Hassan says that women remain incredibly resilient. What they need most is recognition and tangible support to rebuild their lives and societies.

“The amazing tools of women on resilience gives me hope. I saw it so clearly with Syrian women, leaving everything, rebuilding societies, changing everywhere they go. Their accumulation of resilience is what gives me hope,” she says.

However, Mozn is wary of the narrative that glorifies women’s strength without addressing its costs. “We shouldn’t have to be strong all the time. We should be free, and lead lives where we can just be happy without strength and grit. But unfortunately, the times we live in demand resilience.”

Mozn Hassan’s words make us question what peace actually is. It is not merely ceasefires or agreements, but a challenge to deal with patriarchy, violence, and trauma at its core. Healing is political, accountability matters, and rebuilding with women is imperative. As she says: “Maybe it’s not our generation who will see forgiveness, but we can try to leave to others a better daily life than we lived.”

Her vision is both sobering and optimistic: peace will not be arriving tomorrow, but as long as women keep building resilience and insisting upon self-respect, the way to it is not yet closed.

Sania Farooqui is an independent journalist, host of The Peace Brief, a platform dedicated to amplifying women’s voices in peacebuilding and human rights. Sania has previously worked with CNN, Al Jazeera and TIME.

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Delegates at the Second Africa Climate Summit in Addis Ababa, Ethiopia. Credit: Farai Shawn Matiashe/IPS

By Farai Shawn Matiashe
ADDIS ABABA, Sep 11 2025 (IPS)

Despite climate change being a health risk multiplier, health is often underrepresented in climate negotiation processes.

Experts attribute this to a lack of funding by the African governments and a lack of capacity building among climate negotiators.

At the Second Africa Climate Summit (ACS2) in Addis Ababa, Ethiopia, from 8 to 10 September, health experts are calling for funding to bring health negotiators to the table at the Conference of the Parties (COP30) in Belém, Brazil, to demand more funding for the health sector.

Amref Health Africa, a Kenyan-based non-governmental organization providing community and environmental healthcare across Africa, launched a Climate Change and Health Negotiators’ curriculum on 9 September at the summit.

The Climate Change and Health Negotiators’ curriculum, developed for the African Group of Negotiators (AGN), seeks to address this gap by equipping African negotiators with the technical, policy understanding, and advocacy skills required to integrate health considerations into climate policy and finance Agendas.

Desta Lakew, a group director of partnerships and external affairs at Amref Health Africa, said when they started conversations around climate and health, health was not included.

“At COP27, Sharm El Sheikh, Egypt, there were no health ministers because health was not included. We thought we needed to bring the health issues in Africa,” she said while speaking at a side event at the Rockefeller Foundation Pavilion during the ACS2.

“We have developed a curriculum to bring health to the climate negotiation process. AGN; they speak for us and people in the rural areas who are affected by climate change.”

At COP28 in Dubai in 2023, health was included only in the declaration.

But this was seen as progress by climate experts.

Climate change is devastating health in Africa 

Though Africa contributes less than 4 percent of global greenhouse gas emissions, it continues to experience the effects of climate change.

Climate change presents a fundamental threat to human health.

It affects health by increasing heat-related illnesses, worsening respiratory conditions and air quality, expanding the range of infectious diseases and disrupting food and water security.

Extreme weather events like floods in Africa cause injuries and distress while also damaging essential health infrastructure.

In southern Africa, countries such as Botswana, eSwatini, Namibia, and Zimbabwe experienced a dramatic surge in malaria cases in 2025.

From 2023 to 2024, the region was hit by El Niño-induced drought, a natural climate phenomenon in which surface waters of the central and eastern Pacific warm, causing changes in global weather patterns.

In 2025, the region experienced La Niña, which brought above-average rainfall.

The prolonged rains fuelled mosquito breeding.

In other parts of the continent, climate variability is also facilitating the spread of non-communicable and infectious diseases, such as dengue, malaria, West Nile virus, and Lyme disease.

Climate change is not just an environmental issue-it is a health emergency.

Yet, only a tiny fraction of climate funding goes to the health sector.

Many health systems in Africa, which are underfunded and collapsing, were not built for this.

They are being overwhelmed, under-resourced and on the brink.

The World Meteorological Organization (WMO), in a report last year, revealed that Africa warmed faster than the rest of the world.

The WMO report revealed that African countries lost up to 5 percent of their gross domestic product on average, with many of them forced to allocate 9 percent of their budgets to deal with climate extremes.

The WMO estimated that the cost of climate adaptation in sub-Saharan Africa would be between USD 30 and USD 50 billion annually over the next decade.

Adaptation and climate finances could make a difference, giving many people in the path of extreme danger a new lease of life, increasing their access to health infrastructure, smart agriculture, and improved nutrition.

Africa receives less than 5 percent of global climate finance.

Capacitating negotiators on health and climate change issues

The Climate Change and Health Negotiators’ curriculum was developed with support from different partners, including AGNES and Africa Centres for Disease Control and Prevention (Africa CDC), a specialized technical institution of the African Union that works to support public health initiatives across Africa.

Dr Modi Mwatsama, head of capacity and field development for climate and health at Wellcome Trust, a London-based charity focused on health research, said the curriculum would ensure that Africa’s health issues are prioritized in climate negotiation processes.

Dr. Martin Muchangi, a director for population health and environment at Amref Health Africa, said the curriculum targets negotiators, including health and environment ministers, as well as mid-level state and non-state actors.

He said the idea is to train negotiators to understand the technical aspects of climate and health.

Muchangi said the curriculum provides a place where negotiators can always refer.

“We want health to be at the negotiating table. We want to empower AGN by building the capacity of negotiators,” he said while speaking at the same side event.

Muchangi said the curriculum will equip negotiators to use evidence and data to make a strong case at COP30 in Brazil as well as develop actionable plans.

Dr. Petronella Adhiambo, a capacity building officer at AGNES, said the curriculum is in line with what they want, which is to have health featured in the climate negotiation process.

“We will be able to provide evidence,” she said.

Adhiambo said it is possible to have health as an agenda item at COP30 in Brazil in November.

Dr. Jeremiah Mushosho, a regional team lead for climate at the World Health Organization, said the curriculum is aligned with Global Climate Action and is relevant to the needs of African countries.

“This is quite a big opportunity to prepare negotiators and create a regional pool of climate expert negotiators,” he said.

Mushosho said it is critical to push for resources to be allocated equitably.

Dr. Yewande Alimi, Antimicrobial Resistance and One Health Unit lead at Africa CDC, said her organization will amplify this initiative.

She said the curriculum is timely and Africa will no longer just sit at the negotiating table, but negotiators will be able to demonstrate that health should be prioritized.

Health Experts called for more funding to bring health and environment ministers to COP30 to demand health to be on the Agenda, as well as increase funding to the health sector.

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Credit: Corte IDH/Twitter

By Inés M. Pousadela
MONTEVIDEO, Uruguay, Aug 28 2025 (IPS)

On 7 August, the Inter-American Court of Human Rights delivered a groundbreaking decision that could transform women’s lives across the Americas. For the first time in international law, an international tribunal recognised care as an autonomous human right. Advisory Opinion 31/25, issued in response to a request from Argentina, elevates care – long invisible and relegated to the private sphere – to the level of a universal enforceable entitlement.

The court’s decision emerged from a highly participatory process that included extensive written submissions from civil society, academics, governments and international organisations, plus public hearings held in Costa Rica in March 2024. The ruling validates what feminist activists have argued for decades: care work is labour with immense social and economic value that deserves recognition and protection.

Three dimensions of care

The statistics that informed this ruling tell a stark story. In Latin America, women perform between 69 and 86 per cent of all unpaid domestic and care work, hampering their careers, education and personal development. The court recognised this imbalance as a source of structural gender inequality that needs urgent state action.

The decision defines care broadly, covering all tasks necessary for the reproduction and sustenance of life, from providing food and healthcare to offering emotional support. It establishes three interdependent dimensions: the right to provide care, the right to receive care and the right to self-care.

The court interpreted the American Convention on Human Rights as encompassing the right to care, making clear states must respect, protect and guarantee this right through laws, public policies and resources. It outlined measures states should take, including mandatory paid paternity leave equal to maternity leave, workplace flexibility for carers, recognition of care work as labour deserving social protection and comprehensive public care systems.

Feminist advocacy vindicated

The court’s decision reflects the profound influence of feminist scholarship. For decades, feminist activists have insisted that care work, overwhelmingly performed by women, is invisible and undervalued despite being central to sustaining life and economies. The court’s recognition validates these arguments, affirming that care work isn’t a natural extension of women’s roles confined in the private sphere, but labour with immense social and economic value.

The court’s intersectional approach represents another crucial victory for feminist movements. The advisory opinion acknowledged that care burdens aren’t evenly distributed among women: Indigenous, Afro-descendant, migrant and low-income women face disproportionate responsibilities and multiple layers of discrimination. This recognition aligns with feminist movements’ emphasis on the ways gender, race, class and migration status intersect to shape inequality.

Significantly, the court explicitly connected self-care with access to sexual and reproductive health services, recognising that genuine wellbeing requires the ability to make free and informed decisions about pregnancy, childbirth, motherhood and bodily autonomy. It stressed that all people – including women, transgender people and non-binary people who can become pregnant – should be free from imposed mandates of motherhood or care.

Civil society’s crucial role

This victory belongs to civil society. Feminist and human rights organisations across Latin America campaigned to bring the issue before the court and provided crucial expertise. Groups such as ELA-Equipo Latinoamericano de Justicia y Género, Dejusticia, the Global Initiative for Economic, Social and Cultural Rights and Women in Informal Employment-Globalizing and Organizing submitted arguments and evidence that shaped the court’s reasoning.

Organisations documented the realities of women caring for incarcerated relatives, migrant women working care jobs in precarious conditions and communities lacking basic services such as water and sanitation that make unpaid care work even more burdensome. This helped ensure the court’s opinion reflected social realities rather than abstract principles.

The opinion’s transformative potential extends beyond gender equality. By recognising care as a universal human need, it positions it as a cornerstone of sustainable development. Investments in care infrastructure create jobs, reduce inequality and support women’s workplace participation while ensuring that children, older people and people with disabilities can live with dignity and autonomy.

The road to implementation

While advisory opinions aren’t binding, they carry considerable legal and political weight, setting regional standards that influence constitutional reforms, strategic litigation and policy development. This decision provides a blueprint for societies where care isn’t an invisible burden but a shared and supported responsibility.

However, feminist organisations have noted a crucial limitation: the court’s decision not to designate the state as the primary guarantor of care rights creates an ambiguity that risks allowing governments to offload duties onto families, perpetuating the inequalities the decision aims to address.

Civil society faces the crucial task of ensuring that implementation prioritises state responsibility. The test lies in transforming legal recognition into laws, policies and practices that reach those most in need. The struggle now shifts from the courtroom to the political arena. Feminist movements are already preparing strategic cases and launching campaigns to pressure governments to pass laws, allocate budgets and build required infrastructure.

States must pass laws recognising the right to care, design universal care systems, integrate time-use surveys into national accounts and build robust care infrastructure. Employers must adapt workplaces to recognise caregiving responsibilities. Civil society and governments must challenge gender stereotypes and engage men and boys in care work.

The Inter-American Court has shown what’s possible: societies where care is valued, supported and shared. For the millions of women across the Americas who have carried this burden in silence, the work of turning this historic recognition into lived reality begins now.

Inés M. Pousadela is CIVICUS Senior Research Specialist, co-director and writer for CIVICUS Lens and co-author of the State of Civil Society Report.

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

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A patient being checked for BP at Mann PHC. Credit: Rina Mukherji/IPS

By Rina Mukherji
MANN, India, Aug 26 2025 (IPS)

Generally thought to be diseases of the wealthier classes, non-communicable diseases (NCDs) like hypertension and diabetes are on the rise among India’s underprivileged working classes in semi-urban and rural sprawls.

Take the case of Mohan Ahire. A middle-aged gardener in Pune, Mohan never realized that the heaviness in his head was a symptom of hypertension. Last summer, a mid-morning visit to the market saw him fall unconscious on return. Upon regaining consciousness, his wife and sons discovered the paralysis on the right side of his body, leading doctors to diagnose it as a stroke.

Bahinabai Gaekwad, a 56-year-old sweeper in Mann village, was at work when she suddenly collapsed and died. Doctors from the Primary Health Centre (PHC) next door found that she had been suffering from undiagnosed hypertension for a long time. The ailment ultimately led to a fatal cardiac arrest.

The worst problem is that most patients from underprivileged sections are not aware of their health condition.

Praful Mahato, a migrant laborer from Balasore in Odisha, who is currently employed in a dhaba (roadside eatery) in Mann, a fast-industrializing rural outpost of Pune city, had been suffering from heaviness and dizzy spells for some time. But he attributed his symptons to long hours at work and resulting fatigue. A chance visit to a medical camp confirmed high blood pressure and diabetes. Since the last four months, medication has controlled his blood pressure and brought down his sugar level.

Jagdish Mondol, in his 50s, did not realize he had hypertension and diabetes until he needed to undergo a hernia operation at a government hospital in Bhadrak, Odisha. This was despite blurred vision and difficulty in walking. Thankfully, the operation got him to wake up to his health condition. Regular medication has now improved his blood pressure and sugar level.

Fortunately, some patients may seek help on their own. Lalita Parshuram Jadhav, a 40-year-old migrant construction worker from Yavatmal, is one such. “Since the last two years, I have been experiencing pain in my legs; it became quite acute over the past year,” she tells IPS. A medical check-up confirmed hypertension and high sugar levels.

India’s Hypertension and Diabetes Epidemic

The cases cited above exemplify the rising burden of India’s non-communicable disease (NCD) of Hypertension and Diabetes. Ranked among the top ten NCDs responsible for untimely deaths worldwide, these two diseases are interlinked. This means those with hypertension are also vulnerable to developing prediabetes and diabetes.

According to the World Health Organization (WHO), an estimated 1.28 billion adults in the 30-79 age group suffer from hypertension, with two-thirds of them living in low- and middle-income countries. Yet, only 21 percent of those affected have their hypertension under control, while around 46 percent of these remain unaware of their condition and remain undiagnosed and untreated.

Diabetes, notably, can be of two varieties. Type 1 Diabetes is a congenital condition, while Type 2 diabetes is a lifestyle disease that develops later in life. South Asians, Pacific Islanders, and Native Americans have a significantly higher risk of developing the disorder.

The International Diabetes Federation (IDF) recorded a dramatic increase in the number of people affected by Type 2 Diabetes globally since the 1990s, and since 2000, the rise has been dramatic. In India, there are an estimated 77 million people above the age of 18 years suffering from diabetes (type 2), while nearly 25 million are prediabetic (at a higher risk of developing diabetes in the future). Yet, more than 50 percent of these are unaware of their diabetic status.

In India, the prevalence of Diabetes rose from 7.1 percent in 2009 to 8.9 percent in 2019. Meanwhile, 25.2 million adults are estimated to have Impaired Glucose Tolerance (IGT), a prediabetic condition that is estimated to increase to 35.7 million in the year 2045. It is also estimated that approximately 43.9 million people suffering from diabetes remain undiagnosed and untreated in India, posing a major public health risk.

It is a matter of concern that most deaths from these diseases occur in the 30- to 70-year-old age group, posing a major economic loss.

In Mann, doctors at primary health centers (PHCs) are battling this scourge, with hypertension affecting around 28 percent of the population and 12 percent being diabetic. The scenario is similar to that at Mullaheera, in rural Haryana, located just outside the national capital region of Delhi.

Dr. Sona Deshmukh, from the People-to-People Foundation, which is collaborating with the Government of India on its Viksit Bharat @2047 initiative and the in-charge for the Pranaa Project, tells me, “Diabetes is common among the older population, but hypertension is rising among the youth.”

Dangers Posed by Hypertension and Diabetes

The problem with both Hypertension and Diabetes is socio-cultural, with most people viewing these diseases as benign. Yet, ignoring them can lead to paralytic strokes and ultimately, death.

Characterized by headaches, blurred vision, nosebleeds, buzzing in the ears, and chest pain,  uncontrolled and untreated hypertension can lead to—

• chest pain (also termed angina);
• heart attack, which occurs when the blood supply to the heart is blocked and heart muscle cells die from lack of oxygen.
• heart failure, which occurs when the heart cannot pump enough blood and oxygen to other vital body organs; and
• sudden death due to irregular heartbeat.

This is because excessive blood pressure can harden arteries, decreasing the flow of blood and oxygen to the heart. This elevated pressure and reduced blood flow can result in the complications listed above, besides bursting or blocking arteries that supply blood and oxygen to the brain, causing a stroke. It can also cause kidney damage, resulting in kidney failure.

In the case of Diabetes, the body is unable to either produce or use insulin effectively. While individuals with Type I diabetes have a congenital condition wherein the insulin-producing cells in the pancreas are attacked and destroyed, patients with Type II diabetes—which is a preventable lifestyle-related disease—either do not produce enough insulin or are unable to use insulin effectively for the body’s needs. Uncontrolled diabetes can lead to blindness and organ failures that affect the kidneys, heart, and nerves, ultimately leading to diabetic strokes and death.

Reasons Behind the Spurt

So, what are the reasons behind the spurt? Government Medical Officers Dr. Mayadevi Gujar and Dr. Vaishali Patil say, “The transition of many rural outposts into semi-urban industrialized zones has brought in lifestyle changes. Locals, who once partook of healthy home-cooked millets or cereals, now eat cheap, oily snacks from wayside kiosks cooked in reused palm oil. With more disposable income, workers lean towards sugary soft drinks and fast food, making them prone to diabetes. Addictions like tobacco and alcohol are on the rise. Tobacco-chewing remains common to both men and women in rural India.”

Additionally, with climate change affecting agricultural incomes in rural India, the younger generation is stressed with employment issues. These make a potent recipe for hypertension and diabetes.

Dr. Sundeep Salvi, a noted specialist in cardiovascular diseases, who heads the Pulmocare Research and Education (PURE) Foundation and has chaired the respiratory group for the Global Burden of Disease Study, adds, “Unlike in the past, people eat and sleep late, watch late-night television, drink endless cups of tea and coffee, and work late hours. Skipping meals is common, with little time for exercise. Sleep deprivation is a fallout of this. Stress and inadequate sleep are a deadly combination, feeding hypertension and diabetes.”

Salvi calls for hydration and good nutrition to stave off hypertension and diabetes. “Excess tea and coffee are harmful. Caffeine-present in tea and coffee-is a diuretic; it prevents hydration. A dehydrated constitution results in hypertension and diabetes, which, in turn, cause heart disease, stroke, kidney diseases, and eventually, death.”

He also views air pollution as a major risk.

“By air pollution, I am referring to both indoor and outdoor pollution. In rural areas, the burning of crop waste causes outdoor pollution. But indoor pollution in rural homes and urban slums is 5–10 times greater than outdoor pollution. High levels of particulate matter contribute to 20 percent of the global burden of diabetes, as well as hypertension.

Diabetologist and Director of the Diabetes Unit at Pune’s KEM Hospital Prof. Chittaranjan Yajnik, who has been working on this issue for over two decades, has an interesting take on the matter based on his findings.

Yajnik sees a direct correlation between vulnerability to diabetes and poor intrauterine growth.

“Poor intrauterine growth reflects in poor organ growth, especially of the infra-diaphragmatic organs (liver, pancreas, kidneys, and legs), reducing their capacity to perform adequately in later years. Such individuals, when faced with overnutrition and calories later in life, end up with prediabetes and diabetes.”

Yajnik’s research found that two-thirds of prediabetic girls and a third of the prediabetic boys were underweight at birth.

“These findings are suggestive of a ‘dual teratogenesis’ concept, which envisages a combination of undernutrition and overnutrition over a life course due to rapid socio-economic and nutritional transition…” This means intrauterine programming of diabetes needs to be supported in growth-retarded babies since metabolic abnormalities develop very early in life.

Yajnik certainly has a point, since anemia in expectant mothers and low birthweight babies is a major problem all over India. The National Family Health Surveys conducted over the years by the Government have shown a persistently high prevalence of fetal growth restriction in Indian babies. This phenomenon is linked to low birth weight in newborns, which is as high as 18.24 percent, according to the latest data.

The Solution

Recently, the Ministry of Health and Family Welfare (MOHFW) of the Government of India has implemented several schemes nationwide at the primary health level, starting with nutrition, medical care, and immunization for pregnant mothers while ensuring institutional delivery. Offspring are also extended comprehensive help for the 4 D’s (defects at birth, diseases, deficiencies, and developmental delays), immunization, supplementary nutrition, and WASH interventions. These continue through adolescence to prepare a healthy population for reproductive age.

Meanwhile, weekly wellness sessions have been introduced all over India. Deshmukh adds, “Regular screenings for hypertension and diabetes are done every few months for early detection and follow-up. Counselling sessions encourage people to adopt healthier lifestyles, while Yoga is being popularized through events like the International Yoga Day.”

These initiatives, one hopes, will arrest the epidemic.

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Dr. Alvaro Bermejo, Director General of the International Planned Parenthood Federation (IPPF) addresses the Let's Discuss the Future of Africa Together seminar that took place last week (August 21) on the sidelines of TICAD9 in Yokohama City, Japan. Credit: APDA

By Cecilia Russell
YOKOHAMA CITY, Japan & JOHANNESBURG, South Africa, Aug 25 2025 (IPS)

As funding for sexual and reproductive health rights was on a “cliff edge,” parliamentarians now needed to play a “visionary” leadership role because “financing strong, resilient health systems for all their people rests with governments,” said Dr. Alvaro Bermejo, Director General of the International Planned Parenthood Federation (IPPF).

He was speaking at the Let’s Discuss the Future of Africa Together seminar that took place last week (August 21) on the sidelines of TICAD9 in Yokohama City, Japan.

The session was organized by the Asian Population and Development Association (APDA), in collaboration with the Forum of Arab Parliamentarians for Population and Development (FAPPD) and the African Parliamentary Forum on Population and Development (FPA).

He told parliamentarians that their role is most critical.

“Africa’s health faces a serious challenge: According to WHO’s latest analysis, health aid is projected to decline by up to 40% this year compared to just two years ago. This is not a gradual shift—it is a cliff edge,” Bermejo said. “You know as well as I do that lifesaving medicines are sitting in warehouses, health workers are losing jobs, clinics are closing, and millions are missing care.”

While this reality was outrageous, it needed to be adapted to.

“And in this crisis lies an opportunity—an opportunity to shake off the yoke of aid dependency and embrace a new era of sovereignty, self-reliance, and solidarity,” with a clear mission to protect the health and lives of women and vulnerable populations through delivering high-quality sexual and reproductive health services.

Parliamentarians engaged in debates during a policy dialogue seminar organized by the Asian Population and Development Association (APDA), in collaboration with the Forum of Arab Parliamentarians for Population and Development (FAPPD) and the African Parliamentary Forum on Population and Development (FPA). Credit: APDA

This seminar and another in the series, Policy Dialogue on the Africa-Japan Partnership for Population and Development, were both supported by the UN Population Fund (UNFPA) Arab States Regional Office (ASRO), the Japan Trust Fund (JTF) and IPPF.

During the discussions, a wide range of topics about population dynamics in Africa and Africa-Japan cooperation were discussed.

In his opening remarks, Ichiro Aisawa, a member of the House of Representatives of Japan, told the seminar it was necessary to take joint action across borders and generations.

“Youth holds the key to unlocking Africa’s future. By 2050, it is predicted that approximately 70 percent of Africa’s population will be under the age of 30. As African countries enter a demographic dividend period, the role played by parliamentarians in each country will be extremely important.

Aisawa said it was necessary to listen to the voices of the community in addressing issues related to youth empowerment, gender equality, and sexual and reproductive health (SRH).

Parliamentarians should take “concrete action through legislation and policies; it is essential to harnessing the potential of young people, directly linking them to social and economic growth, and creating a society in which no one is left behind.”

Yoko Kamikawa, Chairperson of Japan Parliamentarians for Population (JPFP), addresses a seminar for African and Asian parliamentarians on the sidelines of the TICAD9 in Yokohama City, Japan. Credit: APDA

During the discussions, representatives from Africa gave examples of how Japan had supported their health initiatives, especially important in a climate of decreasing aid.

Maneno Zumura, an MP from Uganda, said what compounded the issues in her country and in Africa was “the changes in climate. The unpredicted climate has affected agricultural activities by 40 percent, especially in drought-prone areas of the country.” This had resulted in nearly a quarter (24 percent) of children experiencing malnutrition.

However, she noted that Japan had made considerable contributions to education and health.

“As we assess Uganda’s development and Japan’s impact, it’s clear that sustainable progress thrives on global solidarity and local governance. Key achievements include a 62 percent rise in women’s incomes through cooperatives, a 50 percent drop in maternal mortality in refugee settlements, and supporting the road infrastructure and education, illustrating how policy-driven interventions can break cycles of poverty and inequality.”

There were several specific projects she alluded to, including education experts from Japan who contributed to an improvement of the quality of primary education in districts of Wakiso, Mbale, and Arua through the Quality Improvement in Primary Education Project (2021-2023). They also trained 1,500 teachers in participatory teaching methods.

“The Government of Japan supported the vulnerable communities like refugees and host communities by strengthening the social services like health in refugee camps like Rhino Camp,” Zumura continued, including construction of a health center with antenatal facilities serving over 300,000 people in camps of Bidibidi and Rhino Camp. They also trained 200 health workers in the management of childhood illnesses and maternal health care.

Mwene Luhamba, MP, Zambia, said his country was looking forward to partnering with Japan in expanding One-Stop Reproductive Health Services, enhancing parliamentary engagement, and investing in youth programs.

Bermejo said part of the solution to the development issues is to confront constraints.

“Some countries in Africa do need global solidarity, but what Africa needs from the world, more than anything else, is fair terms. We must also confront the structural constraints. Debt service burdens are crowding out social investments. Let us seize this moment, not just to repair but to transform,” he said. “Sexual and reproductive health services save lives. They empower individuals, promote dignity, and drive national development.”

In her closing remarks, Yoko Kamikawa, Chairperson of Japan Parliamentarians for Population (JPFP), said that it was through dialogue across borders and sectors that “we build consensus, strengthen legal frameworks, and ensure that national strategies reflect the voices of all people and empower them—especially women and youth.”

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Abortion is illegal in Uganda. Girls who get pregnant resort to deadly backstreet abortion providers. However, it is also criminal to provide safe abortion services. Credit: Wambi Michael/IPS

By Wambi Michael
KAMPALA, Aug 18 2025 (IPS)

Sarah Namukisa nearly missed her final year exams earlier this year. She was subjected to a mandatory pregnancy test—the 25-year-old student at the Medical Laboratory Training School in Jinja was then expelled because she was pregnant.

While Namukisa’s case sparked public criticism, activists say it was by no means an isolated incident.

Across Uganda and other East African countries, pregnant students continue to face expulsion, forced school dropout, and stigma in both public and private educational institutions.

Labila Sumaya Musoke, from the Initiative for Social and Economic Rights (ISER), told IPS that the widespread practice reflects deep-seated systemic discrimination and patriarchal control over young women’s bodies and futures

She said the expulsion mirrors systemic and institutional discrimination that international and regional human rights bodies have explicitly deemed unlawful and incompatible with human rights standards.

Namukisa was lucky that her case attracted the attention of the civil society and Uganda’s Equal Opportunities Commission. The commission ordered her school to rescind the expulsion. Many young women resort to deadly “backstreet” abortions in an effort to find ways to return to school or higher learning institutes. Abortion is still outlawed in Uganda and its neighbors—Kenya and Tanzania.

The most recent Demographic and Health Survey (DHS) datasets of the 12 East African countries found that the overall prevalence of adolescent pregnancy in East Africa was 54.6 percent. The survey concluded that it is vital to design public health interventions targeting higher-risk adolescent girls, particularly those from the poorest households, by enhancing maternal education and empowerment to reduce adolescent pregnancy and its complications.

Teenage pregnancy and motherhood rate in Kenya stands at 18 percent. This implies that about one in every five teenage girls between the ages of 15-19 years has either had a live birth or is pregnant with their first child.

The rate of teenage pregnancy has stagnated for over a decade in Uganda; it stood at 25 percent in 2006, at 24 percent in 2011 and now shows trends of rising at 25 percent. Teenage pregnancy in Tanzania is a significant public health issue, with 22 percent of women aged 15-19 having been pregnant, according to a 2022 Tanzania Demographic and Health Survey.

Rosemary Kirui, the Legal Advisor at the Center for Reproductive Rights—which works in seven countries, including Uganda—said the enjoyment of the Sexual Reproductive Health rights has been limited by barriers related to the legal and policy framework.

“We have a legal environment that has restrictive laws that criminalize some SHRH services. Most of the laws were adopted or inherited from the colonialists. And most of the countries have not changed the laws. So you will find that the penal code is similar, giving a blanket criminalization of abortion. So you will find this is being interpreted narrowly in many African countries,” said Kirui.

She told IPS that the other aspect of restrictive laws is the age of consent, where there is a mandatory third-party requirement for adolescents seeking information and sexual reproduction health services.

Primer Kwagala, a Ugandan Lawyer whose organization, Women Pro Bono Initiative (WPI), has been litigating for access to SHR services, told IPS that the country maintains restrictions on abortion.

“We are saying that 16 women are dying each day due to lack of services in public health facilities. And there are those who are dying in communities due to unsafe abortion. We have on our law books outdated colonial policies preventing health workers from providing life-saving services.”

Uganda’s constitution says that no one can take the life of an unborn child except in exceptional circumstances.

“For many women to exercise autonomy over their bodies and to say, ‘I cannot carry this pregnancy; I need an abortion,’ they cannot go ahead and have that discussion. The first thing the health worker will say is, ‘I don’t want to go to prison,’” said Kwagala.

The Ministry of Health in Uganda has issued guidelines allowing safe abortions in cases of defilement, rape, and incest. But the guidelines, according to Kwagala, are more on paper than in practice.

In 2020, a ruling by the African Committee of Experts on the Rights and Welfare of the Child (ACERWC) against the Republic of Tanzania found that Tanzania’s policy of expelling pregnant schoolgirls constituted a violation of the African Charter on the Rights and Welfare of the Child, particularly the rights to education, health, dignity, and non-discrimination.

Six girls who were pregnant were expelled from the school. The committee urged Tanzania to reform its education policies.

Dr. Godfrey Kangaude, an expert on Sexual Reproductive Health and Rights based in Malawi, said there is a tussle between the gatekeepers who think the SHR issues are for the civil society to handle.

“But I think this is closest to us. Sex and reproduction are relevant to everyone,” said Kangaude while speaking to the East Africa Law Society on litigating for sexual health rights.

He said sexual and reproductive justice is closely interrelated with finance and labor justice and generally the overall well-being of humans.

Kagaunde explained that in Malawi and other countries in the region, there are anomalies when it comes to the age of consent.

“In Malawi, the law says an adult cannot have sex with a child. Okay, we want to protect children. Isn’t it? But the line has been so rigid that an 18-year-old boy can’t have sex with a 17-year-old girl, because a 17-year-old is a minor and an 18-year-old is an adult. We understand that we want to protect people from harmful sexual conduct, especially children, but the law shouldn’t just be arbitrary. It should take into account that the 17-year-old and 18-year-old are peers.”

Criminalization of Consensual Sex 

Kangaunde and others argue that rights-based reform is needed. Laws should be gender-neutral, orientation-neutral, and distinguish exploitative adult–child sex from non-exploitative peer sex. Kangaude points to alternatives like multi-stage consent and close-in-age (“Romeo & Juliet”) exemptions.

Kangaunde and others have been criticized over their stance on the age of consent to sex and access for individuals younger than 18 to access contraceptives and safe abortion services.

“But look, there is a 19-year-old boy who is being charged with the offense of having sex with a girlfriend of 17. I mean, for him, life just went crazy. He is at school, and he had to stop schooling,” said Kangaude, the director at Nyale Institute. His institute provides legal support and engages in strategic litigation to protect and promote sexual and reproductive health rights.

Activists have since 2017 been pushing for a regional Sexual Reproductive Health Rights law. They contend that across East Africa, sexual and reproductive health rights have been narrowly defined as standalone rights.

If enacted, it would require the EAC member states to harmonize provisions on sexual and reproductive health services and information.

The bill has, however, faced significant resistance based especially on social and cultural barriers. The resistance has focused on aspects of comprehensive sex education for teenagers and provisions regarding legal abortion.

Dr. Tom Mulisa, a human rights and constitutional law researcher based at the University of Rwanda, told IPS that sexual and reproductive health rights are broad.

“Constitutions have those rights, and national health laws and policies have those rights, we are talking about the right to health, which most constitutions have, and we are talking about the right to privacy, the right to information, and sexual and reproductive health rights,” he said.

The partner states have ratified the Maputo protocol, which allows for the termination of pregnancy. The protocol is the main regional instrument that advances women’s rights especially sexual and reproductive health rights. The protocol also provides for elimination of discrimination and prohibition of harmful practices, such as female genital cutting.

Within the region, some countries have ratified the protocol, others have not and others have ratified it with reservations. Enforcement of the protocol has been split, making it difficult for all to enjoy the broader rights therein.

Kenya made reservations about Article (14), which provides for safe and legal abortion. Kenya’s constitution, on the other hand, provides for a right to legal and safe abortion when the life of the mother or fetus is at threat.

Learning From Advances in Rwanda

Rwanda has made significant progress in improving the sexual and reproductive health (SRH) of its population, especially young individuals. Like many countries in the region, it had post-colonial laws. It embarked on reform since 2009. The reforms laid the groundwork for what many describe as a flexible system.

Earlier this month, Rwanda’s Parliament passed a new law granting adolescent girls the right to access Sexual and Reproductive Health (SRH) services—particularly family planning—without requiring parental consent. It lowered the legal age to access contraceptives from 18-15.

Mulisa stated that the country modified its new penal code by eliminating the court’s requirement for an abortion. The penal code also included sexual reproductive health rights.

“Previously, the government held the right to health, while individuals were obligated to comply with it. But now the constitution has an explicit right to health,” revealed Mulisa, the founder of the Great Lakes Initiative For Human Rights and Development, which does public interest litigation in Rwanda.

It is now a crime under the penal code in Rwanda if a woman is denied access to contraceptives. And there are fewer restrictions on safe abortion following the removal of the court order requirement.

Rwanda’s ministerial order on abortion defines the right to health more broadly, incorporating the scope outlined by the WHO.

According to the WHO, the right to health includes four essential, interrelated elements: availability, accessibility, acceptability, and quality.

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Strong health systems start with midwives. Credit: Unsplash

By Shreya Komar
UNITED NATIONS, Aug 15 2025 (IPS)

Asia-Pacific’s midwives are a healthcare lifeline capable of delivering nearly 90 percent of essential maternal and newborn services. Yet the region grapples with severe shortages, underinvestment, and systemic neglect.

The newly released State of Asia’s Midwifery 2024 Report, released by the United Nations Population Fund (UNFPA), reveals that despite midwives’ lifesaving potential, many countries lack enough workers, face poor training and support systems, and struggle with weak policy backing. The findings underscore an urgent need to elevate midwives from auxiliary roles to central pillars of health systems across the region.

Drawing on data from 21 countries in the UNFPA Asia-Pacific (AP) region, the report was intended to assist countries in the region to meet the challenges of the health-related SDGs and the Every Woman Every Newborn Everywhere (EWENE) agenda, a global initiative focused on accelerating the reduction of preventable maternal and newborn deaths.

The report shows hundreds of thousands of maternal and newborn deaths in 2023 across the Asia-Pacific that timely midwife interventions could have largely prevented. The region faces a shortage of approximately 200,000 midwives, contributing to an annual toll of roughly 66,000 maternal deaths alone. These stark figures expose both the human cost and the systemic failure to invest in this essential healthcare workforce.

According to the report, at least five Asia-Pacific countries, including Lao PDR, Mongolia, Pakistan, Papua New Guinea (PNG) and Timor-Leste, are estimated to face needs-based midwife shortages, with Pakistan and PNG experiencing the most severe gaps.

The report projects that Pakistan and PNG will still face shortages by 2030, even if they maintain current rates of midwife graduation and full employment. Other countries, such as Afghanistan, Myanmar, and Viet Nam, are also likely to experience ongoing shortages; however, limited data prevents precise estimates of these shortages.

Beyond shortages, the report points to alarming gaps in education quality, regulatory frameworks, and leadership pathways for midwives. Many countries still struggle with limited pre-service training, scarce continuing education opportunities, weak licensing systems, and fragmented governance. Retention suffers as poor pay, inadequate infrastructure, and lack of professional recognition push midwives away, especially from rural and underserved areas.

The report also emphasizes how placing midwives in leadership roles can strengthen decision-making on policies that directly affect maternal and newborn health, improve supervision and mentoring, and ensure midwifery perspectives shape regulation, training, and service delivery.

Countries like Afghanistan, Iran, and Malaysia show how midwife-led governance can integrate professional expertise into national health strategies, ultimately enhancing the quality, reach, and effectiveness of sexual, reproductive, maternal, newborn and adolescent health (SRMNAH) services.

Since 2021, nine countries have increased midwife availability (Bangladesh, Cambodia, Iran, Lao PDR, Maldives, Nepal, PNG, Sri Lanka and Viet Nam), four have seen decreases (Indonesia, Malaysia, Pakistan and the Philippines), and two show no significant change (Mongolia and Timor-Leste). It shows that while some nations are making progress, regional gains are uneven, and shortages can worsen without sustained investment and retention strategies.

The WHO estimates that countries with fewer than 25 doctors, nurses and midwives per 10,000 people will struggle to provide adequate primary healthcare, a threshold that, while general, offers a benchmark for minimum workforce density.

Acting on this information is imperative because midwives are the most cost-effective, accessible answer to achieving safe motherhood and newborn survival goals. As the World Health Organization notes, when well-trained and integrated, midwives can address roughly 90 percent of essential reproductive and newborn health needs. Still, the world faces a global shortfall of nearly 900,000 midwives, and many in Asia endure poor working conditions, low pay, and limited career paths. Thus, saving lives demands investing in midwifery education, fair compensation, regulation, leadership, and full integration into health systems.

Midwife supervisor Arafin Mim, who oversees a team serving over 32,500 Rohingya refugees on the remote island of Bhasan Char in Bangladesh, captures the importance of her work simply.

“I feel this profession from the corner of my heart. It’s about making a connection with a pregnant woman, building a relationship during her pregnancy.”

Mim’s dedication illustrates the commitment and resilience midwives bring to some of the world’s most challenging environments.

In UNFPA’s recent opinion piece, the Regional Director Pio Smith shares a vivid image of midwives delivering in remote Bangladesh during climate crises to describe their resilience.

“When non-stop rain caused flooding in her village, the maternity ward, pharmacy, and storage room were submerged by water. She still continued to deliver babies, without electricity, even supporting emergency cesarean sections as needed with the doctors on call.”

The report urges governments and partners to close needs-based midwife shortages by expanding education in line with ICM standards, improving faculty and curricula, and ensuring equitable deployment. It recommends updating policies so midwives can work to their full scope, using data-driven workforce planning to create sanctioned posts, and adopting fair recruitment, deployment, and retention strategies.

Finally, it calls for empowering midwives with leadership roles in SRMNAH governance, regulation, and service improvement.

UNFPA’s Executive Director, Dr. Natalia Kanem, reminds us in a statement that “midwives are instrumental to navigating these challenges: They can provide up to 90 percent of essential services for sexual and reproductive health and bring their expertise and counsel to women wherever they are.”

Country examples such as Bangladesh, Nepal, and Cambodia offer hopeful signs. Bangladesh’s midwife-led birthing centers, Nepal’s rural midwifery deployments, and Cambodia’s regulatory reforms are exemplary, but much more action and investment are needed.

Midwives must be valued and supported as key professionals with quality education, fair pay, robust licensing, leadership opportunities, and a seat at health policymaking tables. This will result in fewer maternal and infant deaths, stronger newborn health, and more resilient healthcare systems.

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From beautiful bride, to victim of marital rape, this is the story of Shanti, a 19-year-old whose husband has been charged under the Domestic Violence (Prevention and Protection) Act of 2013.

By Zofeen Ebrahim
KARACHI, Pakistan, Jul 30 2025 (IPS)

“The last thing she asked for was a sip of water,” recalled Najma Maheshwari, referring to 19-year-old Shanti, a newlywed who died last week after brutal sexual violence allegedly inflicted by her husband, who is now in custody.

“Then she closed her eyes and never opened them again,” she said quietly, her voice steeped in sadness.

Najma, a social activist from Shanti’s neighborhood, accompanied her brother Sayon to the government-run Shaheed Benazir Bhutto Trauma Centre. “Her insides were torn, she was bleeding profusely from her anus and writhing in pain. Hospital visitors urged us to move the gurney outside, complaining the stench was unbearable.

“While cleaning her, medics removed worms from her gut—her injuries were that severe. I’ve seen much in my work, but never such horror or pain,” Najma told IPS by phone from her home in Lyari, an informal settlement in Karachi.

Najma Maheshwari, the social activist who was with Shanti when she died.

After two weeks at the hospital and a day trip to attend Shanti’s funeral in her village, 38-year-old Najma—mother of four—was deeply shaken. “I can’t eat, and the indescribable stench still haunts me,” she said.

According to the complaint lodged by Sayon with the police, Shanti’s husband, Ashok Mohan, had “inserted a metal pipe” followed by his “hand and arm” in her anus two days after her marriage. Not content, he bit her on her breasts and neck and threatened to kill her if she disclosed the act to anyone.

“They were engaged for two years before we married her off; she was very happy during the celebrations,” recalled Sonya, Shanti’s sister-in-law, adding the groom, 25, lived just a few lanes away and seemed like a good match.

The sexual violence, just three days after her marriage, led Shanti to bleed heavily from the anus. When the bleeding wouldn’t stop, her in-laws took her to two health facilities, but when the doctors gave up, they brought her home.

“We went to see her… she lay motionless, and her mother-in-law claimed it was just diarrhea and her period, so we left, not realizing how serious it was,” said Sonya.

Two weeks later, as Shanti’s condition worsened, her in-laws called her brother. Seeing her state, he rushed her to the hospital—but it was too late.

“There was clear evidence of anal trauma caused by sexual violence,” confirmed Dr. Summaiya Sayed, Karachi’s chief police surgeon, saying Shanti was brought in “comatose” and placed on a ventilator. Her injuries worsened as she continued passing stool, leading to her death three weeks later.

“This is a clear-cut case of marital rape,” said Syeda Bushra, a lawyer at Karachi-based Legal Aid Society, which provides free legal aid. She has handled sexual violence cases for nearly a decade.

While no specific law currently defines marital rape, the Domestic Violence (Prevention and Protection) Act of 2013 holds husbands accountable as violators.

“Though the law may not explicitly mention marital rape, its broadened definition under Section 376 of the Pakistan Penal Code allows prosecution of husbands,” explained Bushra.

This marks a significant shift from Section 375 of the PPC, which previously exempted marital sex—an exemption removed in 2006 by the Protection of Women (Criminal Laws Amendment) Act.

Bushra described marital rape as “undeniably a form of domestic abuse” but noted it remains rarely reported. Many women choose divorce instead, as marital rape is still taboo and often not even recognized as such.

Government surveys reveal grim realities: the Pakistan Demographic and Health Survey (PDHS) reported that 47 percent of respondents in 2012–2013 considered wife-beating justifiable—a figure that only slightly declined to 43 percent by 2017–2018. The World Economic Forum’s 2023 data paints an even darker picture, showing that 85 percent of married women in Pakistan experience physical or sexual violence—far higher than Bangladesh’s 53 percent and India’s 29 percent.

Islamabad-based gender and governance expert Fauzia Yazdani highlights how religious texts and traditions are often deliberately misinterpreted to justify abuse. Supporting Yazdani’s view, lawyer Bushra notes that women brave enough to seek justice frequently face defense attorneys citing selective Quranic verses to defend their husbands. “It’s not just disturbing—it’s deeply problematic,” Bushra said.

While activists challenge these harmful narratives, legal experts push for accountability within the justice system.
“The cruelty of the act that led to Shanti’s death means her husband may face charges of both rape and murder, setting a vital precedent for criminalizing marital rape,” said Bahzad Akbar, a lawyer at the Legal Aid Society who has specialized in gender-based violence cases for four years.

In 2022, Akbar secured Sindh’s first-ever marital rape conviction, where the husband was sentenced to three years’ imprisonment and fined Rs 30,000 (USD 106) for sodomy. But it took two years for the verdict.

Najma (center), Sonya (wearing yellow on Najma’s left), and their brother (on Najma’s right) were sitting on the pavement outside the trauma center where Shanti was fighting for her life. Credit: Seema Maheshwari

Today, with the 2021 Anti-Rape Act having established special courts, Akbar is hopeful for a swift trial and justice in Shanti’s case.

“Shanti’s case will be a test for society,” he said, “Offering hope to women enduring sexual abuse in marriage that justice is possible.”

Tragically, Shanti’s case did not spark widespread outrage.

“That’s because she was a woman, and in this society, women are seen as disposable,” explained Yazdani.

According to her, gender-based violence is rarely recognized as a crime in Pakistan’s collective mindset, which is why it remains inadequately addressed within institutions.

“There’s still no official definition for misogyny and patriarchy; there are no local terms capture these concepts,” she said, holding the government, the judiciary, the police, the country’s opinion makers, and even independent oversight bodies responsible for failing the Pakistani women “over and over again.”

This disconnect between societal attitudes and institutional responses, she argued, creates a void that even robust laws struggle to bridge.

Legal experts acknowledge that while Pakistan has strong laws protecting women, enforcement remains weak.

“When laws are made in a social vacuum, what do you expect; they will remain ineffective,” observed Yazdani.

That disconnect between law and lived reality is starkly visible in the experiences shared by healthcare professionals.

“I meet smart, accomplished women who still believe they have no right to refuse their husbands. Many see sex without consent as their marital duty,” said Dr. Azra Ahsan, a senior gynecologist and obstetrician based in Karachi.

After years of hearing young, married women quietly confide their pain—often long after the damage was done—Dr. Ahsan became convinced that sexual and reproductive health (SRH) education is crucial to raising awareness about reproductive health, including marital rape.

To fill this gap, she and a group of like-minded doctors at the Association for Mothers and Newborns (AMAN)*—the implementation arm of Pakistan’s National Committee for Maternal and Neonatal Health—developed Bakhabar Noujawan (Informed Youth), an online SRH program endorsed by the Ministry of National Health Services, Regulations and Coordination, launched in 2023.

“We’re trying to introduce it in colleges, but convincing faculty is an uphill battle—they first need to grasp the course’s importance,” she said.

Covering over two dozen culturally sensitive topics—from premarital counselling, child and cousin marriage, domestic violence, STIs, to teenage pregnancy—the programme doesn’t shy away from tough conversations. “We’re now developing a module on marital rape,” says Ahsan, head of AMAN. “The first draft is nearly complete.”

Alongside SRH education, Sayed emphasized the need for mental health and emotional wellness programs.

“Too many young people carry the trauma of childhood sexual abuse,” she said. “As they grow, that buried pain can manifest in troubling ways—some develop sadistic or masochistic behaviors, especially when exposed to unchecked pornography. It doesn’t heal them; it deepens the harm.”

Lawyer Akbar, who has handled nearly two dozen child sexual abuse cases over the past four years, said 70% involved incest. At Karachi’s three medicolegal centers, Sayed reports 4–8 sexual violence cases daily, yet only three alleged marital rape cases were recorded in 2024—underscoring severe underreporting.

Experts say this silence stems from deeply entrenched norms conditioning women to endure abuse rather than speak out.

“Even today, parents tell their daughters at marriage, ‘Your husband’s home is your final home—you should only leave it in death’,” said Yazdani, adding that Pakistani society remains bound by social mores that consistently deny women their rights. “She is compartmentalized and viewed only through the lens of relationships, her duty simply to obey the men around her—father, brother, husband, even her son.”

* The writer serves on the executive committee of this nonprofit in a voluntary capacity but had no part in the development of the SRH course.

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About 9.2 million people across the world living with HIV were not receiving treatment in 2024, according to the UNAIDS report. At the launch of the report were Rev. Mbulelo Dyasi, Executive Director of SANARELA. Winnie Byanyima, UNAIDS Executive Director, Aaron Motsoaledi, Minister of Health of South Africa. Juwan Betty Wani, Programme Coordinator, Adolescents Girls and young women Network South Sudan. Helen Rees, Executive Director, Wits RHI. Credit: UNAIDS

By Jennifer Xin-Tsu Lin Levine
UNITED NATIONS, Jul 10 2025 (IPS)

UNAIDS called the funding crisis a ticking time bomb, saying the impact of the US cuts to the President’s Emergency Plan for AIDS Relief (PEPFAR) could result in 4 million unnecessary AIDS-related deaths by 2029.

A historic withdrawal of global HIV/AIDS funding threatens to derail decades of hard-won progress in the fight against AIDS, according to UNAIDS’ annual report, entitled Aids, Crisis and the Power to Transform. This funding shortage – caused by sudden and massive cuts from international donors – is already dismantling frontline services, disrupting lifesaving treatments for millions and endangering countless lives in the world’s most vulnerable communities.

“This is not just a funding gap—it’s a ticking time bomb,” said UNAIDS Executive Director Winnie Byanyima.

Despite major strides in 2024, including a decrease in new HIV infections by 40 percent and a decrease in AIDS-related deaths by 56% since 2010, the onset of restricted international assistance, which makes up 80 percent of prevention in low- and middle-income countries, could have disastrous effects. The report, mostly researched at the end of 2024, concluded that the end of AIDS as a public health threat by 2030 was in sight.

However, in early 2025 the United States government announced “shifting foreign assistance strategies,” causing them to withdraw aid from organizations like the President’s Emergency Plan for AIDS Relief (PEPFAR), which had earlier promised 4.3 billion USD in 2025. PEPFAR is one of the primary HIV testing and treatment services in countries most affected. Such a drastic decision could have ripple effects, including pushing other major donor countries to revoke their aid. The report projected that if international funding permanently disappears, they expect an additional 6 million HIV infections and 4 million AIDS-related deaths by 2029.

At a Press Briefing, Assistant Secretary-General for UNAIDS Angeli Achrekar noted the importance of PEPFAR since its inception in 2003, calling it one of the most successful public health endeavors. She expressed hope that as the US lessens its support, other organizations and countries are able to take up the global promise of ending AIDS without eroding the gains already made.

Achrekar noted “acute shifts” in a weakening of commitment from countries less directly affected by HIV/AIDS since the US has pulled funding.

UNAIDS also reports a rising number of countries criminalizing populations most at risk of HIV – raising stigma and worsening gender-based violence and non-consensual sex, two of the highest HIV risk-enhancing behaviors. The report showed the primary groups who lacked care were child HIV infections and young women, which is likely related to government campaigns  “attacking HIV-related human rights, including for public health, with girls, women and people from key populations.”

These punitive laws include criminalization or prosecution based on general criminal laws of HIV exposure, criminalization of sex work, transgender people and same-sex sexual activity and possession of small amounts of drugs. These laws have been on the rise for the past few years, and in conjunction with limited funding, the results for HIV/AIDS-positive patients could be fatal.

Recently, scientific breakthroughs have been made regarding long-acting medicine to prevent HIV infection. Health workers have seen tremendous success, both with new technologies like annual injections and the potential for more growth in the form of monthly preventative tablets and in old prevention techniques like condom procurement and distribution and access to clean, safe needles for drug users. However, due to various global conflicts and wars, supply chains have been disrupted, often harming countries not in the thick of the altercation but reliant on products like PrEP, an HIV prevention medication.

Although many countries most afflicted with the AIDS crisis have stepped up, promising more national funding for the issue, and many community networks have doubled down on their efforts, the disruption of supply chains and the lack of international frontline health workers cannot be solved overnight. To entirely restructure how healthcare is provided takes time – something those with HIV do not always have.

Areas like sub-Saharan Africa, which in 2024 housed half of the 9.2 million people not receiving HIV treatment, have been particularly affected by the recent changes. The majority of child infections still occur there, and combinations of “debt distress, slow economic growth and underperforming tax systems” provide countries in sub-Saharan Africa with limited fiscal room to increase domestic funding for HIV.

Despite the loss of funding, significant progress has been made to protect essential HIV treatment gains. South Africa currently funds 77% of its AIDS response, and its 2025 budget review includes a 3.3% annual increase for HIV and tuberculosis programs over the next three years. As of December 2024, seven countries in sub-Saharan Africa have achieved the 95-95-95 targets established by UNAIDS: 95% of people living with HIV know their status, 95% of those are on treatment, and 95% of those on treatment are virally suppressed. UNAIDS emphasized the importance of this being scaled up to a global level.

Achrekar observed, referring to countries whose domestic funds towards AIDS have increased, that “prevention is the last thing that is prioritized, but we will never be able to turn off the tap of the new infections without focusing on prevention as well.”

She reiterated the importance of countries most affected by the HIV/AIDS crisis establishing self-sustaining health practices to ensure longevity in both prevention and treatment.

Achrekar praised the global South for their work in taking ownership of treatment while still calling upon the rest of the world to join.

She said, “The HIV response was forged in crisis, and it was built to be resilient. We need, and are calling for, global solidarity once again, to rebuild a nationally owned and led, sustainable and inclusive multi-sectoral HIV response.”

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Over 7 million people die from smoking-related deaths every year. The World Health Organization’s protocols to control and reduce tobacco have been adopted in at least 155 countries. Credit: Unsplash/Kouji Tsuru

By Maximilian Malawista
UNITED NATIONS, Jun 30 2025 (IPS)

Tobacco kills up to half its users who don’t quit, a grim reality that highlights the urgent mission of global tobacco control. A new report from the World Health Organization (WHO) reveals that while many countries have followed the organization’s protocols to reduce tobacco use, major gaps still remain in broader implementation.

The Global Tobacco Epidemic 2025 report was launched on June 23 at the World Conference on Tobacco Control in Dublin, where global health leaders emphasized a renewed commitment towards reducing tobacco-related deaths, which claim more than seven million lives each year. At least 80 percent of the world’s 1.3 billion tobacco users live in low- and middle-income countries, where the risk of tobacco-related illness and death is much higher.

The report focuses on the WHO MPOWER tobacco control measures, the steps that countries need to take to reduce tobacco usage. The WHO MPOWER tobacco control measures include:

· Monitoring tobacco use and prevention policies;
· Protecting people from tobacco smoke with smoke-free air legislation;
· Offering help to quit tobacco use;
· Warning about the dangers of tobacco with pack labels and mass media;
· Enforcing bans on tobacco advertising, promotion, and sponsorship; and
· Raising taxes on tobacco.

The WHO MPOWER measures were first introduced in 2007, where only forty-four countries had implemented at least one tobacco control measure, protecting 1.2 billion people. Their implementation can be viewed through the new data portal, which tracks countries’ progress from 2007-2025.

155 countries have successfully implemented at least one control measure at the best-practice level, the highest marker of implementation. This protects up to 6.1 billion people, or about 75 percent of the global population. Additionally, countries with two or more measures have seen “a nearly tenfold increase,” from 11 to 107 countries, which protects 4.8 billion people. Forty of these countries have adopted two or more measures, while seven of them have implemented four measures, and four have adopted five of the MPOWER measures. Altogether, fifty-one countries have at least three of these measures in place, accounting for the protection of 1.8 billion people.

Dr. Tedros Adhanom Ghebreyesus, WHO Director-General said, “Twenty years since the adoption of the WHO Framework Convention on Tobacco Control, we have many successes to celebrate, but the tobacco industry continues to evolve and so must we.” He added, “By uniting science, policy, and political will, we can create a world where tobacco no longer claims lives, damages economies or steals futures. Together, we can end the tobacco epidemic.”

The report highlights that one practice — graphic health warnings and plain packaging — has made significant progress, with 56 percent of countries having reached ‘best-practice’ level. As one of the key measures under the WHO Framework Convention on Tobacco Control (FCTC), it makes it difficult for people to ignore the health risks. It has been proven that cigarette packaging that contain graphic visual health warnings are effective in informing people about tobacco risks. They can be understood by people across all demographics and countries of all income levels.

Additionally, 110 countries at some levels have adopted these measures, accounting for approximately five billion people, or 62 percent of the world’s population. 36 percent of the global population now live in countries which run best-practice campaigns, which is up from 19 percent in 2022. WHO is urging countries to “invest in message-tested evaluated campaigns”.

Despite this, forty countries have zero MPOWER measures at the best-practice level. More than thirty countries allow the sale of cigarettes without mandatory health warnings. Even as many of the measures are being adopted, WHO notes that enforcement is “inconsistent”. Packaging for smokeless tobacco remains “poorly regulated”, as these items come in irregular packaging, are developed by smaller local producers, and may be found illegally produced and sold. These factors make it difficult to enforce packaging regulations. Furthermore, since 2022 at least 110 countries have failed to run anti-tobacco campaigns.

Many countries are failing to enact policies that would restrict access to cigarettes through taxation. Since 2022, only three counties have increased their taxes on tobacco at the best-practice level. Sixty-eight countries have adopted anti-tobacco media campaigns in the best practice, educating 25 percent globally. Additionally, cost-covered quitting services are accessible to about 33 percent of the world’s population.

While media campaigns and taxation policies target tobacco users, tobacco also affects people second hand. Around 1.6 million people die each year from cardiovascular and respiratory diseases exacerbated by exposure to second-hand smoke. To combat this, seventy-nine countries have implemented “comprehensive smoke-free environments,” which protects at least one-third of the global population. The regulation of e-cigarette devices or ENDS (Electronic Nicotine Delivery Systems) has also begun to pick up traction. As of 2024, 133 countries are regulating or outright banning e-cigarette devices.

To account for the notable lags in progress and enforcement, Dr. Ruediger Krech, WHO Director of Health Promotion said, “Governments must act boldly to close remaining gaps, strengthen enforcement, and invest in the proven tools that save lives. WHO calls on all countries to accelerate progress on MPOWER and ensure that no one is left behind in the fight against tobacco.”

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A young Afghan girl studies at home following the Taliban’s banning of women and girls from pursuing secondary education. Credit: UNICEF/Amin Meerzad

By Oritro Karim
UNITED NATIONS, Jun 23 2025 (IPS)

Nearly four years ago, the Taliban took control of Afghanistan and issued a series of edicts that significantly restricted women’s rights nationwide. This has resulted in a multifaceted humanitarian crisis, one marked by a notable decline in civic freedoms, stunted national development, and a widespread lack of basic services.

On June 17, UN-Women published its 2024 Afghanistan Gender Index, a comprehensive report that details the gender disparities and worsening humanitarian conditions for women and girls across the country. According to the report, the edicts issued by the Taliban have restricted women’s rights to the point that women and girls in the country have fallen far below the global benchmarks for human development.

“Since [2021], we have witnessed a deliberate and unprecedented assault on the rights, dignity and very existence of Afghan women and girls. And yet, despite near-total restrictions on their lives, Afghan women persevere,” said Sofia Calltorp, UN Women’s Chief of Humanitarian Action. “The issue of gender inequality in Afghanistan didn’t start with the Taliban. Their institutionalised discrimination is layered on top of deep-rooted barriers that also hold women back.”

It is estimated that women in Afghanistan have 76 percent fewer rights than men in areas such as health, education, financial independence, and decision-making. In addition, Afghan women are afforded, on average, 17 percent of their rights while women worldwide have 60.7 percent.

This disparity is projected to further widen following the Taliban’s ban on women holding positions in the health sector, removing one of the final strongholds for female autonomy in Afghanistan. Today, roughly 78 percent of Afghan women lack access to any form of formal education, employment, or training, nearly four times the rate for Afghan men. UN Women projects that the rate of secondary school completion for girls will soon fall to zero percent for girls and women.

Furthermore, Afghanistan has one of the widest workforce gaps in the world, with 89 percent of men having roles in the labour force, compared to 24 percent of women. Women are more likely to work in domestic roles and have lower-paying, more insecure jobs. Additionally, there are zero women that hold roles in national or local decision-making bodies, effectively excluding them entirely from having their voices heard on a governmental level.

“Afghanistan’s greatest resource is its women and girls,” said UN Women’s Executive Director Sima Bahous. “Their potential continues to be untapped, yet they persevere. Afghan women are supporting each other, running businesses, delivering humanitarian aid and speaking out against injustice. Their courage and leadership are reshaping their communities, even in the face of immense restrictions.”

The exclusion of all Afghan women from the workforce has had significant impacts on the local economy. According to the United Nations Sustainable Development Group (UNSDG), since 2021 Afghanistan’s economy has seen losses of up to 1 billion USD per year, representing roughly 5 percent of the nation’s gross domestic product. This has led to an overall increase in poverty levels and food insecurity.

“Overlapping economic, political, and humanitarian crises — all with women’s rights at their core — have pushed many households to the brink. In response – often out of sheer necessity — more women are entering the workforce,” Calltorp said.

Furthermore, women in Afghanistan lack any form of economic independence. UN Women estimates that only 6.8 percent of women have access to basic financial resources such as bank accounts and mobile money services. Edicts that prevent women from accessing financial independence will leave the vast majority of Afghan women unequipped for a self-sustainable future.

Afghanistan has also seen a significant surge in rates of gender-based violence since the Taliban’s rise to power. According to the report, Afghan women are exposed to nearly three times the global average rates of intimate-partner violence. Other practices, such as forced and child marriages and honor killings, exacerbate the national levels of gender inequality. Amnesty International states that non-compliance often results in retaliation from the Taliban, with women and girls facing arrests, rape, and torture.

In November 2023, Afghanistan’s de-facto Ministry of Public Health banned women’s access to psychosocial support services, leaving the vast majority of victims of gender-based violence without the adequate resources to recover while perpetrators receive impunity. Additionally, the elimination of women’s healthcare, including women’s access to reproductive health and education services, has made it difficult for many women to find basic care.

Due to these challenges, UN Women believes that Afghan women are less likely than men to live the majority of their lives in good health. It is estimated that the life expectancy of Afghan women is far lower than the global average and is projected to worsen in the coming years.

According to CIVICUS Global Alliance, current civic space conditions in Afghanistan are listed as “closed”, representing one of the worst environments for civic freedoms in the world. Josef Benedict, the Monitor Asia Researcher of CIVICUS, states that the women’s rights issues in Afghanistan have deteriorated to the point that it resembles a “gender apartheid”.

“There has been severe repression and systemic gender-based discrimination faced by Afghan women and girls under the Taliban. Women and girls are being systematically erased from public life and are being denied fundamental human rights, including access to employment, education, and opportunities for political and social engagement,” said Benedict.

“The international community must do more to provide support for women and girls in and from Afghanistan by calling for dismantling of the institutionalized system of gender oppression, ensure the representative, equal, meaningful and safe participation of Afghan women in all discussions concerning the country’s future and support community-led initiatives promoting gender equality and women’s rights.”

Additionally, activists and dissenters are routinely punished by the Taliban, facing harassment, intimidation, and violence. Journalists are often targeted, underscoring the risks of speaking out against a repressive government in an increasingly volatile environment.

“The rating is also due to the crackdown on press freedom,” said Benedict. “Nearly four years on, governments have failed to ensure a strong, united international response to counter the Taliban’s extreme repression, take steps to hold the Taliban accountable or to effectively support Afghan activists in the country and those in exile.”

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Dominican Republic’s Minister of Labor Eddy Olivares Ortega and Javier Cremades, President of the World Jurist Association, hand the Medal of Honor award to Just Rights for Children founder Bhuwan Ribhu.

By Stella Paul
NEW DELHI, May 6 2025 (IPS)

Bhuwan Ribhu didn’t plan to become a child rights activist. But when he saw how many children in India were being trafficked, abused, and forced into marriage, he knew he couldn’t stay silent.

“It all started with failure,” Ribhu says. “We tried to help, but we weren’t stopping the problem. That’s when I realized—no one group can do this alone. Calling the problem for what it truly is—a criminal justice issue rather than a social justice issue—I knew the solution needed holistic scale.”

Today, Bhuwan Ribhu leads Just Rights for Children—one of the world’s largest networks dedicated to protecting children. In recognition of his relentless efforts to combat child marriage and trafficking, he has just been awarded the prestigious Medal of Honor by the World Jurist Association. The award was presented at the recently concluded World Law Congress in the Dominican Republic.

But for Ribhu, the honor isn’t about recognition. “This is a reminder that the world is watching—and that children are counting on us,” he tells IPS in his first interview after receiving the award.

Looking Back: One Meeting Changed Everything

For Ribhu, a lawyer by profession, it has been a long, arduous, and illustrious journey to getting justice for children. But this long journey began during a meeting of small nonprofits in eastern India’s Jharkhand state, where someone spoke up: “Girls from my village are being taken far away, to Kashmir, and sold into marriage.”

That moment hit Ribhu hard.

“That’s when it struck me—one person or one group can’t solve a problem that crosses state borders,” he says. He then started building a nationwide network.

And just like that, the Child Marriage-Free India (CMFI) campaign was born. Dozens of organizations joined, and the number grew steadily until it reached 262.

So far, more than 260 million people have joined in the campaign, with the Indian government launching Bal Vivah Mukt Bharat—a national mission towards ending child marriage in India.

Across villages, towns, and cities, people are speaking up for a child marriage-free India.

“What used to feel impossible is now within reach,” Ribhu says.

Taking the Fight to Courtrooms

Ribhu is a trained lawyer, and for him, the law is a powerful weapon.

Since 2005, he’s fought—and won—dozens of important cases in Indian courts. These have helped define child trafficking in Indian law; make it mandatory for police to act when children go missing; criminalize child labor; set up support systems for abuse survivors; and remove harmful child sexual abuse content from the internet.

One big success came when the courts accepted that if a child is missing, police should assume they might have been trafficked. This changed everything. Reported missing cases dropped from 117,480 to  67,638 a year.

“That’s what justice in action looks like,” said Ribhu.

Taking Along Religious Leaders

One of the most powerful moves of CMFI was reaching out to religious leaders.

The reason was simple: whatever the religion is, it is the religious leader who conducts a marriage.

“If religious leaders refuse to marry children, the practice will stop,” says Ribhu.

The movement began visiting thousands of villages. They met Hindu priests, Muslim clerics, Christian pastors, and others. They asked them to take a simple pledge: “I will not marry a child, and I will report child marriage if I see it.”

The results have been astonishing: on festivals like Akshaya Tritiya—considered auspicious for weddings—many child marriages used to happen until recently. But temples now refuse to perform them.

“Faith can be a big force for justice,” Ribhu says. “And religious texts support education and protection for children.”

Going Global with a Universal Goal

But the campaign is no longer just India’s story. In January of this year, Nepal, inspired by the campaign, launched its own Child Marriage-Free Nepal initiative with the support of Prime Minister K. P. Sharma Oli. All the seven provinces of the country have joined it, vowing to take steps to stop child marriage

The campaign has also spread to 39 other countries, including Kenya and the Democratic Republic of Congo, where calls for a global child protection legal network are gaining momentum.

“The legal systems of different countries and regions may differ, but justice should be the same everywhere,” says Ribhu, who has also authored two books—Just Rights and When Children Have Children—where he has laid out a legal, institutional, and moral framework to end child exploitation called PICKET. “It’s not just about shouting for change. It’s about building systems that protect children every day,” Ribhu says.

Sacrifices and Hope

Ribhu gave up a promising career in law practice. Many people didn’t understand why.

“People said I was wasting my time,” he remembers. “But one day my son said, ‘Even if you save just one child, it’s worth it.’ That meant everything to me.”

A believer in the idea of Gandhian trusteeship—the belief that we should use our talents and privileges to serve others, especially those who need help the most.

“I may not be the one to fight child marriage in Iraq or Congo. But someone will. And we’ll stand beside them.”

A Powerful Award and a Bigger Mission

The World Jurist Association Medal isn’t just a trophy. For Ribhu, it’s a platform. “It tells the world: This is possible. Change is happening. Let’s join in.”

He also hopes that the award will help his team connect with new partners and expand their work to new regions.

“In 2024 alone, over 2.6 lakhs Child Marriages were prevented and stopped and over 56,000 children were rescued from trafficking and exploitation in India. These numbers show that change is not just a dream—it’s real,” he says.

By 2030, Ribhu hopes to see the number of child marriages in India falling below 5 percent.

But there’s more to do. In some countries, like Iraq, girls can still be married as young as 10, and in the United States, 35 states still allow child marriage under certain conditions.

“Justice can’t be occasional,” Ribhu says. “It must be a part of the system everywhere. We must make sure justice isn’t just a word—it’s a way of life.”

IPS UN Bureau Report

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