Two health care workers clean their feet in a bucket of water containing bleach after they leave an Ebola isolation facility during an Ebola simulation at Biankouma Hospital in Côte d’Ivoire. Credit: Marc-André Boisvert/IPS

By Thalif Deen
UNITED NATIONS, Jul 7 2015 (IPS)

Secretary-General Ban Ki-moon, addressing delegates in a run-up to an international Ebola recovery conference, said last month that “all of the investments, all of the sacrifices and all of the risks by relief workers” would be squandered if an outbreak of the disease recurs.

And it did – in Liberia, a country which had been declared free of the Ebola virus."The existing facilities need a complete overhaul, and many new structures need to be built. If another outbreak strikes, the toll would be far worse." -- Dr. Matshidiso Moeti

The World Health Organisation (WHO), which made that declaration on May 9, confirmed that a 17-year-old Liberian who died of Ebola last week had been in contact with nearly 200 people possibly triggering the spread of the infection.

As of last week, more than 27,100 people were affected by the highly contagious disease, which killed over 11,100, mostly in three African countries: Guinea, Sierra Leone and Liberia.

Against this backdrop, the United Nations is hosting a high-level international Ebola Recovery Conference July 10, primarily to provide a platform for the three countries to share their recovery plans and, more importantly, to raise funds to continue the fight against the disease and also strengthen health care systems in the region.

Nicolas Douillet of the U.N. Development Programme (UNDP) in Africa told IPS the conference aims to mobilise the international community in support of the three countries.

The total needs identified by the three countries, and regionally, by the Mano River Union, he said, amount to 7.2 billion dollars for the next 24 months – 3.2 billion for the three countries and 4.0 billion for the Mano River Union, an Intergovernmental Institution comprising Sierra Leone, Liberia, Guinea and Cote d’Ivoire.

The total requested, however, is 9.0 billion dollars, of which 1.8 billion is already committed, leaving a financing gap of 7.2 billion dollars.

Speaking of the need for strong health care systems, former U.S. President Bill Clinton told a U.N. meeting last May that severely limited resources were a “staggering burden” – and countries in West Africa were requesting funds to build better and stronger health systems through multi-year plans.

Before the Ebola outbreak, he said, Liberia had just one physician for every 71,000 people. He said Ebola had been in many fundamental ways a “man-made disaster.”

“Guinea, Liberia, and Sierra Leone entered the Ebola epidemic with severely underfunded health systems,” said Dr. Matshidiso Moeti, WHO Regional Director for Africa.

“After a year of handling far too many severely ill patients, the surviving staff need support, better protection, compensation, and reinforcements. The existing facilities need a complete overhaul, and many new structures need to be built. If another outbreak strikes, the toll would be far worse,” he warned.

Sarah Edwards, head of Policy & Campaigns at Health Poverty Action, told IPS: “Yes, there certainly needs to be a focus on the longer term need for health systems strengthening at this conference and across the wider Ebola response, and specifically this needs to consider how health systems in Ebola-affected countries can be funded sustainably.”

She said this should include measures to support affected countries to explore the potential for increased tax revenues to fund HSS; take action to stop illicit capital flight; and pay compensation for any health workers trained in affected countries who are now working in the UK.

After a visit to the region last October, Magdy Martínez-Solimán, U.N. Assistant Secretary-General and Director of UNDP’s Bureau for Policy and Programme Support, said: “This devastating health crisis is destroying lives and communities. It is also impairing national economies, wiping out livelihoods and basic services, and could undo years of efforts to stabilize West Africa.”

“As we work together to end the outbreak, now is the time to ensure these countries can also continue to function and swiftly get back on their feet,” he added.

Guinea, Liberia and Sierra Leone, already suffering from some of the lowest levels of human development in the world, had emerged from years of civil conflict and political instability and were starting to make encouraging progress, according to UNDP.

Last September, the United Nations established the U.N. Mission for Ebola Emergency Response (UNMEER), a single structure that will aim to stop the spread of the disease and prevent it from appearing in unaffected countries, as well as treat and care for the infected.

The UNDP said gross domestic product (GDP) in Guinea, Sierra Leone and Liberia has shrunk by two to three percentage points. The countries are now projected to lose a total of 13 billion dollars as a result of Ebola. People’s livelihoods are shrinking from lost wages and decreased productivity.

The participants in Friday’s conference at the United Nations include: President Robert Mugabe of Zimbabwe, Chair of the African Union (AU), Alpha Condé, President of Guinea; Ellen Johnson Sirleaf, President of Liberia and Ernest Bai Koroma, President of Sierra Leone.

The meeting is in partnership with the AU, the European Union (EU), the World Bank and the African Development Bank (AfDB).

The AU will hold its own “International Conference on Africa’s Fight Against Ebola” July 20-21 in Malabo, Equatorial Guinea.

Meanwhile the Washington-based ONE campaign said keeping track of pledges and monitoring their disbursement, has proved difficult and – at times – impossible “because of inconsistent, inefficient, and often opaque reporting processes and standards.”

In a white paper released Tuesday, it said: “One of the most fundamental questions asked during a humanitarian crisis is, ‘how much have donors promised to this effort?’

“But in the case of the Ebola outbreak, this question has been incredibly difficult to answer — and that’s a huge problem,” ONE’s Global Health Policy Director Erin Hohlfelder said.

“If we don’t know what has really been pledged and delivered, no one can adequately match promised resources to the needs on the ground. That means gaps cannot be easily identified and we risk losing time, resources, and lives.”

Edited by Kitty Stapp

The writer can be contacted at thalifdeen@aol.com

Less than eight per cent of drug users worldwide have access to a clean syringe programme. Credit: Fahim Siddiqi/IPS

By Thalif Deen
UNITED NATIONS, Feb 26 2015 (IPS)

As the call for the decriminalisation of drugs steadily picks up steam worldwide, a new study by a British charity concludes there has been no significant reduction in the global use of illicit drugs since the creation of three key U.N. anti-drug conventions, the first of which came into force over half a century ago.

“Illicit drugs are now purer, cheaper, and more widely used than ever,” says the report, titled Casualties of War: How the War on Drugs is Harming the World’s Poorest, released Thursday by the London-based Health Poverty Action."This approach hasn’t reduced drug use or managed to control the illicit drug trade. Instead, it keeps drugs profitable and cartels powerful." -- Catherine Martin of Health Poverty Action

The study also cites an opinion poll that shows more than eight in 10 Britons believe the war on drugs cannot be won. And over half favour legalising or decriminalising at least some illicit drugs.

The international treaties to curb drug trafficking include the 1961 Single Convention on Narcotic Drugs, the 1971 Convention on Psychotropic Substances and the 1988 United Nations Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances.

But over the last few decades, several countries have either decriminalised drugs, either fully or partially, or adopted liberal drug laws, including the use of marijuana for medical reasons.

These countries include the Netherlands, Portugal, Czech Republic, Uruguay, Argentina, Brazil, Colombia, Guatemala, Ecuador, Honduras and Mexico, among others.

According to the report, the governments of Mexico, Colombia and Guatemala seek open, evidence-based discussion on U.N. drugs policy reform.

And “both the World Health Organisation (WHO) and UNAIDS not only share this view, but have called for the decriminalisation of drugs use.”

Asked if the United Nations was doing enough in the battle against drugs, Catherine Martin, policy officer at Health Poverty Action, told IPS, “The problem is that the U.N. is doing too much of the wrong things, and not enough of the right things.”

She pointed out that an estimated 100 billion dollars worldwide is poured into drug law enforcement every year, driven by U.N. conventions on drug control.

“However, this approach hasn’t reduced drug use or managed to control the illicit drug trade. Instead, it keeps drugs profitable and cartels powerful (fuelling corruption); spurs violent conflict and human rights violations; and disproportionately punishes small-scale drug producers and people who use drugs,” she added.

The report says UK development organisations have largely remained silent, while calls for drugs reform come from Southern counterparts, British tycoon Sir Richard Branson, current and former presidents, Nobel prizewinning economists and ex-U.N. secretary-general Kofi Annan.

The charity urges the UK development sector to demand pro-poor moves as nations prepare for the U.N. general assembly’s special session on drugs next year.

Many non-governmental organisations (NGOs), including British groups, have no lead contact or set process for participating in the session, says the report.

The report claims many small-scale farmers grow and trade drugs in developing countries as their only income source.

And punitive drug policies penalise farmers who do not have access to the land, sufficient resources and infrastructure that they would need to make a sustainable living from other crops.

Alternative crops or development programmes often fail farmers, because they are led by security concerns and ignore poor communities’ needs, the report notes.

The charity argues the militarisation of the war on drugs has triggered and been used to justify murder, mass imprisonment and systematic human rights violations.

The report stresses that criminalising drugs does not reduce use, but spreads disease, deters people from seeking medical treatment and leads to policies that exclude millions of people from vital pain relief.

Less than eight per cent of drug users have access to a clean needle programme, or opioid substitution therapy, and under four per cent of those living with HIV have access to HIV treatment.

In West Africa, people with conditions linked to cancer and AIDS face severe restrictions in access to pain relief drugs, amid feared diversion to illicit markets, according to the study.

Low and middle-income countries have 90 per cent of AIDS patients around the globe and half of the world’s people with cancer, but use only six per cent of morphine given for pain management.

Health Poverty Action states the war on drugs criminalises the poor, and women are worst hit, through disproportionate imprisonment and the loss of livelihoods.

Drug crop eradication devastates the environment and forces producers underground, often to areas with fragile ecosystems.

Asked what the U.N.’s focus should be, Martin told IPS the world body should focus on evidence-based, pro-poor policies that treat illicit drugs as a health issue, not a security matter.

These policies must protect human rights and end the harm that current policies do to the poor and marginalised, she said.

“Drug policy reform should support and fund harm reduction measures, and ensure access to essential medicines for the five billion people worldwide who live in countries where overly strict drug laws limit access to crucial pain medications,” Martin said.

Meanwhile, the report says that drug policy, like climate change or gender, is a cross-cutting issue that affects most aspects of development work: poverty, human rights, health, democracy, the environment.

And current drug policies undermine economic growth and make development work less effective, the report adds.

Edited by Kitty Stapp

The writer can be contacted at thalifdeen@aol.com