Transgender refugees from Ukraine have met various challenges including access to hormone medicine since fleeing the war torn country. Credit: Ed Holt/IPS

By Ed Holt
BRATISLAVA, Apr 25 2022 (IPS)

Soon after Russia invaded her country, Anastasiia Yeva Domani found herself forced to abandon the regime of vital medicines she was taking.

The transgender activist could no longer get hold of the hormone medicines she needed to regularly take in Ukraine as supply chains were disrupted and the vast majority of pharmacies were closed.

“I, like many others, had to pause hormone treatment for a while. We had no choice,” she told IPS.

Domani spent two weeks off her treatment before she managed to get hold of medicines from Poland.

Now, her home in Kyiv has become the headquarters of a network she and other members of the transgender support organisation that she heads, Cohort, are running that helps find and then distribute hormones to those who need them across Ukraine.

It is not an easy task, though. For transgender people in Ukraine, both among those who have remained in their homes and those who make up part of the estimated 6.5 million internally displaced people in the country, a shortage of hormone medicines remains a major problem.

“There is a big problem getting hormone drugs. Some can be found in some cities in Ukraine, some abroad, and using the internet, and with the help of various LGBT activists and others all over the country, we have managed to get what we can,” she said.

“We have sent some hormones to people in March, but at the end of April, they are going to need more, and we will have to find them somewhere,” she added.

But having to halt hormone therapy is not the only serious problem transgender people are facing because of the conflict.

Activists say many transgender people, especially transgender women, have problems leaving Ukraine.

At the start of the war, all Ukrainian men aged 18-60 were ordered to stay in the country. As refugees began leaving, reports emerged of transgender women being turned back at the border, often because the gender marked on their identification documents did not match their actual gender, but sometimes simply because border guards who gave them physical examinations declared them to be men and told them they could not leave.

LGBT+ organisations which spoke to IPS confirmed they knew of such cases.

“Some transgender people have made it over the border into Poland, but there are many who have not been able to come over,” said Julia Kata of the Polish TransFuzja Foundation, which helps transgender people.

“They have been stopped because of problems with their ID documents where gender markers have not yet been changed, or they do not have the necessary medical confirmation that they have started transition,” she added.

This has led to some taking drastic action to get out of the country, and migration experts have also pointed to other dangers, such as violence and exploitation, which refugees can be exposed to when taking illegal routes out of countries.

“I know some trans women have resorted to leaving the country illegally, but this is not something we would support,” Domani said, adding how dangerous such attempts could be.

However, even when transgender people do make it out of Ukraine, they, and other members of the LGBT+ community, are facing further challenges as they find themselves in countries where LGBT+ communities have in recent years faced increasing prejudice, stigma, and discrimination.

The International Lesbian, Gay, Bi-Sexual, Trans and Intersex Association (ILGA) produces an annual ranking of the laws and policies impacting the human rights of LGBT+ people in individual European countries. In its most recent edition, many states bordering Ukraine scored very poorly.

Wiktoria Magnuszewska, an activist with the Polish Lex Q LGBT+ advocacy organisation, told IPS: “There is a lot of fear among transgender people who come here. This is connected to the general social atmosphere in Poland towards the LGBT+ community.”

Activists in other countries agree. Viktoria Radvanyi of Budapest Pride in Hungary told international media: “They are fleeing from Ukraine where their rights and dignity are not as respected as in other places in free societies. Then they arrive in countries like Hungary, Poland, and Romania where the state doesn’t support LGBTQ equality….”

Some organisations in receiving countries are working to provide help specifically for LGBT+ refugees when they arrive, including finding LGBT+-friendly accommodation, advice, help in dealing with local institutions, psychological support, and helping with access to other healthcare services.

The latter is expected to be of particular importance for transgender people, explained Kata, who said her organisation is co-operating with “trans-inclusive healthcare providers” so that any transgender refugees who need to access Polish healthcare will get appointments with doctors “who view them inclusively”.

She added that one of the main priorities of transgender refugees when they come to Poland, alongside “surviving and finding somewhere to stay”, was how to continue their transition. So far, she said, there had been no reports of any transgender refugees having any problems accessing the hormones they need.

Despite this help, some LGBT+ refugees prefer to move further into Europe rather than stay in countries that do not have a positive attitude toward their community.

“What we are seeing is that some LGBT+ people are leaving because of the situation in society here towards their community,” Justyna Nakielska, an advocacy officer with the Campaign Against Homophobia (KPH) in Poland.

Meanwhile, back in Ukraine, Domani says, attitudes to the LGBT+ community seem, for the moment at least, to have changed markedly in recent weeks.

Before the war, President Volodymyr Zelenskyy had pledged to fight discrimination based on gender identity and sexuality. There had been advances in legal safeguarding of LGBT+ rights, including a ban on workplace discrimination based on sexual orientation and gender identity.

But general attitudes in society towards the LGBT+ community were ambivalent at best, and in the ILGA’s latest rankings, Ukraine had an even worse score than most of the other countries on its borders.

But since the outbreak of war the situation has changed, said Domani.

“Since the war started, all Ukrainians think about are the Russian occupiers – they forgot their homophobia, their xenophobia, and all the focus now is on Russia,” she said.

She warned, though, that in areas which Russian forces had managed to fully occupy, there was already great concern over the fate of LGBT+ people, particularly in light of the Kremlin’s stance towards the community in Russia and reports that before the invasion, it had drawn up ‘kill lists’ targeting activists.

“There are no problems with LGBT+ people in Ukraine at the moment – with the exception of those in the Russian-occupied territories. We already know of some trans people who left the Kherson region [in southern Ukraine] on the day the war started because collaborators gave Russian occupiers information about human rights and LGBT+ activists,” Domani warned.

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A child is vaccinated against the poliovirus. Malawi detected a single case and embarked on a mass vaccination programme against the disease which causes paralysis. Credit: Charles Mpaka/IPS

By Charles Mpaka
Blantyre, Malawi, Apr 18 2022 (IPS)

One polio case is one too many, global health experts say.

And when Malawi announced in February this year that it had detected a polio case in the country’s capital Lilongwe, the alarm was significant, and the response from both the government and global health partners was swift, if not frantic.

Detected on a 3-year-old child, the poliovirus is described by experts as a significant public health concern for several reasons.

According to the World Health Organisation (WHO), polio has no cure, and it is a highly infectious disease.

“It invades the nervous system and can cause total paralysis within hours,” said WHO in a statement released on February 17, 2022, upon the Malawi Government’s announcement of the outbreak.

Furthermore, Malawi has not registered any cases of polio in 30 years. The country last reported a case of poliovirus in 1992.

In 2005, Malawi obtained a polio-free status.

The WHO further says that the last case of wild poliovirus in Africa was detected in northern Nigeria in 2016. Globally, there were only five cases of wild poliovirus recorded in 2021.

In addition, according to the United Nations health body, Africa was declared free of indigenous wild polio in August 2020 after eliminating all forms of wild polio.

To date, says WHO, polio remains endemic in Afghanistan and Pakistan, and laboratory test results on the case in Malawi showed that the strain was linked to the one found in Pakistan’s Sindh Province.

“As long as wild polio exists anywhere in the world, all countries remain at risk of importation of the virus,” Dr Matshidiso Moeti, WHO Regional Director for Africa, said upon the announcement.

Immediately after the outbreak, the government declared a Public Health Emergency.

It also instituted risk assessment and surveillance measures to contain any potential spread of the virus – but it assured that there was no evidence that the poliovirus was circulating in the community. There are no reports of additional cases of polio thus far.

Within 72 hours, the Global Polio Eradication Initiative (GPEI) Rapid Response Team arrived in the country to support the outbreak response.

These efforts were followed by a mass vaccination campaign, the first of four rounds, targeting 2.9 million children under five.

UNICEF procured 6.9 million polio vaccine doses for exercise.

UNICEF had partnered with WHO and the Global Polio Eradication Initiative’s Gavi, Bill and Melinda Gates Foundation, Rotary and Centers for Disease Control and Prevention in supporting the Ministry of Health to vaccinate children in four mass campaigns.

The phase ran from March 21 to 26, 2022.

A Poliovirus Outbreak Response Situation Report released by the government on April 4 says 2.97 million children aged between 0 – and 59 months had been vaccinated in the campaign, representing 102 percent administrative coverage.

The Ministry of Health says it is delighted with the campaign’s success.

“We attribute this to the dedicated workforce, the door-to-door approach and low presence of misconceptions, misinformation and disinformation surrounding polio vaccine,” the ministry’s spokesperson, Adrian Chikumbe, told IPS.

But the campaign was affected by some challenges, the Ministry of Health acknowledges in the vaccination campaign review report.

Malawi is reeling from the impacts of cyclones Ana and Gome, which hit the country in January this year, leading to flooding in many parts of the country and displacement of close to a million people. According to the report, the dispersion of the communities due to flooding increased the workload for vaccination teams.

“Polio campaigns with house-to-house strategy have not been conducted in-country in more than ten years, resulting in house-to-house vaccination not being strictly being followed in some areas. Grassroot social mobilisation was also delayed in some communities,” adds the report.

The second phase of the polio vaccination campaign is slated for late April.

“We urge all of us to sustain the gains in the first round of the campaign by making sure no eligible child is left behind in the subsequent rounds of the campaign. That way, our children will be adequately protected against polio which leads to paralysis or even death,” says Chikumbe.

UNICEF says the re-emergence of the wild poliovirus in Malawi, three decades after it was last detected, is “cause for serious concern”.

“Vaccination is the only way to protect the children of Malawi from this crippling disease which is highly infectious,” says UNICEF representative in Malawi, Rudolf Schwenk.

According to UNICEF, as an epidemic-prone, highly contagious disease, polio can spread easily through the movement of people from endemic to polio-free areas.

This polio vaccination campaign comes nine months after Malawi also administered another polio vaccination drive in July last year when the country undertook a week-long catch-up campaign that targeted 1.8 million children who missed the vaccine earlier.

Ministry of Health says the vaccination campaign last year was intended to immunise all children born after the world had switched from the Trivalent Oral Polio Vaccine (tOPV) to the Bivalent Oral Polio Vaccine (bOPV). The bOPV is said to protect children against all three types of polioviruses.

Community health activist Maziko Matemba tells IPS that one case of polio is one too many because of the high rate of spread of the virus and the severity of its effects.

“You need a rapid response to forestall its spread. You may not manage it if it slips through, so immunisation is key,” says Matemba, also executive director for Health and Rights Education Programme (HREP), a local non-governmental organisation.

But he says the re-emergence of the case after 30 years in Malawi should remind the government of the need to ensure the health system’s resilience.

He says this resilience can be achieved through adequate funding to the health sector.

“As a country, we need to ensure that our health system is resilient and robust. One way we can make it such is by meeting the Abuja Declaration on Health to allocate at least 15 percent of the national budget to the health sector.

“Twenty-one years after that declaration, we still can’t go past 10 percent in budget allocation to the health sector. Without sufficient funding, outbreaks of this nature can spiral out of control, and we will struggle to contain other health shocks,” Matemba says.

Since the last case in 1992, Malawi has sustained its polio surveillance through an independent committee of experts that oversees and coordinates the country’s polio monitoring and reporting system.

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Experts say proper hygiene, especially during the first 1,000 days of a child’s life is critical. Credit: Joyce Chimbi/IPS

By Joyce Chimbi
Nairobi, Kenya, Feb 15 2022 (IPS)

For two days in a row back in 2018, four-year-old Calvin Otieno suffered from diarrhoea and vomiting, and his mother responded by giving him a salt solution.

Pearl Otieno tells IPS that diarrhoea among children in Kibera, the largest urban informal settlement, is commonplace. A mixture of salt and warm water is often the go-to remedy.

“He did not seem to get worse, but he was not getting better either. He lay on the floor too weak to play,” she says.

It was too late by the time Otieno realized the magnitude of the situation and rushed her son to the nearby Mbagathi Hospital.

Kibera has long been synonymous with ‘flying toilets’, where residents relieve themselves in bags during nighttime and throw them away at dawn because they lack toilets inside their homes and fear using public toilets due to insecurity.

“Open defecation, flying toilets, lack of water and money to buy soap, people dumping household and human waste in open spaces is the life that children in the slums are exposed to,” says Nelson Mutinda, a Community Health Volunteer working hand-in-hand with a local NGO.

But Water, Sanitation, and Hygiene (WASH) challenges are not limited to informal settlements in this East African nation.

Overall, even though Kenyans have access to safe drinking water at 59 percent, according to UNICEF statistics, only 29 percent of the population has access to basic sanitation.

In all, five million Kenyans practise open defecation, a problem that statistics by the World Bank show is similarly prevalent in many low- and middle-income countries.

Open defecation is prevalent in Chad, Benin, Burkina Faso, Eritrea, Madagascar, Niger, Namibia, and Sao Tome and Principal. Only a handful of countries such as South Africa, Rwanda, Uganda, Seychelles, Mauritania, and the Gambia have successfully addressed access to sanitation.

World Health Organization (WHO) data indicates that Africa is not on track to achieve universal access to safe drinking water and proper sanitation in keeping with global Sustainable Development Goals (SDGs).

In the absence of increased investments in WASH interventions, the health body stresses that Africa will remain off track due to the added pressure from climate change and projected growth in population.

Against this backdrop, WHO says children in Sub-Saharan Africa are at least 14 times more likely to die before their fifth birthday than children in developed nations.

According to government statistics, in Kenya, at least 64,500 children die every year before reaching the age of five. Three-quarters of these deaths occur before their first birthday.

Mary Wanjiru, a pediatric nurse at Mbagathi Hospital, tells IPS that, like Otieno, many die from preventable diseases because the primary cause of death is diarrhoea, pneumonia, or neonatal complications.

“It is very important for mothers to understand that proper hygiene, especially during the first 1,000 days of a child’s life, is a very important pillar of child health. Poor hygiene can lead to death or a child failing to reach their full developmental and growth potential,” she says.

“WASH interventions are pillars of maternal, newborn and general child health because they prevent life-threatening infections such as tetanus, diarrhoea, sepsis and helps reduce stunted growth.”

According to USAID research, proper hygiene is a fragile pillar in Africa’s low- and middle-income countries.

In all, 50 percent of health care facilities lack piped water, 33 percent lack improved sanitation, 39 percent lack handwashing soap, 39 percent lack adequate infectious waste disposal, and 73 percent lack sterilization equipment, research shows.

While WASH interventions, such as safe drinking water, proper handwashing practices, and even basic sanitation, could prevent an estimated 297,000 global deaths among children under the age of five every year, this goal is not within reach for many Sub-Saharan African countries.

Hand washing, says the WHO, is the single most cost-effective strategy to prevent pneumonia and diarrhoea in young children successfully.

Still, data from UNICEF and WHO Joint Monitoring Programme released in August 2020 shows that an estimated 818 million of the world’s children lacked basic handwashing facilities within their schools. Of these children, 295 million live in Sub-Saharan Africa.

Overall, seven out of 10 schools lacked basic handwashing facilities in the least developed countries worldwide.

It is within this context that UNICEF paints a dire picture. Over 700 children worldwide under the age of five die daily of diarrheal diseases because of a lack of appropriate WASH services.

Children in conflict situations are especially vulnerable because they are nearly 20 times more likely to die from diarrheal diseases than in conflict.

“For ten years, I have worked in four slums in Nairobi. I find it very shocking that people have not understood how serious diarrhoea in children is. But small children will be given a mixture of water and salt, and sometimes some herbs and people just take the situation very lightly,” Mutinda observes.

Wanjiru agrees. She says that diarrhoea can escalate to a fatality within a matter of hours, “by the time mothers rush to the hospital with children suffering from acute watery diarrhoea, it is sometimes a losing race against time. Any form of illness among children should never be a wait-and-see situation. Seek immediate medical attention.”

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Yohei Sasakawa, Chairman of The Nippon Foundation, has served as WHO Goodwill Ambassador for Leprosy Elimination since 2001. He is part of Sasakawa Leprosy (Hansen’s Disease) Initiative, which has organized the “Don’t forget leprosy” campaign.

By External Source
Jan 28 2022 (IPS-Partners)

Sasakawa Leprosy (Hansen’s Disease) Initiative is collaborating with 32 organizations from 13 countries to promote the message “Don’t forget leprosy” in the run-up to World Leprosy Day on January 30. The international campaign includes awareness-raising events and outreach to governments and is being publicized via newspapers, television, radio, and social media.

Based in Tokyo, Japan, Sasakawa Leprosy (Hansen’s Disease) Initiative launched the “Don’t forget leprosy” campaign in August 2021 to ensure efforts against leprosy, also known as Hansen’s disease, are not sidelined amid the coronavirus pandemic.

Taking part are NGOs, organizations of persons affected by leprosy, research institutes, and government agencies from Bangladesh, Brazil, India, Indonesia, Nepal, Nigeria, Papua New Guinea, Portugal, Senegal, Sierra Leone, Tanzania, Uganda, and the United Kingdom.

The Initiative’s Yohei Sasakawa, who serves as WHO Goodwill Ambassador for Leprosy Elimination, said: “The impact of the coronavirus pandemic has been particularly hard on persons affected by leprosy and their families who were in a vulnerable situation to begin with. Lockdowns and other measures to prevent the spread of the virus have caused many problems at the field level, making access to medical services difficult, causing loss of livelihoods, and exacerbating the difficulties that persons affected by leprosy already encounter due to stigma and discrimination. They must not be forgotten.”

From India, which accounts for around 60% of all new cases of leprosy diagnosed globally each year, 13 8 organizations are participating. Activities include intensive awareness-raising events aimed at school children and university students to provide young people with correct knowledge about leprosy and help prevent discrimination from taking root.

In Brazil, the country with the second-highest number of annual new cases and which has yet to eliminate leprosy as a public health problem (with elimination defined as a prevalence rate of less than 1 case per 10,000 population), the campaign is being carried out by more than 2,000 persons affected by leprosy and volunteers from MORHAN (the Movement for the Reintegration of Persons Affected by Hansen’s Disease). Activities include a focus on healthcare professionals and involve training local public health nurses, strengthening the functions of leprosy referral centers and case-finding.

Activities for World Leprosy Day by Sasakawa Leprosy (Hansen’s Disease) Initiative
The Initiative has launched a special website (https://gasasakawa.org/) for the Global Appeal to End Stigma and Discrimination against Persons Affected by Leprosy. Inaugurated by Sasakawa in 2006 and released in conjunction with World Leprosy Day, the annual Global Appeal underlines the messages that leprosy is curable, treatment is available free of charge throughout the world, and that social discrimination has no place.

As side events of this year’s Global Appeal, the Initiative is hosting two webinars on raising awareness of leprosy (“The role of health professionals at the grassroots level” and “The role of young people: sharing discussions from three regions”) as well as a photo contest on social media. A selection of the best photos, which depict the daily lives of persons affected by leprosy and relief activities, will be displayed on the Global Appeal website.

In addition, Sasakawa has posted a message for World Leprosy Day on the WHO website.

About Sasakawa Leprosy (Hansen’s Disease) Initiative
The Initiative is a strategic alliance between WHO Goodwill Ambassador for Leprosy Elimination Yohei Sasakawa, The Nippon Foundation and Sasakawa Health Foundation for achieving a world without leprosy and problems related to the disease. Since 1975, The Nippon Foundation and Sasakawa Health Foundation have supported the national leprosy programs of endemic countries through the WHO, with support totaling some US$200 million to date. In cooperation with the Japanese government and other partners, the foundations have played an important role in advocating with the United Nations, helping to secure a 2010 UN General Assembly resolution on the elimination of discrimination against persons affected by leprosy and their family members and the appointment of a UN Special Rapporteur on leprosy by the UN Human Rights Council in 2017.

See the Initiative’s home page for further details.

About leprosy
Leprosy, also known as Hansen’s disease, is an infectious disease that mainly affects the skin and peripheral nerves. Around 200,000 cases are newly reported each year. Leprosy is curable with multidrug therapy, but left untreated can result in permanent disability. An estimated 3 to 4 million people in the world today are thought to be living with some form of disability as a result of leprosy. Although completely curable, many myths and misunderstandings surround the disease. In various parts of the world, patients, those who have been treated and cured, and even their family members continue to be stigmatized. The discrimination they face limits their opportunities for education, employment, and full participation in society.

Chart1: List of participating organizations

Alice Cruz-UN, Special Rapporteur on eliminating discrimination against persons affected by leprosy and their family members, told the youth that their participation was crucial to removing legal discrimination. Her young son Leo asked the global audience not to forget leprosy. Credit: Joyce Chimbi/IPS

By Joyce Chimbi
Nairobi, Kenya, Jan 25 2022 (IPS)

Yohei Sasakawa said the youth have the power to change the world, and their participation in removing the stigma and myths about leprosy is crucial to the campaign to end the disease.

Sasakawa, the WHO Goodwill Ambassador for Leprosy Elimination and Chairman of the Nippon Foundation, was speaking at a webinar held in the run-up to World Leprosy Day on January 30. He engaged youth from Africa, Asia, and Latin America in an online discussion dubbed ‘Raising Awareness about Leprosy – Role of Youth’.

“The history of the world is changed by young people. The spirit of young people is essential in the fight against leprosy. Speak out and let the world understand leprosy better. Use online tools at your disposal to tell the world not to forget leprosy,” Sasakawa told participants.

“The younger generation has joined our efforts. Our goal is to hear from you, work with you and take action with you towards a day when there will be zero stigma and discrimination against those affected by leprosy.”

At the heart of discussions were highlights from three regional forums, stimulating conversations about leprosy and its related challenges and efforts to build collaboration and networks to combat an ancient disease at risk of being forgotten.

The webinar was organized against the backdrop of the global ‘Don’t Forget Leprosy’ campaign by the Sasakawa Leprosy Initiative. The initiative strategically links the WHO Goodwill Ambassador for Leprosy Elimination, Sasakawa Health Foundation, and the Nippon Foundation towards achieving a leprosy-free world.

Stigmatized, forced to migrate, denial of education, abandonment of children affected by leprosy, difficulties for those affected by leprosy, and women finding marriage partners – were highlighted in the discussions. Leprosy is even recognized as grounds for divorce in some countries.

These were only a few of the many challenges faced by those affected by the disease, speakers said.

Yohei Sasakawa, the WHO Goodwill Ambassador for Leprosy Elimination and Chairman of the Nippon Foundation, told youth from Africa, Asia, and Latin America that they had the means to change perceptions about leprosy. They were educated and knew how to use social media to benefit leprosy-affected communities. Credit: Joyce Chimbi/IPS

“We need collective efforts to address the disease itself and, at the same time, the rampant stigma associated with leprosy. Today, the second generation of those affected by leprosy still find difficulties getting a job because of the stigma,” Sasakawa said.

He said efforts to address leprosy are two-pronged, engaging global and well-respected figures and grassroots actors for community-level engagement.

Participants heard that youths learning about leprosy and sharing that it is curable could accelerate progress towards a world free from medical and social problems related to leprosy.

Youth participation could significantly help dispel myths rooted during the many centuries in which leprosy, also known as Hansen’s disease, was incurable.

The online discussion followed three preparatory regional youth forums held in December 2021 and January 2022. The engagement was in anticipation of a Global Youth Forum on the theme, ‘Don’t Forget Leprosy’, organized by the Sasakawa Leprosy Initiative slated for March 2022.

Dr Michael Chen from HANDA, China, told participants how the first Asia Youth Forum engaged young people in a virtual meeting to discuss the reduction of stigma and discrimination faced by people affected by leprosy.

He said six Asian countries, including Bangladesh, China, India, Indonesia, Myanmar, and Nepal, participated. Discussions included the need to engage the younger generation in a world free of stigma and discrimination.

Similarly, Marcos Costa, from Morhan in Brazil, spoke of the first Latin American and Caribbean Virtual Meeting of young people affected by leprosy, their family members, and supporters.

The meeting, he said, sought to engage young people and their families in a dialogue centered on the challenges faced by those affected by the disease and to explore policy solutions to the problem.

“In Brazil, it is reported that many new leprosy cases were not diagnosed in 2020 because of COVID-19. The pandemic has compounded challenges facing young people as many of them are unemployed due to the stigma attached to people affected by leprosy,” he said.

Likewise, Tadesse Tesfaye from ENAPAL in Ethiopia summarized discussions during the first-ever Africa Youth Forum, with attendance from nine African countries, including Kenya, Niger, and Mozambique.

Tesfaye said the forum explored “how stigma and discrimination manifest upon persons affected by leprosy and their families and the need to build national, regional and international alliances to address social and medical challenges related to the disease.”

Within this context, Alice Cruz, the UN Special Rapporteur on eliminating discrimination against persons affected by leprosy and their family members, reminded the younger generation that leprosy was also a political factor and their voices were needed.

She called for diversity, new faces, ideas, innovations, and the engagement of young people and families affected by leprosy.

Cruz stressed that young people’s contribution to enforcing the human rights of people affected by leprosy should be encouraged. Their contribution was crucial to reforming more than 150 laws and regulations in various parts of the world that discriminate against persons affected by leprosy.

Her young son, Leo, finalized her address calling for a world free of all forms of discrimination and one where leprosy was not forgotten.

Chen and Costa further drummed support for the engagement of young people especially through social media to raise awareness of leprosy and challenge long-standing stereotypes.

“We need to cultivate the potential of young people, provide sufficient funding to young people, and a supportive platform for young people to learn, grow, communicate and solve problems,” Chen said.

Dr Takahiro Nanri, the Sasakawa Health Foundation executive director, moderated a session between the Goodwill Ambassador and young participants, including Costa, Rahul Mahato from ATMA Swabhiman in India, and Joshua Mamane from IDEA in Niger, who are also from a families affected by leprosy.

The discussion stressed the need to engage young people in the fight against leprosy actively.

Sasakawa said youth participation would usher in a new and much-awaited era in global and grassroots efforts to fully tackle leprosy as medical, public health, and human rights issues.

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Yohei Sasakawa, WHO Goodwill Ambassador for Leprosy Elimination and Chairperson of the Nippon Foundation, thanks participants at a webinar ‘Raising Awareness about Leprosy, Role of Health Professionals at the Grassroots Level’ organized by the Sasakawa Leprosy Initiative. He is with other participants from Japan, India and Nepal in the “Don’t Forget Leprosy” campaign event.

By Joyce Chimbi
Nairobi, Kenya, Jan 20 2022 (IPS)

The human rights of people affected by leprosy are central to Yohei Sasakawa’s concept of a leprosy-free world.

Sasakawa, the WHO Goodwill Ambassador for Leprosy Elimination and Chairman of the Nippon Foundation, was speaking at a webinar ‘Raising Awareness about Leprosy, Role of Health Professionals at the Grassroots Level’ organized by the Sasakawa Leprosy Initiative.

A leprosy-free world was one where “patients and those cured of leprosy live free of discrimination and, people around them will be free of the misunderstanding, ignorance and fear that perpetuate discrimination”, he told the webinar.

Sasakawa Leprosy Initiative is a strategic alliance between WHO Goodwill Ambassador for Leprosy Elimination, the Nippon Foundation and Sasakawa Health Foundation for achieving a world without leprosy and problems related to the disease. The initiative spearheaded a campaign, “Don’t Forget Leprosy”, to raise awareness about the condition in the face of the coronavirus pandemic.

The WHO Goodwill Ambassador envisions a post-COVID world where those affected by leprosy will be liberated from such stigma and discrimination in keeping with human rights.

Sasakawa says this world is now at risk of delaying leprosy elimination due to the COVID-19 pandemic, as there was a 37 percent drop in reported new cases and leprosy programs in many countries have stalled or scaled back.

Participants heard about the role of health professionals in combating leprosy, recognition of this role and the successes and challenges faced in addressing leprosy during the ongoing health pandemic.

Their role, Sasakawa said, was a central pillar to the vision of a leprosy free world as it helps reduce transmission and disability.

An estimated three to four million people live with some form of disability caused by leprosy, also known as Hansen’s disease.

“The ‘Don’t Forget Leprosy’ is a global campaign because our voices alone are not enough. Stopping leprosy requires (the involvement of) all of us, from India and Nepal to all other countries around the world,” he said.

Dr Rashmi Shukla outlined efforts in India to identify and treat patients with leprosy. She was speaking at a webinar ‘Raising Awareness about Leprosy, Role of Health Professionals at the Grassroots Level’ organized by the Sasakawa Leprosy Initiative. Credit: Joyce Chimbi/IPS

Dinesh Basnet, Central President of the International Association for Integration, Dignity and Economic Advancement (IDEA) in Nepal, said he was happy to see progress in recent years.

“More so Nepal’s efforts to track and eliminate leprosy. Even during the pandemic, detection and treatment interventions were uninterrupted, and this has been possible due to government commitment and unrelenting efforts of health professionals,” said Basnet.

“People affected by leprosy were not forgotten as communication continued through WhatsApp groups, and this was critical during the lockdown.”

Dr Indra Napit, a senior Orthopedic Surgeon at Anandaban Hospital, Nepal, spoke about innovative technology in the trial of Autologous Blood products to promote ulcer healing in Leprosy. He added that a new drug was on trial to manage reactions to this form of treatment at this leprosy mission.

In a video message, Birodh Khatiwada, Nepal’s Minister of Health and Population, spoke of Nepal’s undisrupted program to address leprosy, including the continued supply of leprosy medication despite the pandemic.

He says Nepal has already prepared the National Leprosy Roadmap, 2021-2030, National Leprosy Strategy 2021-2025, in line with the Global Leprosy Strategy, Neglected Tropical Diseases Roadmap and the Sustainable Development Goals (SDGs).

Sasakawa emphasized that it was indeed the ultimate goal for India and other affected countries worldwide to reach zero leprosy cases by 2030.

Despite challenges in the fight to eliminate leprosy, a ray of hope shines through, with Anju Sharma sharing good practices in case finding in India amid the ongoing health pandemic.

Sharma is an accredited Social Health Activist and is considered a driving force behind India’s public health system and an essential link between the community and the public health system.

“Screening for leprosy during the pandemic is much more difficult. As COVID-19 cases increase, so does my responsibilities because I have to strictly follow COVID-19 protocols, and this takes a lot of time,” Sharma explained.

“Due to the pandemic, people are hesitant about getting screened. But I reassure them that protocols will be observed and remind them that failure to detect and treat leprosy can lead to disability.”

Dr Venkata Ranganadha Rao Pemmaraju, acting team leader, WHO Global Leprosy Programme, emphasized that discussing the role of health workers was critical, and hearing from those in the frontlines helps efforts to eliminate the pandemic move forward.

WHO, he said, subscribes to the Don’t Forget Leprosy campaign. He lauded ongoing efforts to sustain counselling for those affected by leprosy and those who tracked and managed Nepal-India cross border leprosy cases despite challenges COVID-19 protocols like restrictions on movement and lockdowns.

Dinesh Basnet, a person affected by leprosy thanked health care workers and others for their efforts in eliminating the disease. He was talking at a webinar ‘Raising Awareness about Leprosy, Role of Health Professionals at the Grassroots Level’ organized by the Sasakawa Leprosy Initiative. Credit: Joyce Chimbi/IPS

Similarly, Dr Rabindra Baskota, the Leprosy Control and Disability Management Section director in Nepal’s Ministry of Health and Population, confirmed that health workers had been relentless to find new cases, raising awareness on leprosy and treating patients despite ongoing challenges.

“Still, there is a need to train community health workers to detect new cases and manage reactions to leprosy treatment even as older and more experienced health workers retire,” he said.

Dr Anil Kumar, the deputy director-general (Leprosy) in India’s Ministry of Health and Family Welfare, who spoke about good practices in combating leprosy said that a leprosy-free India was not very far off.

Despite a notable decline in screening and detecting cases due to COVID-19, he said critical interventions were nonetheless rolled out, and that leprosy-related services continued at the grassroots level.

“Migrant labourers were screened for leprosy at point of return to home districts and patients on treatment tracked. Treatment defaulters were cross notified based on the address in treatment record,” Kumar said.

“A WhatsApp group titled Leprosy Action Group was created for cross notification, and members included state leprosy officers and partners. Supportive supervision and monitoring up to sub-district level using virtual platforms continues.”

Executive Director of the Sasakawa Health Foundation, Dr Takahiro Nanri, moderated a panel discussion that included a session to further shed light on additional support needed to achieve leprosy elimination milestones.

Sasakawa suggested that health workers’ training included human rights, and the panel lauded health workers for their passionate and proactive steps to eliminate the disease.

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Community support workers are key in raising awareness about TB and promoting diagnosis and treatment. Credit, Busani Bafana/IPS

By Busani Bafana
BULAWAYO, Zimbabwe, Jan 7 2022 (IPS)

Global efforts to end tuberculosis (TB) are futile without dedicated investment in research into the debilitating disease that is killing 4000 people a day, Stop TB Partnership warns.

“TB is a disease that is not a darling of donors and investors,” Lucica Ditiu, the Executive Director of the Stop TB Partnership, told IPS in an interview from Geneva.

“We do not have a Bill Gates that can support TB research, yet TB remains a disease of concern with deaths increasing for the first time in over a decade,” she added.

TB, a bacterial disease mainly affecting the lungs, has been around for over millennia and remains one of the top killer diseases globally. But it is preventable and curable with the right investment in diagnosis and treatment.

Ditiu attributed the rise in TB incidents to several factors; many people diagnosed and on treatment for TB have defaulted owing to the disruption of health services in the wake of the COVID-19 pandemic and global lockdown. Furthermore, many people remain undiagnosed because they have not been reached.

Dr Lucica Ditiu, Executive Director of the Stop TB Partnership. Credit: Stop TB Partnership

“Southern Africa has done a good job in respect of Zambia, Zimbabwe and South Africa as well as Rwanda in trying to disrupt as little as possible the treatment and diagnosis of people with TB,” Ditiu said. She commended awareness programmes in the media and community door-to-door campaigns to promote diagnosis and treatment.

Countries need to invest more in finding people with TB and putting them on treatment. Until you find people, you cannot put them on treatment, and this is where we are very much lagging, she said.

Ditiu fears the worst should the world fail to change the current TB transmission trend. An estimated 5.8 million people received treatment for TB in 2020; a drop of 21 percent from 2019, and more than 4 million people worldwide remain untreated. According to Stop TB Partnership, half of those untreated are likely to die from the disease.

Admitting that funding for TB has always been insufficient, Ditiu said TB was the poor cousin compared to the deep pockets for HIV and AIDS.

“In general, we have available only 30 percent of the funding needed globally. We have places that have done well in preventing TB in people living with HIV. Prevention of TB in people living with HIV is going well, especially in African countries because HIV has resources.”

According to the Stop TB Partnership, a network of international organisations established in 1998 to help end TB as a public health problem, funding for TB research and development (R&D) has remained flat since 2018.

Global funding for tuberculosis (TB) research totalled 915 million US dollars in 2020 – less than half the goal of 2 billion US dollars set forth by participating country governments at the 2018 United Nations High-Level Meeting on TB.

In 2021, TB had a funding gap of 13 billion US dollars globally, with only 5,3 billion US dollars available for its programmes. It experienced a drop in funding amounting to 500 000 US dollars in 2020 as many countries took money away from TB to respond to COVID-19.

A new report, Tuberculosis Research Funding Trends, 2005–2020 by Treatment Action Group (TAG) and the Stop TB Partnership, found that TB received less than 1 percent of the amount invested in COVID-19 Research and Development over the first 11 months of the pandemic.

“The mobilisation of over 100 billion US dollars for COVID-19 research and development in the first 11 months of the pandemic shows us just how powerful a coordinated effort against a disease can be,” noted Ditiu.

While the pandemic has shown that effective vaccines can save lives, the world is still banking on a 100-year-old vaccine, Bacillus Calmette-Guérin or BCG. However, a more effective vaccine could have higher efficacy rates, especially for adults. Why has it taken so long to develop a new, more effective TB vaccine when the health burden of TB is increasing?

“This is the drama,” Ditiu commented. “We have a vaccine for a hundred years that we know for the last 40 years does not work (effectively) except for newly-born babies, and yet we have not done much about it.”

While ongoing research on new vaccines had been slow because of poor funding, Ditiu said several potential vaccines were in the pipeline, and a vaccine could be expected by 2027.

“It takes a long time to get a vaccine. But because of COVID (we realised), it is possible to have a vaccine much quicker, and we hope to use the learnings from COVID-19 to get a TB vaccine,” Ditiu told IPS.

Tuberculosis vaccine research has been slowed by chronic underfunding with only one moderately effective century-old TB vaccine, compared to over 20 COVID-19 vaccines.

“What’s enabled the development of dozens of COVID-19 vaccines in less than a year has essentially been money,” noted Austin Aurinze Obiefuna, Executive Director of the Afro Global Health Alliance and incoming Vice-Chair of the Stop TB Partnership Board.

“I think that the same enormous amount of funding should be applied with equal vigour to the development of TB vaccines. But that simply doesn’t seem to be happening.”

According to the Stop TB Partnership, making much-needed progress against TB demands investment that matches the threat of the disease around the world. This includes a commitment to rectify the inadequate funding of the past. Over the next two years, 10 billion US dollars are needed to close the tuberculosis R&D funding gap.

“Wealthy countries need to step up and put more money into correcting global health inequalities, which COVID-19 vaccine allocation inequities laid bare,” urged Mark Harrington, Executive Director of TAG, an independent activist, and community-based research and policy think tank.

“COVID-19 made more people around the world aware of the importance of R&D spending than ever before. Now is the time to finally start making investments ambitious enough to end TB for good.”

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Online platform Fuzia uses positive reinforcement and creativity to support its community. Credit: Sangeeta CS/Fuzia

By Fairuz Ahmed
New York, Dec 21 2021 (IPS)

This is an age where pandemics are raging, millions live in war-torn strife, yet women are judged on their skin tones and height, says matchmaker Hirion Shah.

“It is sad and frustrating to see educated families, Ph.D. holders, even scientists from high-tech companies turning down suitable matches based on only such issues. I have over 25 years of experience in matrimony matchmaking, and it is high time we change our perspective,” Shah says in an exclusive interview with IPS.

With hundreds of successful matchmaking successes over the years, she expresses her concern about stagnant values that many families demand while looking for potential matches for their children.

“And it does not stop there: fair, dark, skinny, little chubby, tall or not tall enough, these become central traits of being judged. This is almost an epidemic when it comes to Asian communities at home and abroad,” Shah says. “I have seen hundreds of marriages ending in divorce because basic values, characteristics, and overall compatibility were given a backseat during selection, and looks were prioritized.”

According to Compare Comp, in 2020, 55% of marriages across the globe were arranged marriages, and approximately 20 million arranged marriages exist today. The divorce rate for arranged marriages globally is at 6.3%.

India has the highest rate of arranged marriages, hitting 90%, followed by China, Pakistan, Japan, and Bangladesh. It is alarming that 14 million girls get married every year before turning 18.

The UN has declared child marriage a human rights violation. According to the UNFPA, those forced into early or child marriages suffer an increased risk of pregnancy and childbirth complications.

According to IBISWorld, weddings services in the US market alone comprises a $56.7bn industry and are given a center stage in millions of families. Besides wedding expenses, a good chunk of this industry expands to beautification, enhancing and fixing body images, altering skin color or looks.

The American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) says that in 2017, more than half of their practitioners saw an increase in cosmetic surgery or injectables with clients under the age of 30. More than 80% of treatments were cosmetic non-surgical procedures, and the trend was born out of social pressures.

According to Harper’s Bazaar, the top three non-surgical treatments among brides, grooms, and wedding parties are facelifts, eyelifts, and nose jobs. Procedures like Botox, hyaluronic acid injections, and chemical peels are popular. Social media influence, peer pressure, and feeling a need to fit in were the main reasons for approaching a plastic surgeon.

Amina Banu recounts her experience of an arranged marriage.

“I grew up in a metro city. My mother has been a teacher for 30 years and my father a scientist. My older sister and brother both are engineers. I have completed a master’s from Michigan, United States,” Banu says, but none of this seemed to matter.

“It was a tiring process to get married despite our social and economic setting. I met over 25 suitors and settled down with the 26th. The process seems brutal and demeaning.”

She says she was rejected because she is 5’6”, and the suitors’ families thought the partners would look awkward.

Fuzia believe in supporting their online community through workshops, support groups and podcasts where users can understand and gain information about positive body shape affirmation and ways to develop a healthy relationship with their bodies. Credit: Ditsa Mahanti/Fuzia

“Happiness and the mental match have nothing to do with such fickle matter, but still, at our age, these are massive points to weigh in, while families look for suitable grooms or brides. The irony is that my husband is 5’4”, and we have been happily married for the past 12 years,” Banu says. She now has three sons and works in New York. She spends a lot of time promoting healthy lifestyles and body images in teens and young adults in minority communities.

The Obesity Action Coalition has found that among overweight middle-school-aged children, 30% of girls and 24% of boys experienced daily bullying, teasing, or rejection because of their size.

These numbers doubled for overweight, high school students – with 63% of girls and 58% of boys experiencing some form of bullying due to their weight and size. Most of the time, these weight-related comments sound like helpful hints. But in reality, children can feel trapped, alone, and helpless to change their situations.

Also, it is not just school bullies initiating weight teasing, body shaming, or teasing.

A study published on Wiley Online Library in September 2018 states that the victim’s friends, teachers, coaches, and even their parents often participate. They use subtle forms of bullying or relational aggression to bully and tease.

Obesity Action notes that many people bullied or shamed because of their weight suffer depression, anxiety, and low self-esteem.

Pragya Singhal, a social media associate from the online platform Fuzia, says the platform offers support sessions, podcasts and publishes blogs to help people address body image and body-shaming issues.

“The majority of our users’ ages range from teens to young adults. We try to instill the affirmation that, with positivity and a growth mindset, you can become the best and most confident version of yourself,” Singhal says.

Fuzia, which Riya Sinha and Shraddha Varma co-founded, has 5 million users. It has created a safe space where users can network, have a conversation, share their creativity, find work opportunities and study online. The platform has a clear policy about profanity and hate speech and ensures positive engagement.

The online platform uses creative avenues to seek information about mental health, learn ways to cope, ask for help, and express themselves in a safe and judgment-free way.

Shraddha Varma, Fuzia’s co-founder, says that their initiatives align with the Sustainable Development Goals of the United Nations of ensuring good health and well-being.   Fuzia sets up workshops, support groups, and podcasts where users can understand and gain information about positive body shape affirmation and ways to develop a healthy relationship with their bodies.

“In my opinion, body image has long been and is still considered a parameter of how one thinks about themselves and others. We all have something that we want to change about our bodies, and we have very little idea of how hugely it affects our self-esteem,” says Varma.

“Let’s accept that nobody’s perfect, and we must stop body-shaming others and ourselves. What matters instead is what our bodies can do, if we’re aware of our bodies and if we’re taking the right care of our bodies by getting a good dose of sleep, eating healthy, focusing on being strong and fit, and keeping just about a healthy weight.”

• This article is a sponsored feature.

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COVID-19 lockdowns and restrictions meant that many informal sector traders lost their jobs. Not eligible for compensation, some have turned to sex work. Credit: Marko Phiri/IPS

By Marko Phiri
Bulawayo, ZIMBABWE , Nov 4 2021 (IPS)

Thirty-six-year-old Thandiwe Mtshali* watched helplessly as her informal cross-border trading (ICBT) enterprise came to a grinding halt when the Zimbabwean authorities closed the border with South Africa as part of global efforts to stem the spread of the deadly novel coronavirus.

“That was last year, and I had no idea what to do next,” Mtshali told IPS.

Before the lockdown, she made up to four trips each month to Musina and Johannesburg in neighbouring South Africa to buy goods ranging from clothes to electrical appliances for resale in Bulawayo, Zimbabwe’s second city.

And by her account, the money was good.

“I could rent a full house in the suburbs, and my long-term plans have always been to build my own home,” she said.

After months of being idle in Bulawayo, a colleague tipped her about what appeared to be an easy route out of her money troubles: truckers had not been banned from transporting goods between South Africa and Zimbabwe.

As truckers got stuck at the Beitbridge border post for weeks waiting to get their consignments processed by port authorities, it presented a new venture for informal cross-border traders such as Mtshali: sex work.

Today, Mtshali, who has two young children back in Bulawayo, rents a small shack in the border town where she “entertains” truckers and other men willing to pay for sex.

Commercial sex work is illegal in Zimbabwe, but COVID-19 has turned the sector into a necessity for many women who were made redundant by lockdown measures imposed by the government because of public health concerns.

“I do not want to do this, but it is better than sitting and waiting,” Mtshali said.

“My kids are with my mother, and all they know is that I am working in Beitbridge. As long as I send them money and groceries, they don’t need to know anything else,” she told IPS.

Local residents, however, complain that despite the lockdown restrictions that banned travel across cities, there appeared to be an influx of sex workers to the border town, each seeking to make a living.

“We have always had a problem here with sex workers, young and old competing for clients. But now we see even more after borders closed,” said Dumisani Tlou, a resident and taxi driver.

“Every tenant knows they can rent any available backroom to the women who entertain truckers and other illegal dealers, but no one seems to be doing anything about it,” he told IPS.

While the Zimbabwean authorities have made efforts to provide bailout stipends for informal traders, this has been criticised for being too little to improve the lives of millions on the fringes of official economic activity.

Many more, like Mtshali, missed out on the bailouts because they are not registered with any informal traders’ association.

“There is a need to consider special exemptions that will allow cross-border traders to import goods during the lockdown and border closures,” said Fadzai Nyamande-Pangeti, International Organisation for Migration – Zimbabwe spokesperson.

“It is also important for women cross-border traders to formalise their businesses, to make them less likely to be impacted by shocks caused by the pandemic,” she told IPS.

However, for many here at the border town, sex work comes with challenges.

While borders were closed in line with public health safety measures, this has exposed sex workers to concerns about HIV/Aids.

“These women have no social protection or insurance or any other mitigation measures to cushion them in times of disasters such as the current pandemic,” said Mary Mulenga, a representative of the Southern Africa Cross-border Traders Association (SACBTA).

In a submission to the UN Special Rapporteur on Health ahead of the UN General Assembly in October, the Global Network of Sex Work Projects (GNSWP), which brings together sex worker-led organisations across ninety-six countries, says, “during the pandemic, there has been a (global) drop in the availability of HIV treatment services due to the prioritisation of treating and stopping the spread of COVID-19.”

“As a result, sex workers living with HIV have experienced even greater challenges in accessing HIV treatments, further endangering their health and ability to work,” the network says in its brief to the UN.

Truckers have for years been identified as an HIV/Aids high-risk group in southern Africa, raising concerns among campaigners, such as the GNSWP, that while resources are being directed toward addressing the spread of COVID-19, both old and new entrants into the sex trade such as Mtshali are being left out.

According to the UN’s International Organisation for Migration (IOM), informal cross-border trade accounts for up to 40 percent of southern Africa’s intra-trade estimated USD17 billion annually. Still, border closures have upended this due to COVID-19.

Despite these disruptions brought by the novel coronavirus, the once-thriving informal cross-border trade could present more public health concerns: an increase in those living with HIV/Aids.

In recent months, Zimbabwe’s First Lady Auxillia Mnangagwa launched countrywide self-sufficiency projects for sex workers. Still, with the industry continuing to take in new entrants such as Mtshali, it could be a race against daunting odds as global health experts see no easy end to COVID-19.

• The Pulitzer Centre supported this story.
• Name changed to protect identity.

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Food table banking is turning the tables on the systematic and systemic financial exclusion of women. Credit: Joyce Chimbi/IPS

By Joyce Chimbi
NAIROBI, Oct 15 2021 (IPS)

Pascaline Chemutai’s five acres of land located in the country’s breadbasket region of Rift Valley recently produced 115 bags of maize, each weighing 90 kilograms. She tells IPS that of these, 110 bags will be transported to traders in Nairobi and neighbouring Kiambu County at a negotiated price of $23 per bag.

In all, she will have pocketed about $2,500, a significant amount in the village. Not only will she have enough to feed her family of five, but to pay for their school fees and other basic needs. Besides maize farming, Chemutai sells milk to residents in town.

The 45-year-old farmer widowed eight years ago with five young children says that her life as a farmer was made possible and is sustained through table banking.

“My husband was in charge of our farm and handled all business related to the farm. I knew how to farm because I grew up cultivating land, but I had no money to buy seeds and fertilizer or knowledge on the business side of farming,” she says.

Fortunately, a year before the demise of her husband, Chemutai joined a table banking group under the Joyful Women Organization (JOYWO), a registered NGO focused on the economic empowerment of women.

As the name suggests, women place their savings on a table and immediately loan each other accumulated funds.
“Women knew of village saving groups where contributions were spent on household items such as cups, plates and even beddings. We were now learning about saving and borrowing,” she says.

Sharon Alice Anyango says that the simple concept of table banking, where a group of 10 to 35 members use the group-based strategy to fundraise by saving, placing their savings on a table, and borrowing immediately, has turned tables on the systematic and systemic financial exclusion of women.

“Table banking is addressing the primary challenges that women face when dealing with banks and other financial institutions. Where they needed collateral that they did not have to access bank loans, today, they successfully fundraise amongst themselves,” says Anyango, a project officer at the Ministry of Public Service, Youth and Gender.

JOYWO, whose current patron is Rachael Ruto, the wife of Deputy President William Ruto, claims to have a revolving fund of at least $27 million in the hands of its estimated 200,000 members across 1,200 table banking groups in all parts of the country.

“Other estimates show that so popular is the table banking movement that cumulatively, table banking groups throughout the country circulate approximately $550,000 to $730,000,” Anyango says.

She explains that only women were involved at the start, but as they started to accumulate funds, men became interested.

“Men have seen the magic,” she says.

Now the table banking fraternity allows men to join, but the groups’ constitutions ensure that at least 70 percent of the members and all the leadership positions are women.

Chemutai says that their table banking group of 20 members currently has a revolving fund of $30,000. She has taken loans valued at $2,000 to fund various farming and animal husbandry ventures in the last year.

“Seeds, fertilizer, labour, tractors and veterinary services, salary for my farm boy and feeds for my cows cost a lot of money. I borrow from the group and repay, and this cycle repeats itself every year, and all my activities are running smoothly,” she tells IPS.

“Table banking has also linked me to a reliable market. We started interacting with other table banking groups from other parts of the country, and that is how I managed to find a market. I sell all my maize to other women in table banking groups within Nairobi and Kiambu counties. I would never have met these women if it was not for table banking,” she says.

Chemutai’s story is in line with research from the Barilla Center for Food and Nutrition that points to “a high probability that any agricultural product that we buy has been produced by a woman. Women’s contribution is essential for the food security of entire communities and for the farming production of many developing and rural communities.”

The research further points to the many gender disparities that prevent women such as Chemutai from accessing financing. On paper, Chemutai does not own an asset to be used as collateral despite having access to five acres of land because the land is ‘ancestral’ land.

As per the Barilla Center for Food and Nutrition and undoubtedly true for many women in agriculture, “when women are guaranteed the same access as men to community resources, services and economic opportunities, production increased, the economic and social benefits of the community improve, and malnutrition and poverty are reduced.”

Celebrated every October 16, as the global community marks yet another World Food Day under the theme “Our actions are our future. Better production, better nutrition, a better environment and a better life”, gender experts, such as Anyango, tell IPS that this is the level of access that women need to feed the global population.

Agriculture is still the largest employment sector for 60 percent of women in Sub-Saharan Africa. Women like Chemutai also make up two-thirds of the world’s 600 million small livestock managers, according to the U.N’s Food and Agriculture Organization (FAO).

Despite their contribution to agriculture, financing is still largely not affordable, available, and accessible to women farmers. In this East African nation where the table banking movement is more concentrated in rural areas, women now have a lifeline to fund agricultural activities with loans taken under friendly terms and conditions.
Anyango asserts that women must be at the centre of World Food Day’s collective action across 150 countries to promote worldwide awareness of global hunger and the need to ensure healthy diets for all.

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Food experts have many and varied expectations of the UN Food System Summit. It's hoped decisions made here will help the world get back on track for the Sustainable Development Goals 2030. Credit: Alison Kentish/IPS

By Alison Kentish
DOMINICA, Sep 20 2021 (IPS)

Dubbed ‘the People’s Summit, the United Nations Food Systems Summit (UNFSS) hopes to put the world back on a path to achieve the Sustainable Development Goals by 2030, through food systems overhauling. From the tempered to the extremely optimistic, experts in various food system sectors share their expectations of transformation.

The world has been lagging on ambitious climate, biodiversity and sustainable development goals, but the UNFSS is hoping that commitments to transform global food systems will get the world back on track to meeting the Sustainable Development Goals by 2030.

The inaugural UNFSS will take place virtually during the UN General Assembly High-Level Week, under the leadership of UN Secretary-General António Guterres.

It promises to bring together the public and private sectors, non-governmental organisations, farmers groups, indigenous leaders, youth representatives and researchers to outline a clear path to ensure that the world’s food production and distribution are safe, healthy, sustainable and equitable.

Learning from the lessons of the COVID-19 pandemic, the summit also hopes to make food production and distribution more resilient to vulnerabilities, stress and shocks.

Experts in sustainability and various food system sectors have been speaking about their expectations and hopes for a summit that is built on solutions to some of the world’s most pressing issues such as land degradation, inequality, rising hunger, and obesity.

Panellists at a Barilla Center for Food and Nutrition (BCFN) ‘Fixing the Business of Food’ webinar held on September 16, 2021, were asked how optimistic they were, on a scale of 1 to 10, of real food systems transformation in the next 12 months, triggered by the private sector.

“I am going to give a full 10,” said Viktoria de Bourbon de Parme, Head of Food Processing at the World Benchmarking Alliance. “I am super optimistic,” she added. “I think we are there. Momentum is there, and it is going to happen.”

Executive Director of Food and Nature at the World Business Council for Sustainable Development Diane Holdorf is similarly optimistic.

“I would say an 8 out of 10, but I do have to preface this by saying that systems change is complex. With individual leading companies demonstrating what is possible and bringing others along, we are going to see for sure actual system changes,” she said.

Not all experts are optimistic that the UNFSS will bring about the urgent changes required for food systems transformation.

IPS spoke with Million Belay, the Alliance for Food Sovereignty in Africa (AFSA) head, about his expectations for the summit.

Belay, who is also an advisory board member for BCFN and a food systems researcher, said that he and alliance members disagree with the summit’s agenda and structure. The alliance represents farmers, pastoralists, hunter/gatherers, faith-based organisations, indigenous peoples and women’s groups,

“The pre-summit has happened in Rome. During that presummit, we had our own summit, organised by civil society mechanisms, and it was clear that farmers, fisherfolk, indigenous people, local groups, and women’s organisations were all saying no, the UNFFS summit does not represent us. There is no reason to be part of that,” Belay said.

Belay believes that the Committee on World Food Security (CFS) should have been responsible for organising the Summit.

“This is a space where the civil society in general and the civil society mechanism and governments come together to negotiate about food-related issues, so the agenda should have been set there,” he said, adding that, “the UNFSS has set up a scientific body as part of the structure, but we already have a scientific body in the CFS, that is called the High-Level Panel of Experts on Food Security and Nutrition. It is a scientific body, and you can say that we need to beef up this body, but they have established a totally different scientific body.”

While expectations from the summit differ, the experts are unanimous in their view that the world is in urgent need of radical change in how food is grown, sold and distributed to tackle food insecurity, land degradation and rising poverty.

“(The Summit) is one step on a very, very long journey. Perhaps more than ever, as the UN General Assembly opens, we feel the weight and burdens of non-sustainability in the world,” said Jeffrey Sachs, Director of the Center for Sustainable Development at Columbia University.

Sachs says the transformation to sustainable development will demand deep energy and fiscal policy change.

With land-use accounting for about 30 percent of all greenhouse gas emissions and ensuing issues like deforestation and loss of habitat, he is calling for fundamental change in land-use policies across the globe, adding that current, unsustainable use is a ‘massive contributor to crises the board.’

Another aspect of the complex global food system that requires urgent attention is the need for healthy diets.

“About half the world does not have a healthy diet. Of the 8 billion people on the planet, roughly 1 billion live in extreme hunger. Another 2 billion live with one or more micronutrient deficiencies, anaemia, vitamin deficiencies or omega-three fatty acid deficiencies, which are absolutely debilitating for health. Another billion people are obese,” Sachs said.

This week’s UNFSS hopes to get commitments from governments, the private sector, farmers and indigenous groups to work together and change global food production and consumption.

By tackling the food crisis, organisers hope to address the climate, biodiversity, and hunger crises.

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Immigrant Health Professionals have lots to offer Canadian society, but often face barriers.

By Shafi Bhuiyan and team of ITMDs
Toronto, Canada, Aug 27 2021 (IPS)

Albert Einstein said, “In the midst of every crisis lies great opportunity.” The year 2020 was a year of crisis across many sectors in Canada, especially the health care sector. There was a severe strain on the health care system through long waiting lists for family physicians, specialists, and vaccination clinics, and Intensive Care Units were working at a high level of capacity.

People’s Charter for Health describes health as a reflection of a society’s commitment to equity and justice. Health equity is not complete without equity in opportunities for medical professionals from all backgrounds to practice medicine.

Canada’s healthcare system has faced many challenges, including but not limited to long waiting times, geographical disparities, an aging population, and limited access to personal doctors and specialists. The COVID-19 pandemic further brought to light the gaps in healthcare and how opening career pathways for internationally trained medical doctors on the front lines could only be beneficial.

The Canadian demographic pattern is changing through globalization and immigration policies – hence diversity matters. There are increasing numbers of internationally trained medical doctors (ITMDs) who can work in Canada’s health care system but struggle to pursue their careers after moving to Canada due to bureaucratic and other obstacles. The ITMDs can contribute to our health care system alongside Canadian graduates. They also bring culturally sensitive care and in-demand language skills to Canada’s increasingly diverse population. 

Systemic barriers exist in Canadian healthcare for immigrants; hence, inequity in the system needs to be addressed by providing culturally respectful services. ITMDs can ensure equal opportunities to contribute to health services (i.e., indigenous community, aging population, immigrants, and migrant workers).

There is a rising demand for health care talent across the globe. Canada will face increasing competition with other countries to attract such a talented and qualified workforce. Without proper pathways for ITMDs to pursue their careers in Canada, ITMDs will eventually choose to migrate to countries that would enable them to have fair and clear pathways of integration into the healthcare system that will utilize their expertise.

Systemic barriers and inequity exist, and as a result, over 13 000 immigrant doctors are not called ‘Doctor’ in Canada. Only 26.4% of the total number of physicians in Canada are internationally trained medical graduates.

However, In Ontario, hospital care is overwhelmed with an estimated backlog of almost 257,000 surgeries. Also, Canada is the 12th lowest among OECD (Organization for Economic Cooperation and Development) countries in the number of doctors per 1000 population. This implies the need for more doctors in Canada, which can be achieved by opening more opportunities for the thousands of international medical graduates in Canada to practice medicine.

However, it can be argued that the number of doctors has increased by 1.8% from 2018, with a total of 5.2% between 2015 and 20191. Additionally, the number of international medical graduates becoming family physicians in Canada has increased from 28.7% in 2015 to 30% in 20191. Can this be interpreted as increased opportunities for internationally trained medical doctors? The answer to this question requires further exploration of opportunities and residency match processes. Internationally trained specialists with multiple years of training and expertise choose to do family medicine in Canada as the process gets extremely difficult for the specialists to do their respective courses in Canada. This is also evidenced by ITMDs being only 17% of practicing surgical specialists compared to 30% of practicing family physicians.

Furthermore, we cannot ignore that international graduates with specialty training from only certain countries are recognized to pursue Royal College Certification in their respective specialties. However, graduates with specialty training from all other countries have to undergo compulsory residency training despite years of experience in their respective fields.

A recent survey conducted in 2021 by the Internationally Trained Medical Doctors program at Ryerson University showed that 35% of the international graduates who participated in the survey have completed all necessary licensing exams but have not yet been able to secure a residency position. Likewise, 47% of immigrants with internationally obtained post-secondary health education credentials are underutilized: they are either unemployed or work in non-health occupations that require only a high school diploma. Also, the World Health Organization projects a worldwide shortfall of approximately 18 million health care workers by 2030, with certain consequences for patients, economies, and communities. This shortage may fuel global competition for skilled health workers.

Internationally educated and licensed doctors face differential access to opportunities to meet the requirements to practice medicine compared to those trained in Canada. While most immigrant doctors are required to do additional residency training here, there are very limited spaces available. In 2020, only 418 ITMDs obtained a residency position, while 2,895 medical graduates trained in Canada were matched to residency programs. At the end of the match, 56 residency positions were unfilled, 49 of which were in Family Medicine. Furthermore, of the spaces reserved for ITMDs, a majority were filled by Canadians who went abroad to study medicine. On the brighter side, however, 83% of Canadians agree that we should do more to ensure that doctors trained internationally have a fair and reasonable opportunity to practice medicine in Canada.

Hopefully, we will soon reach a stage where we, ITMDs, could look back and say that our time has finally come! Policymakers need to consider existing barriers and take steps forward in utilizing immigrants’ skills to address our society’s demands. ITMDs, let’s stay strong together–tomorrow is a new day! Diversity matters. Together, let’s act now to make our Canadian health system equity-focused and accessible to all.

• The authors are from Asia, the Middle East, Africa, and South American countries.
• The co-authors are Drs Bhuiyan S, Azam S, Krivova A, Orin M, Mukoko P, Radwan E, Adelekan O, Abdulhameed M, Mehrotra M, Anuradha D, Gaby V, Tasnim N, Abolurin A, Dare A, Telchi J, Mariano K, Bukhari S.

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Dr Shafi Bhuiyan is pictured here with a team of ITMDs. Foreign-trained doctors are underutilized in Canada despite shortages of trained personnel.

By Shafi Bhuiyan and team of ITMDs
Toronto, Canada, Aug 20 2021 (IPS)

Canada is ranked number one out of 78 countries globally, with the highest marks in social purpose indicators, emphasizing human rights, social justice, and racial equity commitment, according to a recent U.S. News & World Report survey.

The country follows the Equity, Diversity, and Inclusion (EDI) principles, incorporating them into research and workplace environments, and it acknowledges challenges vulnerable populations face. Adopting these principles in every aspect of people’s lives makes Canada one of the most attractive places for numerous immigrants worldwide, with more than 13 000 internationally trained medical doctors (ITMDs) calling Canada home.

Canada’s health care is based on social equity fundamentals, having universal health coverage for essential medical services free of charge. Nevertheless, in 2019, about 4.6 million Canadians claimed that they do not have regular medical practitioners to seek advice or help.

In 2020, the highest record of 10.5 weeks waiting time from a family physician referral to specialist consultation was documented, with additional 12.1 weeks interval before treatment was initiated.

The COVID-19 pandemic aggravated these issues resulting in about 16 million healthcare services backlogs in Ontario alone. These will need up to almost two years to be resolved.

At the same time, Canada possesses significantly underutilized skilled healthcare professional resources trained abroad. According to the survey conducted among recent ITMDs graduates, 35% have passed the required licensing exams, including Medical Council of Canada Qualifying Examination Part I (MCCQE1), the National Assessment Collaboration Objective Structured Clinical Examination (NAC OSCE). This means they are eligible to enter the residency.

Very few will secure a residency position. The residency quotes retrieved from the Canadian Resident Matching Service (CaRMS) website showed that only 325 out of 3,365 (less than 10 %) spots were available for international medical graduates (IMGs) for the first iteration of the 2021 matching process.

Out of 1,358 IMGs participants, 948 (almost 70%) were unmatched this year partly due to a lack of transparency and understanding of the process rules.

Not to mention the cost associated with licensing examination, the CaRMS application process is a significant financial burden and even a barrier in many cases for the newcomers. According to Statistics Canada report, 47% of foreign-educated health professionals are either unemployed or employed in non-health-related positions that required only a high school diploma.

Nevertheless, internationally trained medical doctors play a significant role in fighting the COVID-19 pandemic, supporting the vaccination clinics, working as contact tracing managers and mental health advisors.

Another issue that needs an urgent solution is physician wellbeing. A recent study in Vancouver showed that the burnout rate reaches 68% among doctors, with 63% feeling emotionally exhausted and 39% depersonalized. Moreover, 21% of them had resigned or have thoughts about leaving their career.

On top of that, the aging population required complex care, along with a growing diverse population of Canada, underserved racialized, and newcomers’ communities need a considerate strategy to encompass community-based, culturally sensitive approaches to health care.

The ITMDs is a culturally diverse group with rich experience in different fields of medicine and research. Thus, foreign-educated health care professionals are fit perfectly to engage underprivileged communities, promote health and disease prevention, and manage multiple health priorities. Hence, the integration of internationally trained health care professionals could be a turning point to solve the current and prospective issues.

Moreover, 80% of Canadians stated that they feel comfortable being cared for by doctors who obtained mainly their training outside Canada, with 83% claimed that it should be more action to ensure fairness and opportunities for IMGs to practice medicine.

The question is: Why are internationally trained medical doctors still sidelined? The action is for the government to bring Equity, Diversity, and Inclusion (EDI) principles into the Canadian health care system.

Thus, a clear roadmap to integrate internationally trained healthcare professionals is necessary to address all existing challenges and strengthen Canada’s health care system. A move considered to be highly beneficial for all stakeholders (patients, physicians, ITMDs, government).

Collaboration is vital to move forward and make the ‘no one left behind ‘strategy a reality.

• The authors are from Asia, the Middle East, Africa, and South American countries.   
• The co-authors are: Drs Bhuiyan S, Krivova A, Orin M, Azam S., Shalaby Y, Tasnim N, Badran H, Al-Chetachi W, Radwan E, Tazrin T, Biswas M, Min K. S, Mehrotra M, Anuradha, Quintanilla E, Begum N, Adhikary I, Fatima N

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Yohei Sasakawa, WHO Goodwill Ambassador for Leprosy Elimination answers questions from Patricia Soares, a guest at the launch of the ‘Don’t Forget Leprosy’ campaign. They are with Takahiro Nanri, Executive Director of the Sasakawa Health Foundation. Credit: Cecilia Russell

By Cecilia Russell
JOHANNESBURG, SOUTH AFRICA, Aug 4 2021 (IPS)

A visit to a leprosy facility in Korea with his father, Ryoichi Sasakawa, spurred Yohei Sasakawa to dedicate his life to eliminating both the disease and discrimination of those affected.

He was speaking in an emotional pre-recorded address ahead of his 20th anniversary as WHO Goodwill Ambassador for Leprosy Elimination and at the launch of a 10-month ‘Don’t Forget Leprosy’ campaign by the Sasakawa Leprosy (Hansen’s Disease) Initiative.

Sasakawa said while he had achieved much in the 20 years, including getting the UN General Assembly to adopt the guidelines for eliminating discrimination of people affected by leprosy, also known as Hansen’s disease, the COVID-19 pandemic threatened the success of an international campaign to eradicate the disease.

In the past 18 months, while the world grappled with the pandemic, there was an estimated 30% to 50% decrease in detecting new leprosy cases. This could lead to increased transmission of the disease and more cases of disability, the webinar heard. In many communities, protocols, including lockdowns, had made it difficult to access treatment. This resulted in a loss of livelihoods and exacerbated discrimination that people affected by leprosy often face.

“Even amid the pandemic, it is very important that everyone involved in leprosy work continues what they are doing. We must not allow leprosy to be forgotten,” Sasakawa said.

Special guest Dr Poonam Khetrapal Singh, Regional Director, WHO Regional Office for Southeast Asia, said the pandemic could undo decades of progress unless addressed.

“Let us be clear COVID-19 will be with us for some time. It is not enough to maintain minimal leprosy services. Rather such services must be restarted or expanded, with a focus on intensifying outreach activities to identify cases and begin treatment to all who need it,” Singh said.

However, as much as the pandemic was a threat, it had also allowed a focus on new technologies.

For many months now, “e-learning materials have helped community volunteers identify potential leprosy cases, and then refer them on to health workers,” Singh said. This was being extended to counselling and mental health support and should be harnessed in this campaign to fight both the disease and discrimination of those affected.

Sasakawa said in his 20 years as a goodwill ambassador, he had been on 200 trips to 100 countries. Here he spread the message of eliminating both disease and discrimination.

In his keynote address, he likened his campaign to a motorcycle with the front wheel symbolising the elimination of the disease and the back wheel eliminating discrimination.

“Both wheels must turn at the same time if we are to make progress toward a world without leprosy and its associated problems,” he told the webinar. This symbol is included in the campaign’s logo.

During an extensive question and answer session, Sasakawa said it was crucial that those affected return to work to support themselves. There were several initiatives, beyond just speaking to top politicians, that could be used.

These initiatives included reskilling but also included getting big businesses involved in the employment of people with disabilities. Sasakawa referred to the Valuable 500 project, launched in 2019 at World Economic Forum in Davos, Switzerland. This project, supported by the Nippon Foundation, called on the top 500 companies to promote the inclusion in business of people with disabilities.

Sasakawa said while he was a person who “believes the solution lies in the field”, the pandemic taught him it was now crucial to include new technology – webinars and social media – in the tool kit to end the disease and discrimination.

“Today, thanks to these technological tools, we are able to share the best practices that are happening in various countries and share with the world,” he said.

The Initiative is a strategic alliance between WHO Goodwill Ambassador for Leprosy Elimination Yohei Sasakawa, The Nippon Foundation and Sasakawa Health Foundation for achieving a world without leprosy and problems related to the disease. Since 1975, The Nippon Foundation and Sasakawa Health Foundation have supported the national leprosy programs of endemic countries through the WHO, with support totalling some US$200 million to date.

Leprosy is an infectious disease that mainly affects the skin and peripheral nerves. Around 200,000 cases are newly reported each year. Leprosy is curable with multidrug therapy but, left untreated, can result in permanent disability. An estimated 3 to 4 million people in the world today are thought to be living with some form of disability as a result of leprosy.

The campaign will feature a total of six webinars, online media briefings, TV and radio spots, social media messaging and videos featuring the Goodwill Ambassador. It will also incorporate other awareness-raising activities, including the annual Global Appeal to End Stigma and Discrimination against Persons Affected by Leprosy issued at the end of January.

Logistic and communication challenges to rolling out the COVID-19 vaccine are immense in the rural and remote highlands region of Papua New Guinea. Credit: Catherine Wilson

By Catherine Wilson
CANBERRA, Australia , Jul 13 2021 (IPS)

Papua New Guinea (PNG), like many other Pacific Island countries, successfully held COVID-19 at bay last year, aided by early shutting of national borders. However, by March this year, the pandemic was surging in the most populous Pacific Island nation, and by July, it had reported 17,282 cases of the virus and 175 fatalities.

PNG has a steep battle against the virus ahead, made more problematic by a high rate of refusal by health workers to take the vaccine. PNG’s Health Minister, Jelta Wong, stressed in an interview with Australia’s Lowy Institute for International Policy in April that “the vaccine will be the key to containing COVID-19 in our country.”

But in Eastern Highlands Province in the country’s rural interior, Dr Max Manape, the province’s Director of Public Health, told IPS that “in our province, there is a huge COVID-19 hesitancy due to so much negativity of COVID-19 vaccinations in social media and we are finding it very hard to convince our fellow frontline workers, including health workers.” By early July, only 23.3 percent of all health and essential workers in the province were vaccinated, including 329 health workers.

The situation is causing wider community concern. “Health workers are the frontline and first responders in this pandemic, and their refusal places them at a greater risk to contract the virus. This will lead to the feared collapse of our struggling health system, and the roll-on effect of other deaths from preventable diseases and maternal health issues created by a lack of manpower,” a spokesperson for the PNG National Council of Women told IPS.

In April, the country was supplied with 132,000 doses of the AstraZeneca vaccine, the first batch of a total supply of 588,000 doses by COVAX, the global alliance of organizations, including the World Health Organization (WHO), working to achieve equitable vaccine access. The Australian Government also supplied eight thousand doses. The national vaccination rollout began in early May, with priority given to frontline responders.

Yet progress has been very slow. By this month, only 59,125 people in a national population of about 9 million had been vaccinated, including 7,844 health workers. The largest group of healthcare recipients, about 1,150, were located in the capital, Port Moresby.

PNG’s Health Minister says there are numerous challenges to achieving widespread inoculation. “In this country, we’ve never had an adult vaccine go out, we’ve always had the children’s ones, and that has worked really well. It is going to be a real challenge for us to do this vaccination rollout…The biggest thing will be education. Our people need to be educated enough to know that this vaccine will help them in the future,” Wong said.

More than 80 percent of people in PNG live in rural and remote areas where logistic and communication challenges are the greatest. Here scepticism of the vaccine is high. Only 12 percent of all health and essential workers in remote Enga Province in the northwestern highlands region have been vaccinated. “The uptake of the vaccine is very poor in Enga Province. Frontline health workers at the hospital have mostly refused the vaccine,” Dr David Mills, Director of Rural Health and Training at Kompiam District Hospital in the province, told IPS.

However, it’s a nationwide issue. PNG’s newspaper, The National, conducted a public online survey last month, reporting that 77 percent of respondents did not want the vaccine. In May, a survey of students at the University of Papua New Guinea by the Crawford School of Public Policy at the Australian National University, Canberra, revealed a high level of indecision among respondents. Only 6 percent said they would accept the vaccine, 46 percent had not decided either way, while 48 percent planned to refuse it.

Doctors and health care leaders claim that major reasons for the low uptake are cultural and religious opposition, misinformation and conspiracy theories being touted on social media. And lack of public trust in the country’s health system, which, for decades, has struggled with an insufficient workforce, very poor infrastructure, and resources.

However, Dr Mills said that the government was very active in responding to conspiracy theories with facts and authoritative health information. “There is plenty of information, too much information. It’s a blizzard of information but sorting it out is the hard part. Keep in mind that there is a high level of mistrust and scepticism generally in this society. People don’t take anything at face value. It’s fertile soil for believing alternative hypotheses,” he said.

Confusion was one of the biggest reasons for indecision among respondents to the Australian National University’s survey. And they were more likely to trust the information provided by local Christian leaders (32 percent), followed by family and friends (31 percent) and the WHO (29 percent). In contrast, faith in the government as a source of information was negative (-8) percent, leading to the study’s conclusion that ‘distrust of institutions of authority and vaccine hesitance goes together.’

Despite having an economy based on natural and mineral resource wealth, PNG has a relatively low human development ranking of 155 out of 189 countries and territories, and basic service delivery beyond urban centres, hindered by lack of investment and corruption, has been deficient for decades. There are 0.5 physicians and 5.3 nurses per 10,000 people in the country, according to the WHO.

Distrust of the vaccine by healthcare staff has consequences. “High vaccine refusal amongst health workers, particularly nurses, confuses the general public and fosters vaccine scepticism. And unvaccinated health workers can be a danger to the very vulnerable patients that we have as inpatients in hospitals,” Professor Glen Mola, Head of Reproductive Health, Obstetrics and Gynaecology at the School of Medicine and Health Services, University of Papua New Guinea in Port Moresby, told IPS.

Although uptake by health staff in the capital could change following a new ruling at the Port Moresby General Hospital. “Recently, the hospital board approved a policy of the hospital management that any new health workers, contract renewals and trainees, like interns and medical students, must be vaccinated before they can enter the clinical care areas of the hospital,” Professor Mola said.

However, in the highlands, Dr Mills said the challenges were too great for vaccinating everyone. “For the broader population, vaccination was never going to be the way out (of the pandemic). The uptake is too small, the delivery too small, and delivery mechanisms too weak. We will get to herd immunity the hard way, which is by getting most people infected,” he claimed.

Nevertheless, in June, further funding of US$30 million was approved by the World Bank to boost PNG’s COVID-19 inoculation program, where it is now being offered to all citizens aged 18 years and over.

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A small boy plays with his toys. Poor nutrition in Zimbabwe is exposing vulnerable children nutrition to mental health challenges according to humanitarian agencies. Credit: Ignatius Banda/IPS

By Ignatius Banda
BULAWAYO, Zimbabwe, Jan 12 2016 (IPS)

Mildren Ndlovu* knows the mental toll of Zimbabwe’s long-drawn economic hardships in a country where a long rehashed statistic by labour unions puts unemployment at 90 per cent.

Ndlovu, a 27-year-old single mother is raising two children, both under 5-years old, and survives on menial jobs such as doing laundry and dishes in neighbouring homes, says she has watched their health deteriorate and not just physically.

“I know they are not growing up the way other children are,” Ndlovu said, as she changed the underwear of her four-year who had just soiled himself.

“At his age, he should be able to visit the toilet by himself, yet I still have to change him,” she said from her one roomed shack in one of Bulawayo’s poor townships that litter the city’s north.

Ndlovu’s concerns about the slow development of her children point to the broader effects of Zimbabwe’s economic decline on vulnerable groups, with the UNICEF early this month releasing the Zimbabwe Poverty Atlas 2015 (http://unicef.org/zimbabwe/resources_17478.html) showing high poverty levels across the country that are affecting children’s mental health.

At the launch of the report, UNICEF, the World Bank and government officials said the poverty atlas is an attempt recognise that “Children are rarely recognised in poverty alleviation efforts and their needs are not properly addressed.”

According to the report, no child from the poorest health quintile reaches higher education, with eight of the country’s ten provinces registering poverty levels between 65 and 75 per cent.

“Child poverty has reduced (their) mental health and is reponsible for poverty when they are adults,” said Dr. Jane Muita, UNICEF’s deputy resident representative in Zimbabwe.

“It (child poverty) results in lower skills and productivity, lower levels of health and educational achievement,” Dr. Muita said.

According Zimbabwe’s health and child welfare, the country has witnessed an increase in mental health diagnoses, and has put in place a Mental Health Strategy 2014-18 to deal with the crisis.

The ministry blames the tough economic conditions that have thrown millions into the streets of unemployment.

There are no available figures of how mental health has affected children, but concerns by parents such as Ndlovu are giving a human face to a crisis that has been highlighted by the UNICEF report on child poverty and their mental health.

In some parts of Zimbabwe in the south-west districts such as Nkayi were found to have up to 95.6 per cent of poverty, while Lupane poverty levels stood at 93 per cent according to the UNICEF’s Zimbabwe Poverty Atlas.

There are concerns that this will slow the country’s march towards realising its Sustainable Development Goals to reduce child poverty by 2030.

Last year, the Zimbabwe Vulnerable Assessment Committee found that up to 36 per cent of children in Zimbabwe have stunted growth which experts say has not only affected them physically, but has also slowed their mental growth because of poor diets.

“The problem with children’s health and their mental development is that the attitude of both parents and some health workers is that these children will soon grow out of these challenges,” said Obias Nsamala, a Bulawayo pediatrician.

“But what I have seen with many children under 5 years is that these mental deficits can be detected when they come for treatment but only become an issue by the time they have began school. I think that is why for a long time this country had something like special classes for children not intellectually gifted,” Nsamala told IPS.

“I believe its been a wrong approach because some of these children may be slow learners or intellectually challenged not because of some genetic deficit but because all the signs were ignored earlier on based on their backgrounds and access to adequate meals,” he said.

As the country seeks to improve the lives of vulnerable groups such as children with government officials saying the country needs to grow the economy in order to reduce poverty, there is no consensus on how exactly this will be achieved to attract investment, with the country continuing to rely on international development partners to create safety nets for the poor.

From 2014 to June last year, UNICEF says it spent 363 million dollars on social services, this at time the country’s critical social services ministries are facing budget cuts which officials have admitted made it impossible to provide adequate assistance such as health care.

Under the 2016 national budget, the health and child welfare ministry received 330 million dollars which will largely be funded by donor countries, leaving a huge deficit which Minister David Parirenyatwa said is not enough to meet such such sectors as the poorly funded psychiatric clinics.

Perhaps to highlight these funding challenges, officials at the country’s largest psychiatric institution which caters for adults, Ingutsheni Hospital in Bulawayo early this year told Minister Parirenyatwa that the mental health hospital requires 23 doctors but only had six.

The social welfare ministry, also previously offering financial support for vulnerable group’s such Ndlovu’s children, has complained of poor funding from government.

Aid agencies say millions will require food assistance in 2016, further pushing Ndlovu and many others on the edge of what UNICEF’s Poverty Atlas says are their mental needs.

*name changed to protect her identity

(End)

By Jo Baker
LONDON, Jan 7 2016 (IPS)

It is a grim fact that prisoners in most countries suffer from poorer health than non-prisoners, and that their right to health is not always protected. But for certain groups these rights can be even more elusive. Such is the case for women.

Jo Baker

For me, this was starkly illustrated during a visit to the clinic of a large women’s jail in the southern Philippines. Here, a very thin woman lay curled and still on a narrow wooden bench. Her hands were cradling her taut, bloated stomach, her eyes tightly closed. The nurse explained that she was an addict, arrested while heavily pregnant for drug possession (a sentence that keeps the country’s women’s jails lamentably stocked), and that her baby had died days earlier in a government hospital because of a condition related to her drug use, after a complicated labour. Being understaffed and short on medicine and beds in the prison, the best treatment she could offer the woman on her return, as she faced her withdrawal, post-labour pain, grief, separation from family, and possible years awaiting trial, were paracetamol, kind words and a bench. Hers would be a particular and gendered kind of purgatory.

In speaking with imprisoned women and healthcare practitioners across five countries, our research team commonly found harmful responses and barriers to healthcare that existed because the inmates were women. These included women who were imprisoned in Jordan while recovering from brutal gender-based violence (including honour crimes and rape), without adequate treatment or rehabilitation; women who prepared for and recovered from childbirth in dirty rooms with little more than substandard prison rations, water and soap; and women who were isolated and punished because of attempts to self-harm or commit suicide. “One girl used the edge of a seafood shell on her wrists,” recounted an inmate in the Philippines. “They scolded her. If you want to die, go ahead, do it now!”

These responses are of course unlikely to be particular only to these countries.

International standards (including the Bangkok Rules) now recognize that because women commonly face certain risk factors and backgrounds, they require a gender-specific framework for healthcare. More women than men suffer from particular diseases, including HIV, hepatitis and some cancers. They have differing sexual and reproductive health (SRH) needs, including those relating for example, to birth, abortion and the menopause. They are more susceptible to particular mental health problems. Studies have found self-harm in prison to be up to ten times higher among women than among men, and suicide to also be proportionally higher. This list goes on.

Women (especially those in conflict with the law) are also, crucially, more likely to have been victims of sustained gender-based violence and sexual abuse. Yet prisons, which are increasingly taking in women, are rarely equipped to respond to these forms of trauma. As I was told quietly by one prison healthcare worker, gesturing to a courtyard of around 20 women. “Almost all the women here are mothers, and a lot have maltreatment and molestation in their histories. I can look around and count more than ten women who have been raped. Some have been prostituted by their families. Then drug use comes in and makes it a vicious cycle.”

These and other cultural factors lead to a different sense of shame, which can also work as a barrier to healthcare. For example inmates in Jordan, Zambia and the Philippines told me that they often avoided reporting urinary tract infections and SRH problems to male health staff. Yet some prisons for women don’t employ female doctors, and these issues remain unrecognized, and sometimes debilitating.

My research findings with DIGNITY (see our comparative study here) therefore stress the urgent need for every prison and place of detention to follow a framework for healthcare that is gender-responsive and trauma-informed – one that treats women’s specific health needs, and trains staff accordingly. In just a few facilities did we find gestures towards this.

But not all gender-sensitive health responses are medical. The traditional prison model – designed as a harsh criminal justice response to violent men – remains the basis for many institutions detaining groups that are neither violent, nor male. In the facilities where women told me of harsh disciplinary structures, negative relationships between staff and inmates, and their isolation from caring relationships, they tended to report very low morale, forms of depression, and other signs of serious struggle, such as self harm and hunger strike. This was markedly different in facilities (such the one described here in Albania) that connected the women with the outside community – particularly their children – and gave them tools to cope, learn, communicate and prepare for the future.

Meanwhile, exercise is known to be important to health and morale, and is a right of prisoners under international law (see the Mandela Rules). Yet only in one of five countries, the Philippines, were detained women encouraged and able to exercise every day. In the other countries, exercise and sports facilities of some kind were common only in prisons for men.

Many of our findings on health fell in line with those observed by the former UN Special Rapporteur on Violence Against Women in her 2013 report on women’s incarceration, and they indicated clear and harmful examples of discrimination. Yet in reviewing issues raised by UN treaty body reports, we found women’s health to largely be a gap: UN experts are not giving this area consideration.

The human rights of these women entitle them to better, and must be championed, internationally and in their own countries. As once said by Dostoevsky, society must be judged by the way that it treats its prisoners. Or rather, and as told to me by one mother and survivor of domestic violence, sentenced to life in a Zambian prison: “If you’ve offended, certain things you must accept. But I don’t deserve to pass through some of these things. I came to prison healthy. I’m not intending to leave sick.”

(End)

Excerpt:

A hospital in Srinagar, Kashmir. Credit: Umer Asif/IPS

By Umar Shah
SRINAGAR, India, Dec 18 2015 (IPS)

In an isolated ward of one of Kashmir’s largest government-run hospitals, 54-year-old Ashraf Ali Khan is finding it hard to sleep properly. His 15-year-old son, Asif, is sitting on a bench near the bed staring at his ailing father.

Asif has not been told by his family that his father is suffering from a potentially terminal disease cancer. He knows his father is suffering from a consistent fever which sent him to the hospital, but doesn’t know his father is in the last stage of the crippling disease.

Ashraf Ali, a carpenter, went to the doctor eight months ago after persistent coughing. He had a chest X-ray which then led to further examinations. After series of tests, it was finally he was diagnosed with lung cancer. He has two months to live at best.

Ashraf is among thousands of people who have ben struck down with the disease. In a war-torn Kashmir, about 4000 cases are found every year in this Himalayan region.

Apart from the political uncertainty, which so far has claimed thousands of lives, experts says there is a 20 per cent rise in cancer cases in Kashmir with figures never decreasing. The latest data published by the state’s health department has Kashmir topping the list of cancer cases in India.

The data reveals in the past three years, more than 1,700 people have died due to cancer in Kashmir. It says that since January 2014 there were 12,091 patients who were detected with cancer in various state hospitals. In 2013, 6,300 patients were detected with the killer disease.

The top 10 cancers taking a toll in Kashmir are lung cancer, stomach, colon (large intestine cancers), breast, brain, esophagus (cancer of food pipe), non-Hodgkin’s lymphoma, gastroesophageal, junction cancer (cancer between the stomach and food pipe), ovarian and skin cancers.

Experts say the cancer mortality rate among the people in Kashmir witnessed a sharp increase due to some leading behavioural and dietary risks, including high body mass index, low fruit and vegetable intake, lack of physical activity, tobacco use and lack of regular check-ups. Changing lifestyle, environmental degradation and differing food habits are reasons attributed to the surge in all the cancers especially in esophagus, colon and breast cancers.

Kashmir’s leading oncologist Mohammad Maqbool Lone says the situation in Kashmir is becoming more grim every day a with the highest number of lung cancers In the country found in the people of Kashmir.

“The situation is indeed alarming in Kashmir. There are patients hailing from every part of Kashmir including the far flung areas which are diagnosed with such a terminal disease,” says Lone.

Until now no single factor has been identified as the main cause of the rising cancers as compared to other regions of India. As health experts in Kashmir are not certain about the major causes for the rise of the deadly disease, they suspect three main components can trigger the rise of cancer in this Himalayan region.

One is a societal component with poor rural lifestyles and general deprivation, in particular a lack of vitamins and dietary nutrients.

The second reason for rising cancers in Kashmir is the use of copper utensils in cooking, the consumption of spicy, deep fried foodstuffs, and the drinking of hot salty tea which is largely being consumed in every home in Kashmir.

The third factor in rising cancer cases is an environmental issue with exposure to high levels of dietary nitrosamines from diverse sources. Overall, these three components are the general pattern that has led to esophageal and other cancers.

Oncologist Abdul Rashid Lone says that rising numbers of smokers has led to a rise in lung cancers here. He also claims that the detection rate also has increased besides the advancement in medical technologies.

“Earlier, most of the cancer cases in Kashmir used to go unnoticed. At present, the technology has advanced so much that a patient can be diagnosed with the disease. This is the main reason that today we say cancer cases rise in Kashmir,” Dr Lone said.

Oncologist Riyaz Ahmad Shah says that apart from the lung cancer, there are cases of stomach cancer on the rise in Kashmir. He says certain types of cancers are found in children including blood cancers and tumours.

“In case of females, there are cancers related to the reproductive system like cervical cancer, ovarian tumours and breast cancer. In males there are stomach, lung, and esophagus cancers found,” said Dr Shah.

Renowned gastroenterologist, Dr Showkat Ahmad Zargar, says any delay in the detection of cancer could prove fatal for the patient. He says due to the massive adulteration in food items, gastric diseases are on rise in Kashmir.

“Such diseases are killing people slowly. The people here are not very much health conscious which leads to the delay in detecting whether a person is suffering from a cancer or not,” Dr Showkat said.

“There are high chances that a person suffering from cancer can be cured if detected at early,” said Dr Sana-ul-lah who heads the oncology department in one of Kashmir’s leading government run hospitals.

Tobacco use in Kashmir has increased along with unhealthy diets. “If the key risk factors are avoided, Kashmir could be saved from this fatal disease which continues to claim thousands of precious lives every year in the region,” Dr Sana-ul-lah said.

Insha Usman, a research scholar says there are no major steps being taken by the state government to ensure that people are informed and are aware of cancer. She says early symptoms and preventive measures should be made public in far flung areas of Kashmir so that people are conscious of the cancer threat.

“Ironically, there is no comprehensive policy available with the government at the present time that could have made people aware of such a fatal disease. Mass awareness campaigns in villages and towns and people are informed about the symptoms of cancer and early treatment,” she said.

According to the latest study, colorectal cancer (CRC) is the major cause of mortality and morbidity worldwide and in Kashmir, CRC has been found to be the third most common gastrointestinal cancer after esophageal and gastric.

The study says there are certain factors which increase person’s risk of developing CRC. “The most important of these are the age, diet, obesity, diabetes and smoking, personal cancer history, alcohol consumption, large intestinal polyps, family history of colon cancer, race and ethnic background, genetic or family predisposition,” said the finding.

It adds that another major cause of cancer deaths was a late visit to the doctor. “The involvement of quacks, inexperienced medical practitioners and post-referral delays make the situation difficult to handle,” the study concluded.

The steady rise in cancer patients began several decades ago leading to the establishment of an NGO. The Cancer Society of Kashmir, formed in 1999, provides medical and financial help to poor patients suffering from the dreadful disease here.

Masood Ahmad Mir from Cancer Society of Kashmir says that they have started a one-day care centre which runs twice a week. “During this time, doctors from different fields like medical oncology, radio oncology, and gastroenterology sit together and treat patients. We do not charge anything from the people who visit us for the treatment,” he said.

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By Vani S. Kulkarni and Raghav Gaiha
PHILADELPHIA AND BOSTON, Nov 10 2015 (IPS)

Few dispute that women’s autonomy and betterment of their lives are moral imperatives. But whether these are also key to economic development is contested.

In an admirably cogent article, Esther Duflo (2013) evaluates a bi-directional relationship between women’s empowerment and development. Although somewhat overemphatic about the role that development alone can play in driving down gender inequality, she highlights that affirmative action has an important role, too. Amartya Sen, in several influential writings, however, has forcefully argued that continuing discrimination against women can hinder development. We are inclined to this view as “masculinity” is unrelated to development.

Dominance and control over women are set in male attributes and behaviour (“masculinity”), regarded as a shared social ideal. Masculinity is characterised by two factors — namely, “relationship control” as a behavioural attribute and “attitudes towards gender equality” as an underlying value. Behavioural changes are, however, slower than changes in male attitudes (UNFPA, 2014).

Women’s empowerment is defined “as improving the ability of women to access the constituents of development—in particular health, education, earning opportunities, rights, and political participation” (Duflo, 2012).

Gender equality and empowerment of all women and girls are enshrined in SDG 5. This is an ambitious goal. The litany of sub-goals is impressive but daunting. These include ending of all forms of discrimination against all women and girls; elimination of all forms of violence against them in the public and private spheres, including trafficking and sexual exploitation; ensuring their full participation in opportunities for leadership in political, economic and social spheres; universal access to sexual and reproductive health and reproductive rights; and equal rights to all economic resources including land.

Duflo argues that gender inequality is often greater among the poor, both within and across countries. Moreover, within countries, gaps between boys and girls persist in poorer and more isolated communities. But economic growth, by reducing poverty and expanding livelihood opportunities, has the potential for reducing gender inequality.

Are girls treated differently than boys? Yes, but only during crises. In India, for example, the excessive mortality rate of girls, relative to boys, spikes during droughts. So, in extreme circumstances, improved access to health services would disproportionately help girls, even if parents do not change their behaviour toward them. This flies in the face of mounting evidence of female foeticide, infanticide and pervasive neglect of girls in education, and wage disparities in some of the more affluent northern states in India. In fact, the selective abortion of female foetuses, usually after a first born girl, has increased over the past few decades, and has contributed to a widening imbalance in the child sex ratio. Cultural taboos prevent women from reporting, for example, gynaecological disorders unless they become acute. So we are far less sanguine about improved access to health services as a by-product of growth –a somewhat dubious proposition in itself – benefiting girls and women disproportionately.

At all level of incomes, women do the majority of housework and care and, correspondingly, spend less time in market work. Constrained in these ways, they are more likely to be engaged in informal but hardly remunerative home-based enterprises. So if economic development frees their time, they are more likely to switch to more productive activities. But this overlooks the imperfections of credit markets that deny them credit for being not creditworthy. Besides, social norms restrict their mobility.

Are labour market outcomes likely to be more favourable? A recent World Bank study (2015) is far from reassuring. It reports that in the workplace, females earn between 20 per cent and 80 per cent lower average wages than do males, depending on the country. Evidence from India’s Labour Bureau is more definitive. The data show that there has been little progress in terms of parity of salaries for men and women for equivalent work. Even more alarming is the fact that, in some spheres of activity in rural areas, the divide has widened. As of 2013, the discrimination in wages paid to women tends to be higher in physically intensive activities (such as ploughing and well-digging), but lower in the case of work such as sowing and harvesting.

So development alone will not accomplish much –indeed, much less than conjectured by Duflo – in empowering women. She doesn’t of course overlook the case for affirmative action to ensure greater participation of women in the political, economic and social spheres. But she remains sceptical of women’s empowerment contributing substantially to development as women are not always the best decision-makers.

Let us consider two examples from her research in which women made a positive contribution to development.

In an earlier but highly influential study (with Chattopadhyay) of Panchayats (village councils) in two Indian states, headed by women elected through quotas, it is demonstrated that these Panchayats invest more in infrastructure that is directly relevant to the expressed development priorities of women. In West Bengal, for example, where women complained more often than men about water and roads, the Panchayats invested more in water and roads. In Rajasthan, where women complained more often about drinking water but less about roads, the councils invested more in water and less in roads. Whether such choices would have been made in the absence of quotas for women heads of Panchayats is highly unlikely. Besides, there may be dynamic gains through changes in male attitudes towards women as decision-makers. Questions, however, remain about complaints by women as a preference revelation mechanism in a rural setting, as also about women Panchayat heads’ autonomy or ability to ignore or circumvent investment allocation priorities handed down from “above”.

In a test of whether income in the hands of women of a household has a different impact on intra-household allocation than income in the hands of the men, she found that pensions received by women in South Africa translated into better nutrition for girls. In contrast, no such effect was found when the pension was received by a man and no corresponding effects were obtained for boys.

Duflo is, however, far from convinced that women generally make the best decisions for development and thus there is a real risk of exaggerating their contribution. The fact that returns on loans given to women to run small enterprises are lower (or even zero) relative to those run by men is not conclusive evidence of women entrepreneurs’ inefficiency. This is a muddled inference for two reasons: as noted by her, women are often compelled to engage in home-based but hardly remunerative enterprises by their family responsibilities and binding time constraint. Relaxation of not just this but other constraints enhances their returns substantially.

A recent World Bank study (2015), as a synthesis of empirical evidence, is illuminating.

Women running subsistence-level firms are prone to external pressures to divest some of the cash from loans or grants to relatives or household expenses.

Evidence shows that women’s demand for saving accounts is high. A review of nine randomized field experiments in countries covering different regions (including Kenya, Philippines, Nepal and Guatemala) shows that savings are a promising way to improve rural women’s productivity. In Western Kenya, for example, women with access to savings accounts invested 45 percent more in their businesses and were less prone to sell business assets during health emergencies.

Capital in-kind (e.g. a physical asset such as livestock) works better than in cash to nudge women to keep the money in the business rather than to divert it for household use or pass it on to relatives.

Many of women’s additional constraints can be overcome by simple, inexpensive adjustments in programme/intervention design.

A two-month grace period versus immediate repayment requirements for poor urban women borrowers in Kolkata, India, significantly raised long-run (three-year) business profits by encouraging risk taking.

Women enjoy greater autonomy if they are able to use mobile money services to conduct financial transactions in private, receive reminders to save and obtain information on prices in real time without having to travel long distances.

Panel household survey data for Bangladesh, covering a twenty-year period, show a beneficial effect, greater for females than for males, of 20-year cumulative microcredit borrowing on household per capita income and the reduction of extreme poverty.

Business skills matter. A vocational training programme in slums in New Delhi imparting skills in tailoring enhanced employment, self- employment and earnings of women but attrition rate was high due to lack of child care support and distance.

In conclusion, the evidence supports the view that economic development and women’s empowerment reinforce each other. If women’s empowerment is a by-product of development, it is just that. That women’s empowerment is a major driver of development is contested but highly plausible.

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Excerpt:

By H.R.H. Princess Sarah Zeid
AMMAN, Oct 30 2015 (IPS)

The 193 member states of the United Nations have adopted an ambitious 15-year sustainable development agenda, the 2030 Global Goals.

H.R.H. Princess Sarah Zeid

To enter through the school gates, I had to negotiate a fetid stream of sewage, broken glass and garbage. The condition of the school building itself was terrible, and even worse were the bathrooms. You could see their appalling state because they had no doors, and thus, zero privacy. All this in a place where the temperature can reach above 120 degrees Fahrenheit (49 degrees Celsius) – it was so hot I felt as if my cheeks were frying.

I look back at this now through the eyes of a mother, and my horror is all the greater. No girl could go to this school, because no girl could go to the bathroom. No child could safely attend this school, because no child could do so without being exposed to disease.

With daughters denied education, confined to home and sons locked in a cycle of exposure to ill health, how can we expect women to participate in commerce, politics, peace and sustainability? How do we think the next generation is going to be educated, skilled and healthy enough to make a positive contribution?

The solutions to women’s and children’s dignity, health and wellbeing lie well beyond the health sector alone, and demand instead an integrated approach, including solutions that deliver water, sanitation and hygiene (WASH) in health and in education.

No one’s needs divide neatly into our professional sectors, and sustainable wellbeing and prosperity will not come from fragmented interventions. A holistic approach spanning across all these domains is urgently needed.

The linkages between WASH, health, education and nutrition for that matter are stark. In the Democratic Republic of the Congo, for example, more than half the cases of measles in the country are caused by lack of clean water, and poor WASH conditions are a leading cause of malnutrition.

Illness and death in childbirth, and in maternal and child health, are not only the result of the lack of access to quality medical care, nursing or pharmaceuticals. They also happen because nearly 40 per cent of health facilities worldwide have no source of water.

In low-income countries – where preventable mortality is at its highest – an estimated 50 per cent of health care facilities lack access to the electricity they need to boil water and sterilize instruments.

WASH also helps promote gender equality. If water, sanitation and hygiene are designed so that the practical burdens women carry daily are reduced, they will be able to play broader and more creative roles in their community’s development, paving the way towards equitable development in countries and globally. Everyone benefits from these contributions.

There is recognition of the importance of joining up. Last autumn, 16 researchers from the World Health Organization, Unicef, WaterAid and others came together to call for action on joining water, sanitation and hygiene to efforts on maternal and newborn health. The World Health Organization has launched an action plan to address the need for water, sanitation and hygiene in healthcare facilities.

This new sustainable development agenda and, quite frankly, the state of the world today, demands of us another dimension of this integration, too: an integration of our development and humanitarian efforts.

The renewed Every Women Every Child Global Strategy for Women and Children’s Health is working to make this happen. Headed by the Office of the UN Secretary General and supported by a global movement of governments, philanthropic institutions, multi-lateral organizations, civil society organizations, the business community and academics, the renewed Strategy gives new priority to humanitarian and fragile settings and pledges the needed integration to save more lives as life is given.

After all, the right to live life in dignity, the rights to health and to water and sanitation are human rights, universal and indivisible. They are rights to be upheld even in the toughest of situations and at the hardest of times. However, without joined-up pipelines of delivery to enable that flow of human dignity for everyone, everywhere, the promise of the Global Goals will just drain away.

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Photo Credit: @islamicrelief

By Siddharth Chatterjee
Mandera County, Kenya, Oct 19 2015 (IPS)

For many women in Mandera County – a hard to reach, insecure and arid part of North Eastern Kenya – the story of life from childhood to adulthood is one about sheer pain and struggle for survival.

As little girls, they undergo female genital mutilation (FGM), a painful carving out of the external genitalia that leaves them with lifelong physical and psychological scars.

Most girls will be married off when barely into their teens, forcing them to drop out of school, their immature bodies thrust into the world of childbearing.

As a result, Mandera – just a two-hour flight from the dynamic, modern East African hub of Nairobi – has maternal mortality ratio of 3,795 deaths per 100,000 live births, a rate that surpasses that of wartime Sierra Leone (2000 deaths per 100,000 live births) and far above Kenya’s national average (448 deaths per 100,000 live births).

Mandera is an example of a marginalized community rife with internecine conflicts, pockets of extremism, poor human development and cross border terrorism, where residents are trapped in poverty, misery and desperation. Cultural norms like status of the women, FGM and child marriage makes it worse. Among the poor, inequities hurt women and girls most.

However, things are looking up. Kenya’s decision to devolve government, putting much more power in the hands of local authorities, is having an impact on the ground. Indicators such as number of health facilities offering basic maternal and child health, and the number of women giving birth in a health facility, are improving.

Just as critical to these improvements is the recently established private sector’s coalition to transform the health landscape of this county, long considered a lost frontier. The goal of this coalition is to develop new products and service delivery models, like community life centers (CLCs) to improve maternal and new-born health among most vulnerable populations in Kenya.

An inter-agency team consisting of the Office of the President of Kenya, Ministry of Health, Kenya Red Cross, UNOCHA, Save the Children, technology company Philips, Amref, Safaricom, GlaxoSmithKlein and UNFPA, visited Mandera on 13 October 2015 with the ambassadors of Turkey and Sweden to Kenya, to launch a Ministry of Health-UNFPA–Philips innovation partnership.

The UNFPA and Philips CLC project is expected to bring quality primary healthcare within reach of about 25,000 people through small improvements that enhance the functionality of health facilities like 24-hour lighting that will allow facility deliveries to take place and sick children attended after dark. If successful, this initiative could be scaled-up and transform maternal and child health in Mandera county.

Mandera has long remained out of bounds for most international UN staff and diplomats due to insecurity. Hopefully the visit by the Turkish and Swedish ambassadors , who are ardent advocates of the rights of women and children, will pave the way for more visits to all the country’s North Eastern counties which face similar challenges.

The ambassadors spoke of their countries’ commitment to work with the county to change the narrative, especially to advance the rights and wellbeing of all women and girls.

The broader partnership, which also includes Huawei, Kenya Health Care Federation and MSD, together with the United Nations’s H4+ partners, will focus on the six counties with a high burden of maternal mortality: Wajir, Marsaibit, Lamu, Isiolo, Migori and Mandera.

The main activities in these six counties will include strengthening supply chain management for health commodities, increasing availability and demand for youth-friendly health services, capacity building for health professionals, youth empowerment and research. These activities be complemented by the results-based financing supported through the Health Results Innovation Trust Fund managed by the World Bank.

It is also in line with the full-scale Kenyan government commitment to reduce maternal deaths and the new polices of free maternity care and user fee removal.

Kenya’s First Lady Margaret Kenyatta once remarked that “I am deeply saddened by the fact that women and children in our country die from causes that can be avoided. It doesn’t have to be this way. This is why I am launching the ‘Beyond Zero Campaign’ which will bring prenatal and postnatal medical treatment to women and children in our country.”

The dividend from healthier women will be a more educated and healthy society, with more economic opportunities and reduced exclusion which will engender peace and hopefully reduce the drivers of violent extremism.

It will be a major score for Mandera towards fulfilling the vision of UN Security Council Resolution 1325, which is about empowerment and participation of women, ending discrimination and the scourge of harmful traditional practices like FGM and child marriage.

(End)

Excerpt:

By Geeta Rao Gupta
UNITED NATIONS, Oct 9 2015 (IPS)

The new Sustainable Development Goals, agreed upon recently by the member states of the United Nations, are all interconnected, as has been reiterated time and again. However, it is in the new Goal 6 – “Ensure access to water and sanitation for all”—for which this interconnectedness is most apparent.

Geeta Rao Gupta

Water flows throughout the 2030 Development Agenda. And sanitation and hygiene underpin any possible gains from access to water.

If we do not reach Goal 6, the other goals and targets will not be reached. Progress in the areas of education, health, inequality and extreme poverty all depends on how well we do on water and sanitation.

The United Nations some years ago declared that access to water and sanitation is a basic human right. However today, 663 million people are without access to adequate drinking water and 2.4 billion lack adequate toilets.

We at UNICEF are particularly concerned about the children, who are disproportionately affected by the lack of access to these basic needs.

It affects their health. Water and sanitation related diseases are one of the leading causes of death in children under five. Without access to sanitation hundreds of them fall ill and die every single day from preventable causes, particularly diarrhoea and other fecal-oral diseases.

It affects their education. In many communities, girls stay out of school because they need to fetch water; because they do not have a safe space to use when they menstruate; because they must help their mothers care for those who are sick – often from water-borne diseases.

It affects their nutritional status and their development. There is emerging evidence of direct linkages between lack of access to water and sanitation, and chronic malnutrition. Around 159 million children worldwide are stunted (short height for age), a condition which causes irreversible physical and cognitive damage. The repercussions of stunting can be felt beyond the individual child. It can significantly diminish the learning and future earning potential of entire generations, and thus negatively affect the local and national economy.

It affects equality and equity. One important aim in the new SDGs is the goal to reduce inequalities. New evidence from the World Bank shows that investing in water and sanitation for the poorest 20 per cent of a population yields greater economic returns than investing in the other quintiles and thus has the potential to reduce societal inequalities.

Our data from 45 developing countries show that in 7 out of 10 households, the burden of collecting water falls to women and girls, so access would also aid gender equity.

A side event in the margins of the UN General Assembly, hosted by the governments of the Netherlands, South Africa, Hungary and Bangladesh, concluded that targeting the poorest and the most marginalized will require an immense mind-shift for governments. But it must be done.

It cannot be done without strengthening institutions and improving the accountability of governments and service providers. And it will not be done without involving those who have the most at stake – the poor, women, and adolescents – in planning and in monitoring of services. Their influence has already been brought to bear in the drafting of Goal 6, the fastest agreed-upon goal.

It is no coincidence that impressive results are achieved by working closely with those directly affected. Partnership with them is not a ‘nice-to-have’ but a must-have.

In short, access to water and sanitation is not only a matter of dignity and human rights, but fundamental to our ability to attain any of the goals the governments of the world have just adopted.

We must start right away on working on Goal 6, and it can’t be business as usual: we need to start with the most disadvantaged, or we risk losing the gains we have so painstakingly made in the last 15 years, and we endanger the future. There is no time to waste.

(End)

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Candlelight vigil co-organised by 350.org, the global grassroots climate movement, held just before the Pope's visit to the Philippines in January this year. Photo credit: LJ Pasion

By Edwin Gariguez
MANILA, Jun 17 2015 (IPS)

My country, the Philippines, is one of the most vulnerable to the impacts of climate change. Even though we are among those countries that hardly contributed emissions and benefited least from burning fossil fuels, we find ourselves at the frontline of the climate crisis.

The catastrophe we experienced from Super Typhoon Haiyan [in early November 2013], one of the most powerful storms ever recorded, which killed thousands and damaged billions of properties, is proof to this. Almost two years later, our people are still struggling to recover from its devastating impact.“If it is wrong to wreck the planet, then it is wrong to benefit from its wreckage; a growing global movement to divest from fossil fuels takes this ethos at heart”

It should therefore not come as a surprise that concern about climate change is higher in the Philippines than elsewhere. A recent public consultation showed that 98 percent of Filipinos are “very concerned” about the impacts of climate change, compared with a global average of around 78 percent.

The Church cannot remain a passive bystander. It is our moral imperative to give voice to the voiceless.

The Catholic Church in the Philippines has pronounced its strong opposition to coal mining because it will make our country contribute to climate change, and endanger ecosystems as well as the health and lives of people.

Our churches have often led the struggles against dirty energy. In my hometown of Atimonan, Quezon, for example, more than 1,500 protesters led by church leaders staged a demonstration against a proposed coal-fired power plant last week.

Similarly, Catholic priests in Batangas are at the forefront of the fight against the construction of a new coal power plant. Last month, about 300 priests held a prayer rally ahead of a committee hearing that discussed the project.

Pope Francis also understands that climate change is not only an environmental issue but a matter of justice. His upcoming encyclical is anticipated to bring the link between climate change and the poor to centre stage.

In the Philippines, we are grateful that Pope Francis came to visit and held mass in areas hit the hardest by Typhoon Haiyan.

We admire him for standing in solidarity with us, using his position to inject momentum for faith communities around the world to take a moral stance on climate change.

A papal encyclical is an extraordinary way to send a powerful message to world leaders whose actions to date lag far behind the scale of the response that is necessary.

We hope that the Pope’s message will remind world leaders of their moral duty to act as we approach the climate summit in Paris [in December], where a new international climate agreement is supposed to be reached.

The moral imperative to act could not be stronger and the world now needs to stand united in the face of the climate crisis that knows no geographic boundaries, while the worst impacts still can be avoided.

Through the Pope’s encyclical, the Church will raise critical issues that need to be taken into account in the global response to this unprecedented threat.

Global capitalism has lifted millions out of poverty by burning fossil fuels. On the flipside, it has also created vast inequalities and sacrificed the environment for the sake of short-term gain. Now is the time to break the stranglehold of fossil fuels over our lives and the planet.

If it is wrong to wreck the planet, then it is wrong to benefit from its wreckage; a growing global movement to divest from fossil fuels takes this ethos at heart.

The Pope’s critique of today’s destructive, fossil-fuel dependent economy will not go down well with the powerful interests that benefit from today’s status quo.

But we, the Church and the people of the Philippines, will stand alongside the Pope as strong allies in the struggle for a socially just, environmentally sustainable and spiritually rich world that Pope Francis and the broader climate movement are fighting for.

Edited by Phil Harris    

The views expressed in this article are those of the author and do not necessarily represent the views of, and should not be attributed to, IPS – Inter Press Service. 

Excerpt:

By Sipho Mthathi
JOHANNESBURG, Jun 12 2015 (IPS)

Africa is known as the ‘paradox of plenty’. How can a continent so rich in natural resources be so poor?

Economic growth is predicted to increase by 4.5 percent across the continent this year, despite falling oil prices and the Ebola crisis. South Africa’s economy, the second biggest in Africa is expected to continue to grow by 3.5 percent this year; Nigeria will grow by an enviable 5.5 percent.

Sipho Mthathi, Executive Director of Oxfam South Africa

However, millions across Africa are struggling.  Economic inequality is on the rise, and public coffers are insufficient due to an increasing demand for public services like health, education and housing.

Recently, Thomas Pogge and other distinguished academics have written about the cost of progress. Surprisingly, history provides us with examples of countries where, if there is a balance between economic growth and public spending, it is possible to address inequality.

There is no time to waste in looking for ways to address this widening gap across Africa.

It is urgent that, collectively, African nations look at the billions of dollars flowing out of the continent every year, most of which can be attributed to corporate tax dodging.

In January, the report of the High Level Panel on Illicit Financial Flows (IFFs) from Africa, chaired by former South African President Thabo Mbeki, contended that IFFs from Africa increased from about 20 billion dollars in 2001 to 60 billion in 2010 in the merchandise sector alone.

According to Global Financial Integrity’s 2014 report on IFFs from developing countries, South Africa alone may have lost more than 122 billion dollars between 2003 and 2012 in IFFs.

This is a lost opportunity for money that could have been reinvested in advancing Africa’s development and increased access to public goods for her Africa’s people.“It is urgent that, collectively, African nations look at the billions of dollars flowing out of the continent every year, most of which can be attributed to corporate tax dodging”

But this is only the half of the story. Multinational companies are gaining at the expense of African people through other ‘legal’ forms of corporate tax dodging, and through negotiated tax breaks. This is happening because of a lack of fair global tax rules, and behind-closed-door deals between corporations and governments, rushing to seal deals under pressure.

Africa’s astounding growth is affecting human development. And these losses in tax revenue come at a time when the role of official development assistance to Africa is declining.

Fair and progressive tax systems should be providing financing for well-functioning government programmes to enable governments to uphold citizens’ rights to basic services (such as healthcare and education), and cement trust between citizens and governments.

Establishing an effective tax system is critical if Africa is going to mobilise the resources it needs to tackle poverty and inequality.  Africa is home to six out of ten of the world’s most unequal countries – South Africa, Lesotho, Namibia, Botswana, Zambia, and Central Africa Republic.  Some estimates on Africa’s financing needs include 40-$60 billion dollars per year to finance the post-2015 development agenda.

This is not just Africa’s problem. Around the world, many lower-income countries have been subject to harmful tax practices, including transfer pricing, whereby a transfer price may be manipulated to shift profits from one jurisdiction to another, usually from a higher-tax to a lower-tax jurisdiction.

After revelations of how multinational enterprises (MNEs) such as Starbucks, Google and Apple deliberately structured themselves to minimise their tax bills, the Organisation for Economic Cooperation and Development (OECD) launched an effort to reform this base erosion and profit shifting (BEPS) practice. This reform is expected to wind up by the end of 2015.

However, since the launch of the BEPS Action Plan, developed countries have not had a real voice or influence in the process.  Just four African countries, including South Africa as a G20 member country, have been invited to participate as observers.  These countries are bringing attention to the many mining corporations which are offered lucrative tax incentives which must be addressed in the BEPS plan.

The African Tax Administration Forum (ATAF) is a regional tax body that has been invited by the OECD/G20 to participate in the BEPS reform process.  This should provide further scope to influence the BEPS process with an African perspective.

At the same time, the South Africa Revenue Services (SARS) is going after billions lost through wasteful incentives and trade mispricing. SARS has recovered 5.8 billion rand (460 million dollars) over the three-year period 2011-2014, 55 percent (3.4 billion rand or 274 million dollars) of which is attributed to the mining industry.

South Africa’s membership in the G20 (and its role as co-Chair of the G20 Development Working Group) provides an enormous opportunity to insist on broad inclusion of all nations in the BEPS reform process.

At a recent conference convened by ATAF, South African Finance Minister Nhlanhla Nene called for “Africa to protect its own tax base, and advance domestic resource mobilisation through a common voice, a common concern and a common action plan.”

It is time that all African finance ministers wake up to the possibility that tax revenues for financing essential services for their citizens, or investment in small-holder agriculture or infrastructure, could come from the recovery of billions of dollars lost from corporate tax dodging and unfair tax competition.

Tax breaks provided to six large foreign mining companies in Sierra Leone, for example, are equivalent to 59 percent of the total budget of the country – or eight times the country’s health budget.

It is time for a global inter-governmental body on international tax cooperation to allow for a more inclusive and coordinated approach to ongoing tax reform, beyond BEPS.

All countries should be able to participate in tax negotiations on an equal footing, which guarantees one country, one vote, and where representatives will have the political mandate to speak on behalf of their governments.  Simply relying on the BEPS process to re-write tax rules will not be enough to end international tax dodging.

Through the BEPS reform process and this new tax body, there would be real potential for an African taxation renaissance.

Edited by Phil Harris

The views expressed in this article are those of the author and do not necessarily represent the views of, and should not be attributed to, IPS – Inter Press Service. 

Excerpt:

We are witnessing a shift in the original rationale behind the unique relationship between the European Union and the African, Caribbean and Pacific countries of the ACP group, which goes beyond the logic of “unilateral aid transfer”, “donor-recipient approach” and “North-South dialogue”.

“The [ACP] Group will have to transform itself if it wants to realise its ambition of becoming a player of global importance, beyond its longstanding partnership with the EU” – Dr Patrick I. Gomes, ACP Secretary General
In November last year, in his mission letter to the newly appointed European Commissioner for International Cooperation and Development, Neven Mimica, European Commission President Jean-Claude Junker said: “The first priority is the post-2015 framework and the second priority of my mandate is the future of EU’s strategic partnership with African, Caribbean and Pacific (ACP) countries.”

With the agreement for that partnership coming to an end in 2020, both the European Union and the ACP group are currently stimulating intense debates on a critical review of the past and future perspective as well as challenging issues for the future “acquis” between the ACP countries and Europe under the umbrella of the Cotonou Agreement.

Last month’s Joint Session of the ACP-EU Council of Ministers held in Brussels (May 28-29) May offered an occasion for discussing innovative options to outline new bases of common interests, needs and difficulties, and to forge forthcoming cooperation, particularly in terms of the post-2015 agenda, financing for development, migration, international trade, climate change and democratic governance.

At ACP level, there is a growing awareness among members that “the Group will have to transform itself if it wants to realise its ambition of becoming a player of global importance, beyond its longstanding partnership with the EU,” said ACP Secretary General, Dr Patrick I. Gomes.

“There is the need to re-balance the ACP-EU partnership in favour of the ACP Group” was one of the key messages from the 101^st ACP Council of Ministers held on May 27-28 to re-align ACP positions before the Joint Session with the European Union.

Within the European Union, there is also recognition of the relevance of the EU-ACP relationship. “Our exchanges of view on a number of key issues such as the post-2015 development agenda and migration once again underlined the importance of our partnership,” said Zanda Kalniņa-Lukaševica, Latvian Parliamentary State Secretary for E.U. Affairs, in a statement.

Zanda Kalniņa-Lukaševica (right), Latvian Parliamentary Secretary of State for E.U. Affairs and Meltek Livtuvanu, Minister for Foreign Affairs of Vanuatu and President of the ACP’s Council of Ministers. Photo Credit: EU Council

On paper, the Cotonou Agreement remains the most sophisticated framework for ACP-EU cooperation, covering political, trade, economic and development cooperation issues.

According to the last figures for the E.U. budget for 2014-2020, a package of 30.5 billion euros is specifically provided to ACP regions and countries. In fact, the ACP still remains the biggest group of states with which the European Union has a partnership.

The European Development Fund (EDF), an implementing instrument of the Cotonou Agreement, will finance E.U. development cooperation projects until 2020 to assist partner countries in poverty eradication. These funds will target the people most in need and finance different sectors such as health and education, infrastructure, environment, energy, food and nutrition.

Looking towards the future, the ACP is determined to move from being on the receiving end of development assistance to asserting its aim to speak with “one voice in global governance institutions”, in the words of ACP Secretary-General Gomes.

The need to consider and treat ACP countries as “responsible partners” at the global level despite the reluctance of the international community, emerged strongly during the E.U.-Africa Summit in  April 2014, with ACP members hoping for a lift-up effect on the ACP’s political leverage.

According to observers, ACP countries matter for the European Union partly to help overcome the effects of the economic crisis. Some ACP countries in the North African region, for example, have witnessed upturns in economic growth since 2004. At the same time, the abundance of natural resources in ACP countries provides an alternative to the volatile Middle East, Russia and some other countries as a source of energy and raw materials.

On the issue of financing for development, Alexandre Polack, European Commission Spokesperson for Humanitarian Aid and Crisis Management & International Cooperation and Development told IPS: “We need to come away from Addis with a comprehensive agreement which covers all the means of implementation for the post-2015 development agenda.”

He was referring to the Third International Conference on Financing for Development which will take place in Addis Ababa, Ethiopia from Jul. 13 to 16 this year.

“This,” added Polack, “means addressing non-financial aspects, including policies. We need an agreement which puts domestic actions and domestic capacities at the heart of poverty eradication and sustainable development, and adheres to the principles of universality in terms of shared responsibilities.”

Observers also point out that the ACP countries can also be important interlocutors during the U.N. Climate Change Conference this coming December in Paris.

While the Western industrialised and emerging countries are the main greenhouse gas emitters, many ACP countries – particularly Small Island Developing States (SIDS) – are directly threatened by the consequences of climate change through, for example, natural disasters, hurricanes and tornados, flooding and drought.

Their voice on this, along with their experience and good practices developed in countering or mitigating the drastic effects of climate change, can make a useful contribution to the deliberations in Paris.

Meanwhile, the ACP-EU Joint Council has endorsed recommendations concerning the migration crisis, including enacting comprehensive legislation on both trafficking in human beings and smuggling of migrants, stressing the differences between both phenomena, while also implementing relevant national laws.

The co-President of the Joint Council, Hon. Meltek Sato Kilman Livtuvanu of Vanuatu, speaking on behalf of the ACP ministers, said: “We consider that even if the military and security approach is meant to discourage and respond immediately to the issue, there is an urgent need to have a comprehensive approach to deal with the root causes of this phenomenon, in partnership with all the countries involved.”

Edited by Phil Harris   

Patient and leading health organisations in South Africa have now joined a Fix the Patent Laws campaign launched in 2011 by Treatment Action Campaign (TAC) and Doctors Without Borders (MSF) to push for reform of the country’s current patent laws.

The campaign’s promoters say that these laws severely restrict access to affordable medicines for all people living in South Africa.

The organisations which have adhered to the campaign are: People Living With Cancer (PLWC), South African Depression and Anxiety Group (SADAG), DiabetesSA, CanSurvive, SA Federation for Mental Health (SAFMH), Stop Stock Outs, Cancer Association of Southern Africa (CANSA), Schizophrenia and Bipolar Disorder Alliance (SABDA), South African Non-Communicable Diseases Alliance (SANCD Alliance), Marie Stopes, Epilepsy South Africa and Cape Mental Health.

Together, they are calling on the South African government to finalise a National Policy on Intellectual Property that champions measures to reduce prices and increase access to a wide range of medicines for people in need across the country.

TAC and MSF reported Jun. 1 that the expanded coalition of organisations represents public and private sector patients in South Africa seeking treatment and care for a range of cancers, mental illnesses, diabetes and other non-communicable diseases – as well as tuberculosis, HIV and sexual and reproductive health diseases.

South Africa currently grants patents on almost every patent application it receives, allowing companies to maintain lengthy monopoly periods on medicines, argues the campaign. This keeps prices of many medicines higher in South Africa than in many other countries.

According to TAC and MSF, it is estimated that 80 percent of patents granted in South Africa do not meet the country’s patentability criteria. This is largely due to the fact that patents are granted without substantive examination of applications to ensure that patentability criteria are met.

“Some cancer patients would rather go to other countries, like India, for treatment – the combined cost of the flight, medical services and drugs is cheaper than buying the drugs alone in South Africa,” said Bernice Lass of cancer group, CanSurvive.

Linda Greeff of PLWC said that her organisation was supporting the campaign because “we want to ensure that there is proper scrutiny of patent applications before patents are granted. We want a patent granting process that is ethical and transparent, so that more people can access the medicines that they need.”

According to Cassey Chambers of SADAG, the group deals with “patients every day who cannot afford medication or treatment, and as a result become more depressed, helpless, hopeless and even suicidal in some cases.”

DiabetesSA’s Keegan Hall stressed that as health organisations, “we have an obligation to take steps to improve affordability and access to medicines. The cost of insulin and other diabetes management tools are far too expensive for many patients,” Hall added.

Health organisations joining the Fix the Patent Laws campaign say that they recognise the opportunity South Africa has to improve access to medicines for all diseases through reforming problematic patent laws.

South Africa’s Department of Trade and Industry (DTI) has already embarked on the process of legislative reform, releasing a Draft National Policy on Intellectual Property for public comment in 2013. The draft policy contained important commitments to reform the laws in order to restore the balance between public and private interest, in favour of people’s health.

The Fix the Patent Laws campaign coalition is calling for urgent approval of a finalised National Policy on Intellectual Property, as a critical first step toward reform of problematic patent laws and practices that deprive people living in South Africa of more affordable treatments for all conditions.

It notes that as a member of the World Trade Organisation (WTO), South Africa is required to uphold minimum standards of intellectual property protection as defined by the international Agreement on Trade Related Aspects of Intellectual Property Rights (TRIPS). This includes granting 20-year patents on medicines.

However, South Africa also has significant flexibility under TRIPS to amend national legislation in order to improve access to medicines. According to the health organisations, reforms could include the government taking measures to limit abusive patents being granted on medicines.

At the same time, it says, government could establish easier procedures for overcoming legitimate patent barriers when medicines are unaffordable, unavailable or not adapted for patient needs.

Edited by Phil Harris   

G7-based companies and investors cheated Africa out of an estimated six billion dollars in a year through just one form of tax dodging, according to a new Oxfam report ‘Money talks: Africa at the G7’, released Jun. 2.

This is equivalent to three times the amount needed to plug the healthcare funding gap in the Ebola-affected countries of Sierra Leone, Liberia, Guinea and at-risk Guinea Bissau.

According to an Oxfam briefing paper release in April this year, an estimated 1.7 billion dollars is required to close the healthcare funding gap to improve dangerously inadequate health systems in these countries. This figure is based on raising spending to the recommendation of the World Health Organisation (WHO) that 86 dollars per capita is required to achieve the minimum package of essential services.“Multinational companies, many with headquarters in the United Kingdom and other G7 countries, are cheating African countries out of billions of dollars in vital tax revenues that could help vulnerable people get decent healthcare and send their children to school” – Nick Brye, Oxfam’s Head of U.K. Campaigns

The new Oxfam report comes as G7 leaders prepare to meet their African counterparts at the annual summit in Bavaria, Germany from Jun. 8 to 9. African leaders from Ethiopia (Prime Minister Hailemariam Desalegn), Liberia (President Ellen Johnson Sirleaf), Nigeria (President Muhammadu Buhari) and Senegal (President Macky Sall) are scheduled to join an outreach session on Jun. 8.

Oxfam is calling for the leaders of the G7 countries – Canada, France, Germany, Italy, Japan, United Kingdom and United States – to include action for ambitious tax reform in discussions about how the group can support economic growth and sustainable development on the continent.

In the United Kingdom, Oxfam is part of a coalition that has been calling on the recently elected new British government to show leadership by introducing a Tax Dodging Bill, which would make it harder for U.K. companies to avoid paying tax in the countries in which they operate – practices which currently cost some of the world’s poorest countries billions each year.

The coalition, which includes ActionAid and Christian Aid in addition to Oxfam, is currently running a Tax Dodging Bill campaign.

According to Oxfam, a well-crafted Tax Dodging Bill would also make it harder for big companies to avoid paying tax in the United Kingdom, and could bring in at least 3.6 billion pounds (5.4 billion dollars) a year to the U.K. Treasury, the equivalent of 600 pounds (910 dollars) for every household living below the poverty line.

“Multinational companies, many with headquarters in the United Kingdom and other G7 countries, are cheating African countries out of billions of dollars in vital tax revenues that could help vulnerable people get decent healthcare and send their children to school,” said Nick Brye, Oxfam’s Head of U.K. Campaigns.

“To fund the fight against poverty and to tackle worsening extreme inequality, we need action to ensure big companies pay their fair share, here and in the world’s poorest nations.”

Oxfam also notes that existing international efforts to tackle corporate tax dodging, such as the BEPS (Base Erosion and Profit Shifting) process, led by the Organisation for Economic Cooperation (OECD) for the G20 group of the world’s major economies, will leave gaping tax loopholes.

It warns that these loopholes can continue to be exploited by multinational companies across the developing world and that many African nations have been shut out of discussions on BEPS reform and will not benefit from them as a result.

Oxfam is also calling for British Chancellor of the Exchequer George Osbourne to attend July’s Financing for Development Conference in Ethiopia which will play host to heads of states and finance ministers from around the world.

The talks, which will focus on how the international community will fund development over the next two decades, are an opportunity for governments to work together to start shaping a more democratic and fairer global tax system.

In 2010, the last year for which data are available, Oxfam says that companies and investors based in G7 countries avoided paying tax on 20 billion dollars of income through a practice called trade mispricing – where a company artificially sets the prices for goods or services sold among its subsidiaries to avoid taxation.

With corporate tax rates in Africa averaging 28 percent, this equates to nearly six billion dollars in lost revenues. In addition, developing countries as a whole lose around 100 billion dollars a year through tax avoidance schemes involving tax havens, according to the U.N. Conference on Trade and Development (UNCTAD).

“Reforming global corporate tax rules so that African governments can claim the money owed to them is vital to tackle extreme poverty and inequality and boost economic growth, said Brye. “That’s why Oxfam has been calling for a U.K. Tax Dodging Bill that would ensure U.K. companies do their bit to help poor families at home and in developing countries.”

Edited by Phil Harris   

An Aboriginal activist shouts slogans during a march in Brisbane, Australia, to stop the cycle of ‘stolen generations’ of Aboriginal children. Credit: Silvia Boarini/IPS

By Silvia Boarini
BRISBANE, May 30 2015 (IPS)

Every year since 1998, Australia has marked ‘National Sorry Day’ on May 26, a day to remember the tens of thousands of indigenous children who, between the 1890s and 1970s, were forcibly removed from their communities by government authorities and placed into the care of white families or institutions to be assimilated into settler society.

‘National Sorry Day’ was set up following publication in 1997 of the ‘Bringing Them Home’ report, the result of the first national inquiry which collected testimonies of ‘stolen’ Aboriginal and Torres Strait Islander children and criticised the racist policies that allowed their systematic separation from their families.

The report played a central role in highlighting the plight of the so-called ‘stolen generations’ but it took a further 11 years until the government formally apologised for this ‘blemished chapter’ in Australia’s history. Only in 2008 did then Labour Prime Minister Kevin Rudd take the unprecedented step.“If you listen to someone from the older age group of stolen generations and the younger ones, the essence of what they say is the same. They never met mother, they never met grandma. They feel they don’t belong anywhere. How they feel inside is the same” - Auntie Hazel, founding member of Grandmothers Against Removals (GMAR)

“For the pain, suffering and hurt of these Stolen Generations (…) we say sorry,” he said on that occasion, before going on to envision a future in which “Parliament resolves that the injustices of the past must never, never happen again.”

Despite the apology, indigenous activists maintain that the ‘stolen generations’ is hardly an isolated chapter, let alone a closed one. “From the first few weeks of the invasion in the 1780s, they started removing our children and breaking down our families,” Sam Watson, a prominent Aboriginal leader and activist, told IPS. “And there are more children being removed now than ever before,” he added.

A recent report by the Government Productivity Commission, titled ‘Overcoming Indigenous Disadvantage’, corroborates Watson’s interpretation. Indigenous children in out-of-home-care numbered 5,059 in June 2004 and 14,991 in June 2014. Barely five percent of the population under 17 is indigenous and yet, the report shows, 35 percent of all children removed are Aboriginal and Strait Islanders.

Mary Moore is founder of the Legislative Ethics Commission and has followed many cases of indigenous and non-indigenous child removal. She calls Australia the ‘child-stealing capital of the world’.

Many jobs depend on this ingrained practice and laws are passed to legitimise it, she says. “Removal and adoption are counter-intuitive strategies,” she told IPS. “They ignore the damaging lifelong consequences on children and they are far more costly than supporting families to remain united.”

Authorities justify removals in the name of ‘child protection’ and point to a context of ‘neglect’ and possible ‘risk’ as justifying factors. But the Aboriginal and Torres Strait Islander minority, overly represented at the bottom of most socio-economic indices, wants to know whose ‘neglect’ and racist policies have contributed to the widespread poverty, soaring incarceration numbers or high mental illness rates affecting their communities.

Although federal government talks of “closing the gap in indigenous disadvantage”, critics say that, often enough, in order to end ongoing state of neglect of Aboriginal communities, the only gap to bridge is between government’s promises and its actions.

In February 2015, at a speech marking the anniversary of the 2008 national apology, former Prime Minister Rudd, while not ignoring the staggering 400 percent increase in removal of indigenous children since 1998, called the crisis a “new type of stolen generation” rather than an unresolved and continuing crisis.

For Auntie Hazel, a founding member of the grassroots pressure group Grandmothers Against Removals (GMAR), there is no difference between what happened then and what happens now. “If you listen to someone from the older age group of stolen generations and the younger ones, the essence of what they say is the same,” she told IPS.

“They never met mother, they never met grandma. They feel they don’t belong anywhere. How they feel inside is the same,” she said.

GMAR was founded in New South Wales (NWS) in January 2014. NSW has the worst track record in child removals explains Auntie Hazel and GMAR was a way to say “enough is enough”. Just a year later, it had grown into a nationwide movement made up of self-organising charters throughout Australia’s affected communities.

The National Aboriginal Strategic Alliance to Bring the Children Home (NASA) now brings together GMAR and other like-minded groups. Protests, round-tables, marches and sit-ins have taken place across Australia and an international solidarity network is growing rapidly.

“We are all one and fighting for the same thing,” said Auntie Hazel. “It’s only when the little ones can nurture their spirit inside that they can become proud Aboriginal people.”

Ultimately, GMAR seeks to achieve self-determination in the care and protection of indigenous children and end the “power and control” that governments hold over the indigenous minority.

At the moment, many in the community complain, children are taken away with worrying ease, sometimes on the basis of unfounded and unchecked hearsay.

Anyone, Auntie Hazel explained, can call a hotline anonymously and say things about you. “Then maybe one day your child spends the lunch money on sweets so the teacher, a mandatory reporter, tells the Department of Community and Social Services (DOCS) that the child had no money for food. And so on until there is a case against you and you just don’t know.”

One of GMAR’s proposals to end this cycle is the establishment of an ‘Aboriginal expert committee’. Made up of health specialists, the committee will work with families deemed “at risk” by the DOCS before the children are removed.

Such a committee would have spared Albert Hartnett, one of GMAR’s male members, much anguish. In 2012 his 18-month-old daughter Stella was removed without warning. “DOCS officials escorted by police officers knocked on my door one Friday morning,” he recalls, still emotionally shaken.

“They said the child was at risk. They asked me ‘where is the dog?’ but I couldn’t understand what they were talking about. We had no dog.” Although DOCS did not find any of the “risks” mentioned in their documents, such as dog excrement on the floor, they still took the child.

Friday removals are a practice being fought by GMAR because it puts DOCS at an advantage by leaving families without support for a whole weekend. “They tell you ‘you are an unsuitable parent’ and it is easy to fall into a downward spiral,” Hartnett said.

With no faith in the system, Hartnett attended the consultations the following Monday and in the evening received a surprise phone call from DOCS asking to assess his home. “It happened backwards,” the father of five told IPS. “First they took the child and then they came to assess.” The child was restored to the family but everyone, said Hartnett, has remained scarred by the experience.

“After the [2008] apology,” Auntie Hazel told IPS, “our community felt disempowered. We were suffering in silence.”

The truth was out about removals and instead “government stigmatised us,” Hartnett told IPS, referring to the 2007 Northern Territory Intervention when, citing unfounded allegations of child abuse, federal government seized control of a number of indigenous communities.

Olivia Nigro, a social justice campaigner and researcher for GMAR told IPS that in this context, what GMAR has achieved is mobilisation from within. “GMAR has galvanised families in affected communities. It has really generated the political confidence to talk about this issue and demand redress for the people.”

Edited by Phil Harris

Yury Fedotov, Executive Director of the U.N. Office on Drugs and Crime (UNODC) with U.N. Secretary-General Ban Ki-moon. "The magnitude of the problems we face is such that it is sometimes hard to imagine how any effort can be enough to confront them. But to quote Nelson Mandela, 'It always seems impossible until it is done'. We must keep working together, until it is done" – Yury Fedotov. Credit: Courtesy of UNODC

By Yury Fedotov
VIENNA, May 27 2015 (IPS)

With terrorism, migrant smuggling and trafficking in cultural property some of the world’s most daunting challenges, “the magnitude of the problems we face is such that it is sometimes hard to imagine how any effort can be enough to confront them. But to quote Nelson Mandela, ‘It always seems impossible until it is done’. We must keep working together, until it is done.”

The words are those of U.N. Office on Drugs and Crime (UNODC) Executive Director Yury Fedotov, who was speaking at the closing of the 24th Session of the Commission on Crime Prevention and Criminal Justice (Crime Commission) held in the Austrian capital from May 18-22.

Earlier this month, IPS Editor-in-Chief Ramesh Jaura interviewed Fedotov on how the challenges facing the United Nations’ drugs and crime agency translate into challenges on the sustainable development front.“The share of citizens experiencing bribery at least once in a year is over 50 percent in some low-income countries. Many detected human trafficking movements are directed from poor areas to more affluent ones. Research also suggests that weak rule of law is connected to lower levels of economic development” – UNODC Executive Director Yury Fedotov

Q. The United Nations Office on Drugs and Crime (UNODC), established in 1997, understands itself as “a global leader in the fight against illicit drugs and international crime”. At the same time, you have taken up the cudgels on behalf of sustainable development. What role does the UNODC envisage for itself in achieving sustainable development goals to be agreed at the U.N. summit to adopt the post-2015 development agenda in September?

A. Crime steals from countries, families and communities and hampers development while exacerbating inequality and violence, especially in vulnerable countries. Trafficking in diamonds and precious metals, for instance, diverts resources from countries that desperately need the income.

The share of citizens experiencing bribery at least once in a year is over 50 percent in some low-income countries. Many detected human trafficking movements are directed from poor areas to more affluent ones. Research also suggests that weak rule of law is connected to lower levels of economic development. These are just some of the many challenges that the international community faces around the world that are related to crime.

UNODC’s broad mandate includes stopping human traffickers and migrant smugglers, as well as tackling illicit drugs. It encompasses promoting health and alternative livelihoods and involves battling corruption, illicit financial flows, money laundering and terrorist financing. Our work confronts emerging and re-emerging crimes, including wildlife and forest crime, and cybercrime, among others, all of which hinder sustainable development.

Currently the United Nations is making the transition from the Millennium Development Goals (MDGs) to the Sustainable Development Goals (SDGs). In Goal 16, the Open Working Group, responsible for identifying the development goals stressed the need to promote peaceful and inclusive societies for sustainable development, and to provide access to justice for all, as well as building effective, accountable and inclusive institutions. Justice is also one of the six essential elements identified by the Secretary-General in his own Synthesis Report on this subject.

Goal 3, which focuses on “ensuring healthy lives”, underlines the importance of strengthening prevention and treatment of substance abuse. These goals – justice and health – go to the very heart of UNODC’s mission. I am hopeful that when the U.N. Heads of State Summit on Sustainable Development in September 2015 takes place these goals will remain.

Q. UNODC organised its Thirteenth Congress on Crime Prevention and Criminal Justice from Apr. 12 to 19 in Doha, Qatar. The 13-page Doha Declaration contains recommendations on how the rule of law can protect and promote sustainable development. Is that the reason that you described Doha as a “point of departure”?

A. The Doha Declaration was passed by acclamation at the 13th Congress on Crime Prevention and Criminal Justice, and contains crucial recommendations on how the rule of law can protect and promote sustainable development. The declaration is driven by the principle that these issues are mutually reinforcing and that crime prevention and criminal justice should be integrated into the wider U.N. system.

At the 24th Session of the Commission on Crime Prevention and Criminal Justice (May 18-22), there were nine resolutions before the Commission and they pave the way for the Doha Declaration to go before the U.N. General Assembly and ECOSOC for approval. The other resolutions, for instance on cultural property and standard rules on the treatment of prisoners, seek to implement the principles of the Doha Declaration.

It is for this reason that I described the 13th Crime Congress in Doha as a significant “point of departure”. Doha is the first, but not the last step in the process of implementing the Declaration and ensuring that we turn fine words into spirited and dedicated action in the areas of crime prevention and criminal justice – action that can benefit the millions of victims of crime, illicit drugs, corruption and terrorism.

If we do this, we have an opportunity to energise the 60-year legacy of Crime Congresses and give it the power to shape how we tackle crime and promote development for many years to come. Indeed, I see a strong, visible thread between the recent Crime Congress, September’s UN Summit on Sustainable Development and the 14^th Crime Congress in Japan in five years’ time.

Q. The Doha Declaration also pleads for integrating crime prevention and criminal justice into the wider United Nations agenda. This suggestion comes at a point in time when the United Nations is turning 70. Are there some issues which the United Nations has ignored until now or is there a range of issues that have emerged over previous decades?

A. Member States are increasingly affected by organised crime, corruption, violence and terrorism. These challenges undercut good governance and the rule of law, threatening security, development and people’s lives.

Sustainable development can be safeguarded through fair, human and effective crime prevention and criminal justice systems as a central component of the rule of law. As stated by U.N. Secretary-General Ban Ki-moon: “There is no peace without development; there is no development without peace; and there is no lasting peace and sustainable development without respect for human rights.”  We need to break down the walls between these activities and integrate the various approaches.

UNODC is well placed to assist. We work closely with regional entities, partner countries, multilateral and bilateral bodies, civil society, academia and the private sector to support the work on development. We can also offer our support at the global, regional, and local levels, through our headquarters and network of field offices.

Q. Do you find willingness on the part of all countries around the world to agree on national, regional and international legal instruments, to combat all forms of crime, and their willingness to pull on the same string when it comes to implementation?

A. Our work is founded on the U.N. Convention against Transnational Organised Crime and its three protocols, the Convention against Corruption, international drug control conventions, universal legal instruments against terrorism and U.N. standards and norms on crime prevention and criminal justice.

Almost all of these international instruments have been universally ratified by the international community. Why? Because countries recognise that crime today is too big, too powerful, too profitable for any one country to handle alone. Countries recognise that, today, crime not only crosses country borders, but regional borders. It is a global problem that warrants comprehensive, integrated global solutions.

The UNODC approach to this unique challenge is threefold. First, we are building political commitment among Member States. Second, we deliver our activities through our integrated regional programmes across the world. Third, we are working with partners, both within and outside the United Nations, to ensure that our delivery is strongly connected to other activities at the field level.

In support of this action, and to give just one example, UNODC is networking the networks. Today’s criminals have widespread networks and vast resources; if we are to successfully confront them, we need to ensure greater cross-border cooperation, information sharing and tracking of criminal proceeds.  The initiative is part of an interregional drug control approach developed by UNODC to stem illicit drug trafficking from Afghanistan and focuses on promoting closer cooperation between existing law enforcement coordination centres and platforms.

Q. UNODC has assigned itself a wide range of tasks. Which are your priorities in the biennium ending this year, during which you have 760.1 million dollars at your disposal?

A. I would mention two matters that are of international importance. First, smuggling of migrants not just in the Mediterranean or the Andaman seas, but also elsewhere. We are witnessing unprecedented movements of people across the globe, the largest since the Second World War. People are leaving because of conflict, insecurity and the desire for a better life. They are falling into the arms of unscrupulous smugglers and many of them are dying, while trying to make the dangerous journey across deserts and seas.

Second, the nexus of transnational organised crime and terrorism is a major threat to global peace and security, and has been recognised as such in recent Security Council resolutions. Every extremist and terrorist group requires sustainable funding. The most reliable, and sometimes the only, means of achieving this is through illicit funds gained from transnational organised crime, including cybercrime, drug trafficking, people smuggling and many other crimes.

Information on the magnitude and exact nature of such relationships remains incomplete, and more research is needed. Based on data and analysis, however, for some regions, we can follow the funding in support of violent extremism and terrorism. In Afghanistan, for example, the Taliban could be receiving as much as 200 million dollars annually as a tax on the drug lords.

Edited by Phil Harris    

Excerpt:

Prof Grace Irimu shows IPS a drip feed bag and a copy of Kenya’s ‘Basic Paediatric Protocols’ as she explains the importance of intravenous treatment in saving the lives of young children affected by acute watery diarrhoea. Credit: Miriam Gathigah/IPS

By Miriam Gathigah
NAIROBI, May 23 2015 (IPS)

Acute watery diarrhoea is a major killer of young children but misunderstanding over the benefits of fluid treatment is preventing many Kenyan parents from resorting to this life-saving technique and threatening to reverse the strides that the country has made in child health.

The 2014 Kenya Demographic and Health Survey, released in April this year, reports that the country’s under-five mortality rate fell to 52 deaths per 1,000 live births in 2014, down from the 74 deaths in 2008-09, but still far from the 32 per 1,000 live births targeted under the Millennium Development Goals (MDGs).“Parents must … understand that rapid fluid treatment is life-saving for children diagnosed with shock or poor blood circulation due to diarrhoea” – Prof Grace Irimu, Associate Professor of Paediatrics, University of Nairobi

The primary treatment for acute watery diarrhoea is rehydration, administered intravenously in the most severe cases of very young children suffering from shock after losing excessively high quantities of body fluids. A fluid bolus – or rapid liquid dose – delivered directly through an intravenous drip allows a much faster delivery than oral rehydration.

However, notes nurse Esther Mayaka at the Jamii Clinic in Mathare, Nairobi, “parents of children brought to hospital with acute watery diarrhoea are refusing to have them put on [drip] fluid treatment and this is a major concern because diarrhoea is a leading killer among children and giving fluids is still the main solution.”

She told IPS that the ongoing rains and floods in many parts of the country “have created a comeback for diseases like cholera whose most telling sign is watery diarrhoea which needs to be managed with fluids.”

In February this year, Kenya’s Director of Medical Services, Dr Nicholas Muraguri, issued a cholera outbreak alert following an increase in cases of acute watery diarrhoea in several counties, including Homa Bay, Migori and Nairobi.

According to Prof Grace Irimu, Associate Professor of Paediatrics at the University of Nairobi, the reluctance to resort to drip fluid treatment has arisen due to misunderstanding generated by a Fluid Expansion As Supportive Therapy (FEAST) study in 2011 to establish whether the bolus technique was the best practice to use among children diagnosed with shock.

The FEAST study, which was conducted among children in Kenya, Tanzania and Uganda, found that fluid boluses increased 48-hour mortality in critically-ill children with poor blood circulation or shock in these resource-limited settings in Africa, but Irimu told IPS that the study excluded diarrhoea and only studied illnesses associated with fever, such malaria and sepsis.

“Parents must therefore understand that rapid fluid treatment is life-saving for children diagnosed with shock or poor blood circulation due to diarrhoea,” she said.

The Kenya Paediatric Association is also trying to set the record straight and, in a statement shared with IPS, the association reiterated that “diarrhoea complicated by severe dehydration is one of the biggest killers of children globally.”

According to the paediatrics association, the FEAST study excluded children with diarrhoea and dehydration because “the value of giving fluids in this group is well known. Giving appropriate fluid therapy is essential.”

Prof Irimu told IPS that the FEAST study had led to a revision of the ‘Basic Paediatric Protocols’, Kenya’s national guidelines for paediatric care, and clauses that address the treatment of diarrhoea were also revised.

Previously, a child diagnosed with shock as a result of diarrhoea would be given fluids in three cycles, every 15 minutes depending on the response. Now, the child receives the fluids in two cycles and if there is no response, health providers are advised to proceed to slower fluid administration where the child is given the amount that the body needs, depending on the level of dehydration.

Meanwhile, the country continues to make strides in dealing with HIV/AIDS – another critical health issue covered by the MDGs – among children. Studies show that the number of children with HIV aged between 18 months and 14 years fell from 184,000 in 2007 to 104,000 in 2012, according to the most recent Kenya Aids Indicator Survey.

However, Prof Joseph Karanja, a reproductive health and HIV/AIDs expert in Nairobi, says that the country can still do better because “through available antiretroviral drugs as a preventive measure among HIV positive mothers, HIV transmission to the infant can be reduced to as low as one percent.”

Dr Pauline Samia, a paediatric neurologist and a board member of the Kenya Paediatric Association, says that there is also a commitment to address conditions that challenge the management of HIV among children such as epilepsy.

“Though research in this area is limited, an estimated 6.7 percent of children with HIV also have epilepsy, with at least 50 percent of children with HIV having central nervous system problems such as delayed development, behavioural challenges and convulsions,” she observes.

Regarding progress in other MDGs, some progress has been made in reducing the prevalence of underweight children less than five years of age, one of the goals set for eradicating extreme hunger and poverty.

The 2014 Kenya Demographic and Health Survey reports that not only has childhood malnutrition declined significantly, from 35 percent in 2008 to the current 26 percent, but the prevalence of underweight children also decreased from 16 percent in 2008 to 11 percent in 2014.

On the front of improving maternal health, the survey says that while maternal mortality remains high at 488 deaths in every 100,000 live births, in the past five years more than three in five births (61 percent) took place in healthcare facilities, a marked improvement compared with the 43 percent in 2008.

Edited by Phil Harris