Coastal villages throughout the Solomon Islands rely on selling fish for household incomes. Selling fish in Auki, Malaita Province, Solomon Islands. Credit: Catherine Wilson/IPS

By Catherine Wilson
SYDNEY, Australia, Apr 29 2026 (IPS)

It is an invisible contaminant that has been found in fisheries, an essential part of the food chain for many Pacific Islanders. Mercury, emitted from fossil fuel power generation and other industrial processes around the world, has now penetrated marine ecosystems in the Pacific Islands with detrimental consequences for people’s health and wellbeing.

But island states, supported by scientific expertise at the Secretariat of the Pacific Regional Environment Program (SPREP), the United Nations Environment Program (UNEP) and funding by the Global Environment Facility (GEF), the world’s largest multilateral fund  for the environment, are implementing the action needed. The Mercury Free Pacific campaign is forging progress to protect islanders and their natural habitats from poisoning.

“Our communities face mercury risks from two main sources: what we eat, fish, and what we use in our homes and workplaces,” Emelipelesa Sam Panapa, Chemical Management Officer at the Department of Environment in the Polynesian atoll island nation of Tuvalu, told IPS. “Fish is the most widespread and challenging risk. It is not just food; it is central to our culture, livelihood and food security.”

The Mercury Free Pacific Campaign has brought together Pacific Island nations and the expertise of the SPREP and UNEP and been made possible with funding by the GEF. Credit: GEF

Mercury is a natural element in the Earth that has been released into the atmosphere for millennia through volcanic events and rock erosion. But human-generated, mostly industrial, processes have accelerated the build-up of mercury emissions. Metal processing facilities, cement works, the production of vinyl monomer and coal-fired power stations are the biggest contributors to the high levels of mercury in the atmosphere today.

From 2010 to 2015 alone, global anthropogenic mercury emissions rose by 20 percent, reports the UNEP. Coal-burning processes account for about 21 percent of all emissions. And this is projected to increase if a further 1,600 planned coal-driven power stations, on top of the existing 3,700 worldwide, are built. Already mercury in the atmosphere is about 450 percent above natural levels, reports UNEP.

After travelling long distances, mercury emissions then deposit in oceans. And toxicity begins when natural bacteria in aquatic environments mix with mercury, transforming it into Methylmercury, which is a neurotoxin. In the Pacific region, Methylmercury has contaminated beaches, coral reefs and fisheries, including swordfish, shark, tuna and mackerel, that are commonly consumed daily. Seafood is an important source of protein for up to 90 percent of Pacific Islanders and contributes to cash-based livelihoods for about 50 percent, reports the Food and Agriculture Organisation (FAO).

Today mercury is named one of the top ten chemicals of concern to public health by the World Health Organization (WHO) and the danger is especially acute in women and children. It can, in higher doses, inflict damage on cardiovascular organs, kidneys and the nervous systems of pregnant women and subsequently affect organ development of the foetus.

A fisherman on the coast of Funafuti, Tuvalu, throwing a weighted net out into the seawater, a traditional form of fishing. Credit: Rodney Dekker / Climate Visuals

The results of a medical study conducted by the Biodiversity Research Institute (BRI) confirmed health concerns.  Testing for traces of mercury in 757 women, aged 18-44 years, in the developing island states of the Caribbean, Indian and Pacific Oceans, including the Cook Islands, Tuvalu, Kiribati, Tonga and Marshall Islands, revealed that 58 percent possessed a level in their bodies that exceeded the safe threshold of 1ppm Hg. Researchers concluded the most likely cause was the high consumption of contaminated fish. In comparison, women who consumed lower amounts of fish and seafood recorded the lowest levels of mercury.

However, islanders also encounter toxicity in their households. Mercury is used in the production of common imported consumer products, such as fluorescent light tubes, electrical switches, dental amalgam fillings and skin lightening cosmetics. But it is when these products reach the end of their lives and are discarded that mercury is at risk of lingering indefinitely in the environment.

“The core of the problem is that mercury-added products are not being separated from municipal solid waste, and there are no local facilities for the environmentally sound disposal of mercury waste,” Soseala Tinilau, SPREP’s Hazardous Waste Management Advisor, told IPS. Also, “medical waste incineration sites are identified as potential sources of mercury emissions to the air.” And in some locations, raw sewerage flows have contributed mercury waste due to affected products being washed down drains into waterways and the sea.

A challenge is that waste management systems in many Pacific Island countries are constrained by lack of capacity, technology, resources and infrastructure. “There are no local facilities for the environmentally sound disposal of mercury waste. Therefore, a system for packing, exporting and disposing of this waste in an approved facility abroad is a critical need,” Tinilau specified.

Fisheries, susceptible to mercury contamination, are a major source of food and protein for Pacific Islanders. Fish market, Port Moresby, Papua New Guinea. Credit: Catherine Wilson/IPS

Several years ago, numerous Pacific Island states, including Kiribati, Palau, Tonga, Tuvalu and Vanuatu, joined the Minamata Convention. The first global agreement to reform the ways in which mercury is used, phase it out in industries and develop better waste management practices, among other measures, came into effect in 2017.

Now governments in the region are drawing further on the power of multilateral collaboration in the Mercury Free Pacific initiative. The expansive mandate of the GEF-funded project includes conducting national surveys of mercury contamination, educating local communities about the risks, reviewing exposure to mercury-added consumer products, reforming waste management practices and assisting governments to develop relevant legislation.

The GEF is funding US$12.6 billion in environmental projects currently underway globally, which are expected to generate a further US$80.5 billion in co-financing. And it has a long view of its commitment to the Mercury Free Pacific project through its GEF Islands program, with goals outlined until at least 2030.

Anil Bruce Sookdeo, the GEF’s coordinator for Chemicals and Waste, elaborated that in the Pacific the GEF has provided US$1.5 million for gathering mapping data, its analysis and developing action and remedial plans in eleven Pacific Island nations, including the Federated States of Micronesia, Samoa, Kiribati, Tuvalu and Vanuatu.

A further US$2 million is allocated to supporting national responses, such as devising effective legislation, community awareness programs and improving waste management processes. The campaign “represents a long-term regional objective, rather than a time-based project and requires sustained commitment and coordinated action by Pacific countries, regional institutions and partners,” he emphasised.

GEF funding has empowered Tuvalu, a country comprising nine coral islands and 11,800 people in the South Pacific, to make strides in its whole-of-society response to the issue.  The government has been able to strengthen its capacity and expertise, organise media awareness campaigns and oversee consultation with industries, communities and civil society organisations.

“For the first time, we have a national estimate of where mercury is coming from…we are beginning to understand the risks to our people and we have a roadmap for future action,” Panapa said in outlining the benefits of the Mercury Free Pacific initiative. At the same time, “these efforts represent the beginning of a longer journey to build community understanding and change behaviours related to mercury-added products, waste disposal and dietary choices.”

But a mitigation goal at the top of the list is to prevent mercury from reaching the islands. “Making marine life safe from mercury contamination is not about eliminating mercury already present in the ocean, but about preventing further contamination and managing the risk of exposure,” Tinilau said.

This means, among other measures, restricting the importation of mercury-added consumer products and galvanising global action to halt mercury emissions. Global consensus on phasing out coal-fired power stations and reforming industrial processes would be a start.

Pacific Island countries are demonstrating the political will and action with “regional coherence, national ownership and sustained momentum toward reducing mercury risks to human health, the environment and food systems in the Pacific,” emphasised Sookdeo from the GEF. Now, big emitters need to heed the urgency of reducing emissions at their source.

Notes: The Eighth Global Environment Facility Assembly will be held from May 30 to June 6, 2026, in Samarkand, Uzbekistan.
This feature is published with the support of the GEF. IPS is solely responsible for the editorial content, and it does not necessarily reflect the views of the GEF.

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Dr Anasaini Cama of the Fred Hollows Foundation conducts tropical disease training in the Solomon Islands. Credit: Shea Flynn/RTI International

By Catherine Wilson
SYDNEY, Australia, Feb 25 2026 (IPS)

Two Pacific Island nations have been applauded for their successes in the global health campaign to eliminate the infectious eye disease, Trachoma.

Better disease data, effective treatment campaigns and improved access to water and hygiene contributed to the major progress now being celebrated as 27 nations worldwide are declared Trachoma-free by the World Health Organization (WHO). But, above all, experts say that the key to the permanent riddance of diseases is a genuine buy-in to the eradication programmes by entire communities.

“Trachoma elimination efforts are most effective when communities understand the disease, trust the interventions and are actively involved in prevention activities,” Dr Anasaini Cama, Pacific Trachoma Technical Lead at The Fred Hollows Foundation, a global non-government organisation working to eradicate preventable blindness, told IPS.

Finally eliminating Trachoma in countries such as Papua New Guinea is a major achievement when more than 80 percent of people live in rural and remote communities, where the risk of infection is especially high.

“This milestone reflects the power of public health at its best…It is a reminder that equity, visibility and prevention must be at the heart of our health system,” Elias Kapavore, Minister for Health in PNG, the most populous Pacific Island nation of more than 10 million people, told the media last year.

The infectious eye disease is one of 21 Neglected Tropical Diseases that, under Sustainable Development Goal 3.3, are being targeted for global eradication by 2030. And reports reveal that strides are being made. Between 2002 and 2025, a period of little more than two decades, the global population at risk of Trachoma fell from 1.5 billion to 97.1 million people, WHO reported in January.

Children in rural communities in southwest Pacific Island countries, including Papua New Guinea, were highly vulnerable to eye infections, such as Trachoma. Now the country has been applauded for its campaign to eliminate the disease. Credit: Catherine Wilson/IPS

“Trachoma, once a leading cause of blindness in Fiji, was widespread in the 1950s, with prevalence exceeding 20 percent among children in some areas. Today, following sustained national action, the prevalence of active Trachoma has fallen to below 1 percent,” Fiji’s Health Minister, Dr Ratu Antonio Lalabalavu, told local media.

Trachoma is the leading cause of blindness around the world and is found primarily in tropical climate zones and rural communities affected by poverty and lack of basic services. It is caused by a micro-organism, Chlamydia trachomatis, known to be carried by flies, with children and those living in overcrowded conditions the most vulnerable. In advanced cases of the disease, there is chronic scarring of the underside of the eyelid, which can then turn inward, resulting in the eyelashes inflicting permanent damage to the eye’s cornea.

Trachoma was first identified in PNG and Fiji when health surveys were conducted in the 1950s. Studies also revealed that it was endemic in the Solomon Islands and Vanuatu. More recently, in 2015, extensive studies were carried out in the provinces of Central, Madang, Morobe, East New Britain, Southern Highlands and Western in PNG as part of the Global Trachoma Mapping Project. The prevalence of trachomatous inflammation-follicular (TF) in children aged 1-9 years was found to be between 6 percent and 12.2 percent, exceeding the WHO threshold of 5 percent.

The disease can be debilitating and make it increasingly difficult for a child to attend and participate in school classes and, thus, hinder their development and increase their exposure to poverty and malnutrition.

Changing the conditions and habits through which the disease thrives is, therefore, crucial. And this is a vital part of WHO’s recommended approach, called the SAFE strategy. That is, surgery for patients with an advanced stage of the disease, including blindness, prescribing antibiotics to diminish infection, encouraging facial cleanliness, and environmental improvements.

Today, the development charity Mercy Works is working to boost better health in very remote villages in Kiunga in Western Province, close to the far western border of PNG, by ensuring supplies of clean water. Here, “safe water remains a daily challenge,” Andrew Lowry, Head of Mercy Works’ Programs, told IPS. “Frequent flooding contaminates water sources and damages infrastructure. Many communities have no road access, so materials and tradespeople travel by plane or boat, and often on foot. Schools and health centres often operate without a reliable water supply, making basic hygiene practices difficult to sustain.”

Mercy Works installs rainwater collection and storage systems in schools, health centres, and villages in both the Western Province and the Simbu Province in the Highlands region.

Nearly 4,000 kilometres southeast of PNG in Fiji, Cama has witnessed the impacts of eye diseases and interventions that have been effective. In the north of the country, she visited villages that were kept clean and neat and it was difficult to see if there was overcrowding in the households. “Generally, extended families living together is considered normal. What we did notice, and similarly in nearby villages, was the water issues, where water was not always available and water trucks would cart water to the village,” Cama told IPS.

In the community, “children were active and did not appear unwell in any way,” she recounted. “It was only when health care workers flipped the child’s eyelids that the inner surface of the eyelid would have follicles that were typical for Trachoma.” Once a child was diagnosed, Tetracycline eye ointment was prescribed to be applied twice a day for six weeks, together with recommended regular face washing.

This year, WHO announced that, for the first time since world records began, the number of people requiring healthcare intervention for Trachoma has fallen below 100 million. Yet the future cannot be one of complacency. Rising climate extremes across the Pacific Islands could reverse this achievement.

“Climate change can impact Trachoma programmes and cause re-emergence of Trachoma, meaning long-term vigilance is required,” Cama emphasised. “Flooding and warmer temperatures can damage sanitation systems that lead to a reduction in environmental hygiene, causing an increase in the presence of flies in the community, which can increase the spread of Trachoma. Through drought and low rainfall, accessibility to water is decreased, making regular face washing and hygiene more challenging.”

Boosting the number of trained health professionals is also critical in countries where national health services battle against limited resources, medical supplies and manpower. “One of the biggest challenges in the Pacific is the shortage of trained eye care specialists,” Cama said.

This is the case in both Fiji and PNG, where “only 8 of 22 provinces actually have an eye doctor”. To overcome this deficit, the Fred Hollows Foundation established the Pacific Eye Institute, the region’s first ophthalmic training institute, in Suva, Fiji. “Our goal is to have at least one eye doctor and a team of eye nurses in every province [in PNG],” she said.

The dividends of extinguishing diseases, such as Trachoma, are profound for people and communities. And aspirations of national development can be realised when health services contend with a diminished burden of illness, more children can finish their education and more people of working age can contribute to their communities and the economy.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

But without transparency, funding, and political will, it may remain that way for years to come. And if that happens, the world could be left just as vulnerable when the next pandemic emerges.
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Community Health Assistants from Kenya. Credit: Friday Phiri/Amref

By Friday Phiri
BONN, Jun 11 2024 (IPS)

There is a rapid realization that climate change is impacting health, which is why the recently adopted World Health Organization’s Climate Change and Health Resolution is considered pivotal.

“Knowing that some of the difficulties we are currently facing are a result of climate change is assisting us in understanding which diseases are prevalent when it’s dry or during heavy rains. That way, we can increase awareness of which of the diseases that commonly occur in Mandera, especially malaria, dengue fever, and cholera, are likely to spread depending on the season,” are the sentiments of health assistants only identified as Nasra, Salima, Samlina and Ubah.

They are among over 100 Community Health Assistants (CHAs) from Mandera County in Kenya who are part of on-going country-wide training by Amref Health Africa to build capacity on essential skills to tackle health challenges.

This exemplifies the different layers of challenges that climate change creates for the health sector, not only altering disease spread and patterns but also complicating service delivery.

African Group of Negotiators Chair Ali Mohamed of Kenya during the SB60 opening session.

It is for this reason that at the just-ended 77th World Health Assembly (WHA 77) in Geneva, Switzerland, the 194 member states of the World Health Organization (WHO) adopted a historic resolution on Climate Change and Health.

The landmark decision marks a pivotal step in the global endeavor to protect communities from the diverse negative health impacts driven by climate change, as well as calling on the health sector to decarbonize.

The escalating climate crisis is a major driver of poor health outcomes, threatening to reverse five decades of progress in development, global health, and poverty reduction while exacerbating existing health disparities both between and within populations. The associated health damage costs are estimated to range between USD 2-4 billion annually by 2030. Regions with fragile health infrastructures, particularly in developing countries, will face the greatest challenges in coping without substantial assistance to bolster their preparedness and response capabilities.

“The movement to position health as ‘the human face of climate change’ has gained significant momentum with the adoption of this resolution, and I am profoundly optimistic about its transformative potential,” said Dr. Githinji Gitahi, Group Chief Executive Officer (CEO) of Amref Health Africa and the COP28 Climate and Health Envoy for Africa.

“This marks a pivotal moment where global leaders have formally acknowledged the urgent need to address the intertwined crises of environmental and public health with a unified, collaborative approach.”

However, there is still some work to be undertaken, as health is not yet part of the mainstream agenda of climate negotiations at the global level. The health community has the daunting task of navigating its way into the United Nations Framework Convention on Climate Change (UNFCCC) processes for a comprehensive global agenda on climate and health.

It is worth noting, however, that there have been efforts at the global and regional levels, such as at COP26 in Glasgow, where the health community reached an important milestone in bringing human health to the forefront of climate change work, with initiatives to support countries in developing climate-resilient and low-carbon sustainable health systems.

At COP28, the Climate and Health Declaration articulated similar commitments, including pledges of financial support to the sector in support of climate and health actions.

At the 60th session of the UN Climate Change Subsidiary Bodies (SB60) in Bonn, Germany, the African constituency is seeking ways to actively engage in the discourse and ensure that Africa’s interests in relation to the impacts of climate change on health are well noted.

Amref Health Africa Director of Population Health and Environment, Dr. Martin Muchangi.

During the preparatory meeting of the African Group of Negotiators prior to the SB60, AGN outgoing Chair, Zambia, raised the climate and health agenda and encouraged negotiators to take keen interest and actively engage in the climate and health discourse to set Africa’s agenda, particularly in the Global Goal on Adaptation’s UAE-Belem work programme on indicators where health is one of the thematic targets.

“A crucial point for us to ponder under the UAE-Belem work programme is the inclusion of health as one of the thematic targets. Instead of waiting for this agenda to be set by others, we should, as a group, be actively involved. The work programme offers a window for us to input in terms of how health should be mainstreamed into climate negotiations. As AGN, we have the AAI, which stands out as a shining example of our capacity to set our own agenda in these processes,” said Dr. Alick Muvundika, representing Zambia, as outgoing Chair of the AGN.

Paragraph 9(c) of the GGA decision at COP28 urges Parties and invites non-Party stakeholders to pursue the objectives of the GGA and increase ambition and enhance adaptation action and support in order to accelerate swift action at scale and at all levels, from local to global, in alignment with other global frameworks, towards; attaining resilience against climate change-related health impacts, promoting climate-resilient health services, and significantly reducing climate-related morbidity and mortality, particularly in the most vulnerable communities.

In view of the decision, the health sector in Africa, led by Amref Health Africa and partners, is leading efforts in support of Africa’s active engagement in the UAE-Belem Work programme on indicators for the GGA framework, as well as general technical support for mainstreaming health in climate policies and plans.

During a meeting of African Civil Society Organizations (CSOs) with AGN Chair at the on-going SB60, Amref Health Africa Director for Population Health and Environment, Martin Muchangi, said climate change is complicating health interventions and delivery, adding that “the visible impacts highlight that health is the human face of climate change.”

Muchangi briefed the AGN Chair on Amref’s availability and readiness to support the group to ensure that the yet-to-be developed indicators and related metrics of the health thematic target in the GGA framework would be in line with Africa’s aspirations in view of the continent’s unique circumstances and vulnerability.

“Amref and partners stand ready to support and ensure that the impacts of climate change on health are systematically addressed through investments, capacity building, building strong and resilient health systems, and ensuring that the voice of reason and science gets us where we want to be,” added Muchangi.

And AGN Chair Ali Mohamed welcomed the World Health Organization (WHO) resolution on climate and health, saying it was a step in the right direction.

Ambassador Mohamed challenged CSOs to heavily invest in research for Africa’s positions to be founded on well-grounded evidence, saying the continent continues grappling with climate-induced challenges, thereby worsening most countries’ debt portfolios.

“I am aware of the climate and health agenda as the WHO passed a resolution last week. This is a welcome move amid the visible impacts of climate change on health. The impacts on infrastructure, water and all other sectors are ultimately on human health. For us, health is one of the thematic targets of the Global Goal on Adaptation and we are ready as a group to engage further on the matter,” said the AGN Chair.

“My plea is for us, and I challenge you as CSOs to invest in research. Let’s generate a formidable base of evidence, building on the existing evidence base of Africa’s vulnerability and disproportionate impacts of climate change so that our arguments in these processes are well informed and clear,” added ambassador Mohamed.

Amidst all this, a recent report by the United Nations Economic Commission for Africa (UNECA), titled “Building Africa’s Resilience to Global Economic Shocks,” indicates that climate shocks generally are highly correlated with the cyclical component of GDP growth and not with the long-term trend in Africa, which suggests that part of the volatility observed in growth emanates from climate-induced shocks.

With the situation already volatile, as highlighted, stakeholders continue to seek integrated interventions, including the mainstreaming of health in climate policies and plans.

Note: The author is the Climate Change Health Advocacy Lead at Amref Health Africa.

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The WHO’s Africa office has published research in 25 peer-reviewed journals in attempt to address the imbalance of research as part of the 2030 SDG agenda, which is to ‘leave no-one behind,’ and a move toward universal health coverage. Credit: WHO

By Maina Waruru
NAIROBI, Apr 29 2024 (IPS)

The World Health Organization’s African regional office and partners published over 25 peer-reviewed articles in scientific journals in 2023 as part of efforts to address the imbalance in global research and ensure that Africa was better represented in the production of health research academic literature, a new report shows.

The office, through its Universal Health Coverage, Communicable and Non-Communicable Diseases (UCN) Cluster, published on a range of health challenges and diseases, including the risk of zoonotic disease in countries ranging from Uganda, Malawi, Tanzania, Ghana, and Nigeria, investigating infectious and non-infectious diseases, and public health approaches to ease Africa’s disease burden.

This research is critical to the continent, says Africa’s Regional Director, Dr. Matshidiso Moeti.

“The WHO African Region arguably bears one of the greatest burdens of disease globally. This has always been exacerbated by poverty, which, in the decade prior to COVID-19, was on the decline. Now, however, these gains have been reversed, not only by COVID-19 but by a series of severe shocks during the 2020–2022 period,” said Dr. Matshidiso Moeti, the Regional Director for Africa,” she told IPS.

“Major threats include climate change, global instability, slowing economic growth, and conflict. This makes it ever more important that we at the WHO Regional Office for Africa focus on the central promise of the 2030 SDG agenda, which is to ‘leave no one behind’, using a health systems strengthening approach to move towards universal health coverage.”

According to the Ending Disease in Africa: Responding to Communicable and Noncommunicable Diseases 2023 report released in April, WHO scientists were able to publish their work in reputable journals, including the Social Sciences and Humanities Open, supporting Africa’s efforts to raise her scientific research production, estimated at only 2 percent of the world’s total.

The works also found homes in open access journals, including America’s Public Library of Science (PLOS), where they are accessible for free by the scientific community and the general public.

Besides Africa-based scientific publications such as the Nigerian Journal of Parasitology, highlighting the need to support the role local publications can play in elevating African science and, by extension, helping address imbalances in global research.

“A country’s ability to create, acquire, translate, and apply scientific and technological advancements is a major determinant of its socioeconomic and industrial development. Many of Africa’s current and future health challenges can only be addressed by conducting research on population-based approaches towards effective disease prevention and control, which are then translated into policy and practice,” the report noted in introducing the work.

“Despite Africa’s disproportionate burden of disease, the region produced 0.7 percent of global research in 2000, 1.3 percent in 2014 and an estimated 2 percent more recently. In response, the UCN Cluster and partners published over 25 peer-reviewed articles in scientific journals in 2023 as part of efforts to address the imbalance in global research, and ensure regional representation in academic literature.”

According to the Ending Disease in Africa: Responding to Communicable and Noncommunicable Diseases, WHO scientists were able to publish their work in reputable journals, supporting Africa’s efforts to raise her scientific research production, which is estimated at only 2 percent of the world’s total. Credit: WHO

In Ghana, the WHO team conducted a “community-based cross-sectional study” to investigate occurrences of skin ulcers, whose findings showed the importance of integrating multiple skin diseases on a common research platform in findings published by PLOS One, while in Tanzania, a “spatio-temporal modelling” of routine health facility data to better guide community-based malaria interventions on the mainland was done.

Some of the papers the WHO-Africa says were examples of “operational and implementation research,” conducted to identify and ensure the successful adoption and adaptation of evidence-based interventions in both clinical and public health on the continent.

They include findings from an impact assessment of a school-based preventive chemotherapy programme for neglected tropical diseases (NTDs), schistosomiasis, and soil-transmitted helminth control in Angola, where used drugs were found to have little impact in controlling the diseases. These findings were published in PLOS Neglected Tropical Diseases.

“This highlighted the need for a comprehensive understanding of individual, community, and environmental factors associated with transmission and consideration for a community-wide control programme,” it concluded.

The Springer Nature’s Malaria Journal published the team’s research on treatment-seeking behavior among parents of children with malaria-related fever in Malawi. It captured  the need for targeted health interventions among communities in low socioeconomic settings and those living far from health facilities.

In Nigeria, an article based on experiences in Nigeria using a novel schistosomiasis community data analysis tool, developed by the UCN Cluster, emphasized the usefulness of the tool for strategic planning purposes, allowing the tool to be deployed around Africa for the management of the disease. Blood flukes (trematode worms) from the genus Schistosoma are the primary cause of the acute and chronic parasitic disease schistosomiasis.

Research on health policy and systems, the aim being to better understand how “collective health goals” are reached. This was done through a range of disciplines, including economics, sociology, anthropology, political science, and public health.

One such journal article was published by  Elsevier’s Social Sciences and Humanities Open, looking at five decades of infectious disease outbreaks on the continent and recommending  that concerted public health action may help reduce outbreaks, as well as drawing important conclusions for disease preparedness and prevention activities.

Quite critically, the experts undertook “knowledge translation” work, the application of knowledge by various actors to deliver the benefits of global and local innovations in strengthening health systems and improving health.

“In the African context, knowledge translation generally includes an aspect of localization, considering local perspectives and approaches and the effects of the social, cultural, political, environmental, and health system context on an intervention’s impact,” the experts explain.

In 2023, the UCN Cluster translated and localized several global knowledge products for use in Africa, including one on oral diseases, a malady suffered by about 44 percent of the population in the region.

Africa, the document observes, has experienced the “steepest rise globally in oral diseases over the last three decades,”  even as spending on treatment costs remains “extremely low,” thus the need to share the newest information on their management.

Away from scientific research, the report reveals that Mauritius became the first country in Africa to fully implement WHO’s package of tobacco control measures, while at the same time WHO-Africa launched an initiative to support better access to breast and cervical cancer detection, treatment, and care services in Côte d’Ivoire, Kenya, and Zimbabwe.

Equally important, WHO Africa, in collaboration with Nigerian authorities, introduced the human papillomavirus (HPV) vaccine into routine immunization schedules, targeting more than 7 million girls, the largest number in a single round of HPV vaccination in Africa.

Success stories emerged in Algeria, which successfully ‘interrupted’ the transmission of schistosomiasis after reporting zero indigenous cases for the past three years, in January 2024, and in Cape Verde, which became the third country to be certified as malaria-free.

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

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Climate change, ecological degradation, migrating populations, conflict, pervasive inequalities, and predatory commercial practices threaten the health and future of children in every country, a new report states. Credit:Tess Bacalla/IPS

By Samira Sadeque
UNITED NATIONS, Feb 21 2020 (IPS)

There is no country that is on the right path to ensure the safety, health and proper environment for their children, an explosive report has claimed. 

The report “A future for the world’s children?” was released in a joint venture by the World Health Organization (WHO), the United Nations Children’s Fund (UNICEF) and The Lancet on Wednesday. 

“Climate change, ecological degradation, migrating populations, conflict, pervasive inequalities, and predatory commercial practices threaten the health and future of children in every country,” the report stated.

It reiterated the need to take into account the “ecological sustainability and equity” in order to make sure that all children, including the most vulnerable, are safe and their futures on the right track.

The report examined and made recommendations in four key areas: early investment in children’s health and education; omission of greenhouse gases as a means to protect children’s future; to address the issue of “commercial harm” done to children; and the key role governments ought to play in ensuring care and protection for all children. 

One of the key observations was made in the section of climate change, where authors claimed an onus of the responsibility falls on a certain section of society.

“The poorest countries have a long way to go towards supporting their children’s ability to live healthy lives,” the report read, “but wealthier countries threaten the future of all children through carbon pollution, on course to cause runaway climate change and environmental disaster.” 

Anthony Costello, Professor of Global Health and Sustainable Development at University College London, pointed out a host of ways in which wealthier countries can do so. He shared with IPS a list of measures wealthier countries can take:

• Stop subsidies to oil, gas and diesel fossil fuels on which governments spend more than $5 trillion per year. Renewables are now cheaper and more economic than fossil fuels.
• Ask big finance to divest from fossil fuel companies. This is gaining momentum.
• Make the transition rapidly to electrified cars and public transport.
• Change our food system: promote a healthier diet based on less red meat and dairy. Tackle the one third wastage of all food with more local production and less transport.
• Plant 500 billion trees. This is doable over ten years. Grazing animals don’t need to be in open fields. Silvopasture is where you graze them in fields with trees. 
• Move to conservation agriculture.
• Cut taxes on income and replace taxes on carbon. This way people can exercise their preference to a low carbon life.

Another key observation made in the report was about the widely negative impact of “commercialisation” on the well-being of children. The authors of the report recommended that the U.N. Convention on the Rights of the Child (CRC) adopt a new protocol that would protect children from commercial harm.

“The commercial sector’s profit motive poses many threats to child health and wellbeing, not least the environmental damage unleashed by unregulated industry,” read the report. “More immediately, children around the world are enormously exposed to advertising from business, whose marketing techniques exploit their developmental vulnerability and whose products can harm their health and wellbeing.”

The report acknowledged the role commercial entities play in job creation and generating economic growth, but reiterated that children need to be protected from these companies’ promotion of “addictive or unhealthy commodities,” including fast-food,  alcohol, and tobacco, gambling, and social media as they have a significant effect on the well-being of children. 

Colorised scanning electron micrograph of MERS virus particles (yellow) both budding and attached to the surface of infected VERO E6 cells (blue). Credit: NIAID

By Samira Sadeque
UNITED NATIONS, Jan 31 2020 (IPS)

Weeks into widespread panic about the “Coronavirus” that has so far killed at least 170 people in China, the World Health Organisation (WHO) on Thursday declared it a public health emergency. As of Friday, the disease had spread to all the regions in Mainland China, with more than 7,500 cases in the country alone, according to the BBC. 

In a statement, WHO Director-General Dr. Tedros Adhanom Ghebreyesus said owing to the large number of cases, the pace at which it is spreading, and for not knowing what this damage could do, he was declaring it “a public health emergency of international concern over the global outbreak of novel coronavirus”.

The virus has so far spread to countries such as South Korea, and England with four countries reporting human-to-human transmission: Vietnam, Germany, Japan and the United States. A key message from Ghebreyesus was the concern regarding facilities in countries that have “weaker health systems”. 

He reiterated that it is not known the extent of the “damage” the virus could do if it spread to countries that don’t have the capacity to address such viruses. It’s unclear in what capacity WHO is working with these countries, and the organisation did not clarify when asked. 

“We support all countries as they coordinate the efforts of multiple sectors of the government and partners – including bi- and multi-laterals, funds and foundations, civil society organisations and private sector – to attain their health objectives and support their national health policies and strategies,” WHO said in a statement to IPS. 

The health network operates in six regions around the world with 149 field offices. 

Experts told IPS some of the main challenges for countries with “weaker health systems” include the laboratory access, staffing challenges, and bedding capacity.  

There remains a grave challenge in diagnosing the Coronavirus, especially given the symptoms are very similar to the flu. Because pneumonia can be caused by a number of viruses, there are extra lab test required to diagnose a patient with the coronavirus, and not all countries are equipped with that. 

Furthermore, it’s difficult to gauge what kind of treatment each patient needs: a person with a “severe” case might require different treatment. Also, if a larger group of patients each require a bed for treatment that can take up to 20 days, not all hospitals may have that capacity. 

Other concerns that experts worry about is how the virus is transmitted and how infected it is in a patient. In many places that fall under the category of “weaker health practices”, the enforcing of Infection Prevention and Control (IPC), the set of regulations for medical staff to prevent the spread of infections, in itself can be a challenge. 

Depending on how it’s contained and how soon a vaccine is available to stop it, the virus could affect anywhere between 39,000 to 190,000 people in Wuhan province of China, according to a Nature report.

Meanwhile, other countries that have key relations with China — such as those in Asia and Africa are turning away flights. Kenya Airways and RwandAir have suspended all flights from China. 

When asked by IPS whether countries with identified cases are seeking out assistance from WHO, the organisation said, “WHO is working 24/7 with networks of scientists, clinicians, disease trackers, governments, supply chain experts and partners from the public and private sector to coordinate the new coronavirus response and support affected and non-affected countries in various capacities as well as providing help if needed.”

Tropical Cyclone Idai made landfall on Mar. 14 and 15, destroying some 90 percent of Beria, the capital of Sofala province, Mozambique, according to reports. A majority of those affected are living in makeshift camps as they try to rebuild. A Global Humanitarian Overview (GHO) 2020 report claimed climate change, “unexpected spread of infectious disease” and regional conflicts were the main reasons pushing millions of people into spaces for humanitarian needs, and why the numbers of those in need was “unprecedented”.  Credit: Andre Catuera/IPS

By Samira Sadeque
UNITED NATIONS, Dec 10 2019 (IPS)

The world had an unexpected number of people in crisis this year, which exceeded projected numbers the United Nations had expected, with climate change being one of the key crises that led to “needs to unprecedented levels” according to a new report. 

The observations were made in Global Humanitarian Overview (GHO) 2020, which was released last week by the United Nations Office for the Coordination of Humanitarian Affairs (OCHA). According to the report, at the time of the GHO 2019 launch, 93.6 million people were targeted for assistance, despite 131.7 million being in need. By November 2019, the 117.4 million were targeted as opposed to the 166.5 million in need.   

The report claimed climate change, “unexpected spread of infectious disease” and regional conflicts were the main reasons pushing millions of people into spaces for humanitarian needs, and why the numbers of those in need was “unprecedented”.  

“Climatic shocks, the unexpected spread of infectious disease, and the impact of protracted and often intensifying conflicts have combined to drive needs to unprecedented levels this year,” Zoe Paxton, with the Humanitarian Affairs and Emergency Relief Coordinator, told IPS. 

“The current state of geopolitics means conflicts are becoming more protracted and intense. Combatants display growing disregard for international humanitarian law,” said Paxton, adding that a combination of issues affecting those caught in conflict situations: displacement, hunger, psychosocial trauma, and loss of their livelihoods, education facilities and health services. 

“That’s in addition to the direct impact of fighting, bombing and other violence affecting their physical safety and security,” she said. 

Perhaps one of the crucial ones remains the issue of climate change, with more frequent drought, floods, and tropical cyclones. Paxton says these concerns disproportionately affect already poor and vulnerable populations.

“Eleven of the 20 countries most vulnerable to climate change have appealed for humanitarian aid in each of the past seven years,” she told IPS. “We need to do better in prioritising climate change adaptation as part of humanitarian response.”

Paxton added that other factors that contribute to climate concerns are slow economic growth and debts of countries.  In 2019, she said, almost 60 million people in need of humanitarian assistance were from 12 of the 33 countries “in, or at risk of, debt distress,” she said. 

Mental health concerns 

One of the other pressing issues that appeared in the report is the mental health concern of those in need. The report says one in five people in conflict areas have some kind of a mental health condition. 

An increase in “highly violent conflicts” — from 36 last year to 41 this year — is leading to humanitarian concerns such as loss of livelihoods, sexual violence, hunger, while exacerbating mental health concerns.  According to a World Health Organisation report from June, of people who have lived in conflict for the past 10 years, about 11% are expected to have moderate or severe mental conditions. 

While mental health is mentioned in the report, it remains underreported or under-documented in some regions. For example, in Afghanistan, the report noted that “at least 11 percent of the population is estimated to have a physical disability, while an unknown number of people are suffering from mental health issues as a result of their constant exposure to conflict”.

Meanwhile, children are likely to bear the brunt of it the most. The report estimates that 24 million children currently living in some kind of conflict will experience some variation of a mental health condition which would require support. However, challenges remain in addressing this need. 

“Though there is increasing focus on mental health, the vast majority of survivors do not have access to care,” Dr. Mark van Ommeren, who authored an analysis of mental disorders in conflict settings, told IPS. “Whether or not support is made available is often dependent on the interest of individuals within donor agencies or individuals within agencies on the ground.”

In his foreword, United Nations Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator Mark Lowcock acknowledged the importance of addressing mental trauma as an issue. “We increasingly understand the need to deal with mental trauma as well as people’s physical health,” he wrote. “We are getting ahead of more crises by taking anticipatory action.”

Polio cases around have declined globally by more than 99 percent since 1988, but the type 1 poliovirus remains endemic in Pakistan and Afghanistan, where it has made a comeback this year and infected 102 people. Credit: Ashfaq Yusufzai/IPS

By James Reinl
UNITED NATIONS, Nov 20 2019 (IPS)

Efforts to wipe polio off the face of the planet took a step forward this week, with a multibillion-dollar fundraiser in the Middle East helping eradication schemes tackle a virus that disproportionately kills and cripples children in poor countries.

Donor governments and philanthropists pledged $2.6 billion on Tuesday in Abu Dhabi to immunise 450 million children against polio each year — further beating back a bug that is only endemic nowadays in Pakistan and Afghanistan.

Some global health experts say mankind is walking its “final mile” towards a polio-free world, but others warn that so-called polioviruses could re-emerge and spread swiftly, as was witnessed to deadly effect in the Philippines earlier this year.

In Abu Dhabi, Tedros Adhanom Ghebreyesus, director-general of the World Health Organisation (WHO), said “one of the world’s largest health workforces” had been assembled so that medics reach “every last child with vaccines”.

#polio end game strategy 2019 – 2023 strongly supported by partners and global leaders pledging U$2.6 billion at Reaching the Last Mile Forum #RLMForum in Adu Dhabi today. read more https://t.co/mQJa8yjqGr

— WHO Afghanistan (@WHOAfghanistan) November 19, 2019

Reem Al Hashimy, Minister of State for International Cooperation for the United Arab Emirates, which hosted the event, said the Gulf nation was working hard injecting Pakistan children so that “together we can consign polio to the pages of history”.

The fundraiser came on the back of last month’s WHO announcement that the second of three types of poliovirus had been successfully eradicated around the world. The other strain was certified as wiped out in 2015.

Polio cases around have declined globally by more than 99 percent since 1988, but the type 1 poliovirus remains endemic in Pakistan and Afghanistan, where it has made a comeback this year and infected 102 people. 

Health workers in South Asia say that conflict prevents them from vaccinating children in Afghanistan’s polio hotspots, while in Pakistan, inaccurate video reports about vaccinations causing sickness have deterred parents from sending their children for jabs.

#DYK last month UNICEF and @WHO mounted a national immunization campaign against #polio aiming to protect all children under 15, across Iraq; including over 4,500 #Syrian children in Bardarash camp, outside Dohuk City in Iraq. pic.twitter.com/2xuiE4QR33

— UNICEF Canada (@UNICEFCanada) November 19, 2019

Polio invades the nervous system and can cause irreversible paralysis within hours. There is no known cure, but the bug can be prevented by vaccination. Immunisation campaigns have reduced worldwide cases in recent decades.

The disease mostly affects children aged under five years. In every 200 cases, one infection will lead to irreversible paralysis. Among those paralysed, between 5-10 percent of victims perish when their breathing muscles stop working.

Nigeria, the last African country to have cases of wild polio, has not seen any such outbreaks since 2016. WHO aims to certify Africa as polio-free next year, under the Global Polio Eradication Initiative’s “endgame strategy”, which culminates in 2023.

Still, polio-eradication efforts have repeatedly faced setbacks. In unvaccinated populations, or in areas where immunity is low and sanitation is poor, the resilient bug can quickly re-emerge and tear through vulnerable populations.

In September, the Philippines said it was planning an emergency vaccination campaign after polio re-surfaced and caused the first two recorded polio cases for 20 years, affecting different parts of the tropical archipelago.

? Incredible news! Thank you to our visionary donors at the #RLMForum who have pledged $2.6 billion to #EndPolio.

Standing together we will protect 450M children each year against polio and make the ? polio-free.#AcceleratingThePacehttps://t.co/GuSLc7R0uh pic.twitter.com/jsRZ504VQO

— Michel Zaffran (@michelzaffran) November 19, 2019

As such, health officials warned that donations in Abu Dhabi alone were not enough. Michel Zaffran, WHO’s point man on polio, told the Wall Street Journal daily that without immunisation schemes polio would “rapidly spread in the Middle East and Asia and go back to Africa.”

The biggest donation of $1.08 billion came from the Bill & Melinda Gates Foundation. Other pledges included Abu Dhabi’s crown prince Mohamed bin Zayed ($160 million) and the United States government ($216 million). 

(L-R) Somappa, 52, Muniraju, 37, and Kaverappa, 54, finish manually emptying a pit, in Bangalore, India in August 2019. Courtesy: WaterAid/ CS Sharada Prasad/ Safai Karmachari Kavalu Samiti

By James Reinl
UNITED NATIONS, Nov 15 2019 (IPS)

People who empty out sewage tanks and scrub down latrines doubtless perform a vital, thankless and even undesirable task. A new report, however, shows that doing such jobs could also cost workers their lives.

A study from the World Health Organization (WHO) and others has revealed that millions of sanitation workers in low-income countries are routinely exposed to contagious bugs, powerful chemicals and filthy conditions that can turn out to be deadly.

The 61-page study titled ‘Health, safety and dignity of sanitation workers‘ holds up the world’s sanitation workers as unsung heroes who risk their lives cleaning other people’s muck, saying they should at the very least get protective clothing and basic employment rights.

Speaking with reporters in New York on Thursday, United Nations spokesman Stephane Dujarric described the “unsafe and undignified working conditions of sanitation workers” across nine developing countries.

Researchers focussed on muck-cleaners in Bangladesh, Bolivia, Burkina Faso, Haiti, India, Kenya, Senegal, South Africa and Uganda who typically toiled in an “informal economy” lacking basic “rights and protection,” added Dujarric.

The report by WHO, together with the International Labour Organization, the World Bank, and WaterAid, a charity, described people around the world emptying pits and septic tanks, cleaning sewers and manholes and handling fecal sludge at treatment and disposal works. 

Researchers shone a spotlight on the case of Wendgoundi Sawadogo, a sanitation worker in Ouagadougou, capital of the landlocked West African country, Burkina Faso, a city of some 2.4 million people.

The 45-year was photographed climbing into latrines and open pits, holding muck-smeared ropes without gloves. In a statement accompanying the report, he described finding discarded syringes and broken calls in fetid pits. 

Sawadogo spoke of colleagues struggling to lift the concrete slabs that cover pits, occasionally breaking fingers, toes, and feet. The work is “really dangerous” and some of his co-workers have perished in such trenches, he added.  

“You have no paper to show that this is your profession. When you die, you die,” said Sawadogo.

“You go with your bucket and your hoe without recognition, without leaving a trace anywhere or a document that shows your offspring that you have practiced such a job. When I think of that, I’m sad. I do not wish any of my children to do the work I do.” 

Another emptier in the same country, Inoussa Ouedraogo, described a slab crushing his finger in an injury that cost the 48-year-old about $100 in local currency during 11 months of “painful”  treatment, in which time he had to carry on working. 

Researchers described sanitation workers toiling in sewage pits around the world without safety gear — risking exposure to cholera, dysentery and other killer bugs. Some 432,000 people perish from diarrhoeal deaths each year, the report said.

They also have to work in tanks amid fumes of ammonia, carbon monoxide, sulfur dioxide and other toxic gases that can cause workers to lose consciousness and die, or face long-term breathing and eyesight problems.

Few low-income countries have health and safety guidelines to protect sanitation workers, researchers said. There are no reliable global statistics, but it is estimated that one manhole worker dies unblocking sewers by hand in India every five days.

Dr Maria Neira, a public health director at WHO, called for much sanitation work to be mechanised so that workers do not have to touch human waste with bare hands. She called for better health and safety laws, training, protective gear, insurance, and health checks.

“Sanitation workers make a key contribution to public health around the world – but in so doing, put their own health at risk. This is unacceptable,” said Neira. “We must improve working conditions for these people.”

A young boy in Pakistan receives an oral polio vaccine (OPV). Over the last 30 years huge progress has been made against polio and it is now only endemic in 2 countries, Afghanistan and Pakistan, with only 33 cases confirmed cases last year. Credit: Ashfaq Yusufzai/IPS

By Tharanga Yakupitiyage
UNITED NATIONS, May 1 2019 (IPS)

Since the introduction of vaccines, diseases such as measles and polio were quickly becoming a thing of the past. However, the world’s progress on immunisation is now being threatened.

According to the World Health Organisation (WHO), 85 percent of the world’s children received basic vaccines, including the measles and diptheria-tetanus-pertussis (DTP) vaccines, which can protect them from infectious diseases that cause serious illness and even death.

In fact, measles immunisation resulted in an 80 percent drop in measles-related deaths between 2000 and 2017 worldwide.

Still, access to vaccines remain elusive for many out-of-reach communities.

In 2017, an estimated 20 million infants did not receive the DTP vaccine, 60 percent of whom live in just 10 countries, including Afghanistan, the Democratic Republic of the Congo, Iraq, and Nigeria.

A rising anti-vaccination movement is also threatening to dismantle progress.

In the United States, there are now more than 700 cases of measles across 22 states making it the highest figures the country has seen since 2000.

The phenomenon has prompted some states to not only make immunisation mandatory, but also to ban unvaccinated children from public spaces.

To mark World Immunisation Week, held during the last week of April, IPS spoke to WHO’s Coordinator of the Expanded Programme on Immunisation Dr. Ann Lindstrand on the challenges of immunisation and the way forward. Excerpts of the interview follow:

World Health Organisation’s Coordinator of the Expanded Programme on Immunisation Dr. Ann Lindstrand.

Inter Press Service (IPS): How is the overall global picture regarding immunisation, and why does immunisation matter? 

AL: Immunisation matters because it is one of the most effective health interventions that we have, and it has saved millions of lives. I don’t think there is any other health intervention that works that well, with such high coverage, worldwide.

Just looking back at what we have gained from immunisation—back in 1963 when we didn’t have any vaccine for measles, there were about 2.6 million deaths every year due to measles. Now, that figure has reduced by 95 percent. The last figures we have are from 2017 with an estimated 110,000 deaths—so there has been a tremendous health gain.

Same with polio—30 years ago, we had widespread polio crippling people but now its only endemic in two countries Afghanistan and Pakistan with only 33 cases confirmed cases last year.

Now the newer vaccines like HPV [human papillomavirus] will help us reduce numbers of cervical cancers and new vaccines on the horizon like the Ebola vaccine which is used in outbreaks in Africa right now has really played a critical role in stopping the spread of the current outbreak in the DRC.

Just this month, the first ever malaria vaccine is being piloted in routine immunisation programs in three countries.

We still need to reach more. We still need to reach the last 15 percent and we need to close equity gaps to reach those furthest away.

IPS: WHO and others have pointed to the anti-vaccination movement as one of the biggest health threats in the world. How concerning is the move away from vaccinations, and what does this mean for people around the world? Is this a new challenge for WHO? 

AL: It is an area of concern, yes.

But it is not the global picture. We do not have the data to say that hesitancy has increased but we have seen that with social media and the internet, misinformation is spread more widely and easily.

That’s something we are really worried about. In some areas, there is a resurgence of disease because of unacceptably low coverage rates or that people are refusing vaccines.

We need to see this in a historic perspective. Anti-vaccine messages have been around for just as long as vaccines have been around—these things come and they go.

But it worries us and we need to be right there to tackle to spread of vaccine misinformation. It is really important to put out the right messages.

I work as a paediatrician and I have talked to a lot of parents who have had these concerns and it takes a lot of effort.

At the heart of it, it is really the health worker who is sitting there with the [parent] who have concerns or have heard something on the internet or media, and they need to be able to respond to their questions and to listen and respect the concerns of parents.

And that those health workers actually have the capacity and time to respond, both with the social ability to listen to the parents’ real concerns and also provide the scientific evidence.

There is a lot of work in training healthcare workers which is ongoing and we need to keep doing that. We need to equip healthcare workers with the right methods, words, scientific evidence to reassure parents.

The bigger picture for us to improve health is for children everywhere to get vaccinated on time and every time. We need to increase access so that vaccine services are made convenient and welcoming so people want to go there, that we are good at putting out credible information from the beginning including what are the facts, what is the evidence.

IPS: Some U.S. states are enacting mandatory immunisation laws or even barring those who have not received vaccines from certain public spaces. Do you agree with these steps, or does more need to be done? 

AL: The only disease where WHO actually recommends mandatory proof of vaccination applies to yellow fever and for international travellers in certain countries.

Beyond that, it is up to every country to make decisions based on existing disease epidemiology, their laws and regulations, and if it is the best way to go.

Many countries have achieved high immunisation coverage without mandatory immunisation.

It is a complex area—how do you sanction parents? How far do you go to enforce laws when they are in place?

That is a conversation that every country needs to have before even considering any of the mandatory vaccinations.

I think it is important to encourage countries to invest in and protect their individuals and communities from vaccine-preventable diseases and then remove barriers—have few access barriers when it comes to cost and convenience.

Make it simple and easy. Make the choice of vaccines the social norm.

IPS: In light of World Immunisation Week, what is your message for people around the world regarding the importance of immunisation?  

AL: Immunisation is a fantastic health intervention. It is a right for all children, and it is also a shared responsibility.

As we have seen with the recent outbreaks, no country and no individual can afford to be complacent about vaccines. It is important that we look at not just putting out fires or responding to outbreaks after they have happened—that’s expensive, ineffective and it costs lives.

What is more important is to have sustainable prevention, thinking and ensuring that everyone everywhere is vaccinated at the right time with the right vaccines and throughout their life course.

It also important to see that vaccines is not just for saving lives, it helps children to learn, grow, keep them in school instead of sick, avert disabilities and long-term consequences. It reduces the health care costs for a country, and protects families and communities from sliding into poverty.

There is no debate to have on the benefit or the risk between vaccines and the vaccine-preventable diseases.

We need to continue to protect people also in the future, and we really need to invest in trust in vaccines and in our healthcare system.

Excerpt:

Family photo of part of the 111 participants in the First Latin American and Caribbean Assembly of Organisations of People Affected by Hansen's Disease, on the steps of the Morisco Palace, the headquarters of the Oswaldo Cruz Foundation, which hosted the three-day meeting in Rio de Janeiro, Brazil. Credit: Mario Osava/IPS

By Mario Osava
RIO DE JANEIRO, Mar 14 2019 (IPS)

With the decision to found a regional coalition to promote rights and greater participation in national and international forums and decisions, the First Latin American and Caribbean Assembly of Organisations of People Affected by Hansen’s disease, popularly known – and stigmatised – as leprosy, came to an end.

The final session of the meeting, on Mar. 14, approved 40 of the 58 proposals presented by the 111 participants in three days of debates at the headquarters of the Oswaldo Cruz Foundation, a renowned scientific, medical and epidemiological research centre in Rio de Janeiro, Brazil.

José Picanço, 46, separated from his family and taken as a newborn to an orphanage because his parents were diagnosed with the disease in 1972, is one of those affected whose right to reparations remains unfulfilled. His three siblings are in the same situation.

When the family was reunited eight years later, the father turned his back on the children. The mother took them in, but died shortly afterwards. “I only lived with her, a saint, for five months,” Picanço recalled, barely managing to hold in his tears while giving testimony at the meeting.

“Humiliated as the children of lepers, suffering bullying and sexual harassment, many of the other children who were with me at the orphanage fell into drug abuse and alcoholism. It was a holocaust,” he said. “I hit my brother on the head, not knowing he was my own brother.”

“Of the 15,000 to 20,000 children separated from their families, more than 80 percent suffer from depression,” said Picanço in an interview with IPS, detailing some of the damage caused by the old rule of segregating the people then called “lepers”.

Mandatory isolation was widespread around the world, during different historical periods, and continues in some countries, even though it is known that the disease is curable and that patients cease to be contagious shortly after starting treatment.

Officially, Brazil abolished this practice in 1976, although it actually lasted 10 more years. Its direct victims were compensated starting in 2007, but their children were not. The activists gathered in Rio de Janeiro called for working for policies of reparations for children separated from their families.

Their complaints and proposals will be taken to the World Congress of associations of people affected by leprosy in Manila in September, which will also receive contributions from Africa and Asia, approved at recent similar regional assemblies.

“The goal is to form a large network of activists, to strengthen the movement” for the eradication of the disease and for care and reparations for those affected, said Kiyomi Takahashi of the independent Nippon Foundation, which is driving this international process of debate and cooperation.

The meeting in Rio de Janeiro fostered “a high-level dialogue, the result of Morhan and Felehansen’s long history of activities,” the Japanese expert told IPS, referring to the Movement for the Reintegration of People Affected by Hanseniasis (Morhan) in Brazil, and the National Federation of Entities Affected by Leprosy or Hansen’s Disease (Felehansen) in Colombia, the two organisers of the regional meeting.

Brazilian activists José Picanço (front) and Evelyne Leandro testified about how Hansen’s disease affected them during a Latin American and Caribbean meeting in Rio de Janeiro. Picanço was separated from his parents when they were diagnosed with leprosy when he was born in 1972 and was only reunited with them eight years later, shortly before his mother died. Leandro wrote a book about the difficulties of being diagnosed with the disease in Germany, where she lives. Credit: Mario Osava/IPS

“Morhan is my safe haven, to preach that separated children should be heard and have opportunities,” said Picanço, who explained that he joined the movement in 1992. Today he gives talks on the direct and indirect effects of the stigma still surrounding the disease, that is suffered by those affected and their families.

A blessing

The disease “was a blessing for me,” Isaias Dussan Weck, 50, the vice-president of the Colombian association Felehansen, told IPS without hesitation.

The diagnosis in 2006 destroyed him, he said. He lost the desire to work or to go out, he let his business of supplying cleaning products to companies go bankrupt, he even contemplated suicide. He ignored the stains on his body that did not prevent him from working and traveling, until they spread to his face, and he noticed that parts of his body were going numb.

He received treatment and was cured, left with only slight numbness in one arm and pains in his left leg.

But everything went badly for him until he was invited to meetings with other people affected by leprosy. “I began to understand, when I heard their testimonies and tears, why a young black girl with severe disabilities said that leprosy was a blessing to her,” Dussan said.

Activism for the benefit of those affected, against the stigma and the damage caused by the disease, in the association of the department of Huila, in southwestern Colombia, allowed him “to gain new meaning for life and to understand and practice love for my neighbour.”

“Helping and seeing a patient’s life improve is a wonderful emotion, and you help other people want to live,” he concluded. That new passion led him to Felehansen, where he took on leadership roles in the federation.

Irma Romero, 42, president of the Nuevo Amanecer Foundation in Barranquilla, on Colombia’s northern coast, had a similar experience. Her lengthy odyssey to a specialist’s diagnosis five years ago reveals the medical system’s shortcomings when it comes to detecting and treating the disease, also known as hanseniasis, which is still viewed by many as “a divine punishment.”

Romero stopped working in the textile industry due to disability and depression. “I couldn’t even walk,” she recalled. “I even denied God,” she told IPS.

Colombian activist Irma Romero, a native of the city of Barranquilla, sitting on the bus that transported the participants of the First Latin American and Caribbean Assembly of Organisations of People Affected by Hansen’s Disease, held Mar. 12-14 in Rio de Janeiro, Brazil. Credit: Mario Osava/IPS

Treatment using medicinal herbs, self-medication, rejection by relatives, attempts to separate her from her two children and abandonment by her husband all formed part of her suffering, which did not end with her treatment and cure.

The only permanent physical effects are numbness in her hands and feet, and sciatic nerve pain. But the discrimination continued.

“My life changed when I joined the association of affected people” four years ago, she said. “There I found people who had things in common with me, and a newfound love of my neighbour that I did not feel before,” said the activist, who became president of the Foundation the following year and reconciled with God.

Her foundation currently has 60 members. In Barranquilla she estimates that there are “about 200 affected people, but many more are hidden.”

The foundation is one of the 10 associations that make up Felehansen, eight of which call the disease hanseniasis or Hansen’s disease, one of which uses the term leprosy, and another of which refers to disabled people and is made up of patients who received a very late diagnosis.

The World Health Organisation (WHO) defines leprosy – the term it uses – as an infectious and chronic disease “transmitted by air through droplets from the nose and mouth, during close and frequent contacts with untreated cases.” It also specifies that leprosy is “one of the least infectious diseases.”

WHO reports that in 2017 there were 211,009 new cases worldwide, according to official data from 159 countries. That amounts to 0.3 cases per 10,000 inhabitants, which means it classifies as having been “eliminated,” according to WHO criteria.

Change of name: another recommendation

Proposing hanseniasis as the official name for the disease is one of the proposals that came out of the Latin American meeting, headed by Brazil, which has already adopted it, even prohibiting the mention of leprosy in the health system since 1995.

They are different concepts, because leprosy and leper have very negative connotations of “dirt, plague, impurities and divine punishment,” strengthened by numerous mentions with that moral burden in the Bible, argued Faustino Pinto, one of Morhan’s national coordinators.

But the activists from Colombia are not convinced. “People only know leprosy, they don’t know it’s Hanseniasis. To explain the issue to the population, you have to mention leprosy,” argued Romero.

“It will be necessary to educate the new generations about the concept of Hansen,” the Norwegian doctor Gerhard Hansen who discovered the bacillus that causes the disease, because adults are not likely to forget the stigma, said Dussan. “It’s harder to unlearn than to learn,” he added.

Another proposal of the Latin American Assembly is to extend the current Committee for Assistance to Brazilian Immigrants Affected by Hanseniasis to all Latin Americans and people from the Caribbean, in addition to extending it to other regions.

The reference point in this is Evelyne Leandro, a 37-year-old Brazilian who has lived in Germany for nine years and had a lot of difficulties getting diagnosed with the disease in a country where it is very rare and where very few doctors are familiar with it.

She was helped by her mother’s suspicion, awakened in Brazil by an outreach campaign on the disease, and by the Institutes of Tropical Medicine in Germany.

Her case and those of other immigrants in Europe are recounted in her book “The Living Death: the struggle with a long forgotten disease”.

Community health worker Urmila Kasdekar performs a health check on a new born baby in Berdaball village of western India. In India, for example, where it is thought that as many as 120,000 babies alone die every year from sepsis caused by antimicrobial-resistant infections, doctors say two of the key factors behind rising AMR are pharmacies selling antibiotics without a prescription and poor infection control in overcrowded healthcare facilities. Credit: Stella Paul/IPS

By Ed Holt
BRUSSELS, Dec 4 2018 (IPS)

European Union officials and global health bodies have called for help for poorer countries as growing resistance to antibiotics threatens to become a ‘global health tragedy’ and jeopardises Sustainable Development Goals in some parts of the world.

Antimicrobial resistance (AMR) has risen by as much as two thirds in the last two decades, according to some studies, and is now responsible for an estimated 700,000 deaths annually worldwide.

But this is projected to rise to 10 million per year by 2050 and cost up to 100 trillion dollars unless governments ramp up efforts to tackle it.

The growing problem with AMR has been put down largely to inappropriate use of antibiotics for both humans and animals.

As antibiotics have been used more widely and more frequently in both humans and animals, bacteria have built up resistance to them, rendering them effectively useless in some cases. Doctors say this would make routine operations more dangerous and certain medical treatments, such as for some cancers, would disappear completely.

When antibiotic resistance emerges in one place it also quickly spreads to other locations, meaning it must be tackled on a global scale.

While all World Health Organization (WHO) member states signed up to a multi-sectoral Global Action Plan on AMR in 2015, progress on its implementation has been mixed.

Some countries, notably in Europe, have made good progress, in other parts of the world things have moved much more slowly, if at all, raising fears that in poorer countries the problem is worsening and SDGs may not be reached.

EU Commissioner for Health and Food Safety, Dr Vytenis Andriukalitis, told IPS: “We need a global framework for tackling AMR in all regions, not just Europe. It needs to be dealt with because otherwise some countries won’t be reaching the SDGs.”

The size of the challenge presented by AMR in developing countries has been underlined in a slew of data and studies released during the World Antibiotic Awareness week last month (November).

An Organisation for Economic Co-operation and Development (OECD) study showed that while AMR rates averaged 17 percent in OECD countries in 2015, rates in India, China and Russia averaged 42 percent and were as high as 90 percent for some antibiotic-bacteria combinations.

Meanwhile, it said, AMR is forecast to grow up to four to seven time faster in some low and middle-income countries than in OECD states and in countries where healthcare systems are financially constrained, AMR is likely to cause ‘an enormous’ death toll, mainly among new-borns, infants and the elderly.

Another study earlier this year by researchers at ETH Zurich, the University of Antwerp and Princeton University showed that while global use of antibiotics in humans was estimated to have risen 65 percent between 2000 – 2015, use in low- and middle-income countries increased 114 percent.

Developing new antibiotics is complex – it has been decades since new classes of antibiotics were invented – and much of the focus in fighting AMR is being put on prevention.

The Global Action Plan is based on a multi-sectoral approach to AMR and charges governments with adopting national action plans involving improved awareness, understanding, surveillance, stewardship and prevention and control measures.

But in many developing countries, lack of funds in both healthcare and animal industries as well as weak legislation and enforcement are major barriers to those measures being effectively implemented.

In India, for example, where it is thought that as many as 120,000 babies alone die every year from sepsis caused by antimicrobial-resistant infections, doctors say two of the key factors behind rising AMR are pharmacies selling antibiotics without a prescription and poor infection control in overcrowded healthcare facilities.

Supporters of over the counter antibiotic sales in India argue that it is vital that antibiotics are available without prescription as there is a severe shortage of qualified doctors in many areas.

The government has tried to limit the sale of at least so-called ‘last resort’ antibiotics which are used when all others fail. However, the measure – putting a red line on boxes of the medicines in pharmacies to alert people – has been largely ineffective.

There are also concerns over the use of antibiotics in livestock.

According to the European Commission, in Europe, 70 percent of antimicrobials are consumed in food-producing animals. The figure is similar in the U.S. and is over 50 percent in China.

But monitoring antibiotic use in the animal industry in poorer countries is often more difficult.

“[Use of antibiotics in animal farming] is extremely difficult to enforce unless you have very good legislation and a system for monitoring,” Dr Nedret Emiroglu, Director Programme Manager, WHO Europe, told IPS.

While legislation on animal antibiotic use exists and is closely checked in developed states, particularly in the EU, in poorer countries it is sometimes absent or adherence is impossible to monitor effectively because of a lack of resources.

Despite the Indian government’s approval of a national action plan on AMR a year a half ago, critics point out that legislation and networks to control use of antibiotics for animal growth and tracking the sale and use of antibiotics in food production are, in reality, non-existent or ineffective.

The WHO has said that many middle- and low-income countries may need long-term development assistance to implement their AMR plans effectively and sustainably.

“We need financial support for low and middle-income countries,” Emiroglu told IPS.

She added this was crucial to ensure progress in one region of the world was not undermined by a lack of progress elsewhere.

“AMR knows no boundaries. What happens in one part of the world affects people in another,” she told IPS.

But many experts on healthcare in developing countries say a one-size fits all approach for all developing states will not work.

“Measures need to be different for different countries, especially when we are talking about poorer states. You cannot compare somewhere like India and Liberia,” Andriukalitis told IPS.

“In some countries they have problems with access to simple antibiotics, but in others there are problems because people are self-treating with no proper controls. In some places there is a lack of any basic understanding of hygiene and sanitation. We need long-term local strategies for [different] countries,” he added.

Meanwhile, AMR is putting SDGs in jeopardy in some places. Although AMR alone is unlikely to stop an SDG being achieved, left unchecked it could contribute to health, poverty and sustainable economic growth SDG targets being missed.

Longer hospital stays because of slower patient recovery and greater risk of treatment complications would put a massive extra strain on already struggling healthcare systems and worsen mortality rates and quality of life. Economies would be hit hard with the cost of not dealing with AMR forecast to cause a drop of as much as 3.8 percent in global GDP by 2050.

Meanwhile, AMR makes illnesses more expensive to treat and, as universal health coverage is limited in many poor countries and people have to pay out of their own pockets for treatment, these increased costs – as well as potential loss of income from morbidity and mortality – could drive individuals and families with limited resources into even greater poverty.

Dr Andrea Ammon, Director of the European Centre for Disease Prevention and Control (ECDC) which has been involved in monitoring AMR in Europe, told IPS: “​To achieve SDG3 [on health], AMR is not the only issue that needs to be addressed, but it is a crucial component.

“A high rate of AMR indicates that various elements in a health system may not be working satisfactorily because of a mix of factors. The factors causing high AMR rates could be cultural values, behaviour of healthcare providers and patients, regulatory issues such as OTC availability, or infection control. These factors may also prevent other targets included within SDG3 being achieved.”

The sprawling informal community of Lord Howe Settlement, in Solomon Islands’ capital city of Honiara, lies along the Mataniko River. The piped sewerage system in the capital does not extend to unplanned settlements as waste, especially untreated sewage, has become a dire threat to coastal waters and their fisheries. Credit: Catherine Wilson/IPS

By Catherine Wilson
CANBERRA, Oct 29 2018 (IPS)

At the mouth of the Mataniko River, which winds its way through the vibrant coastal port town of Honiara to the sea, is the sprawling informal community of Lord Howe Settlement, which hugs the banks of the estuary and seafront. A walk from the nearby main road to the beach involves a meandering route through narrow alleys between crowded dwellings, homes to about 630 people, which are clustered among the trees and overhang the water.

An estimated 40 percent of Honiara’s population of about 67,000 live in at least 30 squatter settlements. Sanitation coverage is about 32 percent in the Solomon Islands and in this capital city the piped sewerage system, which does not extend to unplanned settlements, is dispersed into local waterways and along the coastline.

For centuries, coastal fishing has been central to the nutrition, food security and livelihoods of Pacific Islanders, as it will be in the twenty first century. But, as population growth in the region reaches 70 percent and cities and towns expand along island coastlines, waste, especially untreated sewage, has become a dire threat to coastal waters and their fisheries.

“Areas of high population density, such as cities and tourism areas, are associated with excess release of poorly treated wastewater onto reefs. Many coastal communities rely heavily on fishing for their subsistence and household income and endangering the lagoons and fishing areas will threaten their livelihoods,” is the personal view of Dr. Johann Poinapen, who also holds the position of director of the Institute of Applied Sciences at the University of the South Pacific in Fiji.

Subsistence fishing in near shore areas, typically of finfish, trochus, molluscs, clams, crabs and bêche-de-mer, accounts for 70 percent of all coastal catches in the Pacific Islands and 22 percent of the region’s Gross Domestic Product (GDP).

Sewage waste pollutes the oceans

Sewage waste is a global issue, accounting for about 75 percent of pollution in the world’s oceans, and every Pacific Island state has identified it as a cause of environmental and health problems, ranging from marine ‘dead zones’ and the loss of reefs to outbreaks of seafood poisoning.

Critically its discharge in coastal areas leads to the loss of habitats for marine life, according to Associate Professor Monique Gagnon, an expert in ecotoxicology at the School of Molecular and Life Sciences, Curtin University in Western Australia.

“Effluent, or nutrient pollution, produces eutrophication and the growth of algae can change marine habitats, threatening local fish populations and encouraging invasive species,” Gagnon told IPS.

A semi-submerged graveyard on Togoru, Fiji. Sewage waste is a global issue, accounting for about 75 percent of pollution in the world’s oceans, and every Pacific Island state has identified it as a cause of environmental and health problems. Credit: Pascal Laureyn/IPS

Health and environmental issues

Human effluent generates the over-production of algae and cyanobacteria in waterways and the sea. Toxic algal blooms can infect all types of fish and shellfish and lead to the demise of coral reefs and their fish stocks. Sewage also depletes oxygen in aquatic ecosystems, leading to the condition of Hypoxia, which causes the death of fish through paralysis. And the consumption of fish contaminated by biotoxins can cause serious illnesses, such as paralytic shellfish poisoning and ciguatera.

A study of marine pollution in the Republic of the Marshall Islands in 2016 found that nine of ten ocean and lagoon sites surveyed were heavily polluted, particularly with disease carrying bacteria from human and animal waste.  In Samoa, the Ministry of Health has connected typhoid cases with seafood collected near shore which has been spoiled by effluent from coastal villages.

Lack of sewage treatment facilities and collection services for households in Pacific cities, together with mostly unimproved sanitation in rural areas, are leading to increasing amounts of effluent entering coastal waters or conveyed there from rivers and streams.

The problem is acute in urban areas where under-resourced civic services are struggling to cope with a high influx of people migrating from less developed rural areas. Urban centres are growing at a very high annual rate of 4.7 percent in the Solomon Islands, 3.5 percent in Vanuatu and 2.8 percent in Papua New Guinea.

The situation in Honiara in the Solomon Islands is typical of many other Melanesian towns and cities in the southwest Pacific.

“Upstream [of the Mataniko River] there are sewerage outlets which are coming directly into the river. Then, as you come down, you see these little houses on the riverbanks; these are toilets,” Josephine Teakeni, president of the local women’s civil society group, Vois Blong Mere, told IPS.

Lack of resources restricts improved sanitation

The Honiara City Council is involved in manufacturing affordable toilet hardware items, especially for people in settlements who are on low incomes, and provides a septic tank collection service. But lack of resources severely restricts their operations.

“We don’t have the capacity to do this for the whole city, but we can empty septic systems for anyone who can pay the fee of SB$400 (USD51),” George Titiulu in the Council’s Health and Environment Services told IPS.

He admits that there is an environmental problem.

“We have done some studies of the Mataniko River and there is a high level of E.coli in the water,” Titiulu elaborated.

The proportion of people in the Pacific Islands using improved sanitation rose by only 2 percent, from 29 percent to 31 percent, over the 25 year period from 1990 to 2015, reports the World Health Organization.  This leaves a shortfall of 6.9 million people who lack this basic service across the region.

In the Solomon Islands, as in other developing Pacific Island states, the obstacles to better progress include lack of basic infrastructure, expertise, technical capacity and reliable funding. The challenges are even greater to extend basic services into informal settlements because of complex customary land rights and insecure tenure for residents, as well as their frequent location in natural hazard and disaster prone areas, such as flood plains.

Subsistence fishing in near shore areas, typically of finfish, trochus, molluscs, clams, crabs and bêche-de-mer, accounts for 70 percent of all coastal catches in the Pacific Islands and 22 percent of the region’s Gross Domestic Product (GDP). Credit: Catherine Wilson/IPS

Significant economic losses expected if pollution is not addressed

Yet the issue will have to be tackled with experts predicting that habitat destruction, together with climate change and over-exploitation of marine resources, will drive a continuing decline in coastal fisheries in the coming decades. For Pacific Islanders, this could lead to significant economic losses, a rise in the cost of fish and diminishing food. The regional development organisation, the Pacific Community, predicts that within 15 years an additional 115,000 tonnes of fish will be needed to manage the food gap.

“Tackling sewage pollution in the Pacific Island region is not an easy feat,” Poinapen told IPS. His personal view is that all stakeholders, not just governments, must be involved in developing and implementing appropriate solutions, as well as educational, policy and legislative approaches.

But, to begin with, he believes that “one of the biggest gaps related to sewage pollution is the lack of baseline data to inform the stakeholders on the severity of the issue.”

“We know there is sewage pollution in many receiving waterbodies, but we do not know the extent of this pollution as we have not conducted a robust and systematic quantification of the various contaminants and their effects,” Poinapen emphasised.

• The first global Sustainable Blue Economy Conference will be held in Nairobi, Kenya from Nov. 26 to 28 and is being co-hosted with Canada and Japan. Over 4,000 participants from around the world are coming together to learn how to build a blue economy.

Parched olive groves in northern Croatia, where West Nile Virus has already claimed one victim this year. West Nile Virus infections have sharply increased in Europe this year, the World Health Organisation says, largely due to a longer transmission season in the region which this year saw high temperatures and extended rainy spells followed by dry weather, helping mosquito breeding and propagation. Credit: Ed Holt/IPS

By Ed Holt
VIENNA, Sep 13 2018 (IPS)

Climate change and health experts are warning of the growing threat to public health in Europe from global warming as rising temperatures help potentially lethal diseases spread easily across the continent.

This summer Europe has had to contend with record temperatures, drought, and destructive storms caused by heat and wildfires as forests in turn are left parched.

It has also, though, seen a spike in cases of the West Nile Virus – which by early September had claimed 71 lives – and the dramatic spread of the potentially lethal vibrio bacteria in an exceptionally warm Baltic Sea. The West Nile Virus is a viral infection spread by mosquitos and can cause neurological disease and death. Various species of vibrio bacteria cause Vibriosis, which can sometimes lead to deadly skin infections or gastrointestinal disease.“We need to think about preventing health problems by dealing with the causes of climate change itself.” -- Anne Stauffer, Health and Environment Alliance (HEAL).

And there have been warnings that global warming has increased the risk of tick-borne diseases on the continent and that the geographical range of mosquitoes, which can transmit diseases like dengue, chikungunya, and Zika, is also expanding.

While disease experts are keen to stress that climate change is just one factor involved in the greater incidence of tropical diseases in Europe – increasing global travel, unplanned urbanisation and others factors are also involved – they do, however, agree that changes to temperature, rainfall and humidity make it easier for mosquitoes and other vectors to spread, survive and pass on infections.

Meanwhile, the incidences of vibrio infections – which can cause lethal illnesses in some people with compromised immune systems – reported in the Baltic Sea this year do appear to be directly linked to higher temperatures.

Jan Semenza, acting head of Section Scientific Assessment at the European Centre for Disease Prevention and Control (ECDC), told IPS: “The warming of the Baltic Sea is clearly related to global climate change and the increase in sea surface temperatures there is linked to [the increase in] vibrio bacteria.

“There seems to be a link with a warming climate and vibrio infections in the Baltic Sea.”

He added: “Climate change projections for sea surface temperature ….. indicate a marked upward trend during the summer months and an increase in the relative risk of  these infections in the coming decades.”

Groups dealing with the impact of climate change on health say that this year has been a watershed in European perception of climate change and its effects.

Anne Stauffer, director of Strategy at the non-profit Health and Environment Alliance (HEAL) group which addresses the effects of climate change on human health, told IPS: “In terms of public awareness this summer’s heatwave has really made people see that climate change is happening in Europe and that we are facing threats.

“In previous years people thought about the effects of climate change only in terms of what’s happened in Africa and other places, not Europe, but now they see that Europe is affected and that Europe is facing challenges.”

But while public awareness of the health threats of climate change in Europe has improved over the last decade, it is still lacking, she says.

Experts on tropical diseases agree that in some countries, people are, perhaps understandably, ignorant of even the presence of certain diseases in Europe.

Rachel Lowe, an assistant professor at the London School of Hygiene and Tropical Medicine, told IPS: “It would probably not occur to a lot of people in, say the [United Kingdom], to think about West Nile Virus when they go to Romania.”

Indeed, some tropical diseases have been present in Europe for many years, but confined to very southerly latitudes, while ticks, some of which can carry lyme disease (results in flu-like symptoms and a rash) and encephalitis (inflammation of the brain through an infection), are present in many parts of the continent.

But this year has seen a rise in cases of tick-borne encephalitis in central and southern Europe.

But with temperatures rising, that could change in the future. Cases of West Nile Virus, which have been reported in some parts of Europe for many years now, were much higher this year than in recent years and were seen much earlier than previously. This has been put down, in large part, to higher temperatures earlier in the year.

At the same time, there has been a documented expansion in the range of disease-carrying ticks in recent years to more northerly latitudes and higher elevations. Hot summers and mild winters have also been reported to be linked, along with other factors, to high incidence of tick-borne disease in certain parts of central and northern Europe.

A spokesman for the World Health Organization (WHO) told IPS: “Increases in temperatures in Europe might allow the establishment of tropical and semitropical vector species, permitting transmission of diseases in areas where low temperatures have hitherto prevented their over-wintering.”

Facing this potential threat, the WHO’s European Region Office has devoted increasing attention over recent years to what it says is the “emerging challenge of vector-borne diseases”.

It has developed a regional framework for surveillance and control of mosquitoes and recommends involving a mix of action, including, among others, political commitment supported with adequate financial resources as well as community engagement for both personal protection against insect bites and vector control activities.

But experts say that general awareness of the presence and threat of tropical diseases in Europe needs to be raised, especially as climate change models see similar long, hot summers as well as milder winters becoming more common across the continent in future and countries could suddenly face outbreaks of diseases they have not had to deal with in the past.

The WHO spokesperson told IPS: “Due to globalisation, increasing volume and pace of travel and trade and weather patterns, vector-borne disease may spread to new areas, thus affecting new populations never exposed to them before.

“In these areas, low general awareness about diseases such as West Nile Virus, dengue or chikungunya among the public and both human and animal health professionals might challenge early detection of cases.”

And Lowe told IPS: “People need to be more aware of this [tropical diseases in Europe]. People are becoming more aware of infectious diseases in general, but probably not so aware of the fact there are certain infectious diseases in Europe.”

It is not just public awareness, though, which will help Europe deal with the health threats posed by a changing climate. Whether, for example, mosquito-borne disease outbreaks, would be successfully contained, would depend on a number of factors. “This would include factors such as surveillance of mosquito spread, mosquito control as well as general public awareness,” Lowe told IPS.

The WHO told IPS that public health advice needs to be communicated to people for self-protection and while authorities need to make sure mosquito breeding sites are drained so that they do not become breeding grounds for mosquitos while doctors need to be regularly trained to recognise diseases which were uncommon in Europe.

But what some other experts suggest is, rather than trying to deal with outbreaks of diseases, governments should be working to halt climate change and prevent disease outbreaks happening in the first place.

Stauffer told IPS: “There are still unknowns with regards to the health threats potentially posed by climate change and we do not know how they will play out… but the lesson learnt from this summer is that we need to strengthen efforts to tackle climate change – not just adapting healthcare to cope with a warmer climate but also acting to reduce emissions.

“We need to think about preventing health problems by dealing with the causes of climate change itself.”

The tension between monopoly for patent holders (usually the big drug companies) and access to medicines for all has become acute and there are social movements around the world, both in developing and developed countries, that are fighting for patient’s rights and against excessive monopolies by companies. Credit: Bigstock

By Martin Khor
PENANG, Apr 13 2017 (IPS)

What’s the most precious thing in the world which unfortunately we take for granted and realise it true value when it is impaired? Good health, of course.

That’s something many people must have reminded themselves as they celebrated World Health Day on 7 April.

Attaining good health and well-being may be a top priority goal, but achieving it is elusive for almost everyone, and next to impossible for the poor.

In the 1980s, the World Health Organisation’s Director-General Halfdan Mahler steered through a declaration with the popular slogan ‘Health for All by the year 2000’.

We crossed into the 21^st century without realising that noble goal. Although health has improved in most countries, due mainly to cleaner water and sanitation, but also due to better treatment, much remains to be done.

In recent years, the slogan ‘Health for All’ has been strengthened by the recognition in the United Nations of health as a human right.  It has been further boosted by the adoption of the principle of universal healthcare.

This means that no one should be deprived of health care even they are too poor to afford it.  Unfortunately, while the prices of old medicines whose patents have expired have gone down, there are many newer medicines which are too expensive for the ordinary person to afford.

That’s because a company that owns the patent has a monopoly over the production and sale of the medicine. Since there are no competitors, the price can be skyrocketed to high or to even astronomical levels.  The patent normally lasts 20 years.

Martin Khor

For example, the prices of medicines for HIV AIDs had been at the level of US$15,000 per person per year in the United States.  For most AIDS patients in Africa and other developing countries this meant they could just not afford them.

Since those medicines were not yet patented in India, because India had until 2005 to implement the TRIPs Agreement of the World Trade Organisation, an Indian drug company CIPLA, was able to sell and distribute a three-in-one combination drug for about US$300 per person per year. Later, the price levels of the generic producers fell further to about US$60.

Millions of lives around the world were saved by competitor generic companies which could sell the medicines at a more affordable price. Health agencies like the Global Fund for AIDS, TB and Malaria were set up to and took advantage of the falling prices to make AIDS medicines available to poor countries.

In recent years a similar storm has been brewing over the prices of new drugs for Hepatitis C, a life-threatening disease which millions around the world suffer from. One of the drugs is Sofosbuvir, which has an efficacy rate of 95% and with fewer side effects, but is being sold in the US for about US$85,000.

Some generic companies in India have been allowed by the patent-holding company to produce and sell it at their own price level, which is currently around US$200-400 per patient for a course of treatment. They sell these drugs in India and in lower income countries at these much cheaper prices.

But they are not allowed by the patent holder to sell in most middle income countries, so almost two billion people in developing countries cannot have the medicine at the affordable price.

What can be done?

Whist the TRIPs Agreement mandates that patents have to be granted for genuine inventions, countries are also allowed to issue a compulsory licence or a government use licence to import or manufacture generic versions of the patented drug, if the original medicine is found to be too expensive.  Thus those countries taking this action can access affordable generic drugs.

The patent owner will receive a remuneration (usually a percentage of sales revenue) from the generic company or the government that is selling the generic product.

Countries can also carefully examine companies’ application for patents and reject those that are not genuine inventions, for example if a new patent is applied for a product with just a different dosage or the use of the same drug for another disease.

In reality, there are many new medicines already in existence or coming on stream that are patented and therefore out of reach of most patients. This tension between monopoly for patent holders (usually the big drug companies) and access to medicines for all has become acute and there are social movements around the world, both in developing and developed countries, that are fighting for patient’s rights and against excessive monopolies by companies.

Another interesting recent development is the recognition that too much sugar consumed can lead to and has led to an epidemic of many ailments, such as obesity, heart problems, diabetes. The authorities in more and more countries are taking action to limit the sugar content for example of soft drinks. The WHO has guidelines on sugar consumption and on how to avoid excessive sugar in many foods, especially those taken by children.

For world health day, consumers should resolve to cut down on sugar in their drinks and food.

An emerging threat that endangers human life is the resistance of bacteria and other pathogens to antibiotics and other antimicrobials.

Many antibiotics can no longer work on an increasing number of patients in a wide range of ailments, including TB, malaria, gonorrhoea and stomach ailments. Diseases that were once easily cured are now developing resistance, meaning the drugs don’t work anymore.

We have stark warnings from top public health offices like the WHO Director General Margaret Chan and the United Kingdom’s Chief Medical Office Dame Sally Davies, that we are approaching a post antibiotic era. In the future, even a simple scratch on a child’s knee or infection during surgery could lead to death, according to these officials.

Last September, political leaders meeting at the UN General Assembly pledged to take serious action to deal with antibiotic resistance. A coordinating group from UN agencies and selected individuals has been formed to review the situation and to recommend further action.

Finally, the World Health Assembly May this year will be electing a new Director General for the WHO. There are three candidates from Pakistan, Ethiopia and the United Kingdom. May the successful candidate do a superb job in addressing all the ailments, diseases and problems in world health.

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Excerpt:

Depression causes persistent sadness, a loss of interest in activities that you normally enjoy and an inability to carry out daily activities. Credit: WHO

By Baher Kamal
ROME, Apr 3 2017 (IPS)

Just three weeks after celebrating the International Day of Happiness, the United Nations now asks you the following questions: do you feel like life is not worth living? Are you living with somebody with depression? Do you know someone who may be considering suicide?

Not that the world body all of a sudden wants to spoil your happiness—it is just that depression affects people of all ages, from all walks of life, in all countries, and as many as over 300 million people worldwide, according to the latest estimates from the World Health Organization (WHO).

“These new figures are a wake-up call for all countries to re-think their approaches to mental health and to treat it with the urgency that it deserves,” WHO Director-General Margaret Chan said in a news release.

Depression causes mental anguish and impacts on people’s ability to carry out even the simplest everyday tasks, with sometimes devastating consequences for relationships with family and friends and the ability to earn a living. At worst, WHO adds, depression can lead to suicide, now the second leading cause of death among 15- to 29-year-olds.

Credit: WHO

No wonder then that the World Health Day on 7 April provides everybody –depressed or not– with a special opportunity to mobilise action around a specific health topic of concern to people all over the world.

Understandably then, the theme of 2017 World Health Day campaign is Depression: Let’s Talk.

In spite of these warnings, not all news is bad news. A better understanding of what depression is, and how it can be prevented and treated, will help reduce the stigma associated with the condition, and lead to more people seeking help.

What Is Depression All About?

To start with, the world health body explains what depression is all about: it is an illness characterised by persistent sadness and a loss of interest in activities that you normally enjoy, accompanied by an inability to carry out daily activities, for at least two weeks.

In addition, people with depression normally have several of the following: a loss of energy; a change in appetite; sleeping more or less; anxiety; reduced concentration; indecisiveness; restlessness; feelings of worthlessness, guilt, or hopelessness; and thoughts of self-harm or suicide.

Credit: WHO

But do not panic–depression is something that can happen to anybody, it is not a sign of weakness, and more importantly: it is treatable, with talking therapies or antidepressant medication or a combination of these.

Fine then. Now that the world leading body specialised in health issues assures once and again that much can be done to prevent and treat depression, you may ask what to do to overcome this bad feeling?

Stop Prejudice, Discrimination, Stigma

One of the first steps is to address issues around prejudice and discrimination. “The continuing stigma associated with mental illness was the reason why we decided to name our campaign Depression: let’s talk,” said Dr Shekhar Saxena, Director of the Department of Mental Health and Substance Abuse at WHO.

“For someone living with depression, talking to a person they trust is often the first step towards treatment and recovery.”

There is also the need to increase investment–in many countries, there is no, or very little, support available for people with mental health disorders. Even in high-income countries, nearly 50 per cent of people with depression do not get treatment.

On average, just 3 per cent of government health budgets is invested in mental health, varying from less than 1% in low-income countries to 5 per cent in high-income countries.

Credit: WHO

On top of this, WHO reminds that investment in mental health makes economic sense–every 1 dollar invested in scaling up treatment for depression and anxiety leads to a return of 4 dollars in better health and ability to work.

What to Do to Prevent Depression

To begin with, WHO recommends to talk to someone you trust about your feelings. Most people feel better after talking to someone who cares about them.

Should this not be enough, then seek professional help–your local health-care worker or doctor is a good place to start.

Meantime, keep up with activities that you used to enjoy when you were well; stay connected, keep in contact with family and friends; exercise regularly, even if it’s just a short walk, and stick to regular eating and sleeping habits.

As importantly, don’t by shy—just accept that you might have depression and adjust your expectations. You may not be able to accomplish as much as you do usually.

And, of course, void or restrict alcohol intake and refrain from using illicit drugs–they can worsen depression.

As you see, depression can be treated. And it goes without saying that if you think you have depression, all you need is to just seek help.

It goes without saying that the best recommendation would be not to feel depressed! But!

Come on, it is not the end of the world!

Excerpt:

Credit: ©UNICEFKENYA/2011/MODOLA

By Rudi Eggers and Werner Schultink
NAIROBI, Jan 20 2017 (IPS)

For a long time, no person in Kenya suffered the devastating disability that is caused by polio. In fact, the only reminder in the early 2000s was the victims in the streets of Nairobi, many of whom had been paralyzed as children and adults. Their lives were ravaged by this terrible, vaccine-preventable disease.

A five-day polio campaign that started on 18 January, 2017 targets more than 2.9 million children below the age of 5 years in fifteen counties. Children in high-risk areas -- some of whom have never had access to immunization services before -- will have an opportunity to be vaccinated against polio.
Sadly, in 2013 a large outbreak of polio in Nigeria spread across the continent, affecting several countries on its way east. Kenya was not spared.  Fourteen new polio cases were confirmed. The polio virus struck those that were unvaccinated – the most vulnerable and the most excluded — children in areas with poor access to health services, refugees, and nomadic communities.  Fortunately, a rapid response by the Kenyan Government brought the polio outbreak under control, and the last case was reported in July 2013.  At that time, it seemed that the country was well on the road to being declared polio-free.

However, recently, concerned scientists have pointed to the increasing risk of polio, particularly the large numbers of children who remain unvaccinated, especially those in vulnerable populations in the northern part of the country and in the informal settlements of Nairobi and Mombasa.  Furthermore, the notion that the African continent was free from the polio virus was shattered when four new polio cases were reported in northern Nigeria. Given the previous experience, health experts and Ministries of Health recommended that the areas with low vaccination rates should be targeted with vaccination campaigns, specifically designed to reach those that missed out on the routine vaccinations.

Since the establishment of the Expanded Programme of Immunization (EPI) in 1980, Kenya deserves credit for reaching majority of the children with life-saving vaccines. But there is still a lot more work that needs to be done; progress in the country is very uneven and many children remain unvaccinated. It is estimated that 400,000 (3 out of 10) children still do not receive all the required scheduled doses of vaccines by their first birthday. This build-up of under-immunized children has previously contributed to outbreaks of polio. Most of these children come from poor families, the urban informal settlements and the hard-to-reach parts of the country, particularly arid and semi-arid (ASAL) regions where access to health services is limited.

A child receives vaccination against polio in a Mother and Child Health (MCH) Clinic at Mukuru Health Centre, in Nairobi, Kenya. Credit: ©UNICEFKENYA/2016/NOORANI

As long as there is a child out there who has contracted this disease, no matter where they live or who they are – all children everywhere are not safe. The four cases confirmed in October 2016 in the current polio outbreak in Nigeria place other African countries, including Kenya, at risk of importing the wild polio virus, due to the unaccounted number of unvaccinated children across the continent as well as the high population movement.

In the final push towards eradicating polio by 2018, Kenya with its strict monitoring system for the safety and quality assurance of vaccines, has already proved that it has the capacity to make the whole country polio-free. A five-day polio campaign that started on 18 January, 2017 targets more than 2.9 million children below the age of 5 years in the fifteen counties of Bungoma, Busia, Garissa, Isiolo, Lamu, Mandera, Marsabit, Nairobi, Samburu, Tana River, Trans Nzoia, Turkana, Wajir, West Pokot and Uasin Gishu. Children in high-risk areas — some of whom have never had access to immunization services before — will have an opportunity to be vaccinated against polio.

To ensure that all vulnerable children are reached, the exercise will be relying on the steadfast commitment of vaccination teams and the communities they serve. These heroic women and men in most cases walk long distances from house-to-house, often in the most dangerous of circumstances to reach all children. Communities where the polio campaign is backed and encouraged by religious and community leaders have much higher rates of protection than those that lack this support.

As part of the worldwide campaign to eradicate polio, there is need for everyone to rally behind this polio vaccination campaign, to reach each and every child regardless of their geographical location of their status in society. We have a responsibility to protect hundreds of thousands of children in Kenya from being paralyzed for life; from being excluded from their communities; and from being denied their right to a full and productive life.

In 2017 and beyond, no child in Kenya should suffer the consequences of a vaccine-preventable disease, for every child deserves to live in a polio-free world.

Excerpt:

A cigarette vendor in Manila sells a pack of 20 sticks for less than a dollar. Credit: Kara Santos/IPS

By Lyndal Rowlands
UNITED NATIONS, Jan 13 2017 (IPS)

Low and middle-income countries have far fewer tobacco regulations than high-income countries and are paying the price – with bigger health and economic impacts.

Yet, according to new wide-ranging research published by the World Health Organization (WHO), tobacco companies are misleading governments, telling them that tobacco regulations will potentially harm their economies.

The research was compiled in a new monograph titled The Eonomics of Tobacco and Tobacco Control, published jointly by the WHO and the National Cancer Institute of the US-based National Institutes of Health.

Frank Chaloupka, who edited the monograph, told IPS that when low and middle income countries do implement regulations, there is usually a much bigger pay off.

“We present some new evidence in the monograph on tobacco advertising bans that shows they have a bigger effect in low- and middle-income countries than they do in high-income countries,” said Chaloupka who is also Distinguished Professor of Economics & Public Health at the University of Illinois.

“I think it’s partly because of the fact that in a lot of low- and middle-income countries they haven’t been exposed to the same information about the health consequences of tobacco use, people are more susceptible to the industry(’s positive) portrayals of tobacco,” noted Chaloupka.

For example, says Chaloupka, graphic warning labels have proven more effective in low- and middle-income countries.

“People can really see the damage caused by tobacco through the graphic warnings.” For those who have had less exposure to these warnings from other sources of information, the warnings have an even bigger impact.

Taxes on tobacco sales in low and middle countries also have a bigger impact than in high-income countries, Chaloupka added.

“Given people’s lower incomes, people are more responsive to changes in the price,” he said.

There are several reasons why low- and middle-income countries have less tobacco regulations than high-income countries, said Chaloupka, but one problematic cause is misleading arguments made by the industry:

“The industry’s arguments around things like illicit trade, impact on jobs and the broader economic impact, the impact on the poor, the impact on their tax revenues, really the economic arguments that the industry uses against tobacco control are really misleading, and for the most part, false.”

This has contributed to a widening gap between regulations in low and middle-income versus high-income countries. The gap has also widened because of how quickly high-income countries moved to implement control measures:

“We’ve seen governments get serious and really take action, and adopt strong tobacco control measures, push up taxes, ban smoking in public places, ban tobacco marketing as a result we’ve seen tobacco use falling for at least a few decades in most high-income countries.”

While some low and middle-income countries may lack the capacity to implement complex regulations, Chaloupka noted that often simpler policies can be more effective.

“The Philippines (had) a complicated tax system where we had different rates on different brands,” he said. “Over time they moved toward a significant reform in their system and they’re in the process of moving to a single uniform tax which is a lot easier to administer and much better at deterring tax avoidance and tax evasion.”

However although so-called excise taxes on tobacco products can act as a deterrent worldwide they are far from helping governments recoup the costs of tobacco use to economies and society.

“The estimate we have for the global cost is about $1.4 trillion, and less than $300 billion being generated in tax revenues,” said Chaloupka, adding that less than $1 billion of tobacco-related tax revenues is being used for tobacco control.

Chaloupka also pointed to Turkey as an example of a middle-income country that has successfully regulated tobacco use.

“If you go back a few decades the Turkish government used to be the tobacco industry in Turkey. They used to be one of the biggest growers of tobacco leaf in the world, and over time they’ve completely moved in the other direction.”

“They privatised their tobacco industry (and) they didn’t make any promises to the tobacco companies that moved into their markets, and really then did move forward with strong tobacco control policies.”

Correction: An earlier version of this article referred to “$300 million being generated in tax revenues” and “$1 million of tobacco-related tax revenues…” it should have read billion(s) not million(s).

A child receives an oral polio vaccine in Peshawar, Pakistan. Credit: Ashfaq Yusufzai/IPS.

By Andy Hazel
UNITED NATIONS, Dec 30 2016 (IPS)

Childhood immunisation is one of the safest and most cost-effective health interventions available, yet many of the world’s most vulnerable children continue to miss out.

A World Health Organisation report entitled State of inequality: childhood immunisation was released last week. While the report is mostly good news, immunisation rates are up and many countries have eradicated diseases entirely, a large population of children remain unimmunised.

To better reach these children the authors also looked at another metric: disease as a marker of inequality. Or, in the words of Robin Nandy, Principal Adviser and Chief of Immunisation at UNICEF, “a virus doesn’t lie”.

“The presence of disease is the best indicator of where a bigger problem is,” he explains. “Diseases tend to show up where there are weak systems of health coverage and in areas of conflict.”

“It is very likely that where there is low immunisation coverage there are multiple deprivations.”

“The nutritional status of the kids in these areas could be compromised, they could lack water or sanitation, common childhood illnesses such as diarrhoea or pneumonia could be present.”

Using data from 69 countries, the study examined inequality amongst rates of childhood immunisation and measured changes in rates of immunisation over the last ten years. The most prominent inequalities recorded were those of household economic status and the level of maternal education.

While the report showed that rates of immunisation for diseases such as measles, polio and yellow fever are around 85 percent globally, progressing beyond this number is hard and the biggest barrier to progress is political willpower.

“Once you’ve hit 80 percent the remaining 15 to 20 percent tend to be in remote locations, in underprivileged populations,” says Nandy. “In many countries the communities that want immunisation are marginalised. Political will is extremely important to shift the mindset from wide coverage to wide coverage with equality.”

“There are some areas that are right under our noses that we tend not to prioritise because we’re focused elsewhere, like urban slums. Often they don’t show up in population data and that is why they’re not prioritised in health services.”

Nandy points to a rapidly urbanising world and the growing population of children living in refugee camps or moving between regions as key examples of the complex operating environments. “There has to be a proactive and deliberate attempt to reach these populations and it won’t happen by delivering services in a normal way. We need tailored approaches for each country to make sure these populations are reached.”

Polio, which has neared complete eradication but setbacks in 2015-16, illustrates the difficulty of reaching children most in need.

“Where are we still seeing polio transmission?” Nandy asks rhetorically. “It’s on the Pakistan / Afghanistan border, places like Baluchistan and Waziristan, places that have security issues. These limit the access of health workers into that area.”

“You will get increases in rates of diseases like polio when parents cannot bring their kids to clinics.”

The current situation in many countries shows that further improvement is needed to lessen inequalities, and data such as this may prove invaluable.

Panoramic view of a neighbourhood in southern Mexico City, with buildings semi-hidden by air pollution. Credit: Emilio Godoy/IPS

By Martin Khor
PENANG, Nov 14 2016 (IPS)

As evidence mounts on the threats posed by air pollution to both human health and the environment, action must be urgently taken to address this problem.  

At the global level, the Paris Agreement that came into force on 10 November aims to get countries to significantly reduce Greenhouse Gas emissions and to better cope with climate change.

In May 2016, Health Ministers approved a global “roadmap” to address air pollution at the World Health Assembly.  And the United Nations’ sustainable development goals, adopted in 2015, contain accompanying targets for reducing air pollution.

But much more needs to be done, especially at the national level, to seriously tackle this crisis.

The adverse health effects of air pollution have been growing worse with a 8% increase from 2008 to 2013 in deaths globally caused by urban air pollution, according to World Health Organisation data. Although the situation has improved in developed countries, it has deteriorated in most developing countries.

Countering air pollution should thus be a top priority. What should be done?   First, more details and data should be collected in all countries, through improvements in monitoring air pollution and its adverse health effects.

Second, a public education campaign is needed to make the public more aware of the dangers of air pollution so they can take actions to prevent the pollution and to avoid being exposed.

Third, and most important, the causes of the pollution must be identified and action plans drawn up to eliminate or reduce the factors these sources.

Martin Khor

Outdoor air pollution is caused by transport vehicles that emit pollutants, coal-fired power plants, industrial factories, burning of wastes and fires in forest and agricultural areas.  Indoor pollution is mainly caused by the use of fuels that are based on wood and coal.

Besides the direct effects on human health, the pollution is also a major cause of global warming, which in turn also affects health.

It is thus doubly important to tackle these causes.  Actions should include the following:

• Reduce vehicle emissions through better energy-efficiency and air-pollution standards for vehicles and control of private transport.
• Give priority to public transport and promote clean transport such as railways, bicycles and walkways
• Phase out of coal powered plants, shift to clean modes of power generation, and promote renewable energy
• Impose strict air pollution controls in industry and phase in clean low-emissions technologies.
• Promote energy efficiency in the design of buildings.
• Phase out the use of wood and charcoal as household fuels used in traditional stoves, and replace them with safe and efficient stoves.
• Reduce waste through recycling and reuse, introduce alternatives to open incineration of solid waste and stop the open burning of household wastes.
• Stop the burning of forests, mangroves and in agriculture; this is the most important to prevent the South-east Asian “haze.”
• Take measures so as to adhere to the WHO guidelines for outdoor and indoor air pollution. (The WHO guideline for particulate matter (PM) outdoor pollution is 10 microgram per cubic meter annual mean for particles below the size of 2.5 microns in diameter, and 20 microgram for particles below 10 microns in size).

Drastically reducing air pollution would be tackling the world’s biggest health and environmental problems, as air pollution is the major source of deaths and diseases, as well as the main cause of climate change
Air pollution reduction measures should become part of wider health and environmental strategies and be given priority and resources in the country’s development plans.

The problem must also be given the global attention it deserves.  In May 2016, the World Health Assembly for the first time adopted a road map to tackle air pollution and its causes. (WHA Document A69/18;  6 May 2016).  The four-point road map calls on the health sector to:

• Expand the knowledge base on air pollution, its health effects and effectiveness of policies;
• Increase monitoring of air pollution locally and assess the health impacts of its sources;
• Take on a leadership role in national policies to respond to air pollution and at the global level;
• Build its own capacity to influence policy and decision making processes to take joint action on air pollution and health.

The UN’s Agenda 2030 and its Sustainable Development Goals, adopted by world leaders in September 2015, also has goals and targets relevant to air pollution.   These include goals and associated targets relevant to health (Goal 3); cities (Goal 11) and household energy (Goal 7).   The three indicators most relevant to air pollution are:

• SDG Indicator 3.9.1 for goal 3 on health (mortality rate attributed to household and ambient air pollution);
• SDG Indicator 11.6.2 for goal 11 on cities (annual mean levels of fine particulate matter (PM) in cities; and
• SDG Indicator 7.1.2 for goal 7 on energy (proportion of population with primary reliance on clean fuels and technologies).

Cutting down on air pollution, which is closely related to emissions of Greenhouse Gases, is one the major actions (if not the very top action) countries are expected to take to fight climate change, and thus most relevant to the implementation of the Paris Agreement of the UN Climate Change Convention adopted in December 2015.

Indeed, drastically reducing air pollution would be tackling the world’s biggest health and environmental problems, as air pollution is the major source of deaths and diseases, as well as the main cause of climate change.

Action plans on air pollution are thus urgently needed at both national and global levels.

“Fast action to tackle air pollution can’t come soon enough,” said Dr Maria Neira, WHO Director, Department of Public Health, Environmental and Social Determinants of Health. “Solutions exist with sustainable transport in cities, solid waste management, access to clean household fuels and cook-stoves, as well as renewable energies and industrial emissions reductions.”

We are only at the starting phase of understanding the huge health problem that air pollution causes.  We have however been made conscious of the grave crisis that it has caused to the environment.

While the actions needed are quite clear, getting them implemented will be an immense challenge, as the causes of air pollution are presently so embedded in modern lifestyles and economic structures.

Excerpt:

Dark pollution clouds over Cairo. Credit: Khaled Moussa Al-Omrani/IPS.

By Martin Khor
PENANG, Nov 11 2016 (IPS)

New research is showing that air pollution is a powerful if silent killer, causing 6.5 million worldwide deaths as well as being the major cause of climate change.   

Air pollution has emerged as a leading cause of deaths and serious ailments in the world.  Emissions that cause air pollution and are Greenhouse Gases are also the main factor causing climate change.

Therefore, drastically reducing air pollution should now be treated as a top priority.

The seriousness of this problem was highlighted by the heavy smog that enveloped New Delhi for days at the beginning of November, forcing the government to declare an emergency, schools to be closed and a ban on construction work for several days.

The level of the harmful PM2.5 pollutants had almost reached 1,000 at some times in the Indian capital city, far above the safety level of 60.

Recent research shows that air pollution is the number one environmental cause of human deaths and kills more people annually worldwide than road accidents, violence, fires and wars combined.

This “silent killer” is not as dramatic or visible as car crashes, murders, terrorist attacks or natural disasters, but it is nevertheless even more dangerous as it contaminates vital organs, causing serious diseases and deaths to many millions of people.

Altogether 6.5 million people worldwide are estimated by the World Health Organisation (WHO) to have died prematurely in 2012 because of air pollution.

This means that of the 56 million deaths worldwide in 2012, 11.6% or one in nine were attributable to air pollution.

In comparison, there were 5 million deaths from all injuries including from road accidents (1.3 million deaths), falls, fires, and war in 2012, according to WHO data.

Martin Khor

Indeed, air pollution may have become one of the top killers. Tobacco use, usually described as the world’s leading preventable cause of death, is responsible for nearly 6 million deaths annually, or around 10% of total deaths.

Air pollution may have overtaken it as the world’s leading cause of death.

The WHO estimates that there are 4.3 million deaths attributable to indoor pollution and another 3.7 million deaths to outdoor pollution.

Because some deaths may be due to both outdoor and indoor pollution, it is not possible to add up the two figures to obtain the total deaths.

Thus in its latest estimate in September 2016, the WHO has explained that there were 6.5 million deaths from outdoor and indoor air pollution combined in 2012.

Young children are among the most vulnerable to the effects of air pollution.  A new UNICEF study released on 31 October 2016 found  air pollution is a major contributing factor in the deaths of around 600,000 children under five every year, and that around 2 billion children live in areas where outdoor air pollution exceeded the WHO air quality guidelines.
Besides its threat to human lives and health, air pollution is also the major cause of climate change as it is linked to much of the Greenhouse Gas emissions.

The Paris Agreement of the UN Climate Change Conference that came into force on 10 November aims to limit the rise of the average global temperature to 2 or 1.5 degrees Celsius above the pre-industrial era levels.

At the current rate of global emissions, and even at rates reduced by the Paris Agreement commitments, global warming will far exceed this limit, and thus the world faces potentially catastrophic effects to the global environment, food supplies and also human health.

Thus, air pollution ranks as the biggest threat to both human health and the environment.  Reducing this pollution should therefore be at the top of the global agenda as well as national agendas.

Outdoor Air Pollution

At the end of September, the WHO for the first time published country-by-country details about the extent of outdoor air pollution and the deaths associated with it.

The study shows that 3 million premature deaths worldwide were linked to ambient or outdoor air pollution in 2012.   Of this, 88% of the deaths were in developing countries and two out of three occurred in the Southeast Asia and the Western Pacific regions.

Two countries alone accounted for more than half of the total deaths — China with 1.03 million and India with 621,138.

Other high-numbered countries include Russia (140,851), Indonesia (61,792), Ukraine (54,507), Egypt (43,531), Nigeria (46,750), Pakistan (59,241), United States (38,043), Bangladesh (37,449), Turkey (32,668), Japan (30,790) the Philippines (28,696), Vietnam (27,340), Poland  (26,589), Iran (26,267), Brazil (26,241) and Germany (26,160).

Most of the deaths attributable to outdoor air pollution were caused by non-communicable diseases, especially ischaemic heart diseases (36% of the total deaths), strokes (36%), lung cancer (14%), chronic obstructive pulmonary disease (8%), and acute lower respiratory infections (8%).

The situation is truly pervasive: 92% of the world’s population are exposed to the dangers of unsafe air quality as they live in places that do not meet the WHO health standard for outdoor air quality.

The world as a whole has an annual median exposure to outdoor mean annual concentration of PM2.5 of 39  microgram per cubic metre.  This is four times above the WHO’s guideline limit of 10 microgram per cubic metre for PM2.5.

The regions with the highest outdoor air pollution rates are Eastern Mediterranean high-income countries (91 microgram per cubic metre of PM2.5), Eastern Mediterranean low and middle income countries (55), Southeast Asia (55), Western Pacific low and middle income countries (49) and Africa (32).

The situation is truly pervasive: 92% of the world’s population are exposed to the dangers of unsafe air quality as they live in places that do not meet the WHO health standard for outdoor air quality.
Countries with high incidence of outdoor air pollution include Saudi Arabia (108 microgram per cubic metre of PM2.5), Qatar (103), Egypt (93), Kuwait (75), Bangladesh (84), Cameroon (65), Mauritania (65), United Arab Emirates (64), India (62), Libya (61), Pakistan (60), Bahrain (60) and China (54).

The PM2.5 level is the annual median concentration of particulate matter of a diameter less than 2.5 micrometres.  PM2.5 includes very fine (and thus the most damaging) particles of pollutants such as sulphate, nitrates, ammonia, sodium chloride, black carbon and mineral dust, which penetrate and lodge deep inside the lungs and in the cardiovascular system, posing the greatest health risks of developing cardiovascular and respiratory diseases and lung cancer.

Air quality is normally measured in terms of daily or annual mean concentrations of PM10 or PM2.5 particles (with diameter of 10 or 2.5 micrograms) per cubic metre of air volume.

(The WHO guidelines for particulate matter (PM) outdoor pollution is an annual mean of 10 microgram per cubic meter for particles below the size of 2.5 microns in diameter, and 20 microgram per cubic metre for particles below 10 microns in size.)

The world also suffered 84.9 million years of life lost in 2012, attributable to outdoor air pollution, according to the WHO report.   Years of life lost is a measure of the extent of premature death compared to the normal expected life span.

Of the total years of life lost, 26% was due to lung cancer, 17% to stroke, 17% to acute respiratory disease, 16% to ischaemic heart disease and 8% to chronic obstructive pulmonary disease.

The WHO report “Ambient air pollution: a global assessment of exposure and burden of disease” was based on satellite data, air transport models and ground station monitors for more than 3000 rural and urban locations.

The study does not include indoor or household air pollution, which may be even more dangerous than outdoor air pollution.

Indoor Air Pollution

Worldwide, 4.3 million people die annually from indoor air pollution, mainly from stroke (34%), ischaemic heart disease (26%), chronic obstructive pulmonary disease (22%), pneumonia (12%) and lung cancer (6%).

The main form of the deadly household pollution is the use of solid fuels for cooking and heating.  Nearly 3 billion poor people rely on wood, animal dung, charcoal, crop wastes and coal which are burned in highly polluting simple stoves or open fires.

The resulting pollution, which includes small soot particles that penetrate deep into the lungs, especially affects women and children who spend a lot of time near the kitchen or hearth.

In poorly ventilated homes, indoor smoke can be 100 times higher than the acceptable levels for fine particles, according to WHO.   The use of kerosene lamps for lighting also exposes the families to very high levels of fine particles.

The emissions of black carbon and methane from the stoves also contribute to outdoor air pollution and increase climate change as both are powerful Greenhouse Gases.

The WHO has new indoor air quality guidelines for household fuel combustion and recommendations on types of fuels and technologies to protect health, in addition to guidelines on specific indoor pollutants.  It will also do a study of indoor pollution and when the figures are published they will reveal the full problems caused by air pollution.

Excerpt:

Margaret Chan (left), Director-General of the World Health Organization visiting Sierra Leone during the Ebola crisis in December 2014.

By Lyndal Rowlands
UNITED NATIONS, Oct 24 2016 (IPS)

Health problems increasingly transcend the borders of the World Health Organization’s 194 member states, a challenge which the six candidates vying to lead the global body must address with care.

Those 194 member states will pick the next Director-General of the world’s peak health body in May 2017, after the current six candidates are whittled down by the World Health Organization (WHO) Executive Board in January. The successful candidate will replace current Director-General Dr Margaret Chan, of China in July 2017.

The ninth Director-General of the world’s peak health body will play a key role in ensuring global responses to an increasingly complex and contrasting list of global health problems: the spread of mosquito borne diseases due to climate change, multi-drug resistant tuberculosis, the unfinished business of AIDS and HIV, air pollution, domestic violence, the global rise in noncommunicable diseases such as diabetes as well as the inevitable emergence of the next Ebola-like pathogen.

She, or he, will need to navigate a delicate balance between serving each of the global body’s member states while also ensuring that the world’s only global health body is greater than the sum of its parts.

“Today when we talk about WHO’s role it really transcends states, it goes into a global response category,” Esperanza Martinez, Head of the Health Unit at the International Committee of the Red Cross (ICRC) told IPS.

“What you need is someone who is able to lead the organisation – not to confront the states – but to challenge the states to do better, to challenge the states to fulfill their obligations, to challenge the states to be more efficient and effective,” she said.

Yet, like any other UN body, the WHO “is no better or worse than the governments who make it up,” Susannah Sirkin Director of international policy and partnerships at Physicians for Human Rights told IPS.

The new Director-General will take over after a period of heavy soul searching for the Geneva-based organisation following deep criticism of the WHO’s handling of Ebola in West Africa.

“There is an enormous call for increased transparency and efficiency within the organisation,” said Sirkin.

In order to address emerging epidemics, such as Ebola and Zika, Martinez says that it is essential that the WHO is ready and able to spring into action.

“The fact that WHO has to wait for minsters of health and governments to qualify crisis really can delay interventions in critical moments,” said Martinez.

The new Director-General will also need to be prepared to “hit the ground running,” meaning that they should be “someone who already understands how the UN system works and how the WHO works,” she added.

“We need someone who understands the dynamics of humanitarian and emergency responses today.”

For Sirkin, the new Director-General will also need to transcend the “historic limitations” which have often seen the WHO adopt “relative silence” towards matters that are seen as within the control of national governments.

Health is politicised, said Sirkin, when governments fail “to invest to an adequate degree in the provision of both preventative and curative health care, or (fail) to invest a proportionate or reasonable amount of their national budget in health care.”

“The next Director-General has to really have some political courage and the ability to galvanise,” to overcome the constraints which have historically limited the WHO from speaking out.

“Somehow the WHO as an agency needs to transcend that.”

For example, she said the WHO should be able to speak out when the Syrian government “overtly obstructed the delivery of humanitarian including medical aid in an alarming way.”

She welcomed the WHO’s new role in addressing the global problem of attacks on health workers and health facilities, but noted that this is another area where the new Director-General will be required to have political courage.

Beyond humanitarian crises, the new Director-General will face many other challenges, including emerging threats such as antimicrobial resistance, as well as much older health challenges such as maternal mortality.

Two of the six candidates for the position of Director-General are women. Unlike the position of Secretary-General of the United Nations, which has always been held by men, two women, Chan and Gro Harlem Brundtland of Norway, have already led the WHO.

However although women and children’s health have been considered priorities of the UN and the WHO, Sirkin says that it is important for the WHO to do more than pay lip service to gender inequality in health, whether a man or a woman holds the role of Director-General, “especially since there is now known an enormous correlation between women’s rights and health.”

“Basic women’s rights – including reproductive rights, violence against women (and) sexual violence – over the long run is going to be a continuing enormous barrier to the development of global health,” she said.

The six candidates will address the members of the World Health Organization as well as members of the public on November 1 and 2.

More than half, 4 hail from Europe – Italy, France, Hungary and the United Kingdom – the other two come from Ethiopia and Pakistan. The hopefuls all share backgrounds as medical doctors, and most have extensive experience in public health or politics.

A group of demonstrators with black crosses, symbolising the victims of femicide in Peru and other countries of Latin America, march down a street in the centre of Lima during an Aug. 13 march against gender violence. Credit: Noemí Melgarejo/IPS

By Aramis Castro
LIMA, Aug 16 2016 (IPS)

Peruvians took to the streets en masse to reject violence against women, in what was seen as a major new step in awareness-raising in the country that ranks third in the world in terms of domestic sexual violence.

The Saturday Aug. 13 march in Lima and simultaneous protests held in nearly a dozen other cities and towns around the country, includingCuzco, Arequipa and Libertad,was a reaction tolenient court sentences handed down in cases of femicide – defined as the violent and deliberate killing of a woman – rape and domestic violence.

The case that sparked the demonstrations was that of Arlette Contreras, who was beaten in July 2015 by her then boyfriendin the southern city of Ayacucho, Adriano Pozo, in an attack that was caught on hotel cameras.“We want justice; we want the attackers, rapists and murderers to go to jail. We want the state to offer us, the victims, safety.” -- Arlette Contreras

Despite the evidence – the footage of the attack – Pozo, the son of a local politician, was merely given a one-year suspended sentence for rape and attempted femicide, because of “mitigating factors”: the fact that he was drunk and jealous. When a higher court upheld the sentence in July, the prosecutor described the decision as “outrageous”.

“We want justice; we want the attackers, rapists and murderers to go to jail. We want the state to offer us, the victims, safety,” Contreras told IPS during the march to the palace of justice in Lima, which was headed by victims and their families.

According to the World Health Organisation (WHO), Peru is in second place in Latin America in terms of gender-based killings, and in a multi-country study on sexual intimate partner violence, it ranked third.

“Enough!”, “The judiciary, a national disgrace”, “You touch one of us, you touch us all”were some of the chants repeated during the march, in which some 100,000 people took part according to the organisers of the protest, which emerged over the social networks and was not affiliated with any political party or movement, although President Pedro Pablo Kuczynski and members of his government participated.

Entire families took part, especially the relatives of victims of femicide, who carried signs with photos and the names of the women who have beenkilled and their attackers.

“My daughter was killed, but they only gave her murderer six months of preventive detention,” said Isabel Laines, carrying a sign with a photo of her daughter. She told IPS she had come from the southern department of Ica, over four hours away by bus, to join the protest in Lima.

Other participants in the march were families and victims of forced sterilizations carried out under the government of Alberto Fujimori (1990-2000). In 2002, a parliamentary investigation commission estimated that more than 346,000 women were sterilised against their will between 1993 and 2000.

In late June, the public prosecutor’s office ruled that Fujimori and his three health ministers were not responsible for the state policy of mass forced sterilisations, and recommended that individual doctors be charged instead.

The ruling enraged those demanding justice and reparations for the thousands of victims of forced sterilization, who are mainly poor, indigenous women.

Over the social networks, the sense of outrage grew as victims told their stories and discovered others who had undergone similar experiences, under the hashtags #YoNoMeCallo (I won’t keep quiet) and #NiUnaMenos (Not one less – a reference to the victims of femicide).

“After seeing the video of Arlette (Contreras), and the indignation when her attacker went free, a group of us organised over Facebook and we started a chat,” one of the organisers of the march and the group Ni UnaMenos, Natalia Iguíñiz, told IPS.

In the first half of this year alone, there were 54 femicides and 118 attempted femicides in Peru, according to the Women’s Ministry. The statistics also indicate that on average 16 people are raped every day in this country.

President Pedro Pablo Kuczynskitook part in the march against gender violence in Peru, where 54 femicides and 118 attempted femicides were committed in the first half of 2016 alone. Credit: Presidency of Peru

Between 2009 and 2015, 795 women were the victims of gender-based killings, 60 percent of them between the ages of 18 and 34.

Women’s rights organisations complain that up to now, Peruvian society has been tolerant of gender violence, and they say opinion polls reflect this.

In a survey carried out by the polling company Ipsos in Lima before the march, 41 percent of the women interviewed said Peru was not safe at all for women and 74 percent said they lived in a sexist society.

Meanwhile, 53 percent of men and women surveyed believed, for example, that if a woman wears a mini-skirt it is her fault if she is harassed in public areas, and 76 percent believe a man should be forgiven if he beats his wife for being unfaithful.

Since Kuczynski took office on Jul. 28, the issue of gender violence has been put on the public agenda and different political leaders have called for measures to be taken, such as gender-sensitive training for judicial officers and police, to strengthen enforcement of laws in cases of violence against women.

“The problem of gender violence is that the silence absorbs the blows and it’s not easy for people to report,” said the president before participating in the march along with several ministers, legislators and other authorities.

Iguíñiz said the march represented the start of a new way of tackling the phenomenon of violence against women in Peru, and added that the momentum of the citizen mobilisation would be kept up, with further demonstrations and other activities.

“Thousands of people are organising. We’re a small group that proposes a few basic things, but there are a lot of groups working culturally, in their neighbourhoods, in thousands of actions that are being taken at a national level: districts, vocational institutes, different associations,” she said.

In her view, the call for people to get involved “has had such a strong response because it is so broad.”

The movement Ni Una Menoshas organised previous demonstrations against violence against women in other Latin American countries, like Argentina, where a mass protest was held in the capital in June 2015.

“We are in coordination with people involved in the group in other countries,” said Iguíñiz.“We’re going to create a platform for petitions but we’re planning to do it at a regional level, in all of the countries of Latin America.”

The private Facebook group “Ni UnaMenos: movilización ya” (Not one less: mobilisation now), which started organising the march in July, now has some 60,000 members, and was the main coordinator of the demonstrations, although conventional media outlets and human rights groups later got involved as well.

In addition, hundreds of women who have suffered abuse, sexual attacks or harassment at work began to tell their stories online, in an ongoing process.

Peruvians abroad held activities in support of the march in cities like Barcelona, Geneva, London, Madrid and Washington.

With reporting by Alicia Tovar and Jaime Vargas in Lima

Margaret Chan, Director-General of the World Health Organization (WHO), during the WHO Executive Board's special session on the Ebola emergency. Credit: UN Photo/Violaine Martin.

By Lyndal Rowlands
UNITED NATIONS, May 24 2016 (IPS)

Putting economic interests over public health is leading the world towards three slow-motion health disasters, Margaret Chan, Director-General of the World Health Organization’s warned the world’s health ministers on Monday.

Changes in the world’s climate, the failure of more and more antibiotic drugs and the increase in so-called lifestyle diseases caused by poor diet and exercise, are all growing health disasters related to the prioritisation of the economy over public health.

“These are not natural disasters. They are man-made disasters created by policies that place economic interests above concerns about the well-being of human lives and the planet that sustains them,” she said.

Chan’s warnings were part of her speech at the opening of the 69th World Health Assembly in Geneva. Some 3500 delegates from the WHO’s 194 member states will participate in meetings at the assembly about some of the world’s most pressing health issues from May 23 to 27.

During her speech Chan also acknowledged the world’s many recent public health successes, however overall she argued that advances in health services and systems could not keep up with the global changes which mean health threats are increasingly traversing borders.

“The burning of fossil fuels powers economies,” said Chan, contributing to changes in climate, which have led to the spread of mosquito-borne diseases, as well as to air pollution which the WHO says kills millions of people every year.

“Highly processed foods that are cheap, convenient, and tasty gain a bigger market share than fresh fruits and vegetables,” she added, noting that the resulting non-communicable diseases such as diabetes, obesity and heart disease are now the “leading killers worldwide.”

However antibiotic resistance may be the problem that has the global health community most concerned, threatening to throw the world back into the dark ages of health care said Chan.

The over-prescription and incorrect use of antibiotics has led to the once wonder drug failing with increasing frequency.

Chan noted that infectious diseases are also becoming more volatile, and that the global health system was not as prepared as it should be for a true global health emergency.

She pointed to examples of recent surges in infectious diseases such as Ebola, Zika, Dengue, Yellow Fever and Chikungunya.

She described the spread of mosquito-borne diseases such as dengue as “the price being paid for a massive policy failure that dropped the ball on mosquito control in the 1970s.”

She noted the connection between Zika virus and microcephaly had taken the medical community by surprise.

“The possibility that a mosquito bite during pregnancy could be linked to severe brain abnormalities in newborns alarmed the public and astonished scientists.”

“Confirmation of a causal link between infection and microcephaly has transformed the profile of Zika from a mild disease to a devastating diagnosis for pregnant women and a significant threat to global health.”

However she said that the re-emergence of Zika have decades of slumber in part reflected “changes in the way humanity inhabits the planet (that) have given the volatile microbial world multiple new opportunities to exploit.”

Chan reserved some of her harshest criticisms for the world’s failure to prevent the current re-emergence of yellow fever in Africa, an outbreak the WHO is currently monitoring closely.

She described the conditions in urban environments fueling the current outbreak as a powder-keg.

“For more than a decade, WHO has been warning that changes in demography and land use patterns in Africa have created ideal conditions for explosive outbreaks of urban yellow fever,” she said.

Chan noted that beyond the failure to control mosquitos, the re-emergence of yellow fever also reflected a failure to adequately vaccinate against the disease.

“The lesson from yellow fever is especially brutal. The world failed to use an excellent preventive tool to its full strategic advantage,” she said, noting that there has been a safe low-cost yellow fever vaccine available since 1937.

Chan’s speech is not the only recent stand taken by the medical community showing increasing frustration with the current state of global politics.

Chan also alluded to the medical community’s increasing frustration with the deteriorating conditions of warfare which have seen hospitals bombed, in violation of humanitarian law.

“It also falls to the health sector to show some principled ethical backbone in a world that, for all practical appearances, has lost its moral compass,” she said.

However the successes that Chan highlighted, proving the potential of the world’s health system to address global challenges. also showed that another reality is possible.

“We can celebrate the 19,000 fewer children dying every day, the 44 percent drop in maternal mortality, and the 85 percent of tuberculosis cases that are successfully cured,” said Chan.

She also highlighted the 60 percent decline in malaria mortality in Africa, showing that the fight against mosquito-borne diseases is having success, in at least one area.

By Germán Velásquez
GENEVA, Nov 10 2015 (IPS)

The important relationship between the examination of patents carried out by national patent offices and the right of citizens to access to medicines hasn’t always been well-understood. Too often these are viewed as unrelated functions or responsibilities of the state. And the reason is clear: patentability requirements are not defined by patent offices, but frequently by the courts, tribunals, legislation or treaty negotiators.

Germán Velásquez

Given the impact of pharmaceutical patents on access to medicines, patent offices should continue to align their work in support of national health and medicine policies, using the freedom permitted by the Trade Related Aspects of Intellectual Property Rights Agreement (TRIPS) to define patentability requirements.

The TRIPS Agreement requires all World Trade Organization (WTO) member states to incorporate into their legislation universal minimum standards for almost all rights in this domain: copyright, patents and trademarks.

A patent is a title granted by the public authorities conferring a temporary monopoly for the exploitation of an invention upon the person who reveals it, furnishes a sufficiently clear and full description of it, and claims this monopoly.

As with any monopoly, it may lead to high prices that in turn may restrict access. The problem is compounded in the case of medicines, when patents confer a monopoly for a public good and essential products needed to prevent illness or death and improve health.

According to the TRIPS Agreement, the patentability requirements used by national intellectual property offices require a product or manufacturing process to meet the conditions necessary to grant patent protection, namely: novelty, inventive step and industrial applicability (utility).

These three elements, however, are not defined in the TRIPS agreement and WTO Member States are free to define these three criteria in a manner consistent with the public health objectives defined by each country.

It is widely held that patents are granted to protect new medicines to reward the innovation effort. However, the number of patents obtained annually to protect truly new pharmaceutical products is very low and falling. Moreover, of the thousands of patents that are granted for pharmaceutical products each year, a few are for new medicines – e..g. new molecular entities (NMEs).

All of the above led the World Health Organization (WHO), in collaboration with the United Nations Conference on Trade and Development (UNCTAD), the United Nations Development Programme (UNDP) and the International Centre for Trade and Sustainable Development (ICTSD), to develop, in 2007, guidelines for the examination of pharmaceutical patents from a public health perspective.

The guidelines were intended to contribute to improving the transparency and efficacy of the patent system for pharmaceutical products, so that countries could pay more attention to patent examination and granting procedures in order to avoid the negative effects of non-inventive developments on access to medicines. The major problems can be identified in the current use of the patent system to protect pharmaceutical innovation: reduction in innovation, high prices of medicines, lack of transparency in research and development costs, and proliferation of patents.

A study carried out by the journal Prescrire analysed the medicines that were introduced to the French market between 2006 and 2011, arriving at the conclusion that the number of molecules that produced significant therapeutic progress reduced drastically: 22 in 2006; 15, 10, 7, 4 in the following years up to 2011, which was a year in which Prescrire declared that only one medicine of significant therapeutic interest was brought to the market. Given that France is one of the largest pharmaceutical markets in the world, the reduction in innovation confirmed France is a good indicator of the global situation.

Oncologists from fifteen countries recently denounced the excessive prices of cancer treatments, which are necessary to save the lives of the patients, and urged that moral implications should prevail; according to them, of the 12 cancer treatments approved in 2012 by the United States Food and Drug Administration, 11 cost more than 100,000 dollars per patient per year.

Since the 1950s, there have been some references to the costs of Research and Development (R&D) for pharmaceutical products. According to some sources the average cost of research for a new pharmaceutical product these figures have increased from 1 million dollars in 1950 to 2.5 billion dollars for the development of a single product.

During the summer of 2014, a number of European countries, including France and Spain, spent many months negotiating with the company Gilead on the price of a new medicine for hepatitis C known as Solvaldi. The price fixed by Gilead was 56,000 Euros per patient for a twelve-week treatment, or 666 Euros per tablet. According the newspaper Le Monde the price of each tablet was 280 times more than the production cost. In France, it is calculated that 250,000 patients should receive this medicine, the cost of which would represent 7 per cent of the annual state medicine budget.

The application of patentability requirements for medicines, given their public health dimension, should be considered with even more care than in the case of regular merchandise or luxury items. The first and most important step is to use the freedom permitted by the TRIPs Agreement to define the patentability requirements: novelty, inventive step and industrial applicability (utility) in a way that keeps sight of public interest in the wide dissemination of knowledge.

(End)

Excerpt:

The First Lady of Kenya, Governor Ali Roba and the Executive Director of UNFPA, Dr Osotimehin, in Mandera County. Credit: UNDP Kenya

By Ruth Kagia and Siddharth Chatterjee
NAIROBI, Kenya, Nov 9 2015 (IPS)

Mandera in northeastern Kenya, has often been described as “the worst place on earth to give birth.” Mandera’s maternal mortality ratio stands at 3,795 deaths per 100,000 live births, almost double that of wartime Sierra Leone at 2,000 deaths per 100,000 live births.

But Mandera also demonstrates what can be achieved with strong political leadership and strategic partnerships. Just under a year ago, on December 2, 2014, we were part of a team from the United Nations, World Bank, charities and the Office of the President of Kenya that undertook the two-hour flight to Mandera to determine what could be done to address this critical development bottleneck.

Minutes before take-off, news came through that 36 Kenyans had been brutally murdered in Mandera by the Somali militant group al Shabaab.

No official briefing could have better highlighted the challenges of the task ahead. Rather than acting as a deterrent, it strengthened our resolve and we continued with our journey.

Marginalization combined with internecine conflicts, pockets of extremism, poor human development and cross border terrorism have trapped so many of Mandera’s people in poverty and misery. In addition, women and girls are subjected to cultural practices such as female genital mutilation and child marriage, which contribute to high school dropouts and complicate delivery.

The government has been focused in its resolve to change the narrative in Mandera and in other historically disadvantaged parts of Kenya. The introduction of free maternity services, for example, has increased the number of Kenyan women giving birth under skilled care from about 40 to 60 per cent since 2013.

Together with the government, the United Nations Population Fund (UNFPA) Kenya mobilised private sector partners to develop innovative strategies to improve maternal and child health, especially in the six counties with the highest maternal and child health burden: Lamu, Isiolo, Wajir, Mandera, Marsabit and Migori.

On October 13, we launched a Community Life Centre in Mandera with the technology company Philips. The centre, equipped with solar lighting, fridges, lab and diagnostic equipment, will provide better healthcare services for about 25,000 people.

UNFPA Executive Director Dr Babatunde Osotimehin has given a very clear message that UNFPA must help the hard to reach and the most vulnerable. With this resolve, UNFPA, together with the World Bank, UNICEF and the World Health Organization, supported by the Ministry of Health, mobilized 15 million dollars to improve maternal, child and adolescent health services in the six counties in March 2015.

These efforts were given a major boost on November 6, 2015, when Kenya’s First Lady H.E. Margaret Kenyatta handed over a fully-kitted mobile clinic to Mandera. The First Lady launched the Beyond Zero campaign in 2014 to reduce maternal and child mortality in Kenya.

Dr. Osotimehin flew in from New York for the event, and was joined by the ambassadors of the European Union, Denmark, Sweden and Finland.

The First Lady said: “For too long, the prospect of childbirth in Kenya, to thousands of women, has been tantamount to a death sentence. No one should die giving life.”

Dr Osotimehin said: ‘‘When we invest in strengthening the health system from the community to the facility, when we invest in strong referral systems and complementary basic services, we save women’s lives but we also underwrite our future as humanity.”

Maternal health is a perfect illustration of the fact that the process of development is multi-dimensional. Poor maternal health affects women, their children and their communities. It affects nutrition, human development, population dynamics and it undermines the quality of the labour force.

When you improve maternal health, you create healthy families, strong communities and strong economies.

Like the tentative steps of an infant beginning to walk, these may seem modest achievements in the face of the significant challenges in these remote counties. The counties require structural changes which can lead women out of poverty, eliminate gender inequalities and build stronger health systems.

The partners’ grit and the commitment demonstrated by the government together with leaders like the First Lady and Mandera County Governor Ali Roba give reason for optimism that these challenges can be overcome.

Improving maternal health is not only achievable, it is a goal worth reaching.

(End)

Excerpt:

Sixty-five years after a major international summit here on malaria, the mosquito-borne disease remains a scourge and its incidence may even be rising in parts of sub-Saharan Africa due to the combined effects of climate change, agricultural practices and population displacement.

Almost half the world’s population is deemed at risk of malaria, and an estimated 214 million people will contract it in 2015, with nearly half a million dying.

Credit: FAO

“Malaria is the number one public health problem in our country,” says Babria Babiler El-Sayed, director of Sudan’s Tropical Medicine Research Institute. Sudan has begun, with the assistance of FAO and the IAEA, to release sterilized male mosquitoes into the air in hopes that they crowd out their virile brethren and lead to reduced mosquito populations.

The Unite d Nations Food and Agriculture Organization (FAO) and the International Atomic Energy Association (IAEA) have used this “nuclear” technique with success against the lethal tsetse fly and the produce-destroying fruit fly. Malaria is a new area, and the two agencies are experimenting across East Africa with this so-called Sterile Insect Technique (SIT) of pest control.

And yet malaria is demonstrably preventable – and that is why it is explicitly named in Sustainable Development Goal No. 3 as something to be ended by 2030.

The key is not to rely on one method or tool but to develop integrated efforts to subdue the disease, notes El-Sayed.

That fits FAO’s broader approach. While working with the IAEA on the logistics and technology of SIT, field officers emphasize the need to integrate agricultural practices ranging from crop selection, tilling technique, water use and even rural home locations.

It’s a shift from 1950, when a World Health Organization conference held in Kampala resolved to support the intensive use of Dichlorodiphenyltrichloroethane (DDT) to eradicate the disease. As was learned the hard way, even such a potent chemical cannot on its own sustainably solve the problem. Indeed, in the emblematic case of the Tennessee Valley in the United States, it was a mass anti-poverty campaign coupled with a huge hydroelectric public-works program that led to the rapid demise of malaria without the use of chemicals in the 1930s.

Warmer climate helps bugs fly higher

Particularly alarming is malaria’s literal ascent into the densely-populated highlands of east Africa. Inhabitants of southwest Uganda and parts of Zambia and Rwanda typically lack the genetic resistance to malaria developed by farmers in mosquito-prone areas.

Climate change wreaks all sorts of changes in the risk profile of the human environment. For example, more and more Zambians are killed by crocodiles, lions and buffalos as they travel further for water in times of drought. Less headline-grabbing, but more pervasive, is the way one poor harvest can wipe out livelihoods, driving people to sell their livestock, tools and even land in a bid to survive and ending up mired in poverty. Similarly, pressure on the land – sometimes linked to civil conflict – is driving record flows of migrants, the majority of whom don’t leave their countries, but move into new ecosystems, as scores of Ugandans are doing by moving to the hilly southwest regions of this country and ultimately taking up a form of farming that enhances the risk of malaria.

Add to this the steady climb in average temperatures, which increase the potential habitat for the main malarial vectors and are “related to altitude rather than latitude,” according to recent research done by the International Food Policy Research Institute into why the incidence of malaria has risen so dramatically in Uganda’s upcountry. That spells special risks for elevations above 2,000 meters in Kenya, Ethiopia and Burundi, too.

Strategies must be integrated and local

Despite popular images today, malaria is not particularly a tropical disease. Indeed, it was the successful use of DDT in postwar Italy that galvanized the Kampala conference, even though it now appears the rising incomes linked to Marshall Plan-funded economic growth was the determining factor.

Integrated methods – farming techniques, crops themselves, and human practices such as the use of nets – are all part of any success story in malaria. Zambia’s Malaria Institute at Macha has, with international support, practically eliminated malaria in its southern district, and the credit should go primarily to an engaged community effort, according to Dr. Phil Thuma, one of the institute’s mainstays and an advocate of what he calls “full court press” tactics in battling the epidemic.

FAO has long been involved in distributing mosquito nets, one of the simple but critical tools in any effort. Indeed, one current FAO project promotes the use of insecticide-treated nets around livestock barns in Kenya and has led to a sharp uptick in dairy production as both humans and animals are healthier.

The media has long indulged in donor-depressing tales about Zambian fishermen using anti-mosquito nets to boost their catch or – in one quirky story from Uganda but published in Botswana – p eople using the nets to make bridal dresses. But in fact most people in eastern Africa have and use their government-provided nets today, and many buy another one in a sign of conviction about their utility, according to a detailed survey of actual behaviour in Tanzania.

The real problem is that many farmers have to get up before dawn, or stay out in their fields late, and as a result their work forces them to forgo protection during the biting hours.

Almost everybody knows the basics about malaria, but few had heard about climate change. Intriguingly, those with secondary or higher education tended to worry about unpredictable rain patterns while those with only primary education are focused on rising temperatures.

Empirical surveys clearly show that where cultivation practices reduce vegetation cover, temperatures rise in mosquito breeding sites. That means land use and reforestation efforts need to be part of the community-driven policy mix. Farmer field schools, a longtime FAO priority focus, are key to spreading knowledge that is locally useful, such as casting shade on breeding places or fostering fish in ponds.

Developing “malaria-smart” programs need to be drawn up with that in mind, especially given efforts to increase irrigation infrastructures to boost agricultural yields in sub-Saharan Africa. One survey in Ethiopia found that the rate of childhood malaria was seven times higher in villages within three kilometres of a microdam for irrigation than children living more than eight kilometres away.

Maize cultivation, a huge force in the region, may also be lifting the incidence of malaria because the higher-yield hybrid varieties used pollinate later in the year, helping fatten up mosquito larvae – meaning more, bigger and longer-living adult ones.

(End)

An outbreak of dengue fever in Yemen’s most populated governorate has prompted urgent calls from the World Health Organisation (WHO) for a “humanitarian corridor” to facilitate the flow of medicines to over three million civilians trapped in the war-torn area.

Taiz, located on the country’s southern tip, has been on the frontline of fighting between Houthi rebels and a Saudi Arabia-backed coalition of Arab states supporting fighters loyal to deposed President Abd-Rabbu Mansour Hadi since March 2015.

Three of Taiz’s major hospitals have either been destroyed or are inaccessible, leaving 3.2 million people – many of them sick or injured – without access to basic healthcare.

An estimated 832 people in the governorate have died and 6,135 have been wounded since the war broke out.

To make matters worse, in the past two weeks alone the number of suspected dengue cases has nearly tripled from 145 cases in early August to nearly 421 by the month’s end.

As the conflict escalates with both sides showing little regard for civilian safety, the WHO fears that the health situation will deteriorate in the coming months, worsening the misery of people caught between Houthi gunfire and Coalition airstrikes.

In a statement released on Aug. 27, WHO Regional Director for the Eastern Mediterranean Ala Alwan said: “All parties to the conflict must observe a ceasefire and demilitarize all hospitals and health facilities in Taiz, allow for the safe delivery of the supplies, implement measures to control the dengue outbreak, provide treatment and enable access to injured people and other patients.”

A mosquito-borne disease caused by the dengue virus, this tropical fever causes flu-like symptoms including high temperatures and muscle pains.

If symptoms are not quickly identified and managed, the patient may experience dangerously low platelet counts, internal bleeding or low blood pressure. Undetected, the disease can be fatal.

Mosquitoes carrying the virus thrive in stagnant water, and dengue epidemics often spread quickly in densely populated areas where open sewer systems or uncollected garbage provide convenient homes for the larvae.

With huge numbers of displaced Yemenis living in cramped and unsanitary makeshift settlements, it is small wonder that the disease is moving so rapidly.

The WHO’s most recent situation report for Yemen reveals that the country has logged over 5,600 suspected cases of dengue fever since March, including 3,000 cases in the coastal city of Aden alone.

Incomplete levels of medical reporting as a result of heavy fighting suggest that the real number of cases could be much higher.

Children are more likely than adults to develop the severe form of the disease, known as the Dengue Haemorrhagic Fever. With children accounting for over 600,000 of the nearly 1.5 million displaced in Yemen, health officials are on red alert.

Since there is no vaccine against the diseases, and no specific antiviral drug with which to treat the symptoms, prevention is the only long-term solution.

The WHO is partnering with other organisations and local health authorities to distribute insecticide-treated mosquito nets, educate families on the causes of the diseases, conduct indoor spraying to disrupt breeding grounds and secure necessary laboratory supplies for medical facilities.

These tasks are not easily accomplished in the midst of relentless air strikes and heavy fighting.

“We need protection and safety for all people working to control the worrying outbreak of dengue fever in Taiz,” the WHO said today, adding that parties to the conflict must stay mindful of their obligations under international law to protect medical facilities and health personnel during war-time.

Edited by Kitty Stapp