UN Falls Short of Aid Pledge to Yemen Despite Peace Efforts — Global Issues

In the southern city of Taiz, 11-month-old Ameer Hellal receives WFP supplementary food for malnutrition. Photo: WFP/Albaraa Mansoor
  • by Alexander Kozul-Wright (geneva)
  • Inter Press Service

While the Humanitarian Affairs and Emergency Relief Coordinator Martin Griffiths noted that the UN had received 31 commitments during the conference on February 30, 2023, in Geneva, the amount pledged remains well below the organisation’s target of US$4.3 billion.

The conflict in Yemen started in 2014 when Iranian-backed Houthi rebels – representing the country’s Zaidi Shia Muslim minority – seized the capital, Sanaa. The war intensified in 2015 when a Saudi-led coalition intervened on behalf of the government against the Houthis.

Owing to repeated Saudi-led bombardment campaigns and deep territorial divisions (half of the country remains under Houthi control in the north and the other half under government control in the south), Yemen’s economy has ground to a halt.

Last year, exogenous factors also led to steep falls in Yemen’s Rial relative to the U.S. dollar, pushing inflation up to 45 percent. Elsewhere, food prices surged by 58 percent. In 2022, 13 million people in Yemen relied on the UN’s World Food Program for basic staples.

To date, the conflict has killed more than 375,000 people, sixty percent from indirect causes (mainly from malnutrition and disease). The war has also razed the country’s civilian and physical infrastructure, including its oil sector – Yemen’s only source of foreign exchange.

Last year, warring parties agreed to an UN-brokered cease-fire. Though it expired in October, the six-month truce led to a reduction in casualties. It also enabled commercial traffic to flow through the port of Hodeida, increasing the supply of goods and aid into the country.

A slight improvement in food security at the end of last year meant two million fewer Yemenis suffered from acute hunger. The number of people in famine-like conditions also dropped from 161,000 to zero. But progress remains fragile.

Yemen continues to rely on foreign aid. “More than 21 million people, or two-thirds of the country’s population, will need humanitarian assistance in 2023,” said UN secretary-general António Guterres.

Among those in need, more than 17 million are understood to be living below Yemen’s poverty line. Meanwhile, an estimated 4.5 million Yemenis are internally displaced, largely due to climate-change-related events.

According to the UN, Yemen is “highly vulnerable” to the effects of rising global temperatures (notably arid weather). In recent years, severe droughts have exacerbated food shortages caused by the war.

Yemen Remains in Need of External Support

The UN’s US$4.3 billion funding objective is nearly double what it received last year. Looking ahead, reliance on external aid will be particularly acute in 2023 due to constrained oil exports linked to Houthi attacks on government-held oil terminals last October.

This week’s conference took place as the country’s rival groups agreed to an informal suspension of hostilities. Efforts are underway to declare a lasting peace after the parties failed to extend their UN-backed peace agreement last year.

“We have a real opportunity to change Yemen’s trajectory and move toward peace by renewing and expanding the truce,” noted Guterres at the pledging event, co-hosted by Sweden and Switzerland.

The meeting was attended by officials worldwide, including U.S. Secretary of State Antony Blinken and Germany’s Foreign Minister Annalena Baerbock. In his speech, Blinken called on donors to step up their contributions, citing last year’s funding shortages.

The UN missed its financing target for Yemen by US$2 billion last year. Blinken also urged the international community to help restore Yemen’s economy, suggesting this would “reduce people’s suffering over the long term.”

“Large-scale investment will be needed to rebuild Yemen’s physical infrastructure. Securing peace, however, remains the top priority. “Without it, millions will continue to face extreme levels of poverty, hunger and suffering,” added Blinken.

Meanwhile, the UN secretary-general warned that aid funding would not provide a panacea for Yemen.

“Humanitarian assistance is a band-aid. It saves people’s lives but cannot resolve the conflict itself.”
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Role of Regional Economic Cooperation in Inclusive Digital Transformation in Asia — Global Issues

Farmer using tablet to contact customer/ iStock
  • Opinion by Hsiao Chink Tang, Anne Cortez (beijing, the people’s republic of china)
  • Inter Press Service

Coronavirus (COVID-19) pandemic has accelerated digital transformations, but not all countries have benefitted equally. For example, rural farmers in the People’s Republic of China (PRC) were able to take advantage of existing digital mobile network, digital payment, and logistic services to find alternative markets and sell their produce online.

Many turned to established e-commerce platforms, such as, Pinduoduo, Taobao, and JD, and doing so innovatively via live-streaming.

In contrast, rural farmers in some other parts of Asia struggled to keep their livelihoods during the pandemic. Without access to face-to-face trades due to lockdowns, let alone selling online, many had to live with little or no income.

Businesses of micro, small, and medium-sized enterprises (MSMEs) in many parts of Asia also suffered during the pandemic. Even in ordinary circumstances, persistent barriers such as poor and costly infrastructure, poor digital literacy, and limited government support hinder the growth of MSMEs in many developing economies.

Inevitably, during COVID, many MSMEs failed to capitalize on the pandemic-triggered digital transformation.

The above are some of the issues discussed in a dialogue organized by the ADB-PRC Regional Knowledge Sharing Initiatives (RKSI) and the Ministry of Finance, the PRC, on the topic of digital transformation and regional cooperation.

The forum acknowledged that despite the many opportunities presented by the digital economy in Asia, a great part of the region’s digital potential remains untapped, and key regulatory, infrastructural, financial, and capacity challenges remain.

There is also a widening digital divide among countries that are under-connected and those that are digitalized.

Prevailing digital infrastructure and non-infrastructure gaps, specifically in e-commerce across Central Asia, are highlighted in a Central Asia Regional Economic Cooperation Program (CAREC) Institute study. The study shows that e-commerce development among CAREC countries is highly varied and key gaps remain.

These gaps include those in basic digital infrastructure and regulatory policies resulting in a lack of economic opportunities, income inequality and weaknesses in the business environment. A solution to bridge this gap and drive an inclusive digital growth is regional cooperation.

In 2021, ministers from Central Asia Regional Economic Cooperation (CAREC) member countries endorsed the Digital Strategy 2030, which identifies areas that can catalyze collaboration and digitalization in the region. Similarly, Greater Mekong Subregion (GMS) countries are considering a proposal to promote and enhance cooperation in the digital economy, leveraging on the GMS cross-border e-commerce cooperation platform.

Region-wide cooperation allows governments and stakeholders to coordinate policies, share costs of building and maintaining infrastructure, and expand markets to advance the digital economy. Regional cooperation mechanisms also help build trust and harmonization that are crucial for digital development among countries.

In turn, digital advancement promotes regional cooperation in trade, finance, transport, energy, and other sectors. To make inclusive digital transformation a reality, cooperation must extend beyond the public sector and encourage collaboration with partners from international organizations, private businesses, MSMEs, civil society, and other stakeholders.

Regional cooperation offers great potential to level the field and ensure that no one is left behind in the digital economy. Regional cooperation also means sharing and learning from country experiences across the region.

There are rich lessons and inspirational stories from not just digital-focused firms, but also individuals with digital skills, who have transformed their lives and that of their families and communities waiting to be heard and shared.

Regional focused platforms such as CAREC, GMS, and RKSI, play a crucial role on this front in facilitating such cross-border knowledge exchanges and partnerships to ensure inclusive and sustainable development, and improve people’s wellbeing.

Hsiao Chink Tang is a Senior Economist and Anne Cortez is a Communication Specialist at the Asian Development Bank-PRC RKSI, a south-south development knowledge sharing platform that draws on the PRC’s experience and facilitates knowledge exchange among ADB’s developing member countries.

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UN Hobbled by Junta and Under Pressure Over Myanmar Aid Crisis — Global Issues

Rohingya IDPs confined to a Sittwe camp in Rakhine State wait for international intervention. More than 1.5 million people are displaced in Myanmar. Credit: Sara Perria/IPS
  • by Guy Dinmore, Thompson Chau (bangkok)
  • Inter Press Service

The numbers needing support continue to rise from the estimated 14 million people needing aid last year. More than 10,000 people were displaced by fighting in southern Kayin State in early January alone, joining more than 1.5 million IDPs across the country.

The UN says it recognises the urgent need to remain in Myanmar and step up humanitarian operations, but it is caught between a hostile military junta imposing restrictions on its activities and a loose network of resistance groups accusing the world body of legitimising an illegal regime.

UN Secretary-General Antonio Guterres is also facing increasing criticism for his apparent hands-off leadership in the crisis.

“Almost 18 million people – nearly one-third of the Myanmar population – are estimated to be in humanitarian need nationwide in 2023, with conflict continuing to threaten the lives of civilians in many parts of the country,” said Ramanathan Balakrishnan, UN Resident and Humanitarian Coordinator for Myanmar.

He told IPS that international and local humanitarian aid organisations are “using a range of approaches” in different areas and had reached over four million people in 2022 despite severe underfunding and what he called “heavy bureaucratic and access constraints”.

Balakrishnan defended the importance of the UN’s engagement with General Min Aung Hlaing’s regime, which has ruthlessly crushed dissent since seizing power two years ago and overthrowing the elected government led by Aung San Suu Kyi.

“Principled engagement with all sides is a must to negotiate access and also to advocate on key protection issues. Advocacy to stop the heavy fighting and airstrikes in populated areas that are threatening the safety of both civilians and aid workers is as important as reaching people in need with humanitarian aid,” he said.

Aid workers accuse the junta of further restricting aid operations and blocking urgently needed aid from reaching millions of people. The regime admitted this month it cannot effectively administer about one-third of Myanmar’s townships. But it is able to choke access to some areas controlled by resistance groups and ethnic armed organisations that have been fighting the military for decades.

The junta is seeking to impose its authority with a new law making registration compulsory for national and international non-governmental organizations and associations and introducing criminal penalties for non-registered entities with up to five years of imprisonment.

“Civic space has been decimated in the country already due to the military’s actions, particularly its systematic harassment, arrest, and prosecution of anyone who opposed their coup,” said James Rodehaver, chief of the UN Human Rights Office for South-East Asia (OHCHR) Myanmar Team. “These new rules could greatly diminish what operational space is left for civic organisations to deliver essential goods and services to a population that is struggling to survive.”

Many of the more than one million refugees outside Myanmar also need help. Most are stateless Rohingya Muslims forced out of Rakhine State into Bangladesh in waves of ethnic cleansing before the 2021 coup, with many held in border camps.

The UN’s reputation was already battered before the coup over its handling of the long-festering Rohingya crisis in which it was accused by aid workers and activists of being too accommodating with the Myanmar military. And it has come under further fire since.

In a joint letter last September, more than 600 Burmese civil society organisations said they “condemn in the strongest terms the recent public signing of new agreements and presenting of letters of appointment to the illegitimate Myanmar military junta by UN agencies, funds, programmes and other entities working inside Myanmar.”

“We call on you and all UN entities to immediately cease all forms of cooperation and engagement that lends legitimacy to the illegal, murderous junta,” said the letter addressed to the UN Secretary-General. The signatories argued that letters of appointment and agreements should be presented to what they regard as the legitimate government of Myanmar – the parallel National Unity Government established by ousted lawmakers – and “ethnic revolutionary organisations.”

A Myanmar researcher specialising in civil society and international assistance highlighted the role of Burmese CSOs in delivering aid. “Local CSOs comprehend the complexity of specific local needs in the current crisis as the communities they serve struggle with security concerns and essential public services, including healthcare and education,” said the researcher, who goes by the name Kyaw Swar for fear of security reprisals.

He said that donors and foreign organisations had adopted risk aversion arrangements post-coup, referring to UN and INGO’s costs for capacity-building components and disproportionate country-office operations. “Local CSOs have fewer operations, and risk management options have no choice but to channel international aid to their respective communities.”

UN officials reject the notion that they are legitimising the regime and insist that only by operating in the junta-controlled heartland and also through cross-border assistance can aid be delivered to a substantial part of the population in desperate need.

“The UN finds itself in an almost existential bind. It can’t engage with an oppressive regime without being seen to condone its actions,” commented Charles Petrie, former UN Assistant Secretary-General and former UN chief in Myanmar.

“Somehow, the UN’s senior leadership needs to convince all that engaging in a dialogue with a pariah regime is not the same as supporting it and that it should be judged on the outcome of the discussions rather than being condemned for the simple fact of engaging,” he said.

“But being able to do so successfully implies that it has the level of credibility that right now it still needs to rebuild,” he added.

Questions have also been raised about the apparent lack of hands-on leadership on the part of Guterres. The UN Secretary-General seems to have made little personal intervention beyond routine statements, such as the latest marking the second anniversary of the coup in which he condemned “all forms of violence” and said he “continues to stand in solidarity with the people of Myanmar and to support their democratic aspirations for an inclusive, peaceful and just society and the protection of all communities, including the Rohingya.”

Since the coup and despite the unfolding humanitarian crisis, Guterres is seen as having taken a back seat and delegating to two successive special envoys. This stands in contrast to his predecessor Ban Ki-moon who actively intervened during the Cyclone Nargis disaster in 2008, personally meeting then-junta leader General Than Shwe and negotiating the opening of Myanmar to aid workers.

Petrie suggested Guterres should take a page out of Ban’s book and provide much more active leadership on Myanmar and be “more openly engaged and supportive of the work done by his special envoy.”

While China and Russia lend military and other support to the junta, much of the rest of the diplomatic world has taken a step back from the Myanmar crisis, leaning instead on ASEAN to assume the lead.

But the 10-member bloc has been ineffective so far. It has coordinated an unprecedented shunning of the junta’s leadership in regional meetings, but neighbouring countries – with their own blemished democratic records – are unwilling to penalise the regime. The ASEAN Coordinating Centre for Humanitarian Assistance on Disaster Management (AHA Centre) has been charged to respond to the humanitarian crisis, but with no success.

Laetitia van den Assum, the former Dutch ambassador to Myanmar and Thailand, said the aid response would have been more effective if ASEAN had set up a partnership between AHA and experienced UN and other organisations.

“That, in fact, is what happened in the aftermath of Nargis, when under the strong leadership of Dr Surin Pitsuwan, ASEAN and UN worked in tandem. It took time to put the effort together, but ultimately it took off,” van den Assum told IPS.

As with the UN leadership, Lim Jock Hoi, a Bruneian government official who was ASEAN chief until last month, was barely noticed on the issue of Myanmar, in stark contrast to Pitsuwan, who helped persuade Than Shwe to accept humanitarian assistance in 2008 when Cyclone Nargis killed over 100,000 people.

“UN agencies like OCHA, WFP and UNICEF, as well as many dedicated INGOs, continue to provide assistance, more often than not under difficult circumstances, and with countless Myanmar civil society organisations playing critical roles,” Van den Assum observed.

“But until now, the SAC has stood in the way of more effective aid,” she added. “What is missing is an overall agreement between Myanmar and ASEAN about such assistance, how to expand it and how to guarantee that all those in need are served. ASEAN and AHA have not been able to deliver on this.”

Observers point out that AHA is set up to respond to natural disasters and has no experience in intervening with aid in conflict situations.

“That had already become clear in 2018 when AHA was tasked to make recommendations for ASEAN assistance to northern Rakhine state after the enforced deportation of more than 750,000 Rohingya. The initiative died a slow death,” Van den Assum said.

“AHA was not to blame. Rather, ASEAN politicians had taken a decision without first considering whether it was the most advisable approach,” the veteran diplomat said.

No breakthrough is in sight. The junta has extended a state of emergency for another six months, admitting that it lacks control over many areas for the new elections it says it wants to stage but which have already been widely denounced by the resistance as a sham.

“Heavy fighting, including airstrikes, tight security, access restrictions, and threats against aid workers have continued unabated, particularly in the Southeast, endangering lives and hampering humanitarian operations,” the UN Office for the Coordination of Humanitarian Affairs reported in its latest update.

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Worlds Deadliest Earthquake Leaves over 33,000 Dead — Global Issues

“A street of local markets in a residential area in North Syria that has been blocked by the ruins of collapsed buildings.” Credit: Norwegian Refugee Council (NRC)
  • by Sania Farooqui (new delhi, india)
  • Inter Press Service

Rawan Kahwaji was fast asleep in her apartment in Gaziantep, in Turkey when she woke up to the sounds of people screaming. The first two minutes, she says, did not make sense to her. “It was a nightmare, I remember waking up not knowing what was going on. My apartment was shaking really hard and it went on for sometime, we didn’t expect it to be this bad, we just thought we would get out of the apartment for a few hours because earthquakes happen quite regularly. But this time with each hour that we spent waiting outside, following the aftershocks, we realised the situation was much worse,” Kahwaji said.

War in Syria had displaced Kahwaji and her family once, before they moved to Gaziantep in 2015. For many displaced like her, documents which included ID, educational degrees and travel documents meant more than anything for survival. “In the middle of that chaos, we realised we needed our documents in case we had to leave the city. Our apartment was full of cracks and everything inside was destroyed, we somehow managed to get our documents.

After spending two days in a shelter in Gaziantep, Kahwaji and her family were amongst the few who managed to get to Ankara safely, but she describes the experience as something she has never seen before. “There were people on the road screaming, we could hear people crying for help, I saw people collapsing because they were having heart attacks. I don’t know if they made it through or not, but it was complete chaos. We lost a lot, we lost our business, our lives, physically we are safe, but mentally we are not fine. I am still imagining the earth shaking and we are all simply sitting, waiting in anticipation that something is going to happen to us again,” Kahwaji said.

It has been almost a week of relentless search and rescue operations, as workers across these regions are still trying to pull survivors from the rubble – there have been some harrowing stories of success and also of heartbreak. Turkish President Recep Tayyip Erdogan has announced a three-month state of emergency in 10 provinces worst-affected by the earthquake.

Syria Civil Defence – also known as White Helmets have been in news since the beginning of the earthquake for their immediate call to action to rescue those trapped under rubbles and for saving lives.

Almost 3000 White Helmet volunteers have been on the ground searching for survivors and pulling the dead from collapsed buildings. It’s been a race against the clock, those who have made it through for them the challenge has been to survive the cold weather, toxic smoke as people burnt plastic to stay warm, lack of water and basic necessities.

Cities closest to the epicentre of the earthquake, as per this report, when the temperatures rose on Sunday and it became warm, “odour of rotting bodies became discernible. It was the smell of death.”

“The situation has been very catastrophic, both personally and also collectively,” says Muzna Dureid, Senior Program Manager, White Helmets in an interview given to IPS said, “One of the worst impacted regions is North West Syria, home to almost 4.5 million people who have been forcefully displaced multiple times, they have witnessed the siege, the chemical attacks, bombardments, all types of suffering and now this earthquake.

“Unfortunately the situation has been beyond the capacity of our team, we are working with very limited resources as cities and villages have been completely destroyed. Families have been destroyed, so many are living on the streets in dire weather conditions,” Dureid said.

The possibility of finding survivors continues to decrease as the hours pass. A UN liaison officer warned that the two countries are nearing the end of the search and rescue window. The World Health Organization (WHO) estimates up to 23 million people could be affected by the earthquake across both the countries.

The Norwegian Refugee Council (NRC) has been working on the ground across Syria providing relief, water, and support to those affected by the earthquake. In a statement issued here, NRC says, “The quake happened at the worst time of the night at the worst time of the year. The destructive extent of the shock hit a number of cities in Syria, including Aleppo, Idlib, Homs, Hamah and Lattakia, including internally displaced people across Syria’s north.”

“We are now entering a new phase with search and rescue operations largely coming to an end. The real scale of the disaster will start to crystallise in the coming days,” says Emilie Luciani, Country Director, Syria Response Office, Norwegian Refugee council in an interview to IPS.

“Thousands of families are without shelter in open areas or seeking refuge in damaged buildings, existing internally displaced people’s (IDP) sites, reception centres, collective centres or beings temporarily hosted by other families. Communication has been very difficult, and roads around the main affected areas are damaged.

“People in North West Syria are in a desperate situation. They have already spent many years displaced and reliant on humanitarian assistance, and now unfortunately, the aid reaching them is also restricted as the United Nations can only utilise one crossing-point to reach them from Turkey which only just reopened – 5 days after the earthquake,” says Luciani.

According to this report, the Syrian government in Damascus has been receiving aid from international donors, but there is a lot of uncertainty about whether that will be equitably distributed to all the affected parts of Syria including the rebel held North West.

The Red Cross has called for urgent access in Northern Syria to help people who need urgent support. “Impartial humanitarian assistance should never be hindered, nor politicised,” it says.

Avril Benoit, Executive Director, Doctors Without Borders (MSF) USA said: “The massive consequences of this disaster will require an equally massive international response. People urgently need shelter, food, blankets, clothes, heating materials, hygiene kits, and medical assistance – including access to mental health support. For Syrians living the earthquake zone, this is catastrophe layered on top of crisis after crisis. People have endured more than a decade of war, an economic crisis, the COVID-19 pandemic and a recent cholera outbreak, benoit said.

UNHCR has warned that according to its preliminary data, as many as 5.3 million people in Syria may have been affected by the recent earthquake and will need some form of shelter assistance. A huge number and this destruction comes to a population already suffering mass displacement.

“We are really worried, as we have seen in the past, the world has the habit of replacing a crisis with a new crisis and so on. Right now everyone is opening their doors, giving donations, opening relief camps and emergency response which is needed, no doubt but what after that? We are worried that after a week or so when everyone goes back to their routine life, we will forget about those impacted by the earthquake, especially women and children, says Anila Noor, Managing Director of Women Connectors and a policy expert on refugees and migration.

“These are poor people, who have suffered due to war, they live with very limited resources especially in Syria. Emergency response is the first step, but we need to see how we can help them later, make an ecosystem and a system of accountability to track where the money and aid goes, and also see the local efforts,” says Noor.

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The Climate Conversations — Global Issues

The Gabura union, a small island adjacent to the Sundarbans forest, is expected to be submerged in seawater by 2050. Credit: Mohammad Rakibul Hasan
  • by Mohammad Rakibul Hasan – and AI Artificial Intelligence (dhaka, bangladesh)
  • Inter Press Service

Another significant barrier to progress on climate change is the need for more political will among leaders of countries. In some cases, leaders may not see climate change as a priority or may be reluctant to take on the economic and political costs of reducing emissions or investing in clean energy due to political reasons. Some countries may be influenced by powerful fossil fuel lobbies that push against climate action. Developed countries must be willing to take on more significant emissions reductions and provide financial assistance to developing countries to help them adapt to the effects of climate change. Developing countries, in turn, need to be willing to take on emissions reduction measures and invest in clean energy and other climate mitigation measures.This can happen through more effective multilateral negotiations such as United Nations Framework Convention on Climate Change (UNFCCC), where all countries agree to set emissions reduction targets and support developing countries.

Bangladesh is located in the low-lying delta region of the Ganges, Brahmaputra, and Meghna rivers, making the country particularly susceptible to flooding and rising sea levels. Bangladesh is also prone to cyclones and other extreme weather events, which are becoming more frequent and severe due to climate change. The country has a long coastline, much of which is low-lying and vulnerable to flooding. As sea levels continue to rise, the risk of coastal flooding is increasing, devastatingly impacting the lives and livelihoods of the people in these areas. These events are causing widespread damage to homes and infrastructure and affecting the country’s agricultural sector, a significant source of income for many people in Bangladesh. Many people in the coastal areas have lost their homes and livelihoods due to sea level rise and coastal flooding. They face food and water insecurity due to increased soil and water salinity.

Globally, rich countries can assist Bangladesh cope with climate change in several ways. One crucial way is by providing financial assistance to help the country adapt to the impacts of climate change. This may include funding for building sea walls and other flood protection infrastructure and programs to help people in coastal areas relocate to higher ground. Another way rich countries can help is by providing technical assistance to Bangladesh to develop and implement clean energy and other climate mitigation measures. This could include funding and expertise to help the country develop renewable energy sources such as solar and wind power, as well as to improve energy efficiency and to reduce emissions from the industrial and transportation sectors.

The Sundarbans forests, located in the coastal belt of Bangladesh, is one of the most vulnerable areas in the country to the impacts of climate change. The forests span over 10,000 square kilometres and is home to various plant and animal species, including the Royal Bengal tiger. Sea level rise is one of the most significant threats to the Sundarbans forest making it particularly susceptible to flooding and rising sea levels. According to a study by the Intergovernmental Panel on Climate Change, sea levels in the Bay of Bengal are projected to increase by up to 1 meter by the end of the century. This would devastate the Sundarban forests, as seawater would submerge large areas.

The impacts of climate change on the Sundarban forests are also likely to have knock-on effects on the people living in the surrounding areas. The forests are a significant source of livelihood for many people in the region, who rely on it for fishing, agriculture, and other activities. As the forests are damaged by sea level rise and extreme weather events, these people will also be affected by food and water insecurity and the loss of their homes and livelihoods. Many people who lost their homes and land to flooding, were forced to relocate to higher grounds.

The health impacts of climate change on people living around the Sundarban are also significant. As a result of sea level rise and increased flooding, many are at risk of waterborne diseases such as cholera and diarrhea. Extreme weather events are accelerating salinity across the coastal belt of Bangladesh. Women are experiencing uterus cancers, infertility, and skin diseases, and men, too, are experiencing fertility problems and other health issues. Due to the loss of livelihoods and displacement, many people face food insecurity and malnutrition. In addition to these immediate impacts, climate change exacerbates the region’s existing social and economic inequalities. People living in poverty and marginalized communities are disproportionately affected by climate change, as they have fewer resources to cope with the impacts and less access to services and support.

Climate change has led to a growing number of people migrating from these areas, searching for better opportunities and escaping the impacts of climate change. Most climate migrants from coastal belt areas of Bangladesh are moving to urban areas, such as the capital city of Dhaka and other major cities. These migrants often seek better job opportunities and access to services and support. However, many migrants face challenges in their new locations, such as a lack of affordable housing, discrimination, and limited access to services and support. The future is uncertain for those still living in coastal areas of Bangladesh and fighting the climate crisis. Many of the people living in these areas are among the country’s most vulnerable and marginalized communities, making them particularly susceptible to the impacts of climate change. Climate conversations worldwide by world leaders and major organizations have been occurring every year. But they must see the severity of the situation for the people suffering and take concrete actions beyond being in a room to converse about the effects of climate change.


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More Austerity in 2023 Will Fuel Protests — Global Issues

Anti-Austerity protests in 2006-2020. Credit: World Protests Platform
  • Opinion by Isabel Ortiz, Sara Burke (new york)
  • Inter Press Service

Only three months earlier, finance ministers had gathered in Washington DC for the same reason. The mood was grim. The need for ambitious actions could not be greater; however, there were no agreements, evidencing the fragility of multilateralism and international cooperation.

Worse, policy makers -advised by the International Monetary Fund- are resorting to old, failed and regressive policies, such as austerity (now called “fiscal restraint” or “fiscal consolidation”), instead of much needed corporate/wealth taxation and debt reduction initiatives, to ensure an equitable recovery for all.

A recent global report alerts of the dangers of a post-pandemic wave of austerity, far more premature and severe than the one that followed the global financial crisis a decade ago. While governments started cutting public expenditures in 2021, a tsunami of budget cuts is expected in 143 countries in 2023, which will impact more than 6.7 billion people or 85% of the world population.

Analysis of the austerity measures considered or already implemented by governments worldwide shows their significant negative impacts on people, harming women in particular. These austerity policies are:

  • targeting social protection, excluding vulnerable populations in need of support by cutting programs for families, the elderly and persons with disabilities (in 120 countries);
  • cutting or capping the public sector wage bill, this is, reducing the number and salaries of civil servants, including frontline workers like teachers and health workers (in 91 countries);
  • eliminating subsidies (in 80 countries);
  • privatizing public services or reforming state-owned enterprises (SOEs) in areas such as public transport, energy, water;
  • reforming hard-earned pensions by adjusting benefits and parameters, resulting in lower incomes for retirees (in 74 countries);
  • (6) labor flexibilization reforms (in 60 countries);
  • reducing employers’ social security contributions, making social security unsustainable (in 47 countries);
  • and even cutting health expenditures despite COVID-19 is not over.

Austerity and all the human suffering it causes is evitable, there are alternatives. There are at least nine financing options, available even in the poorest countries, fully endorsed by the UN and international financial institutions, from increasing progressive taxation to reducing debt. Policymakers must urgently look into these. Many countries have already implemented them.

In recent years, citizens have protested austerity all around the world. A recent study on world protests shows that nearly 1,500 protests in the period 2006-2020 were against austerity. Citizens demand better public services, social protection, jobs with decent wages, tax and fiscal justice, equitable land distribution, and better living standards, among others. Protests against pension reforms, and high food and energy prices have also been very prevalent. Recently, the jobs and cost-of-living crises have been accentuated by the COVID-19 pandemic, resulting in more protests despite lockdowns.

The majority of global protests against austerity and for economic justice have manifested people’s indignation at gross inequalities. The idea of the “1% versus the 99%,” that emerged a decade ago during protests over the 2008 financial crisis, has spread around the world, feeding grievances against elites and corporations manipulating public policies in their favor, while the majority of citizens continue to endure low living standards, aggravated by austerity cuts.

Let’s remember that trillions of dollars have been used to support corporations during the pandemic and to support military spending. Now people are being asked to endure austerity cuts, at a time when they are suffering a cost-of-living crisis. The 2023 meetings in Davos are being faced with new protests and demands to tax the rich.

Unless policymakers change course, we shouldn’t be surprised to see increasing waves of protests all over the world. Clashes in the street are likely to intensify if governments continue to fail to respond to people’s demands and persist in implementing harmful austerity policies.

Governments need to listen to the demands of citizens that are legitimately protesting the denial of social, economic and civil rights. From jobs, public services and social security to tax and climate justice, the majority of protesters’ demands are in full accordance with United Nations proposals and the Universal Declaration of Human Rights. Leaders and policymakers will only generate further unrest if they fail to act on these legitimate demands.

Isabel Ortiz is Director of the Global Social Justice Program at Joseph Stiglitz’s Initiative for Policy Dialogue at Columbia University, former Director at the International Labour Organization (ILO) and UNICEF.

Sara Burke is Senior Policy Analyst at Friedrich-Ebert-Stiftung (FES) New York

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Forget About All this Humanitarian Blah Blah (And Buy More Weapons) — Global Issues

Sales of arms and military services by the 100 largest companies in the industry reached 592 billion US dollars in 2021, a 1.9% increase compared with 2020 in real terms. Credit: Shutterstock
  • by Baher Kamal (madrid)
  • Inter Press Service

Not only the available funding for humanitarian aid is already short, but next year will also set another record for humanitarian relief requirements, with 339 million people in need of assistance in 69 countries, an increase of 65 million people compared to the same time last year, the United Nations and partner organisations on 1 December 2022 said.

“The estimated cost of the humanitarian response going into 2023 is US$51.5 billion, a 25% increase compared to the beginning of 2022.”

Such highly needed 51.5 billion US dollars amount to less than one-tenth of the total sales of weapons which reached 592 billion US dollars just in one year: 2021.

As if humanitarian aid funding were not already short enough in times when it is more needed than ever, UN Members Try Defunding Budgets for Human Rights Work, warns Louis Charbonneau, United Nations Director at Human Rights Watch.

“United Nations member countries need to overhaul the budgetary approval process for UN human rights work. The current system, overseen by the General Assembly’s Fifth Committee, is inefficient and overly politicised.”

Human rights mechanisms, exposed

It unnecessarily exposes UN human rights mechanisms – teams of independent experts established to investigate serious international crimes – to attempts by hostile governments to curtail their resources or defund them, adds Charbonneau.

Russia has repeatedly tried to defund investigations of its ally Syria, just as China has done for Myanmar. China and Russia have also worked hard to chip away at funding and staffing levels for other human rights activities and the Office of the UN High Commissioner for Human Rights, he said.

“It’s not only China and Russia. The United States and some European Union countries joined Israel last year to try to defund the Commission of Inquiry on Israel and Palestine. They may try again.”

Social services, dismantled

Even in their own rich countries, politicians go on cutting further the funding of social services such as public health, public education, and other programmes which citizens and taxpayers have voted for them to provide.

Simply, the wave of privatising all social public services now blows strongly from the United States to an overwhelming majority of countries.

Meanwhile, amidst growing social unrest, protests and strikes, politicians seem to have leaned under the heavy pressure of the arms industry, therefore devoting more and more public funds to purchasing weapons.

Arms sales increase for the seventh year

No wonder: sales of arms and military services by the 100 largest companies in the industry reached 592 billion US dollars in 2021, a 1.9% increase compared with 2020 in real terms, according to new data released on 5 December 2022 by the Stockholm International Peace Research Institute (SIPRI).

Such an increase marked the seventh consecutive year of rising global arms sales. It took place despite the fact that many parts of the arms industry were still affected by pandemic-related disruptions in global supply chains in 2021, which included delays in global shipping and shortages of vital components, says SIPRI.

‘We might have expected even greater growth in arms sales in 2021 without persistent supply chain issues,’ said Dr Lucie Béraud-Sudreau, Director of the SIPRI Military Expenditure and Arms Production Programme.

“Both larger and smaller arms companies said that their sales had been affected during the year. Some companies, such as Airbus and General Dynamics, also reported labour shortages.”

Need to replenish weapons sent to Ukraine

According to the Stockholm-based peace research institute, Russia’s invasion of Ukraine in February 2022 has added to supply chain challenges for arms companies, not least because Russia is a major supplier of raw materials used in arms production.

“This could hamper ongoing efforts in the United States and Europe to strengthen their armed forces and to replenish their stockpiles after sending billions of dollars’ worth of ammunition and other equipment to Ukraine.”

So far, the United States has reportedly spent 100 billion dollars on weapons provided to Ukraine.

US companies dominate the Top 100

The arms sales of the 40 US companies in the listing totalled 299 dollars billion in 2021, the research further explains. North America was the only region to see a drop in arms sales compared with 2020. The 0.8 per cent real-term decline was partly due to high inflation in the US economy during 2021.

Since 2018, the top five companies in the Top 100 have all been based in the USA.

A recent wave of mergers and acquisitions in the US arms industry continued in 2021. One of the most significant acquisitions was Peraton’s purchase of Perspecta, a government IT specialist, for 7.1 billion US dollars.

Private equity companies are becoming more active in the arms industry, particularly in the USA. This could affect the transparency of arms sales data, due to less stringent financial reporting requirements compared with public companies, according to the report.

Chinese companies drive rapid growth in Asian arms sales

The combined arms sales of the 21 companies in Asia and Oceania included in the Top 100 reached 136 billion US dollars in 2021—5.8 % more than in 2020, SIPRI reports. The eight Chinese arms companies in the listing had total arms sales of 109 billion dollars, a 6.3% increase.

There has been a wave of consolidation in the Chinese arms industry since the mid-2010s, said Xiao Liang, a researcher with the SIPRI Military Expenditure and Arms Production Programme. In 2021 this saw China’s CSSC becoming the biggest military shipbuilder in the world, with arms sales of 11.1 billion US dollars, after a merger between two existing companies.

Europe, Russian and the Middle East among the top 100

In 2021 there were 27 Top 100 companies headquartered in Europe. Their combined arms sales increased by 4.2% compared with 2020, reaching 123 billion US dollars.

Meanwhile, six Russian companies are included in the Top 100 for 2021. Their arms sales totalled 17.8 billion US dollars—an increase of only 0.4% over 2020. There were signs that stagnation was widespread across the Russian arms industry, reports SIPRI.

And the five Top 100 companies based in the Middle East generated 15.0 billion US dollars in arms sales in 2021. This was a 6.5% increase compared with 2020, the fastest pace of growth of all regions represented in the Top 100.

© Inter Press Service (2022) — All Rights ReservedOriginal source: Inter Press Service



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New Political Agreement Finally Tackles Venezuela’s Social Crisis — Global Issues

The World Food Program has been active in Venezuela since last year, delivering bags of food to families of schoolchildren in some poor areas, such as remote areas accessed by river in the Arismedi municipality, in the southwestern plains state of Barinas. CREDIT: Gabriel Gómez/WFP
  • by Humberto Marquez (caracas)
  • Inter Press Service

When the pact was signed on Nov. 26, renowned nutritionist Susana Raffalli published a photograph of the legs of a girl whose height is eight centimeters shorter than what is appropriate for her age. “I measured her today. Her growth has been irreversibly stunted,” she said.

“Between the first announcement of the social roundtable (meetings to that purpose were already held in 2014) and the one signed today in Mexico, a generation of Venezuelans like her was born. The agreement is not a trophy. It is a commitment to hope,” Raffalli stated.

The Social Agreement signed in Mexico “is an important contribution, which could mean urgent aid for children, the elderly, the disabled and indigenous people, whose situation is extremely critical,” Roberto Patiño, founder of Alimenta la Solidaridad, a network of soup kitchens for children, told IPS.

The resources involved in the agreement are Venezuelan state funds frozen in the United States and European nations that in 2019 refused to accept the re-election of President Nicolás Maduro, in power since 2013, adopted sanctions and recognized opposition lawmaker Juan Guaidó as president.

Now, in talks between the government and the opposition, with the mediation of governments from this region and Norway, an agreement was reached to unfreeze part of the funds and allocate them to social programs under United Nations supervision.

The United States and European countries are participating in the deal as sanctioning parties and the UN as manager of the released funds and social programs covered by them.

“These are absolutely insufficient resources in the face of the crisis, but well-managed they can have a positive impact given the country’s complex humanitarian emergency,” Piero Trepiccione, coordinator of the network of social centers in Latin America and the Caribbean run by the Catholic Jesuit order Society of Jesus, told IPS.

The HumVenezuela Platform, made up of dozens of civil society organizations, has maintained since 2019 that the social situation in this South American country is a complex humanitarian emergency, based on its records on food, water and sanitation, health, basic education and living conditions.

The sharp deterioration in the living conditions in this country over the last decade has gone hand in hand with the decline of the Venezuelan economy – a collapsed oil industry and several years of hyperinflation – whose most visible international consequence has been the migration of seven million Venezuelans.

Barrier against life

In recent years, U.S. sanctions and the political clash with other governments, as in the case of Colombia, a neighbor with which the borders and the transit of people and goods were closed, have had a major impact.

For example, tragedy struck the low-income family of Michel Saraí, a five-year-old girl with pneumonia who was treated at a small hospital in La Fría, a small town in the southwest near the border with Colombia, which lacked the equipment needed for the necessary tests and treatment.

When her health took a turn for the worse on Nov. 30, her parents decided not to take her to the public hospital in the regional capital, San Cristóbal, because they did not have the dozens of dollars charged there to accept patients, who must bring their own supplies and pay for tests.

A Civil Defense ambulance, with fuel donated by a neighbor – gasoline is scarce in the state of Táchira and others – took the girl and her mother some 25 kilometers to the border bridge in the town of Boca de Grita, so that she could be treated free of charge in the cities of Cúcuta or Puerto Santander, on the Colombian side.

With the border formally closed, the Colombian military agreed to receive the ambulance due to the emergency, but the Venezuelan National Guard refused to allow passage of the vehicle carrying the little girl connected to oxygen.

“We had no money to offer them to see if they would let her get through,” the father, Jonathan Pernía, told local reporters a few days later.

In desperation, the mother and an aunt accepted what seemed like the only alternative: disconnecting her from the oxygen, placing her on a wheelbarrow – “as if she were a sack of potatoes,” Pernía lamented – and running with her through the rain to the Colombian side of the bridge, where another ambulance was waiting for them. But the little girl arrived without vital signs.

At the morgue of the hospital in San Cristobal her parents picked up the body. A week later they were still trying to find the money needed to pay the burial expenses.

Figures behind the crisis

In Venezuela, poverty – defined as those who cannot afford the basic food basket – currently affects 81.5 percent of the population (90.9 percent in 2021), according to the Living Conditions Survey of the Andrés Bello Catholic University, which surveyed 2300 households throughout the country. This is the first time in seven years that it has gone down, partly attributable to a rebound in the economy and remittances from migrants.

Meanwhile, multidimensional poverty – which takes into account housing, education, employment, services and income – fell from 65.2 percent in 2021 to 50.5 percent in 2022, and extreme poverty dropped from 68 percent in 2021 to 53.3 percent in 2022.

Venezuela is the most unequal country in the Americas, and along with Angola, Mozambique and Namibia is one of the most unequal in the world, as the richest 10 percent earn 70 times more (553.20 dollars per month on average) than the poorest 10 percent (7.90 dollars).

Seven million children are in school, down from 7.7 million in 2019, and an estimated 1.5 million children and adolescents are not in the educational system. Preschool and daycare coverage is just 56 percent.

The survey reported an improvement in formal employment and income this year, with average monthly earnings of 113 dollars for public employees, 142 dollars for the self-employed, and 150 dollars for people working in private sector companies.

As a consequence, food insecurity declined from 88 percent of Venezuelans worried about running out of food in 2021, to 78 percent, while the proportion of people who have gone a whole day without eating dropped to 14 percent, from 34 percent in 2021.

More than 90 percent of poor households have received food assistance from the government -especially carbohydrates- but only one third receive these products monthly.

In health, according to the survey, the use of public services is decreasing (70 percent) and health care is becoming more expensive because, while prices in private clinics are skyrocketing, 13 percent of those who turned to public services had to pay in outpatient clinics and 16 percent in hospitals, and in 65 percent of the cases they had to pay themselves for the medicine that was prescribed for them.

Mexican formula

Jorge Rodríguez, president of the legislative National Assembly and the ruling party’s lead negotiator, said that with the funds released after the agreement reached in Mexico, the infrastructure and materials in 2300 schools will be covered, and the vaccines required in accordance with the World Health Organization (WHO) guidelines will be purchased.

Medicine for oncological and HIV patients will be obtained, radiotherapy programs, blood banks and at least 21 hospitals will be revived, while more than one billion dollars will be allocated to the national electricity grid.

The World Food Program (WFP), meanwhile, which now delivers food to families of 100,000 schoolchildren in poor areas in the north of the country, hopes to raise funds to provide meals to more than one million people by the end of 2023.

According to Trepiccione, of the Jesuit network, resources should be directed “to the recovery of the infrastructure of hospitals and schools, which are in terrible condition, because that generates a chain of jobs, services and economic activity along with the obvious improvements in the provision of health care and the quality of education.”

“The same can be said of reactivating the electrical system, hit by blackouts that affect above all the economy and the life of people in the western part of the country,” he added.

Patiño, from the network of soup kitchens, said priorities were “programs for early childhood care, pregnant women, school feeding, as well as care for the elderly and indigenous communities, segments where many are dying too young due to lack of urgent health care.”

Government pensions, which are equal to the minimum wage, were equivalent to 30 dollars at the beginning of the year, but with the depreciation of the local currency they are equivalent to just nine dollars per month as of this December.

“We must also emphasize that this social agreement is absolutely insufficient in the face of the precarious conditions that exist in our country. These are resources that will be exhausted and the needs will not disappear,” said Patiño.

In his view, “the only thing that can really solve the crisis, the best possible social program, is a decent job, with a sufficient income and with a social security and public health program that takes care of the most needy.”

Funds for the agreement, frozen in banks in industrialized countries, will be released gradually under the supervision of a government-opposition committee and with UN agency management to tender, implement and oversee the programs, in 2023 and 2024.

And over the coming year new meetings will be held and further political agreements are expected, which may lead to an easing or lifting of sanctions and, eventually, to an improvement in the living conditions of Venezuela’s 28 million people.

© Inter Press Service (2022) — All Rights ReservedOriginal source: Inter Press Service

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COP27 Fiddling as World Warms — Global Issues

  • Opinion by Jomo Kwame Sundaram, Hezri A Adnan (kuala lumpur, malaysia)
  • Inter Press Service

COP27 takes place amidst worsening poverty, hunger and war, and higher prices, exacerbating many interlinked climate, environmental and socio-economic crises.

The looming world economic recession is likely to be deeper than in 2008. The likely spiral into stagflation will make addressing the climate crisis even more difficult.

Invoking the Ukraine war as pretext, governments and corporations are rushing to increase fossil fuel production to offset the deepening energy crisis.

Resources which should be deployed for climate adaptation and mitigation have been diverted for war, fossil fuel extraction and use, including resumption of shale gas ‘fracking’ as well as coal mining and burning.

War causes huge social and economic damage to people, society and the environment. The wars in Ukraine, Yemen and elsewhere impose high costs on all, disrupting energy and food supplies, and raising prices sharply.

Russia’s Ukraine incursion has provided a convenient smokescreen for a hasty return to fossil fuels, as military-industrial processes alone account for 6% of all greenhouse gases.

The future is already here

All these have worsened crises facing the world’s environment and economy. The most optimistic Intergovernmental Panel on Climate Change (IPCC) scenario expects the 1.5°C rise above pre-industrial levels threshold for climate catastrophe to be breached by 2040.

Crossing it, the world faces risks of far more severe climate change effects on people and ecosystems, especially in the tropics and sub-tropical zone.

But the future is already upon us. Accelerating warming is already causing worse extreme weather events, ravaging economies, communities and ecosystems.

Recent floods in Pakistan displaced 33 million people. Wildfires, extreme heat, ice melt, drought, and extreme weather phenomena are already evident on many continents, causing disasters worldwide.

In 2021, the sea level rose to a record high, and is expected to continue rising. UN reports estimate women and children are 14 times more likely than adult men to die during climate disasters.

Popular sentiment is shifting, even in the US, where ‘climate scepticism’ is strongest. Devastation threatened by Hurricane Ida in 2021 not only revived painful memories of Katrina in 2005, but also heightened awareness of warming-related extreme weather events.

Stronger climate action needed

In international negotiations, rich nations have evaded historical responsibility for ‘climate debt’ by only focusing on current emissions. Hence, there is no recognition of a duty to compensate those most adversely impacted in the global South.

Last year’s COP26 Glasgow Climate Pact was hailed for its call to ‘phase-out’ coal. This has now been quickly abandoned by Europe with the war. And for developing countries, Glasgow failed to deliver any significant progress on climate finance.

At COP27, the Egyptian presidency has proposed an additional ‘loss and damage’ finance facility to compensate for irreparable damage due to climate impacts.

After failing to even meet its modest climate finance promises of 2009, the rich North is dithering, pleading for further talks until 2024 to work out financing details.

Meanwhile, the G7 has muddied the waters by counter-offering its Global Shield Against Climate Risks – a disaster insurance scheme.

Get priorities right

What the world needs, instead, are rapidly promoted and implemented measures as part of a more rapid, just, internationally funded transition for the global South. This should:

  • replace fossil fuels with renewable energy, including by subsidizing renewable energy generation for energy-deficient poor populations.
  • promote energy-saving and efficiency measures to reduce its use and greenhouse gas emissions by at least 70% (from 1990) by 2030.
  • implement a massive global public works programme, creating ‘green jobs’ to replace employment in ‘unsustainable’ industries.
  • develop needed sustainable technologies, e.g., to replace corporate agricultural practices with ‘agroecological’ farming methods, investment and technology.

Another world is possible

Another world is possible. A massive social and political transformation is needed. But the relentless pursuit of private profit has always been at the expense of people and nature.

Greed cannot be expected to become the basis for a just solution to climate change, let alone environmental degradation, world poverty, hunger and gross inequalities.

The COP27 conference is now taking place in Sharm-al-Sheikh, an isolated, heavily policed tourist resort. Only one major road goes in and out, as if designed to keep out civil society and drown out voices from the global South.

The luxury hotels there are charging rates that have put COP27 beyond the means of many, especially climate justice activists from poorer countries. The rich and powerful arrived in over 400 private jets, making a mockery of decarbonization rhetoric.

Thus, the COP process is increasingly seen as exclusive. Without making real progress on the most important issues, it is increasingly seen as slow, irrelevant and ineffective.

Generating inadequate agreements at best, the illusion of progress thus created is dangerously misleading at worst.

By generating great expectations and false hopes, but actually delivering little, it is failing the world, even when it painstakingly achieves difficult compromises which fall short of what is needed.

Multilateralism at risk

Multilateral platforms, such as the UNFCCC, have long been expected to engage governments to cooperate in developing, implementing and enforcing solutions. With the erosion of multilateralism since the end of the Cold War, these are increasingly being bypassed.

Instead, self-appointed private interests, with means, pretend to speak for world civil society. Strapped for resources, multilateral platforms and other organizations are under pressure to forge partnerships and other forms of collaboration with them.

Thus, inadequate ostensible private solutions increasingly dominate policy discourses. Widespread fiscal deficits have generated interest in them due to the illusory prospect of private funding.

Private interests have thus gained considerable influence. Thus, the new spinmeisters of Davos and others have gained influence, offering seductively attractive, but ultimately false, often misleading and typically biased solutions.

Meanwhile, global warming has gone from bad to worse. UN Member States must stiffen the backs of multilateral organizations to do what is right and urgently needed, rather than simply going with the flow, typically of cash.

Hezri A Adnan is an environmental policy analyst and Fellow of the Academy of Sciences, Malaysia. He is author of The Sustainability Shift: Reshaping Malaysia’s Future.

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A New Digitalisation Effort in Bangladesh Could Change Community Health Globally — Global Issues

  • Opinion by Morseda Chowdhury (dhaka, bangladesh)
  • Inter Press Service

Amid the COVID-19 pandemic, BRAC digitalised the work of our 4,100 shasthya kormi, specially trained community health workers, in Bangladesh. Shasthya kormi are women experienced in health education, antenatal and postnatal checkups, non-communicable disease prevention, reproductive health and nutrition. The digital transformation of their work created benefits on a remarkable number of levels, underscored the vast potential for further scaling, and yielded insights directly relevant to increasing the quality of healthcare globally.

Each shasthya kormi was given an Android tablet and trained in its use. That enabled immediate time saving in myriad ways: faster and more accurate record-keeping; reports conveyed online rather than in person; training conducted online and at convenient times rather than only at designated times in person; and related administrative travel and costs avoided. The time saved can exceed a full day every two weeks. The digital devices also enabled us to save approximately USD3.8 million per year in monitoring costs.

But that is just the beginning of the benefits. The digital tablets enhance the prestige of shasthya kormi, as they now have access to vital information at their fingertips. They can screen for diseases and conditions, confirm diagnoses, have complete confidence in describing required treatment and management, and arrange video chats with doctors and specialists. Their decision-making is quicker and more accurate, improving their quality of care and giving them more time to spend with patients.

Electronic reporting enabled the creation of a database that we expect will grow to cover 76 million people. That database can now be tracked and analysed for trends – in the incidence of disease or other conditions, in the delivery of services, and in outcomes. Those trends can be analysed and addressed in real time – locally and nationally, as BRAC’s shasthya kormi cover 61 of Bangladesh’s 64 districts.

For COVID-19, for instance, reports of symptoms and test results can be tracked, as can vaccinations and outcomes. Recognizing the incidence of positive test results in Bangladesh’s border regions is especially valuable to understanding how trends evolve across regions.

For tuberculosis, 1.4 million samples have been collected and tracked. Similarly, non-communicable diseases like hypertension and diabetes, for both of which the incidences are rising in Bangladesh, can be tracked and addressed. If anyone has high blood pressure, a shasthya kormi can precisely record it. A blood glucose test administered by a shasthya kormi can detect abnormal blood sugar levels indicating possible diabetes. The database can track the percentage of pregnant women who are at high risk.

The overall database – with its 150 data points so far – also enables cross-tabulation of facility-specific and community-specific data. It makes it possible to merge BRAC’s trend analyses with data from government and other institutions. It responds to internal migration, with each individual’s medical records linked to their government-issued national identification card – so each person’s health record moves with them.

When these benefits are combined with the cost-effective nature of this digital approach, the potential for scaling increases dramatically. Each digital tablet costs about $100, so 4,100 shasthya kormi can be equipped for less than half a million dollars. In addition, they save money through the efficiencies described above. Patients also save – out-of-pocket expenditure makes up 63% of medical expenses in Bangladesh, and tests conducted by shasthya kormi often cost one tenth what they would in a private clinic. This in turn also takes pressure off health facilities.

The initiative has enormous potential to scale further – within Bangladesh and around the world. Shasthya kormi can be recruited locally and trained in a matter of weeks. They can be equipped digitally without great expense. The quality of their work can be monitored digitally, and everyone benefits from the enhanced access to health care that results.

Key to scaling are several insights that emerged as we orchestrated this digital transformation.

First, it was critical to track data input closely from the start, to identify anyone struggling with the transformation. One of the first clues was a lot of data being entered after 5:00 pm. It was not because people did not know how to enter it, but because they were nervous about using the devices in public, and did not want to make errors in front of the people who trust them.

Once we saw this in the data and figured out the reason behind it, we could easily work with each person to overcome it. Early on, we created a team of 40 technical officers who provided additional training and support for anyone struggling. The help was provided in some cases over the phone, but otherwise in person. Initially most people needed it, but now only about 10% of people need assistance.

Second, the digital tablets enabled constant, on-demand professional development. Needs, equipment and trends change regularly in the health sector, and these changes can occur rapidly. Shasthya kormi could assess their skills at any time convenient to them using tests available on the tablet, and the module would identify weaknesses and suggest further training to address it. Managers could also track their supervisee’s progress. This enhanced the expertise of the network broadly.

Third, we observed a tendency to skip entering critical but more difficult to obtain inputs, like National Identity numbers and birth registration numbers. Fortunately, we can often fill gaps by cross-tabulating with our mobile-based cash transfer system. We also noticed that counselling information was not recorded as seriously as service data. Iterative training has gradually solved these challenges.

Fourth, the digital transformation addressed a decades-old challenge – prestige. Shasthya kormi are often taken for granted, and they are sometimes welcomed, sometimes not. In order to establish the rapport they need to do their work, however, which is often of a sensitive nature, particularly in conservative communities, it is crucial that they are accepted into every household. Digitalisation has elevated the level of respect they receive in the community, particularly among men.

The success of this digital transformation, if scaled, could change community health globally. The result would be superior primary health care service delivery, operational efficiency and establishment of an infrastructure for real time health trend analysis, in a time when we have never struggled more with quality and accessibility of health care around the world.

Morseda Chowdhury is Director of the Health, Nutrition, and Population Programme at BRAC in Bangladesh.

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