ISLAMABAD, Pakistan, Feb 24 (IPS) – While its origins may be rooted in the discrimination faced by people living with HIV, Zero Discrimination Day has evolved to celebrate commitments to the fundamental human right of being treated equally in law and in practice.
Within the context of global health, the day is an opportunity to examine discrimination from the perspective of health and care workers, who face barriers based on their race, gender, and other socio-economic and cultural factors.
In the context of a global health workforce under siege from the threat of the great resignation in health, it is especially important to examine the impact of discrimination on health systems at global, national and local levels.
In recent times, recognition of the gender pay gap in health of 24% and its impact on national and regional economy has spurred greater research into the unequal treatment of women, taking into account their specific contexts and locations. Despite efforts to address these issues, progress has been uneven.
Mounting evidence around gender inequities in the health workforce, specifically at the leadership level underscores the problem of gender bias in health decision-making. Women who make up 70% of the overall health workforce and 90% of frontline staff continue to be marginalised in leadership, occupying just one-quarter of the decision-making roles in health.
Furthermore, occupational segregation and the clustering of women into low-earning professions and settings further limit their career advancement. Their experiences in the health workforce are further compounded by various forms of discrimination, such as harassment, violence, assault and discrimination at several levels.
Gender is not the only factor at play. As health workers migrate from rural and remote areas to well-resourced urban centres, or from developing to developed countries, new forms of barriers and biases emerge in a global context where high-income nations wield most of the socio-economic power.
These include the need to undergo resource-intensive accreditation and licensing exams, encountering anti-immigrant hostility and changing patient-provider dynamics, limited options from smaller job pools, and being affected by global events and geopolitical shifts.
This “brain drain” of health workers also has negative implications for the understaffed health systems that they leave behind.
In addition to gender and migrant status, healthcare workers may also face discrimination based on their race, ethnicity, language and dialect, marital status and sexual orientation, amidst other factors. These experiences affect the health workforce in different ways, resulting in inefficiencies, demotivation and burnout at the local, national and regional levels.
Healthcare systems that fail to acknowledge and address latent discriminatory actions may unintentionally perpetuate these inequalities, further exacerbating the biased experiences of healthcare workers, despite the need for a diverse health workforce to better serve their diverse populations.
While we talk about zero discrimination, dignity, decent work, fair pay, and the importance of endorsing diversity and practising inclusion at the macro level of health systems, are we also ‘seeing’ and ‘acknowledging’ where this discrimination exists and understanding the negative consequences on health workers and population’s health? Are we collecting and analysing the data that give us the full picture?
More importantly, discrimination in healthcare settings not only violates the fundamental human right to be treated with respect and equality, but also severely limits the chances of achieving the SDGs by 2030. The 2017 UN statement succinctly framed this understanding in their call to end discrimination in healthcare settings.
Equal opportunities and experiences for health and care workers must be ensured at every stage of their career, including recruitment, promotion, growth and advancement, particularly in the post-COVID era of globalisation.
Gender and race are the primary drivers of inequality, around which most of the structural discrimination in health revolves. Therefore, policies and practices must be devised to study and address this discrimination and their underlying drivers, to fully exploit the available talent and potential of the health workforce and to ensure equitable opportunities for growth and leadership and strategically achieve UHC.
Now more than ever, it is urgent that leaders in global health take bold action by committing to a new social contract that prioritises the rights of health and care workers. This step will not only ensure a more equitable and just health workforce, but also provide better health outcomes for communities worldwide.
Roomi Aziz is Technical Lead of the Pakistan Chapter, Women in Global Health
“A child in North Syria passing by the ruins, after the earthquake hit his town.” – Credit: Norwegian Refugee Council (NRC)
by Baher Kamal (madrid)
Inter Press Service
MADRID, Feb 23 (IPS) – While the world’s biggest powers and their giant private corporations continue to attach high priority to their military –and commercial– dominance, both of them being shockingly profitable, entire generations are being lost to deadly armed conflicts, devastating climate catastrophes, diseases, hunger and more imposed impoverishment.
Part I of this series of two articles focussed on the unprecedented suffering of the most innocent and helpless human beings – children– in 11 countries. But there are many more.
According to the UN Children Fund (UNICEF), hundreds of thousands of children continue to pay the highest price of a mixture of man-made brutalities, with their lives, apart from the unfolding proxy war in Ukraine, and the not yet final account of victims of the Türkiye and Syria earthquakes, which are forcing children to sleep in the streets under the rumble, amid the chilling cold.
Nigeria
Nigeria is just one of the already reported cases of 11 countries. UNICEF on 11 February 2023 appealed for 1.3 billion US dollars to stop what it calls “the ticking bomb of child malnutrition.”
The appeal is meant to help six million people severely affected by conflict, disease, and disaster in Northeast Nigeria.
“The large-scale humanitarian and protection crisis shows no sign of abating,” said Matthias Schmale, the UN Resident and Humanitarian Coordinator for Nigeria. “An estimated 2.4 million people are in acute need – impacted by conflict, disaster and disease – and require urgent support.”
The “ticking time bomb” of child malnutrition is escalating in Nigeria’s Northeast, with the number of children suffering from acute malnutrition projected to increase to two million in 2023, up from 1.74 million last year, the UN Office for the Coordination of Humanitarian Affairs reported.
Already high levels of severe acute malnutrition are projected to more than double from 2022 to a projected 697,000 this year. Women and girls are the hardest hit, said Schmale.
“Over 80% of people in need of humanitarian assistance across Borno, Adamawa and Yobe states are women and children. They face increased risks of violence, abduction, rape and abuse.”
The UN Special Adviser on the Prevention of Genocide Alice Nderitu raised concerns about a worsening security situation, calling for urgent action to address conflicts and prevent “atrocity crimes.”
Urgent immediate actions must be taken now, both to address the crisis in the short-term and long-term. Credit: James Jeffrey/IPS
Horn of Africa: the suffering of over 20 million children
By the end of 2022, UNICEF warned of a funding shortfall as the region faces an unprecedented fifth consecutive failed rainy season and a poor outlook for the sixth.
The number of children suffering dire drought conditions across Ethiopia, Kenya and Somalia has “more than doubled in five months,” according to UNICEF.
“Around 20.2 million children are now facing the threat of severe hunger, thirst and disease, compared to 10 million in July , as climate change, conflict, global inflation and grain shortages devastate the region.”
While collective and accelerated efforts have mitigated some of the worst impacts of what had been feared, “children in the Horn of Africa are still facing the most severe drought in more than two generations,” said UNICEF Deputy Regional Director for Eastern and Southern Africa Lieke van de Wiel.
“Humanitarian assistance must be continued to save lives and build the resilience of the staggering number of children and families who are being pushed to the edge – dying from hunger and disease and being displaced in search of food, water and pasture for their livestock.”
More than two million people are displaced internally because of drought.
Water insecurity has more than doubled with close to 24 million people now confronting dire water shortages.
Approximately 2.7 million children are out of school because of the drought, with an additional estimated 4 million children at risk of dropping out.
As families are driven to the edge dealing with increased stress, children face a range of protection risks – including child labour, child marriage and female genital mutilation.
Gender-based violence, including sexual violence, exploitation and abuse, is also increasing due to widespread food insecurity and displacement.
UNICEF’s 2023 emergency appeal of US$759 million to provide life-saving support to children and their families will require timely and flexible funding support, especially in the areas of education, water and sanitation, and child protection, which were ”severely underfunded” during UNICEF’s 2022 response.
An additional US$690 million is required to support long-term investments to help children and their families to recover and adapt to climate change.
Meanwhile, more unfolding tragedies for children
The above-reported suffering for the most defenceless human beings–children, does not end here. Indeed, two more major tragedies continue unfolding. Such is the case of the brutal proxy war in Ukraine and the most destructive earthquakes in Türkiye and Syria.
“A child in North Syria passing by the ruins, after the earthquake hit his town.” – Credit: Norwegian Refugee Council (NRC)
Türkiye-Syria Earthquakes
A steady flow of UN aid trucks filled with vital humanitarian relief continues to cross the border from Southern Türkiye into Northwest Syria to help communities enduring “terrible trauma” caused by the earthquake disaster, UN aid teams on 17 February 2023 reported.
As UN aid convoys continue to deliver more relief to quake-hit Northwest Syria via additional land routes from Türkiye, UN humanitarians warned that “many thousands of children have likely been killed,” while millions more vulnerable people urgently need support.
“Even without verified numbers, it’s tragically clear the number of children killed, the number of children orphaned is going to keep on rising,” on 14 February 2023 said UN Children Fund (UNICEF) spokesperson James Elder.
In Türkiye, the total number of children living in the 10 provinces before the emergency was 4.6 million, and 2.5 million in Syria.
And as the humanitarian focus shifts from rescue to recovery, eight days after the disaster, Elder warned that cases of “hypothermia and respiratory infections” were rising among youngsters, as he appealed for continued solidarity with all those affected by the emergency.
“Everyone, everywhere, needs more support, more safe water, more warmth, more shelter, more fuel, more medicines, more funding,” he said.
“Families with children are sleeping in streets, malls, mosques, schools, under bridges, staying out in the open for fear of returning to their homes.”
“Unimaginable hardship”
“The children and families of Türkiye and Syria are facing unimaginable hardship in the aftermath of these devastating earthquakes,” said UNICEF Executive Director Catherine Russell.
“We must do everything in our power to ensure that everyone who survived this catastrophe receives life-saving support, including safe water, sanitation, critical nutrition and health supplies, and support for children’s mental health. Not only now, but over the long term.”
The number of children killed and injured during the quakes and their aftermath has not yet been confirmed but is likely to be in the many thousands. The official total death toll has now passed 45,000.
Freezing
Many families have lost their homes and are now living in temporary shelters, “often in freezing conditions and with snow and rain adding to their suffering.” Access to safe water and sanitation is also a major concern, as are the health needs of the affected population.
Hundreds of thousands of people have seen their homes, businesses or schools damaged or destroyed while continuing attacks on critical energy infrastructure have left millions of children without sustained access to electricity, heating and water.
The list of brutalities committed against the world’s children goes on. The funds desperately needed to save their lives represent a tiny faction of all that is being spent on wars.
Cooperative members in southern Lebanon make a rare, traditional bread called Mallet El Smid to be sold at the MENNA shop in Beirut. Women are central to meeting the SDGs, say parliamentarians. Credit: UN Women/Joe Saade
by IPS Correspondent (johannesburg)
Inter Press Service
JOHANNESBURG, Feb 23 (IPS) – The post-COVID-19 period has been a crucial one for members of parliament who have their work cut out to ensure that issues that arose during the pandemic are addressed, especially concerning the ICPD25 commitments and programmes of action for universal access to sexual and reproductive rights, gender-based violence and building peaceful, just and inclusive societies. Across the world, progress toward achieving the SDGs by 2030 was impacted during the pandemic.
As Dr Samar Haddad, a former member of the Lebanese Parliament and head of the Population Committee at the Bar Association in Lebanon commented at a recent meeting of the Forum of the Arab Parliamentarians for Population and Development (FAPPD): “The main theme for this year is combating gender-based violence, which is a scourge that the entire world suffers from, and its rate has risen alarmingly in light of the economic crisis, bloody stability, wars, and displacement.”
IPS was privileged to interview two members of parliament from the region about how they are tackling GBV, youth empowerment, and women’s participation in politics, society, and the economy.
Here are edited excerpts from the interviews:
Pierre Bou Assi, MP from Lebanon
Pierre Bou Assi, MP from Lebanon
IPS:What legislation, budgets, and monitoring frameworks are in place or planned for combating GBV in Lebanon?
Pierre Bou Assi (PA): Lebanon has launched a project to support protection and prevention systems to prevent gender-based violence within the framework of continuous efforts aimed at responding to social and economic challenges in Lebanon and aims to strengthen prevention and monitoring mechanisms for gender-based violence, and support the efforts made by the Public Security Directorate through the Department Family and juvenile protection.
IPS: One of your speakers at a recent conference spoke about rapid population growth, youth, and high urbanization rates. Youth are often impacted by unemployment or low rates of decent employment. What are parliamentarians doing to assist youth in ensuring that the country can benefit from its demographic dividend?
PA: Youth are the pillar of the nation, its present and future, and the means and goal of development. They are the title of a strong society and its future, stressing that the conscious youth (educated and mindful) armed with science and knowledge are more than capable of facing the challenges of the present and the most prepared to enter the midst of the future.
I would like to say that the Youth Committee in the Lebanese Parliament is working on developing a targeted and real strategy that includes advanced programs that are agreed upon by experts and active institutions in this field to consolidate the principles of citizenship, the rule of law and patriotism, and empower the youth politically and economically to achieve their potential and develop and expand their horizons.
In addition, we are expanding youth participation in public life by providing them with opportunities for practical training in legislative and oversight institutions, and refining the participants’ personal skills by informing them of the decision-making process in the Council.
IPS:Looking back at the COVID-19 situation, most countries experienced two clear issues, an increase in GBV and its impact on children’s education. There was also an issue with high levels of violence experienced by children. Are parliamentarians concerned about the COVID impacts on children, and what programs have been implemented to support them?
PA: There is no doubt that Lebanon, like other countries in the world, was affected by the coronavirus pandemic in all aspects of life, including children and its impact on the quality of education, as well as the high level of violence that children were exposed to during that period, as I would like to take a look at the more positive side. We note a number of measures Lebanon took during the pandemic – which included the release of children who were in detention, the strengthening or expansion of social protection systems through cash assistance, and an overall decrease in levels of violence in conflict situations.
Lebanon has a plan that includes the following points:
The continuity and safety of learning for all school children, including bridging the digital divide and creating low-cost technology.Implementing a basic package for equitable access to primary health care for children and mothers.Expanding the scope and appropriateness of infant and young child feeding programs and general educational messages.Expanding social protection systems to reach the most affected children and families through cash transfer programmes.Enhancing government budgetary allocations and public funding for social sectors, with a special focus on health care and education. Hmoud Al-Yahyai, MP from Oman.
Hmoud Al-Yahyai, MP from Oman
Al-Yahyai spoke to IPS about the development of a human-rights-based framework. The interview followed a meeting with the theme “Human Rights and their relationship to the goals of sustainable development. The meeting was held by the Omani Parliamentary Committee for Population and Development in cooperation Omani National Commission for Human Rights, the Forum of Arab Parliamentarians for Population and Development (FAPPD), and the Asian Population and Development Association (APDA) on “Human Rights and their relationship to the goals of sustainable development.”
IPS: How is Oman working towards a human rights-based legislative framework, and what role are parliamentarians taking to ensure implementation? What role does Oman Vision 2040 play in this?
Hmoud Al-Yahyai (HY): The government of the Sultanate of Oman has integrated the sustainable development goals into national development strategies and plans and made them a major component of the long-term national development strategy components and axes known as Oman Vision 2040. The strategy is enhanced by broad societal participation when designing and implementing it and evaluating the plans and policies set. And we, as parliamentarians, make sure, as stated in the voluntary national report, (to provide oversight of) the government’s commitment to achieving the goals of sustainable development, with its three dimensions, economic, social, and environmental, within the specified time frame.
I commend the efforts of the Sultanate of Oman in implementing the goals of sustainable development through several axes, including the pillars of sustainable development, implementation mechanisms, progress achieved, and future directions for the localization of the sustainable development agenda in the short and medium term, and the consistency of Oman Vision 2040.
The Sultanate of Oman reviewed its first voluntary national report on sustainable development at the United Nations headquarters as part of its participation in the work of the UN Economic and Social Council.
Sustainability is crucial to Sultanate, emphasizing that development is not an end in itself, but aimed at building up its population.
Future directions for the localization of the SDGs in the short and medium term are represented on five axes, which include raising community awareness, localizing sustainable development, development partnerships, monitoring progress and making evidence-based policies, and institutional support.
The axes for sustainable development are human empowerment, a competitive knowledge economy, environmental resilience through commitment and prevention, and peace. These form the pillars for sustainable development through efficient financing, local development, and monitoring and evaluation.
Oman has adopted a coordinated package of social, economic, and financial policies to achieve inclusive development based on a competitive and innovative economy. This is being worked upon toward Oman Vision 2040 and its implementation plans, through a set of programs and initiatives that seek to localize the development plan toward achieving the SDGs 2030 and beyond.
IPS: What role do women play in your legislative framework, and do they play a role in ensuring, for example, SRHR rights?
HY: The Sultanate has taken many positive measures to sponsor women. The Sultanate’s policies towards accelerating equality between men and women stem from the directives of the Sultan and his initiatives to appoint women to high positions, to feminize the titles of positions when women fill them, and to grant them political, economic, and social rights.
Women benefit from support in the
Social field: through comprehensive social insurance and social security system.
Political field: through the appointment of female ministers, undersecretaries, and ambassadors, and in the field of public prosecution.
Economic field: through labor and corporate law.
Cultural field: through the system of education and grants.
There are many programs geared or dedicated to women. The government has begun to circulate and implement a program to support maternal and childcare services at the national level to reduce disease and death rates by providing health care for women during pregnancy, childbirth, and postpartum and encouraging childbirth under medical supervision.
IPS: What are the achievements of Oman in reaching SDG Target 3.7 (Sexual and reproductive health by 2030, ensure universal access to sexual and reproductive healthcare services, including family planning, information and education, and the integration of reproductive health into national strategies)?
HY: In this regard, a campaign was launched on sexual and reproductive health in the Sultanate due to its positive impact on public health and society. This campaign confirms that reproductive health services are an integral part of primary health care and health security in the country and that it has long-term repercussions on health and social and economic health. Family planning is one of the most important of these services because, if it is not organized, it constitutes a social bomb that can hit everyone, whether a citizen or an official. Therefore, we must take proactive preventive steps.
LONDON, Feb 23 (IPS) – It’s been 25 years since the 1997 Asian financial crisis led to the creation of the G20 forum for finance ministers; and 15 years since this became a leader-level meeting following the global financial crisis. During this period, there has been significant shift in the global finance and economic landscape.
The ascent of several emerging economies has seen their contributions to the multilateral finance system that supports development rise significantly. Our new report collates those contributions over the last decade for the first time. It charts how China’s annual contributions to the UN and multilateral development banks rose twenty-fold from $0.1bn to $2.2bn.
But it also looks collectively at a group of 13 rising economies whose developmental contributions to multilateral finance institutions have risen five-fold to over $6bn over the last decade.
These contributions now make up an eighth of the total; and have seen the creation of two new multilateral finance institutions.
In this piece, we draw out key findings from our analysis, including the balance between funding existing and new institutions like the New Development Bank.
We consider whether continued growth in the 13 emerging actors could generate enough new funding for development over the next quarter century, and even create an institution as large at the World Bank’s fund for low-income countries (IDA).
Despite recent rhetoric around the return to a bipolar world order, this report is evidence that a wide group of countries are already playing major role in the global economic and development system, and will continue to do so in years to come
The transformational effect of economic growth on the multilateral system
In 1990 most people in the world lived in low-income countries; by 2020, this share had fallen dramatically to just seven percent of people. Meanwhile, the share of the global population living in middle-income countries swelled from 30 percent in 1990 to 73 percent in 2020.
Such a transformation implies a greater number of countries with the economic output to contribute internationally: widening and deepening participation in the multilateral system.
And this is just what we’ve seen. Over the decade to 2019, we find a group of emerging actors have significantly increased their contributions of development finance to multilateral organisations.
These include thirteen major economies outside the group of more established providers within the Development Assistance Committee (DAC), which tend to receive more attention.
Ten of these emerging actors are G20 members, including the BRICS—Brazil, Russia, India, China, and South Africa—but others have grown quickly too: Argentina, Chile, Indonesia, Israel, Mexico, Saudi Arabia, Turkey, and the United Arab Emirates. Collectively, we refer to these thirteen emerging actors as the “E13.”
Over the decade, the E13’s annual contributions of development finance to multilateral organisations (both core and funding earmarked for particular purposes) have increased almost five-fold, from $1.3bn in 2010 to $6.3bn in 2019 (up 377 percent). And their unrestricted core contributions have risen even more: increasing from $1.0bn to $5.2bn (up 410 percent).
Of these core contributions, we see that those to UN agencies more than quadrupled over the decade, steadily rising from $0.3bn to $1.2bn (up 330 percent). But by far the most striking development in E13 core contributions has come from the creation and capitalisation of two new multilateral organisations: the Asian Infrastructure Investment Bank (AIIB) and the New Development Bank (NDB).
The role of China
Although China has recently stepped back its bilateral finance efforts, its multilateral contributions increased steadily to 2019; and provided a third (34 percent) of the E13 total over the decade. Our colleagues have examined this in detail, including how China has the second highest aggregate voting share after the US in international finance institutions it supports.
Still, our analysis also highlights the importance of Russia, Brazil and India who each contributed over $3bn over the period and collectively contributed a further third of the total. While China’s multilateral contributions have been concentrated (59 percent) in new institutions it co-founded (see below), other providers have concentrated funding in traditional institutions: for example, Argentina, Chile and Mexico did not support the new institutions while for Saudi Arabia and UAE they were 17 percent and 21 percent respectively.
Creating new multilateral finance organisations
Over the ten-year period we examine, almost half of the E13’s core multilateral contributions were to the two new institutions (AIIB and NDB). After 2016, funding provided to these institutions made up over two-thirds of their contributions. Indeed, in 2016 the first financial contributions to AIIB and NDB causedE13 multilateral development finance to triple in a single year.
The E13 provided an additional $6.0bn of core funds for AIIB and NDB in 2016, without reducing their multilateral contributions through other channels.
Though annual contributions reduced to $3.1bn in 2019, AIIB and NDB still accounted for half of the E13’s multilateral development finance in that year, leaving their contributions at the end of the decade far ahead of the beginning.
Figure 1. E13 core and earmarked contributions of development finance to multilateral organisations (nominal USD billions)Source: Authors’ analysis
Emerging actors fund a sixth of the UN system
As well as higher absolute contributions (Figure 1), the E13’s role in the multilateral system has also grown in relative terms (Figure 2). As a share of the level of finance provided by the 29 high-income countries in the OECD DAC, the E13’s core multilateral contributions rose from 5 percent in 2010 to 12 percent in 2019—more than doubling their relative significance.
This was largely due to the effect of AIIB and NDB (clearly seen by the 2016 peak), but we also see that E13 core contributions to the UN system steadily and quickly rose as a share of the DAC level across the decade: from 5 percent in 2010 to 17 percent in 2019.
Figure 2. E13 core contributions of development finance to multilateral organisations as a share of contributions from DAC countriesSource: Authors’ analysis
A look to 2050—what role might the emerging economies play?
As the economies of the E13 continue to grow, what might this mean for their multilateral contributions in the future? Figure 3 shows how the share of economic output provided as development finance to multilateral organisations (either core or earmarked) tends to increase with higher levels of income per capita.
Though the relationship is steeper for the DAC than the E13, even the E13’s current trajectory implies a significant increase in future multilateral development finance from this group.
Ian Mitchell is Co-Director, Development Cooperation in Europe and Senior Policy Fellow at the Center for Global Development. Sam Hughes is a Research Assistant at the Center for Global Development.
MADRID, Feb 22 (IPS) – Today, there are more children in need of desperate humanitarian assistance than at any other time since World War II.
“Across the globe, children and their families are facing a deadly mix of crises, from conflict and displacement to disease, outbreaks and soaring rates of malnutrition. Meanwhile, climate change is making these crises worse and unleashing new ones.”
Tragically enough, UNICEF – the world’s body which was created in the aftermath of the Second World War to save the lives of millions of children who fell prey to the devastating weapons used by their own continent: Europe – could not depict more accurately the current situation of the most innocent humans.
The UN Children Fund in fact reports on the pressing need to provide life-saving help to millions of children trapped in continuing atrocities committed by adults.
Unprecedented flooding in South Sudan has taken a devastating toll on families. Crops have been destroyed, grazing spaces for cattle and other livestock have been submerged and families have been forced to flee their homes.
With hunger and malnutrition on the rise across the flooded regions, some communities are likely to face starvation without sustained humanitarian assistance.
UNICEF is working to screen and treat children with severe acute malnutrition, also known as severe wasting – the most lethal form of undernutrition, and one of the top threats to child survival. Read the latest appeal for South Sudan
Yemen
After eight years of conflict, the systems that Yemen’s families depend on remain on the edge of total collapse. More than 23.4 million people, including 12.9 million children, have, so far, fallen victim to such a brutal war.
In addition, more than 11,000 children have been killed or maimed since 2015, while conflict, massive displacement and recurring climate shocks have left more than 2 million children “acutely malnourished and struggling to survive.” Read the latest appeal for Yemen
Haiti
Political turmoil, civil unrest and gang violence, crippling poverty and natural disasters, a deadly combination of threats are already posing a massive challenge for families in Haiti. A surge in cholera in 2022 is posing yet another risk for children’s health – and their lives.
“There is an urgent need to step up efforts to protect families against cholera by delivering cholera kits and water purifying tablets and trucking in clean water.”
To contain malnutrition, UNICEF is also screening children for wasting to ensure that those who need help can be treated in mobile clinics and other facilities. Read the latest appeal for Haiti
DR Congo
An escalation in armed conflict and recurrent outbreaks of deadly diseases are taking a heavy toll on millions of children in the Democratic Republic of the Congo.
The country hosts the “second-highest number of internally displaced people in the world.”
A father and son remove their belonging from their flooded home in Taluka, Shujabad, District Mirpurkhas, Pakistan. Credit: RDF
Pakistan
The rains that brought historic flooding to much of Pakistan in 2022 may have ended, but the crisis for children has not.
Months after floods ravaged the country, vast swathes of cropland and villages remain under water, while millions of girls and boys are still in need of immediate lifesaving support.
Around 8 million people are still exposed to flood waters or living close to flooded areas. “Many of these families are still living in makeshift tents alongside the road or near the rubble of their home – often in the open, right next to contaminated and stagnant water.”
Political fragility, the impacts of climate change and economic and health crises have contributed to the internal displacement of around 1.7 million people in Burkina Faso – 60% of them are children.
“The anxiety, depression and other stress-related problems associated with displacement can take a lifelong toll on children’s emotional and physical health.” Read the latest appeal for Burkina Faso
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
Myanmar
Deepening conflict in Myanmar continues to impact children and their families, with some 5.6 million children in need of humanitarian assistance.
The conflict has undermined the delivery of child health services, including routine immunisation, threatening to take a long-lasting toll on children’s health and well-being. Read the latest appeal for Myanmar
Palestine
“Children in the State of Palestine continue to face a protracted protection crisis and an ongoing occupation.” Around 2.1 million people – more than half of them children – now require humanitarian assistance.
Since 2009, UNICEF has been supporting family centres across the Gaza Strip to provide psychosocial care for children.
Children in need of more specialised services – such as those facing violence at home, school or work – are provided with a case manager who works directly with them and their families. Read the latest appeal for the State of Palestine
Bangladesh
As the Rohingya refugee crisis enters its fifth year, Bangladesh still hosts hundreds of thousands of Rohingya refugees who settled in the Cox’s Bazar District after fleeing “extreme violence” in Myanmar.
While basic services have been provided in the camps, “children still face disease outbreaks, malnutrition, inadequate educational opportunities and other risks like exploitation and violence.” Read the latest appeal for Bangladesh
Syria
The situation was already dire far earlier to the recent earthquakes. In fact, “more than a decade of humanitarian crises and hostilities has left children in Syria facing one of the most complex emergencies in the world.”
“Two thirds of the population require assistance” due to the worsening economic crisis, continued localised hostilities, mass displacement and devastated public infrastructure.
The conflict has seen one of the largest education crises in recent history, with “a whole generation of Syrian children paying a devastating price.” Read the latest appeal for Syria
Kenya
Four failed rainy seasons in a row have left Kenya experiencing its worst drought in 40 years. Without water, crops cannot grow, and animals and livestock die.
The resulting loss of nutritious food, combined with poor sanitation, has left “hundreds of thousands of children requiring treatment for wasting.”
Children with wasting are too thin and their immune systems are weak, leaving them vulnerable to developmental delays, disease and death. Read the latest appeal for Kenya
Millions more
In addition to these 11 nations so far identified by UNICEF as needing urgent life-saving humanitarian assistance, with millions of children being the most vulnerable, there are several other countries where they live in dire situations, on which IPS reports in Part II of this two-part series.
A girl reads a story book with lessons on life skills at an ELA club in Uganda. Credit: Uganda/BRAC
by Naureen Hossain (united nations)
Inter Press Service
UNITED NATIONS, Feb 22 (IPS) – BRAC’s Empowerment and Livelihood Program (ELA) has benefitted tens of thousands of girls, and its recently released report shows an organization willing to adapt to the circumstances to continue to ensure adolescent girls and young women receive meaningful sexual and reproductive health rights support.
The report titled Adolescent Empowerment at a scale: Successes and challenges of an evidence-based approach to young women’s programming in Africa was launched on February 15, 2023, at a BRAC and the United Nations Population Fund (UNFPA) jointly hosted event. The report was written with the support of the Spotlight Initiative, an UN-led, multi-partner initiative that aims to respond to and eliminate violence against women and girls, with a particular focus on family and intimate partner violence, sexual and gender-based violence, and harmful practices.
The history of BRAC’s Empowerment and Livelihood Program (ELA), which was designed to provide sexual and reproductive health education and livelihood training to adolescent girls and young women, is covered in the report. The program was launched in Uganda in 2006 and has since been implemented in Sierra Leone, South Sudan, and Liberia. During the program’s peak from 2013 to 2015, BRAC hosted over 1800 clubs with over 80,000 members.
“The reason that we partnered with BRAC, have partnered with them in the field… is because of the incredible work that they do in this very efficient, kind of way,” said moderator Satvika Chalasani, a Technical Specialist for UNFPA who oversees programs for adolescent girls and ending child marriage.
BRAC’s report Adolescent Empowerment at a scale: Successes and challenges of an evidence-based approach to young women’s programming in Africa talks about its successes and also the need to change programs to ensure their success in a changing society. Credit: BRAC
Chalasani observed that BRAC had gotten to tens of thousands of women on the African continent through their program, Empowerment, and Livelihood for Adolescents, and it was important to learn from their experiences of 15 years in the field.
Willibald Zeck, UNFPA’s Chief of Sexual and Reproductive Health and Rights, also noted BRAC’s record with youth empowerment programs in his opening remarks while adding that demographic changes in certain regions have influenced how such programs must be designed and implemented. It is estimated that over 60% of Africa’s population is under 25.
“As you know, in UNFPA, we really work across the continuum of sexual reproductive health and rights… And we see in certain regions around the globe the new demographics that are showing that there will be more adolescents in the population, but especially on the African continent. Which is a great opportunity in so many ways, but it also brings more challenges.”
Sarah Tofte, a research and policy consultant, and the report’s primary author, presented her findings, breaking down the program’s initial model and implementation and its eventual reset and adaptations.
The report includes findings from academic evaluations conducted by experts, randomized control trials (RCTs) conducted in the regions where ELA programs were hosted, and nearly 100 field interviews with participants and ELA staff.
The findings reveal an overall positive reception and impact on participants and their communities.
Tofte, the co-founder of Understory Consulting, a research and policy consulting firm, noted that the interviewees reported a greater, newfound sense of self through the ELA program, which they connected to making well-informed decisions and contributing productively to the community.
“So based on these positive academic results, and then what I was hearing from field interviews and what participants have been saying over many years, ELA really became a model for other adolescent and youth empowerment programming around the globe, including at the World Bank and at USAID.”
As the report explains, implementation challenges would surface as the program continued. Tofte, the co-founder, noted that while the program’s initial results had been positive, it had slowly ceased to achieve its intended impact.
“By 2017, anecdotal reports had emerged within BRAC about lagging performance of ELA clubs in several countries, including drops in attendance and gaps in the delivery of programming,” she said.
The decline in the program quality and the resulting challenge of sustaining the program over long periods of time also made it difficult to secure funding that would have gone toward addressing the decline. The program had become repetitive for some participants and staff, and issues of deeper community engagement had presented a hurdle for the program’s success.
In 2020, ELA would undergo a “reset” significantly through making fundamental and necessary changes to the curriculum. This would not only update the discussions on reproductive health and livelihood training but would make it more relevant to the economic and social circumstances of the girls they were intended for – while placing more emphasis on providing vocational and livelihood training and financial literacy. Other changes to the curriculum included adjusting the weekly ELA club meetings to optimize engagement and a new graduation model for students to leave the program after one year of completion. The resets were applied at a reduced scale to approximately 140 clubs in the countries where ELA programs were already present.
“Early feedback from this curriculum revamp from the participants suggest that the new curriculum is well received by participants and is driving a positive outcome in attendance and program impact,” Tofte said.
The ELA program adjustments are critical to modernizing the curriculum. What should be of note were the considerations taken to improve community engagement.
“Another big focus of the reset was to deepen community engagement. Prior, a lack of formalized mechanisms for community engagement resulted in some pushback at times from parents of community members who may not have fully bought into the ELA model,” Tofte said. She added that in some cases, the pushback was targeted at the sexual and reproductive health components when the content went against community norms around matters such as child marriage and sexual health.
In response, BRAC, through ELA, has taken measures to establish formal channels with community stakeholders and parents of the participants. By directly engaging with the community’s village elders, religious leaders, and other respected community members, ELA staff members can obtain their support before establishing a program. Formal community leadership committees are also formed, working with ELA staff to ensure smooth operations.
Rudo Kayambo, Regional Director of Africa for BRAC International, pointed out how the findings through field research and the trials were able to be synthesized and focused enough that they could be incorporated into the new program structure, which included paying attention to community members and groups that BRAC did not commonly work with in the past.
“One of the DNAs of BRAC is being able to learn and adapt it quickly,” she said. “…We have now managed to integrate all the lessons into a bigger multicultural program, and some of the key lessons were that they need to support the frontline workers.”
When asked to elaborate, Kayambo added that BRAC would provide technical training and the infrastructure to help monitor and use digital technology. “ are the heart of delivering the value of the ELA program and all its components.”
Another significant change to the rollout of the new ELA program was the introduction of sexual and reproductive health programs targeted at adolescent boys. Boys were included in the program partly to fill a gap in youth-empowerment programs that had thus far been only directed at adolescent girls and women. Through a series of RCTs conducted in 50 rural communities, trial programs similar to ELA were conducted with boys and young men, targeting them specifically.
“ the need to also incorporate adolescent boys and young men, because that formalizes our commitment to getting community buy-in,” said Kayambo.
Manisha Shah, a professor of public policy at UCLA who worked with BRAC to conduct the randomized trials, elaborated that the rationale was to include boys since they were already involved in the decisions and issues that girls and women had to contend with when it came to their health.
“Unless we get these boys on board with the agenda, it’s going to be really hard to think about how we improve the outcomes related to female sexual reproductive health,” she said.
A follow-up survey conducted in those communities two years after the trial programs ended revealed a decrease in intimate partner violence between 20 percent and 60 percent, with a “significant change in these boys’ attitude around violence” and an overall more positive reception and understanding of sexual and reproductive health.
“This just proves that we also need to be targeting the other side of the coin, which is the boys and the young men,” Shah said.
The event also showcased how other organizations partnered with BRAC through the ELA program, such as other NGOs like the Bill and Melinda Gates Foundation. The Foundation’s deputy director for women’s empowerment Diva Dhar remarked that it was critical to recognize that adolescents deal with “really important transitions on school to work, to marriage, to financial, economic independence, to employment.”
“ are a very important age group… because that attitudes and norms crystallize at this age and can have long-term implications, including for future generations,” Dhar said.
When looking at women’s economic empowerment, Dhar stated that further causal evidence would be needed to explore the intersections between economic independence and family planning and health outcomes.
For the Gates Foundation, this has involved investing in programs that build up skills and training for girls and women, including non-traditional opportunities that will build empowerment.
The ELA program in Africa is a testament to BRAC’s success as an NGO, given its ability to inspire similarly multifaceted youth-empowerment programs and its model to evolve and improve their work. However, the report makes it clear that this is achievable through the continued support from partners and donors and from fostering community engagement. Only then can the communities’ women and girls be empowered through the knowledge and skills they obtain through the program.
“One of the key findings we are taking from this is that the role of mentors and community assistance are so important,” Kayambo said. “We are creating room for them to engage from an empowered perspective, and building their own agency, to give room for them to engage and build themselves up before they can empower others in the community.”
Universal Health Care priorities in Pakistan have been boosted by free healthcare insurance for the poor. Credit: Ashfaq Yusufzai/IPS
by Ashfaq Yusufzai (peshawar)
Inter Press Service
PESHAWAR, Feb 22 (IPS) – A free health insurance initiative started in Pakistan has benefited poor patients, especially women who have outnumbered men in using the cashless health services under the Sehat Card Plus programme.
“The initiative is in line with the ICPD25 Programme of Action, under which 4.5 million people have received free services, with 62 percent of them women. In the last three years, we have been able to cut down maternal mortality rate from 186 deaths per 100,000 live births to 172,” Dr Muhammad Riaz Tanoli, CEO of the Sehat Card Plus (SCP), told IPS.
The International Conference on Population and Development (ICPD) held in Nairobi in 2019 set a programme of action aimed at empowering women and girls. The SCP aims to ensure Pakistan meets the 2030 deadline for sustainable development goals for universal health and women.
So far, USD 80 million have been spent on treating patients at 1,100 hospitals across the country.
Shaheen Begum, a resident of Peshawar, is thankful to former Prime Minister Imran Khan, who launched the programme and said that her sister had died of delivery-related complication years ago because they didn’t have money to get quality treatment. She was lucky to undergo a caesarean section at one of the city’s top private hospitals on SCP, and she and her newborn baby are in good health.
“Since my first-month pregnancy, I have been getting diagnostic services free of cost. Two days before delivery, I was admitted because of complications, and doctors performed a caesarean operation,” Begum, 26, a housewife, said.
Pakistanis living abroad with chronic ailments return to the country for treatment. Muhammad Kashif, 55, recently arrived from Malaysia to undergo liver transplant surgery.
Kashif said that the cost of a liver transplant in Malaysia was USD 7,000. Not only was it beyond his reach, but he would have had to call relatives to Malaysia to donate a liver. That would have been impossible, he said in an interview with IPS.
“One of my friends called me and asked to come back and get the surgery free of cost. I came to my native Khyber Pakhtunkhwa province in November last year, and next month, my transplant was done at one of the country’s premier hospitals,” he said.
Like Kashif, Mushtari Gul, a Pakistani nurse working in Saudi Arabia, became extremely sick as her kidneys stopped functioning.
“Initially, I received dialysis for two months, but doctors advised renal transplant that wasn’t possible there due to its cost and donor,” she said.
Gul, 51, is one of the 235 people who received free renal transplants under the SCP. She said it wasn’t possible without an insurance scheme because its cost was USD 6,500, not affordable even by affluent people.
Pakistan Medical Association (PMA) is appreciative of the scheme. “It is an unprecedented programme where the people are able to get services in expensive hospitals. Most patients who couldn’t afford heart surgeries are among the beneficiaries,” PMA’s Secretary, Dr Qaisar Sajjad, told IPS.
PMA has been asking the government to ensure World Health Organization’s aim for Universal Health Coverage is delivered, and this was a step in that direction, Dr Qaisar said.
Public health specialist Dr Fayyaz Shah told IPS that the system has been very good. Unlike the health insurance schemes in developed countries where people deposit annual premiums, here, the government pays the insurance company without charging people.
Before the programme’s launch, the infant mortality rate was 41 per 1,000 live births, which has now come down to 35. Shah elaborated that other health indicators also show improvement as poor people receive timely treatment.
Patients are getting free services for renal and liver transplants and major ailments and procedures, including cancers, surgeries, cardiac diseases, hernia, cataracts, gynaecology, eye, ear, nose and throat and other diseases.
The major beneficiaries are women and children, followed by cancer, heart, dialysis and people with urinary and diabetic problems, he said.
Local gynaecologist Dr Naseem Akhtar terms the programme a blessing for women. Ever since the start of the programme, there has been a drastic decline in mortality among women for pregnancy-related complications.
“Our staff also work harder because they get extra financial incentives from the funds generated from SCP. The patients in hospitals also get free medicines and diagnostic services,” she said.
At the end of every month, we send patients’ details and expenses to the government, and the payment is made within a week. The state-run insurance company is implementing the programme on behalf of the government, which has proved beneficial both for patients and healthcare providers, she said.
A senior nurse, Sania Ali, at a local hospital, said her monthly salary is $200, but she earns $300 additional from the patients undergoing treatment on SCP.
“Our doctors, nurses and paramedical staff want the mechanism to continue as it was a big source of their extra income they received in addition to their fixed salaries,” he said.
“This system has not only helped the poor patients but is also a big source of income for private hospitals. We are extremely busy dealing with patients, and our staff is working round-the-clock to operate on more patients and get more money,” said Dr Shah Raj, a public health physician. She said that each family is entitled to $4,500 per year from the programme. In case of liver and kidney transplants, the patients’ benefits are around $20,000, she said.
Opinion by Ulrika Modeer, Steve Utterwulghe (united nations)
Inter Press Service
UNITED NATIONS, Feb 22 (IPS) – Flexible and predictable funding allows UN agencies to respond promptly and with agility in times of crisis. In countries such as Afghanistan, Yemen, and Ukraine, UNDP implements projects and programmes that help protect livelihoods and enhance the resilience of vulnerable communities.
The UN has estimated that the world will need to spend between US$3 trillion and US$5 trillion annually to meet the Sustainable Development Goals (SDGs) by 2030, while the COVID-19 pandemic has already increased that estimate by an additional US$2 trillion annually.
In addition, the highly fragile global economic outlook, impacts of climate change and rising geopolitical tensions, have led to a major deterioration in international public finance, resulting in 51 developing economies being highly indebted, with the spectre of defaults looming on the horizon for over-indebted developing countries.
Considering this dark scenario of compounded crisis, the multilateral system is being called upon to become more fit-for-purpose to support global public goods and overcome global challenges.
It is therefore imperative that institutions such as the UN and International Financial Institutions (IFIs) need to bolster their partnership to provide coordinated, effective, and targeted support to developing countries’ widening needs for SDG financing.
Against this backdrop and in response to the Addis Ababa Action Agenda and UN Secretary-General’s Roadmap for Financing the 2030 Agenda for Sustainable Development, the UN System and IFIs have strived to work more closely together to promote sustainable and innovative financial systems at country level, and to catalyse more private finance.
In 2018, for example, UN Secretary-General António Guterres and former World Bank Group President Jim Yong Kim signed a Strategic Partnership Framework, which consolidated their joint commitment to cooperate in helping countries implement the 2030 Agenda for Sustainable Development.
UN agencies have developed financial and non-financial partnerships with IFIs with the aim to support governments to leverage financing, technical expertise, and advocacy from a wider range of sources.
By joining forces, UN agencies and IFIs can use and complement their respective comparative advantages in support of national development priorities and maximize development impact on the ground.
Last week, the Executive Board of the United Nations Development Programme (UNDP) held its first regular session of the year in New York. It was clear that Member States are keen to see greater engagement with IFIs to deliver on sustainable development results at scale.
As we are gearing towards the SDG Summit, there is a reckoning that we cannot do business as usual. We need all hands on deck to make progress towards 2030.
This call for joint action should also be an opportunity for Member States – usually the same donors funding the UN system and IFIs – to reflect on the global funding architecture of the United Nations Development System (UNDS). The UNDS needs predictable, un-earmarked, and flexible resources to perform its core functions and preserve the core values of multilateralism, universalism, and development effectiveness.
Nevertheless, a report by the Dag Hammarskjöld Foundation points out that OECD-DAC countries’ funding to the UNDS is more projectized and highly earmarked than the World Bank and the International Monetary Fund, or regional development banks.
In this moment of immense global uncertainty, following the UNDP Strategic Plan, UNDP is scaling up its engagement with IFIs to support countries access the capital, technical expertise, and partnerships required to achieve the SDGs.
Since 2017, UNDP has mobilized over US$1.85 billion from IFI partners, both directly through grant contributions and indirectly through government financing to support loan implementation.
In many fragile and conflict-affected states, UN agencies, such as UNDP, stay and deliver, sometimes on behalf of IFIs who cannot always fully operate in these settings. UNDP works in close cooperation with the humanitarian system and across the development, peace, and human rights pillars of the UN system.
Flexible and predictable funding allows UN agencies to respond promptly and with agility in times of crisis. In countries such as Afghanistan, Yemen, and Ukraine, UNDP implements projects and programmes that help protect livelihoods and enhance the resilience of vulnerable communities.
Member States and shareholders of Multilateral Development Banks and other IFIs recognize the synergistic and complementary mandates of many UN agencies and IFIs. The partnership is or should be obvious in areas such as sustainable finance, climate action, crisis and fragility, and poverty alleviation.
But as the world is faced with unprecedented global challenges that require unparalleled levels of partnerships and a strong multilateral system, Member States should enable a deeper engagement between the UNDS and IFIs through robust political commitment backed by a funding architecture befitting a world racing towards 2030.
Ulrika Modeer is UN Assistant Secretary-General and Director of the Bureau of External Relations and Advocacy, UNDP. Steve Utterwulghe is Director of Public Partnerships, UNDP
Opinion by Hsiao Chink Tang, Anne Cortez (beijing, the people’s republic of china)
Inter Press Service
BEIJING, The People’s Republic of China, Feb 21 (IPS) – Digitalization is a key driver of competitiveness and development. As the world takes the path to unprecedented digital advancement, Asia continues to be a powerhouse of digital transformations in a wide range of areas from microchip manufacturing to electric vehicles, from digital currency to e-commerce.
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.
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
BANGKOK, Feb 21 (IPS) – Nearly 18 million people – about one-third of Myanmar’s population – need humanitarian aid this year because of civil war and the post-coup economic crisis, according to the latest United Nations estimates.
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.”
Muslim Rohingya IDPs wait for aid to be unloaded in Pawktaw camp in Rakhine State, an hour by boat from the main city of Sittwe. Credit: Sara Perria/IPS
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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