“The surge in the global cocaine supply should put all of us on high alert,” UNODC Executive Director Ghada Waly said. “The potential for the cocaine market to expand in Africa and Asia is a dangerous reality.”
Sky high supply and demand
Criminal networks are now diversifying with alarming results alongside record levels of production, moving beyond the pandemic and its related global shutdown, which had appeared to have temporarily hobbled the illicit trade, UNODC said in its Global Report on Cocaine 2023.
To best respond, Ms. Waly urged governments and others to closely examine the report’s findings to determine how this transnational threatcan be met with transnational responses based on awareness raising, prevention, and international and regional cooperation.
Inroads into Africa and Asia
The report details how coca cultivation soared 35 per cent from 2020 to 2021, a record high and the sharpest year-to-year increase since 2016.
The rise is a result of both an expansion in coca bush cultivation and improvements in the process of converting coca bush to cocaine hydrochloride, the drug which is then sold on the streets.
The supply surge matches a steep growth in demand, with many regions showing a steady rise in cocaine users over the past decade. While the cocaine market remains quite concentrated in the Americas and parts of Europe, the report warns that there is a strong potential for a large expansion in Africa and Asia.
The report examines the emergence of new hubs for cocaine trafficking, noting that countries in Southeastern Europe and Africa – particularly those in West and Central Africa – are increasingly being used as key transit zones for the drug.
Ports on the North Sea like Antwerp, Rotterdam, and Hamburg, meanwhile, have eclipsed traditional entry points in Spain and Portugal, for cocaine arriving in Western Europe. Traffickers are also diversifying their routes in Central America by sending more and more cocaine to Europe, in addition to North America.
Record-high seizures
Arrests and seizures have also skyrocketed. Interceptions of cocaine shipments by law enforcement around the world recorded seizures reaching a record high of nearly 2,000 tons in 2021.
The report shows a criminal landscape fragmented into myriad trafficking networks. Examining these groups’ modalities, the report found new traffickers filling gaps and an array of so-called “service providers” lending supply-chain services “for a fee”.
For instance, the demobilization of fighters from the Revolutionary Armed Forces of Colombia (FARC), which had previously controlled many of Colombia’s coca-growing regions, created an opening for others to step in. This includes new, local actors, ex-FARC fighters, and foreign groups from Mexico and Europe, the report showed.
Tracking trends
Angela Me, Chief of the UNODC Research and Analysis Branch, said the report contains a wealth of more information about the phenomenon.
“With its latest knowledge and trends on the routes, modalities, and networks employed by criminal actors,” she said, “it is my hope that the report will support evidence-based strategies which stay ahead of future developments in cocaine production, trafficking, and use.”
Ms. Me told UN News in an interview before the report launch that dealing with the increase in demand for cocaine was a major international challenge, so rethinking ways in which countries could work together to tackle the problem was much needed.
“The evidence shows that the cocaine problem is a transnational trans-Atlantic transcontinental problem,” she told us.
According to the UN agency, African nations have been worst-hit by the phenomenon, with 37 countries on the continent facing health worker shortages that threaten their chances of achieving universal health care by 2030 – a key Sustainable Development Goals pledge.
The actions of wealthy countries that belong to the Organization for Economic Cooperation and Development (OECD) come under scrutiny in the WHO alert, among other regions.
Recruitment drive
“Within Africa it’s a very vibrant economy that is creating new opportunities”, said Dr. Jim Campbell, the Director responsible for health worker policy at WHO.
“The Gulf States have traditionally been reliant on international personnel and then some of the OECD high-income countries have really accelerated their recruitment and employment to respond to the pandemic and respond to the loss of lives, the infections, the absences of workers during the pandemic”.
To help countries protect their vulnerable healthcare systems, WHO has issued an updated health workforce support and safeguards list, which highlights nations with low numbers of qualified health care staff.
“These countries require priority support for health workforce development and health system strengthening, along with additional safeguards that limit active international recruitment,” the WHO insisted.
A 5-month-old baby is vaccinated at a camp for displaced people n the Kurdistan Region of Iraq.
Tedros call
Supporting the call for universal healthcare for all countries, in line with the Sustainable Development Goals, WHO Director-General, Tedros Adhanom Ghebreyesus called on all countries “to respect the provisions in the WHO health workforce support and safeguards list”.
Health workers “are the backbone of every health system, and yet 55 countries with some of the world’s most fragile health systems do not have enough and many are losing their health workers to international migration,” Tedros added.
Commercial interest
Although many countries do respect existing WHO guidelines on recruitment of health care workers, the principle is not accepted wholesale, WHO warned.
“What we are seeing is that the majority of countries are respecting those provisions (by) not actively recruiting from these (vulnerable) countries,” said WHO’s Dr Campbell. “But there is also a private recruitment market that does exist and we’re looking to them to also reach some of the global standards that are anticipated in terms of their practice and behaviour.”
Mechanisms also exist for governments or other individuals to notify WHO if they are “worried” about the behaviour of recruiters, the WHO official added.
The WHO health workforce support and safeguard list does not prohibit international recruitment, but recommends that governments involved in such programmes are informed about the impact on the health system in countries where they source qualified health professionals.
Benson Musyoka rides his motorcycle from Kamboo health centre to transport vaccines to Yindalani village. Photo Joyce Chimbi/IPS
by Joyce Chimbi (nairobi)
Inter Press Service
NAIROBI, Mar 13 (IPS) – Up until 2019, nurses in three health facilities located in the semi-arid south-eastern Kenya region of Makueni County struggled to bring critical health services closer to a hard-to-reach population scattered across three remote, far-flung villages.
“Kamboo, Yindalani and Yiuma Mavui villages are located 17 and 28 kilometres away from Makindu sub-county hospital, and 10 and 22 kilometres away from the nearest electricity grid,” Benson Musyoka, the nurse in charge of Ndalani dispensary in Yindalani village tells IPS.
Without a cold chain capacity to store vital vaccines and drugs, health facilities records show vaccination coverage across these villages was well below 25 percent.
Babies were delivered at home because mothers could not raise 6 to 12 USDs to hire a boda boda or motorbike taxi, which is the only means of transportation in the area. Others could not reach the hospital in time to deliver.
“Every morning, I would collect vaccines at Makindu sub-county hospital and transport them inside a vaccine carrier box to Ndalani dispensary. Once the vaccines are inside the carrier box, they are only viable for up to six hours, at which point whatever doses will have remained unused must be returned to storage at Makindu sub-county hospital for refrigeration or thrown away,” Musyoka expounds.
In February 2019, a groundbreaking donation of a solar-powered freezer to the Kamboo health centre significantly improved availability and access to vaccinations as well as maternal health services across the three villages and surrounding areas.
Francis Muli, the nurse in charge of Kamboo health centre, tells IPS that without a fridge or freezer, “you cannot stock Oxytocin, and without Oxytocin, you cannot provide labour and delivery services.”
He says it would be extremely dangerous to do so because Oxytocin is injected into all mothers immediately after delivery to prevent postpartum haemorrhage. Oxytocin is also used to induce labour.
As recommended by the World Health Organization, Oxytocin is the gold standard for preventing postpartum haemorrhage and is central to Kenya’s ambitious goal to achieve zero preventable maternal deaths.
In 2017, the Ministry of Health identified sub-standard care in 9 out of 10 maternal deaths owing to postpartum haemorrhage. Overall, postpartum haemorrhage accounts for 25 percent of maternal deaths in this East African nation.
Usungu dispensary and Ndalani dispensary are each located 10 kilometres away from Kamboo health centre in different directions. Nurses in charge of the facilities no longer make the long journey of 28 kilometres to and another 28 kilometres from Makindu to collect and return unused vaccine doses on vaccination days.
“We collect vaccine doses from Makindu sub-county hospital at the beginning of the month and store them in the freezer at Kamboo health centre. The freezer is large enough to store thousands of various vaccine doses collected from the sub-county hospital for all three facilities,” says Antony Matali, the nurse in charge of Usungu dispensary in Yiuma Mavui village.
Two to three times a week, Matali and Musyoka collect doses of various vaccines, including all standard routine immunization vaccines, with the exception of Yellow Fever. The vaccines are transported to their respective dispensaries in a carrier box that can hold up to 500 doses of different vaccines, including the COVID-19 vaccines. All three facilities have recorded significant improvement in immunization coverage from a low of 25 percent.
At Kamboo health centre, where the freezer is domiciled, records show measles immunization rate has surpassed the target of 100 percent to include additional clients outside the catchment population area of 4,560 people. Overall immunization coverage is at 95 percent, well above the government target of 90 percent.
At Ndalani dispensary, the immunization rate for measles has also surpassed the target of 100 percent as additional patients, or transit patients from four surrounding villages and neighbouring Kitui County, receive services at the dispensary. The overall vaccination rate for all standard vaccines is 50 to 65 percent.
In the Usungu dispensary, the vaccination rate for measles is at 75 percent, and for other vaccines, coverage is hovering at the 50 percent mark.
“Usungu and Ndalani have not reached the 90 percent mark because we suffer from both missed opportunities and dropouts. Missed opportunities are patients who drop by a facility seeking a service and find that it is not available at that very moment. Dropouts are those who feel inconvenienced if they do not find what they need in their subsequent visits, so they drop out along the way,” Musyoka explains.
A cold chain or storage facility such as the solar-powered freezer, Muli says, is the cornerstone of any primary health unit in cash-strapped rural settings, and all services related to mother and child are the pillars of any health facility. Without these services, he emphasizes, all you have is brick and mortar.
“At Usungu and Ndalani, we are currently not offering labour and delivery services because we do not have Oxytocin in the facility at all times due to lack of storage, and we cannot carry it around in the hope that a delivery will materialize that day due to the six-hour time limit,” Musyoka expounds.
Still, pregnant women receive the standard tetanus jabs and all other prenatal services, but close to the delivery period, Ndalani and Usungu refer the women to the Kamboo health centre and follow-up to ensure that they receive referred services. Facility records show zero infant and maternal mortality.
Annually, the Ministry of Health targets to vaccinate at least 1.5 million children against vaccine-preventable diseases such as measles, polio, tuberculosis, diarrhoea and pneumonia. Currently, one in six children under one year does not complete their scheduled vaccines.
Only one in two children below two years have received the second jab of Measles-Rubella, and only one in three girls aged 10 have received two doses of the HPV vaccine which protects against cervical cancer.
Ongoing efforts are helping address these gaps. For instance, the HPV vaccine was introduced in Makueni in March 2021. Musyoka vaccinated 46 girls aged 10 years with the two doses of HPV vaccine in 2021, and another 17 girls received their first HPV dose in 2022 and are due for the second dose in November 2022.
Healthcare providers say the freezer has transformed the delivery of mother and child services in the area by bringing critical immunization services closer to a marginalized and highly vulnerable community.
Uganda used public health measures like screening, testing of temperatures, and isolation of suspected cases to contain the Ebola outbreak. While those measures were successful, scientists warn that another outbreak could occur. Credit: Wambi Michael/IPS
by Wambi Michael (kampala & mubende)
Inter Press Service
KAMPALA & MUBENDE, Mar 10 (IPS) – It is two months since the World Health Organization declared Uganda free of the most recent Sudan ebolavirus, which killed 55 people.
Uganda employed public health measures to end the outbreak. In the absence of vaccines and therapeutics, the threat of the next outbreak looms.
Scientists are yet to find answers to questions like who was the first person to be affected? Or the index case, what viral host reservoir did that patient get in contact with?
“We don’t have answers to those questions. And honestly, we are hoping that Uganda will provide us and the world with those answers,” says Emmy Bore, program director for the CDC’s Division of Global Health Protection in Uganda.
“In every Ebola outbreak we have responded to, in West Africa, in DRC, there have been attempts to trace the roots back to the very first person who got infected. When you figure out where that person went and what they ate, you can figure out how they managed to get the virus. In most outbreaks, we don’t,” she said.
With those questions answered, Lt Colonel Dr Kyobe Henry Bossa, who has been at the front lines against Ebola outbreaks and COVID-19, told IPS that it is urgent they track precisely the viral host reservoir before the next outbreak.
“We know that the reservoir lives in the jungle innocently. We suspect that the viral host reservoir is a bat circulating in the area, and the virus is maintained in nature,” said Kyobe.
Bats have long been the prime suspects for what scientists have termed as the “spillover” of novel pathogens to humans. They are believed to harbor diverse viruses more lethal to humans than any other mammals.
Ugandan Veterinarian and Epidemiologist Dr Monica Musenero Masanza is no stranger to fighting viruses like Ebola and Marburg in Uganda and West Africa. Musenero came to be commonly known as Dr Kornya—loosely translated as a female warrior for her fight against Ebola in Port Loko in northern Sierra Leone. She told IPS that Ebola is categorized among emerging or re-emerging diseases.
“And those diseases show up with a lot of drama. Ebola, when it shows up, there is a lot of drama. Now those emerging and re-emerging diseases are attracting a lot of attention. Unfortunately, because we don’t know much about them, there is usually little we can do about them in the immediate except control,” said Musenero.
According to Musenero, now that Uganda successfully ended the Sudan ebolavirus, efforts should be geared towards finding pathogen X otherwise, another outbreak is guaranteed. “It’s not a matter of if, but when. That is why we should get to the jungles to find the host reservoir,” she said.
On September 20, 2022, Uganda declared an Ebola disease outbreak caused by the Sudan ebolavirus species in the Mubende district.
It was the country’s first Sudan ebolavirus outbreak in a decade and its fifth of this kind of Ebola. There were 164 cases (142 confirmed and 22 probable), 55 confirmed deaths, and 87 recovered patients.
The outbreaks have over the years occurred in a very similar region, with the suspected viral host reservoir suspected to be a bat.
Dr Trevor Shoemaker, an epidemiologist in the Division of High-Consequence Pathogens and Pathology at the National Center for Emerging and Zoonotic Diseases at the Center for Disease Control (CDC), suspects that bats carrying the virus are circulating in that area.
“It is not unexpected that there would be an outbreak where we have seen previous outbreaks in the central region of Uganda,” said Shoemaker.
According to Shoemaker, during the course of testing for ebolavirus cases in the just-ended outbreak, three of the samples were negative for ebolavirus but tested positive for another viral hemorrhagic fever called Crimean Congo hemorrhagic fever.
“There are pathogens that we know about, and there are those we know. So we need to trace them before they spill over to humans,” said Shoemaker.
Scientists from the University of Bonn have in the past confirmed the presence of Crimean Congo viruses in African bats and therefore suggesting that bats could play a role in spreading the virus.
Others studies have linked Crimean Congo viruses to ticks. While bats have been suspected as reservoirs of the Sudan ebolavirus, no conclusive evidence exists.
The district of Mubende and Kasanda forested with indigenous trees. Some private plantation forests are also thriving. Late in the evening, different species of bats fly into the darkening sky.
Fortytwo-year-old Bright Ndawula is an Ebola survivor. He tells IPS that there are as more as ten types of bats that he knows of “Some are tiny, they live under the rooftops, some are big, and they live in trees. Health workers told us that bats carry Ebola, but we don’t know one,” said Ndawula who lost his wife and three family members to the virus.
So far, scientists have been able to identify only one species of African fruit bat (R. aegyptiacus) positive for Marburg virus infection. No evidence of the Marburg virus was identified in the other species of insect-eating or fruit bats tested.
A few kilometers out of Mubende town, IPS comes across farmers and loggers living on the edge of the forest, risking some of the infectious diseases that may spill over from bats to humans.
Dr Charles Drago Kato leads a surveillance team with USAID funded project named Strategies to Prevent Spillover, or STOP Spillover. It targets viral zoonotic diseases—infections that originate in animals before they “spill over” into humans. His teams have been to Districts like Mubende, Kibale, and parts of the Rwenzori Mountains, specifically researching bats and humans.
He told IPS that under the project, they are trying to trace pathogens in bats that may be dangerous when they cross over to humans.
In our region, women and girls continue to be disproportionately affected by HIV, accounting for 63% of the region’s new HIV infections in 2021, write the authors. Credit: Shutterstock
Opinion by Anne Githuku-Shongwe, Eva Kiwango (johannesburg)
Inter Press Service
Anne Githuku-Shongwe is the UNAIDS Regional Support Team for Eastern and Southern Africa Director and Eva Kiwango is the Country Director of UNAIDS South Africa
JOHANNESBURG, Mar 07 (IPS) – Recent crises have pushed the gender inequality gap even wider and new technology has brought new threats to women’s autonomy and safety. This year’s International Women’s Day celebrated under the theme “DigitALL: Innovation and technology for gender equality” is an opportunity to strengthen efforts to uplift and empower women and girls’ digital participation to ultimately improve their lives.
Sima Bahous, UN Under-Secretary-General and Executive Director of UN Women has described it as “digital poverty”: the digital divide which “disproportionately affects women and girls with low literacy or low income, those living in rural or remote areas, migrants, women with disabilities, and older women”.
On a continent that contributes only 13% towards global internet users, nearly 45% fewer women than men have access to the internet in sub-Saharan Africa.
That means alarmingly high numbers of African women and girls are left out of digitally-enhanced opportunities such as employment, mobile money transactions and banking.
From a health perspective, excluding women and girls from digital participation restricts their access to life-saving information. That can have dire consequences in a region such as eastern and southern Africa where young women and girls carry the burden of HIV.
In our region, women and girls continue to be disproportionately affected by HIV, accounting for 63% of the region’s new HIV infections in 2021. HIV infections are three times higher among adolescent girls and young women (aged 15 to 24 years) than among males of the same age.
The factors fueling this reality are power, deep-set inequalities and limited access to information among other factors.
Our report Dangerous Inequalities highlights that sexual reproductive health rights (SRHR) barriers, lack of quality comprehensive sexuality education (CSE) and restrictive and contradictory policy frameworks make it difficult, if not impossible, for adolescent girls and young women to access essential SRHR and HIV prevention and treatment services.
Furthermore, sociocultural norms, stigmas, discrimination, perceptions and age of consent laws impede young women and girls from accessing HIV testing and SRHR services.
Such barriers discourage young women and adolescent girls from approaching healthcare centres for their sexual reproductive needs.
This leaves girls with insufficient knowledge and skills to protect themselves from unsafe and unhealthy sexual practices, leading to HIV infection and sexually transmitted infections, teenage pregnancies, unsafe abortions and sexual violence.
The UNFPA “Seeing The Unseen” report highlights that 13% of all young women in developing countries begin childbearing while still being children themselves. In eastern and southern Africa, the overall weighted pregnancy prevalence among adolescent girls and young women (10-24 years of age) is alarmingly high at 25%.
We have completely normalised the abnormal. That is a crisis in itself. However, closing the gender equality gap will give us the opportunity to change the inequality trajectory for women and girls.
Technology and the digital space should be made more inclusive and accessible in our region and beyond. Virtual medical consultations, SRHR apps and searchable information should be options our young women and girls should be able to explore in a shame-free, destigmatised environment.
We applaud African developers who have created multiple free apps such as In Her Hands developed by the Southern African Development Community with the support of UNAIDS. Such apps work to empower young women and girls with SRHR information as well as expand HIV prevention outreach.
However, all our efforts to make the digital world accessible and inclusive should also be safe. Unfettered access to information and unscrupulous persons leave women vulnerable to misinformation on the very health issues they would seek to treat.
Furthermore, while the virtual world gives us a space to create boundaries and interact at a seemingly safe level for school, work and socialization, online violence against women is proving to be pervasive.
A UN brief shares physical threats, sexual harassment, stalking, zoombombing and sex trolling as examples of some of the attacks women face online.
It is therefore important to accelerate internet literacy for women and girls and equip them with precautionary and reactionary measures to ensure their digital safety before online violence permeates the physical world leading to serious challenges such as physical stalking, abduction and trafficking.
In spite of the challenges and safety concerns, the digital world can be an empowering space when harnessed correctly. Safe digital spaces hold the potential to disseminate life-saving, evidence-based information on SRHR, HIV prevention, treatment, GBV reporting and related support mechanisms at the click of a button.
Initiatives addressing SRHR and HIV ought to be framed with an inclusive digital lens at the fore. Multi-stakeholder collaboration is key, particularly with the private sector, internet service providers and data hubs.
At UNAIDS, we have partnered with UNESCO, UNICEF, UNFPA and UN Women to launch the ‘Education Plus’ Initiative. The initiative accelerates actions and investments to prevent HIV by ensuring adolescent girls and young women in Africa have equal opportunities to access quality secondary education, alongside key education and health services and support for their economic autonomy and empowerment.
Furthermore, the Transforming Education Summit is a key initiative of Our Common Agenda launched by UN Secretary-General, Antonio Guterres, in September 2021. It works to recover pandemic-related learning losses and sow the seeds to transform education in a rapidly changing world.
If harnessed effectively, connectivity and openly accessible digital teaching and learning resources can contribute to the transformation and democratization of education.
As we work to end AIDS by 2030, access to new prevention technologies such as long-acting PrEP to be rolled out in Botswana, Uganda and Zimbabwe should be expanded to the entire region. That should be rolled out without disparity between rich and poorer countries.
Emerging technologies such as the vaginal ring, an important feminist option, need to be supported to increase efficacy and accessibility. Furthermore, the preventive benefits of antiretroviral treatment need to be promoted and understood. Platforms such as social media should be considered powerful and accessible tools to raise awareness of HIV prevention and care in our region.
Technology is a game changer in access to health information and enabling young people to break taboos around sexual health and HIV and feel empowered in their bodies.
We need to urgently level the digital space, use it to end gender inequalities and safeguard our women and girls from the scourge of HIV. There is no price on human life: Ending AIDS is a promise that can and must be kept.
Nearly every maternal death is preventable, and the clinical expertise and technology necessary to avert these losses have existed for decades. Credit: Patrick Burnett/IPS
by Baher Kamal (madrid)
Inter Press Service
MADRID, Mar 07 (IPS) – The answer is that there are alarming setbacks for maternal health care and, in many cases, even a total lack of maternity services, which threaten to further raise the number of these tragic preventable deaths one million or more a year by 2030.
Severe bleeding, high blood pressure, pregnancy-related infections, complications from unsafe abortion, and underlying conditions that can be aggravated by pregnancy (such as HIV/AIDS and malaria) are the leading causes of maternal deaths, UN specialised bodies report.
“These are all largely preventable and treatable with access to quality and respectful healthcare.”
Why then are these causes still not prevented and treated?
In theory, ending maternal mortality should be achievable, the UN Population Fund (UNFPA), the world’s sexual and reproductive health agency, on 23 February stated, that’s just three weeks ahead of this year’s International Women’s Day (8 March).
“Nearly every maternal death is preventable, and the clinical expertise and technology necessary to avert these losses have existed for decades.”
“Why, then, do almost 800 women still die every day from maternal causes? How, today, can one woman die every two minutes from pregnancy or childbirth?”
The report reveals “alarming setbacks” for women’s health over recent years, as maternal deaths either increased or stagnated in nearly all regions of the world.
“While pregnancy should be a time of immense hope and a positive experience for all women, it is tragically still a shockingly dangerous experience for millions around the world who lack access to high quality, respectful health care,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO).
“These new statistics reveal the urgent need to ensure every woman and girl has access to critical health services before, during and after childbirth, and that they can fully exercise their reproductive rights.”
A miracle turned into tragedy
“For millions of families, the miracle of childbirth is marred by the tragedy of maternal deaths,” said UNICEF’s Executive Director Catherine Russell.
“No mother should have to fear for her life while bringing a baby into the world, especially when the knowledge and tools to treat common complications exist. Equity in healthcare gives every mother, no matter who they are or where they are, a fair chance at a safe delivery and a healthy future with their family.”
More poverty, more death
In total numbers, maternal deaths continue to be largely concentrated in the poorest parts of the world and in countries affected by conflict, according to the report.
In 2020, about 70% of all maternal deaths were in sub-Saharan Africa. In nine countries facing severe humanitarian crises, maternal mortality rates were more than double the world average (551 maternal deaths per 100.000 live births, compared to 223 globally).
Moreover, “inequities related to income, education, race or ethnicity further increase risks for marginalised pregnant women, who have the least access to essential maternity care but are most likely to experience underlying health problems in pregnancy.”
Needless deaths
“It is unacceptable that so many women continue to die needlessly in pregnancy and childbirth. Over 280.000 fatalities in a single year is unconscionable,” said UNFPA Executive Director Dr. Natalia Kanem.
“We can and must do better by urgently investing in family planning and filling the global shortage of 900.000 midwives so that every woman can get the lifesaving care she needs. We have the tools, knowledge and resources to end preventable maternal deaths; what we need now is the political will.”
The report reveals that the world must “significantly accelerate progress to meet global targets for reducing maternal deaths, or else risk the lives of over one million more women by 2030.”
Question: How much money is needed to put an end to such horrifying deaths? Wouldn’t it be enough to dedicate what the world’s giant private business gains in just one minute through selling weapons, speculating with oil, power and food prices, marketing artificial baby milk, and a very long etcetera, let alone technologies?
Is digitisation more urgent?
There is another question needing an answer: how come that, in spite of the above-mentioned findings, the United Nations now focuses on the need to ‘digilitalise’ the lives of women?
See what the UN says about this year’s International Women’s Day (8 March), under the theme: DigitALL: Innovation and technology for gender equality:
“Our lives depend on strong technological integration: attending a course, calling loved ones, making a bank transaction, or booking a medical appointment. Everything currently goes through a digital process.”
“However, 37% of women do not use the internet. 259 million fewer women have access to the Internet than men, even though they account for nearly half the world’s population.”
The world’s major multilateral body further explains that if women are unable to access the Internet and do not feel safe online, they are unable to develop the necessary digital skills to engage in digital spaces, which diminishes their opportunities to pursue careers in science, technology, engineering, and mathematics (STEM) related fields.
And that by 2050, 75% of jobs will be related to STEM areas. “Yet today, women hold just 22% of positions in artificial intelligence, to name just one.”
True: women have historically been victims of all sorts of abuse, violence, and targeted inequalities that have systematically left them far behind in all aspects of life.
Shouldn’t their indisputable right to the most basic health care be –now and always– a high priority on the world’s agenda?
A cell phone gives rural women access to financial services, training, networks, and, importantly, information and knowledge. Credit: Prashanth Vishwanathan (CCAFS)
Opinion by Nicoline de Haan (nairobi, kenya)
Inter Press Service
Dr. Nicoline de Haan is Director of the CGIAR GENDER Impact Platform
NAIROBI, Kenya, Mar 06 (IPS) – While 100 million people worldwide are using the AI chatbot ChatGPT to get ahead on homework and try out for top jobs at Google, more than 370 million women in developing countries lack the services of a simple cell phone.
The world may be witnessing a quantum leap in the digital revolution, but cell phones and mobile internet would give these women enough of a foothold to access unprecedented opportunities to improve their incomes, nutrition and health.
For rural women and girls in low-income countries who rely on small-scale agriculture, ICT can unlock financial services, training and networks, and, importantly, information and knowledge. Without these core technologies, women are farming with one hand tied behind their backs, making up just a quarter of registered users of agricultural applications in Africa.
The potential of digital technology to transform farming and agriculture in countries across the Global South is increasingly compelling. Producers in sub-Saharan Africa who adopted online services were found to increase their incomes by up to 40 per cent while new forecasting and early warning systems can also help farmers stay ahead of climate shocks. Digital innovations are therefore an essential component of agricultural research strategies to strengthen food and economic security around the world.
Nicoline de Haan
Subsidising technologies like cell phones for women can be one effective way for governments and NGOs to start closing the digital gender divide while boosting overall agricultural productivity.
Women in sub-Saharan Africa are 15 per cent less likely to own a cell phone and more than 40 per cent less likely to use mobile internet than are men. Yet when women were given cell phones, SIM cards and time charge cards in one study in Tunisia, 75 per cent said they benefitted either through better connectivity to agricultural information, such as veterinary advice, or greater levels of communication.
Meanwhile, a project to provide app-based drone delivery of livestock vaccines is set to allow women in Ghana to overcome gender norms that dictate men farmers liaise with men veterinarians, and better care for their chickens and goats.
But to ensure that women get maximum benefit, both the technology and the training to use it must be optimized to account for different needs and contexts – and this needs ongoing investment into gender-responsive agricultural research.
While cell phones and SMS have increased the reach of agricultural information services, disproportionate levels of illiteracy among women require innovative forms of delivery to be impactful. For example, developing interactive voice response (IVR) technology and voice messages in local languages can allow women to receive the same valuable information in a format that acknowledges gendered differences in education levels.
Similarly, complementary technologies ensure that greater access translates into greater benefit. Using radio programming in combination with SMS, and avoiding gendered greetings such as “dear brother farmer”, can improve both women’s access to and capacity to leverage information.
Perhaps the greatest barrier when it comes to closing the digital gender divide are the norms that continue to limit women’s access to technology, and the slow social and cultural acceptance of women making use of digital tools in agriculture.
One approach is to support efforts to work with the gatekeepers of technology within the community, whether fathers, clerics or elders, to encourage behaviour change. Another promising tactic is for governments and research partners to develop community-based opportunities for women to access and act upon information technologies collectively.
Radio Listeners Clubs in Rwanda were found to help remove the significant disparities in awareness, access and use of climate information that usually exist between women and men smallholder farmers. The greatest improvements in income and social standing as a result were among women.
Digital innovations can themselves play a part in deconstructing gender norms. #BintiShujaaz (“Heroine Girl”), a social media campaign launched in Tanzania, used posts, videos, comics and two online panel discussions to showcase positive examples of young women in the chicken business. The campaign reached 4.4 million young Tanzanians, with more than 500,000 engagements, to help improve the perception of women in the poultry business.
Access to information through digital technologies can be a powerful leveller and a critical weapon in the arsenal. And when it comes to gender inequality, it can generate multiple benefits, not only for women but for their families, communities and economies.
It is vital that governments, development partners and agricultural research institutes do everything they can to ensure women not only have access to the information and knowledge they need but are empowered to use it in their best interests.
Mangroves in Tai O, Hong Kong. Coastal wetland protection and restoration is an example of the kind of multifunctional solution that is needed to address multiple global crises together. Credit: Chunyip Wong / iStock
Opinion by Paula Harrison – Pamela McElwee – David Obura (bonn)
Inter Press Service
BONN, Mar 02 (IPS) – When global crises are interlinked, they overlap and compound each other. In such cases, the most effective solutions are those that work at the nexus of all these challenges.
In September, almost every Government on Earth will gather at the UN Sustainable Development Summit in New York to take stock at the halfway mark of the Sustainable Development Goals (SDGs) of what has been achieved and what remains to be done.
Despite some progress, global development efforts have been hamstrung by unprecedented environmental, social and economic crises, in particular biodiversity loss and climate change, compounded of course by the COVID-19 pandemic.
Tackling these interlinked challenges separately risks creating situations even more damaging to people and communities around the world, and exacerbates the already high risk of not meeting the goals and targets of the 2030 Agenda for Sustainable Development.
This is especially true because the myriad drivers of risk and damage affect many different sectors at once, across scales from local to global, and can result in negative impacts being compounded. For example, when demands for food and timber combine with the effects of pollution and climate change, they can decimate already degraded ecosystems, driving species to extinction and severely reducing nature’s contributions to people.
The global food system offers another example of this negative spiral of interlocking crises – where food that is produced unsustainably leads to water overconsumption and waste, pollution, increased health risks and loss of biodiversity. It also leads to excessive greenhouse gas emissions, contributing to climate change.
Yet policies often treat each of these global threats in isolation, resulting in separate, uncoordinated actions that typically address only one of the root causes and fail to take advantage of the many potential solution synergies. In the worst cases, actions taken on one challenge directly undermine those needed to tackle another because they fail to account for trade-offs, resulting in unintended consequences, or the impacts being externalised, as someone else’s problem.
This is why almost 140 Governments turned to the Intergovernmental Platform on Biodiversity and Ecosystem Services (IPBES) – requesting IPBES to undertake a major multiyear assessment of the interlinkages among biodiversity, water, food and health in the context of the rapidly-changing climate. This ‘Nexus Assessment’ is among the most complex and important expert assessments ever undertaken – crossing key biophysical domains of climate and biodiversity and elements central to human wellbeing like food, water and health. It will also address how interactions are affected by energy, pollution, conflict and other socio-political challenges.
To fully address this ‘nexus’, the assessment is considering interactions across scales, geographic regions and ecosystems. It also covers past, present and future trends in these interlinkages. And, most importantly, it will offer concrete options for responses to the crises that address the interactions of risk and damage jointly and equitably – providing a vital set of possible solutions for the more sustainable future we want for people and our planet.
One example of the mutifunctional solutions that will be explored is nature-based solutions – such as coastal wetland protection and restoration. When coastal wetland ecosystems are healthy – whether conserved or where necessary, restored – they are a refuge and habitat for biodiversity, improving fish stocks for greater food security and contributing to improve human health and wellbeing. They can also sequester carbon, helping to mitigate climate change, and protect adjacent communities and settlements from flooding and sea level rise.
To develop and implement these kinds of multi-functional solutions, responses for dealing with the major global crises need to be better coordinated, integrated, and made more synergistic across sectors, both public and private. Decision-makers at all levels need better evidence and knowledge to implement such solutions.
Work on the nexus assessment began in 2021 – with the final report expected to be considered and adopted by IPBES member States in 2024. A majority of the 170 expert authors and review editors from around the world are meeting in March in the Kruger National Park in South Africa to further strengthen the draft report, responding to the many thousands of comments received during a first external review period.
The assessment will also include evidence and expertise contributed by indigenous peoples and local communities – whose rich and varied direct experiences and knowledge systems that consider humans and nature as an interconnected whole have embodied a nexus approach for generations.
The Paris Agreement on Climate Change and the recently-agreed Kunming-Montreal Global Biodiversity Framework provide the roadmaps for tackling the climate and biodiversity crises. The IPBES nexus assessment will offer policymakers a practical guide to bridge the vital interlinkages across the two challenges, to other relevant frameworks, and link to the sustainable development agenda.
For more information about IPBES or about the ongoing progress on the nexus assessment, go to www.ipbes.net or follow @ipbes on social media.
Prof. Paula Harrison is a Principal Natural Capital Scientist and Professor of Land and Water Modelling at the UK Centre for Ecology & Hydrology, United Kingdom.
Prof. Pamela McElwee is a Professor in the Department of Human Ecology in the School of Environmental and Biological Sciences at Rutgers, The State University of New Jersey, USA.
Dr. David Obura is a Founding Director of CORDIO (Coastal Oceans Research and Development – Indian Ocean) East Africa, Kenya.
Patients in Africa often cannot access treatment as per the WHO hepatitis B guidelines. Now researchers have found a way to improve the diagnosis and care of people living with hepatitis B. Credit: Charles Mpaka/IPS
by Charles Mpaka (blantyre)
Inter Press Service
BLANTYRE, Mar 02 (IPS) – Researchers have found that cheaper and more accessible blood testing methods can improve the care of patients with chronic hepatitis B in Africa.
In a study published in Nature Communications, the researchers recommend revising the current World Health Organization (WHO) guidelines on managing the condition.
“Our data are important for informing clinical practice in and should be considered in the next revision of the WHO hepatitis B guidelines,” say the researchers who make up the Hepatitis B in Africa Collaborative Network (HEPSANET).
Lead author of the study, Asgeir Johannessen, tells IPS that clinicians working in Africa have “repeatedly reported that very few patients in Africa” are eligible for treatment using the current WHO guidelines published in 2015.
“The lack of data from Africa is a major challenge, and we wanted to use African data from African patients to inform African treatment guidelines,” says Johannessen, a specialist in internal medicine and infectious diseases at the Institute of Clinical Medicine, University of Oslo in Norway.
According to the study, Africa represents one of the high-burden regions for chronic hepatitis B virus. Of the estimated 316 million people that live with chronic hepatitis B virus infection worldwide, 82 million are in Africa.
The research further says that antiviral therapy effectively reduces the risk of complications resulting from hepatitis B virus infection.
But with current WHO-recommended guidelines, early diagnosis and treatment are impacted because often only picked up when there is advanced liver damage.
The challenge in clinical practice in Africa has been to identify patients at risk of progressive liver disease who should start antiviral therapy in good time.
“In resource-limited settings, however, these fibrosis assessment tools are rarely available, and antiviral treatment is therefore often delayed until the patients have developed symptoms of advanced chronic liver disease,” the research paper says.
So, the researchers set out to deal with this question: “Can we diagnose advanced liver fibrosis in the Africa region, using routinely available and low-cost blood tests for patients with hepatitis B?” says Alexander Stockdale, a member of the team and senior clinical lecturer at the University of Liverpool and Malawi Liverpool Wellcome Programme.
In the study, the 23 researchers reviewed data for 3,548 chronic hepatitis B patients living in eight sub-Saharan African countries, namely Burkina Faso, Ethiopia, The Gambia, Malawi, Nigeria, Senegal, South Africa, and Zambia.
They evaluated the existing WHO treatment guidelines and a simple liver damage biomarker developed in West Africa.
They established that the conventional hepatitis B care standards are unsuitable for patient management in Africa. They found that the diagnosis level as set by the WHO “is inappropriately high in sub-Saharan Africa,” which is often constrained by a lack of resources.
The problem, the researchers say, is that the existing WHO guidelines are not adapted for the African population.
The study that informed these guidelines was performed among active chronic hepatitis C patients in the USA, much older than Africa’s hepatitis B virus population and on a very different patient population compared to African chronic hepatitis B patients.
“Our data are important for informing clinical practice in SSA and should be considered in the next revision of the WHO hepatitis B guidelines,” says Johannessen.
He says they have shared their findings with the WHO and the Centre for Disease Control (CDC) in Africa.
“We believe our findings will inspire the first ever African hepatitis B treatment guidelines, and even the WHO is now changing their guidelines because of our work,” he tells IPS.
“Africa is now the epicenter of the hepatitis B epidemic. In fact, 2 of 3 new infections occur on the African continent. To combat the hepatitis B pandemic in Africa, we need African data to inform practice,” Johannessen says.
Initially, the researchers thought their main challenge would be to get people to share data.
“But in fact, everyone we reached out to were eager to participate. It is obvious that this is a topic that feels like a priority to colleagues working throughout Africa,” he says.
The study is the largest, most comprehensive, and geographically representative analysis ever conducted in Africa.
“We, therefore, believe our results are generalizable,” the researchers conclude.
However, they admit some limitations of their study. For example, the method used to assess liver damage has been associated with technical limitations, including unsuccessful measurements reported in patients with certain health conditions such as obesity. The researchers did not ascertain the rates of failure of these tests.
“This may affect the overall applicability of our findings to the entire population with HBV,” they say.
But Adamson Muula, Professor and Head of Community and Environmental Health at the Kamuzu University of Health Sciences (KUHES) in Malawi, says in terms of the methodology used in this study, the systematic review of data was relevant in answering the question at hand.
“In the hierarchy of evidence, systematic reviews and meta-analyses are high up with respect to the rigor of the findings,” says Muula, who was not part of the research.
He noted, however, that there are downsides to this approach, including the fact that in the interpretation of the findings, there is an implicit sense that Africa is one place. Muula argues that African health systems can be different even within the same country.
Within a country, you can find a health system comparable with developed countries; others are more closely aligned to developing countries. The studies applied more to those with less sophisticated health systems.
Regardless, the study is vital, he acknowledges.
Hepatitis B diagnosis on the continent has been a luxury. In Malawi, for example, where 5 percent of the adults are estimated to be infected, virtually no screening or diagnostic system exists.
Individual patients may interact with the health system, but more so when things are already out of hand when irreversible liver damage has already happened.
“Efforts to reduce the time at which diagnosis can happen are therefore commendable. This study adds guidance as to when such earlier diagnosis may be attained.
“However, research is one thing, health systems strengthening another. Studies like this one add to the impetus and arm the policymakers to make the right decisions,” he says.
But he urges communities to take charge of these findings instead of leaving action in the hands of “sometimes incapacitated policymakers’ hands.”
“The question should be, what is the community saying about findings such as these? If we wait for policymakers to decide when they are going to invest in hepatitis B interventions, we will wait for the rest of our lifetimes.
“Time has come for community groups to work with the duty-bearers to the extent that hepatitis B is not a neglected tropical disease anymore,” he says.
The WHO’s goal is to have hepatitis eliminated by 2030.
“I have rarely been so disturbed and heartbroken,” saidWHO Director-General Tedros Adhanom Ghebreyesus, speaking later at a media briefing.
“The earthquake that struck more than three weeks ago adds unimaginable suffering to people who have already suffered so much over 12 years of war, economic collapse, the COVID-19 pandemic and an ongoing cholera outbreak.”
Sorrow, respect, commitment
The region is the last redoubt of opposition fighters, who continue to resist government forces and their allies, with millions of civilians sheltering there – many having been displaced multiple times.
Tedros met with WHO partners who are delivering essential care, including specialized orthopaedic and paediactric services.
He offered his deepest sorrow to those who lost their loved ones, homes and livelihoods, while expressing deepest respect for the responders and health workers, many of whom also lost family members.
He underlined the UN agency’s commitment to continue to assist Syrians but urged greater international support for the recovery and rebuilding efforts.
Appeal to Syrian leaders
“At the same time, I call on the leaders of both sides of the Syrian conflict to use the shared suffering of this crisis as a platform for peace,” said Tedros.
The war has delivered nothing but suffering, division and the destruction of Syria’s proud history and rich culture, he added.
“The earthquake must shake all of us to the realisation that we are one humanity, sharing one planet. We have no future but a shared future. More than ever, the people of Syria need health for peace, and peace for health.”
Distributing life-saving aid
WHO also distributed additional life-saving medicines, supplies and equipment to three hospitals in northwest Syria on Wednesday.
The supplies were sufficient for 280,000 treatments, including for the management of trauma, diabetes, and pneumonia, as well as vitally needed anaesthesia drugs and surgical supplies.
Northwest Syria and neighbouring Türkiye were struck by powerful earthquakes on 6 February, which killed more than 40,000 people.
In the first hours of the tragedy, WHO distributed 183 metric tonnes of supplies prepositioned inside northwest Syria from warehouses in Azaz and Idlib to more than 200 health facilities.
Additionally, over 140 tonnes of supplies have been transported into the region from across the border in Türkiye, and across lines within Syria.
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