Tag: Women

A Shot in the Arm Can Prevent Cervical Cancer — Global Issues

Afshan Bhurgri, a cancer survivor, advises women to listen to their bodies and be aware of the symptoms of cervical cancer. Credit: Zofeen Ebrahim/IPS
  • by Zofeen Ebrahim (karachi)
  • Inter Press Service

KARACHI, Jul 26 (IPS) – “Listen to your body, and if there is anything strange happening, do not ignore it,” is the advice of 57-year-old Afshan Bhurgri, a cancer survivor.

Eight years ago, she was diagnosed with cervical cancer at a time when she was “in a good place” in life. Her kids were grown up, and she had more time to herself. A fitness freak, the schoolteacher’s daily routine included going to the gym daily. “I joined a creative writing class as I loved penning my thoughts!” she reminisced.

But then everything changed when she found out she had cancer.

Cancer of the cervix uteri is the fourth most common cancer among women worldwide, with an estimated 604,127 new cases and causing the death of 341,831 in 2020.

In Pakistan, an estimated 73.8 million women over the age of 15 are at risk of developing cervical cancer caused by the human papillomavirus (HPV).

Cervical cancer in Pakistan.
Cervical cancer in Pakistan.

In the absence of complete data, it is estimated that of the 5,000 women diagnosed with this cancer in Pakistan, some 3,000 lose their lives every year due to lack of access to prevention, screening and treatment, thus making it the third leading cause of cancer-related deaths in women of the reproductive age group in the country, after breast and ovarian cancers. Up to 88 percent of cervical cancer cases are due to human papillomavirus (HPV) serotypes 16 and 18, as reported by the International Agency for Research on Cancer.

“We are short on authentic data on the prevalence of the disease burden,” said Dr Arshad Chandio, who works at Jhpiego Pakistan as an immunisation lead. His organisation, which has supported HPV vaccine introduction in seven countries with Gavi support, is partnering with the federal and provincial governments, along with WHO, UNICEF, and USAID, to implement a roadmap for cervical cancer prevention and introduction of HPV vaccine in Pakistan. Cervical cancer is the only cancer that is preventable by a vaccine.

Cervical cancer worldwide.

“Without authentic data, our plan to eradicate this disease will not be watertight,” admitted Dr Irshad Memon, the director general of the Expanded Programme on Immunisation in Sindh.

Dr Shahid Pervez, senior consultant histopathologist at the Aga Khan University Hospital (AKUH), co-chair of the country’s newly established National Cancer Registry, recommends legislation to make reporting of cancer mandatory. “This will be one way of collecting basic data, at one place, which is expected by international agencies to roll out an effective cancer control programme in Pakistan,” he added.

Although Bhurgri had knowledge about cancer of the cervix and went for regular health checkups and screenings, her doctors did not carry out full examinations, which led to the infection turning cancerous. It all started in 2009, five years prior to being diagnosed with cancer when she started noticing a “foul smell emanating from my vagina” after her period became “heavier” than usual.

Cervical cancer warning signs.

“Let alone screening and testing for the cancer, many healthcare professionals do not even know of the disease, or how women get infected,” pointed out Chandio.

“I am an educated person, I could afford to get the best medical help, and I went to three of the city’s top gynaecologists, got pap smears done on their requests over the years, and I was only sent for HPV test when it was too late,” rued Bhurgri. In 2014, a doctor suggested an ultrasound which gave a true picture. A biopsy confirmed she had cervical cancer.

After her biopsy, Bhurgri started reading up on cervical cancer, and one of the indications was the foul vaginal smell.

“It could have been nipped in the bud if only the doctors had carried out a thorough examination,” said gynaecologist and obstetrician Dr Azra Ahsan, president of the Association for Mothers and Newborns, blaming “sheer negligence” on the part of her fraternity.

“A gynaecological consultation must not only be limited to a conversation across the table,” said Ahsan, but should include an “examination on the couch including a proper internal examination, ideally a pap smear and visual inspection,” especially if, like Bhurgri, a patient was complaining of heavy bleeding and a foul smell.

Bhurgri’s journey towards wellness was tough. A radical hysterectomy was recommended, and her cervix, her uterus and her ovaries were removed. Twenty-eight radiations and five chemos later, over a five-month period, she was given a clean chit by her oncologist. The cost of treatment, back in 2014 at a private hospital, was a whopping Rs30,000,000 (USD 1,097) back then.

Screening can save lives

Although Bhurgri’s cancer may have remained under the radar despite regular screening via pap smears, doctors say HPV and pap smear tests are the best way to screen a woman for cervical cancer. They can identify patients who are at high risk of developing pre-cancerous changes on the cervix as well as pick up those who have already developed these changes.

These precancerous lesions can be treated before they turn into cancer. Sadly, in Pakistan, the uptake of pap smears is negligible and estimated to be as low as 2 percent.

According to Dr Uzma Chishti, assistant professor and consultant gynecologic oncologist, Department of Obstetrics and Gynecology, AKUH, Pakistan’s health system is so financially stretched that it cannot afford to provide screening of women by these expensive tests. Instead, she recommends WHO’s recommendations of performing a visual inspection of the cervix by acetic acid (VIA) to screen women to help reduce the incidence of cervical cancer. “VIA is an alternative screening test for low-and-middle-income countries like ours,” she said.

Vaccinations the Best Option

The WHO triple intervention recommendation to eliminate cervical cancer in countries like Pakistan includes scaling up HPV vaccination to 90 percent for girls aged between 9 to 14, twice-lifetime cervical screening to 70 percent and treatment of pre-invasive lesions and invasive cancer to 90 percent by 2030. “All three are essential if we want to eliminate cervical cancer completely,” emphasised said Ahsan.

HPV vaccinations to prevent cervical cancer are the way forward as it provides primary prevention, said Chishti, in the absence of VIA, screenings and pap smear tests. Almost 60 per cent of cervical cancer cases occur in countries that have not yet introduced HPV vaccination. Pakistan is one of them.

Once up and about, the first thing Bhurgri did was get her 14-year-old daughter vaccinated for human papillomavirus (HPV) vaccine. “My older daughter remains unvaccinated as she was 21 then and studying abroad. She needed three shots and could not make it to that timeline,” she said.

In Pakistan, two globally licensed HPV vaccines are available in the market – a quadrivalent vaccine and a bivalent vaccine Cervarix. Gardasil is protective against the HPV serotypes 6, 11, 16, and 18, providing protection against both cervical cancer and genital warts. Cervarix is effective against serotypes 16 and 18, thereby protecting only against cervical cancer.

In 2021, medical students at the AKUH interviewed 384 women attending outpatient clinics between the ages of 15 to 50 to find out their knowledge about cervical cancer. They found that of the 61.2 percent of women who had heard about cervical cancer, 47.0 percent knew about pap smear tests, and among them, 73 percent had gotten a pap test. A total of 25.5 percent of women, out of the 61.2 percent, knew that a vaccine existed for prevention, but only 9.8 percent had been vaccinated against human papillomavirus. The study concluded that a majority of the women interviewed for the study belonged to a higher socioeconomic class and were mostly educated, yet their knowledge regarding the prevention and screening of cervical cancer was poor. “This reflects that the knowledge levels as a whole would be considerably lower in the city’s general population,” the study concluded.

Shamsi highlighted the challenges of discussing HPV in a conservative society where sexual health topics are hardly discussed due to the embarrassment and taboo associated with sexually transmitted infections (STIs). This communication conundrum has resulted in a general lack of information about the disease. “There is a total lack of information about HPV, cervical cancer, and its prevention among the masses,” she said.

But this may change if Pakistan introduces the HPV vaccine at a national level, utilising routine effective and established immunisation delivery strategies. According to Dr Uzma Shamsi, a cancer epidemiologist at the AKUH, implementing the HPV vaccine at a national level in Pakistan could save hundreds of thousands of lives annually.

The benefits are enormous, and hundreds of thousands of lives could be saved each year, she emphasised.

Pakistan is in talks with Gavi the vaccine alliance, to support the country in including the single-dose HPV (two covers four strains) vaccine in its routine immunisation programme. “It will probably take another two years and USD 16 million before we can roll out the vaccine, but when it happens, it will be a country-wide campaign,” confirmed Memon.

Shamsi predicted some tribulation because the primary target group for vaccination is pre-adolescent girls. “A new vaccine for a new target age group comes with its own set of challenges in a society where conspiracy theories about vaccination programmes, stigma and misinformation about cancer and sexual health persist,” she said. And so before the actual rollout,  Shamsi emphasised, it was important to increase awareness about the HPV virus, cervical cancer causes, and vaccine’s safety and usage among the general public, patients, and healthcare professionals while actively dispelling misinformation.

Memon agreed that “conversation around the vaccine must begin”. For its part, the Sindh government set aside Rs 100 million ($365,884) for advocacy of HPV vaccine uptake in its current budget. “We will initiate a dissemination campaign once we know when the HPV vaccination programme is to begin,” he said. The Sindh province was also the first to initiate the typhoid conjugate virus vaccine after an extensively drug-resistant virus was found in the province. He was hopeful there would be less resistance to the HPV vaccine after the successful administration of measles and rubella and the pediatric Covid-19 vaccines earlier.

However, said Memon, “We will need more women vaccinators this time as young girls are shy of rolling their shirt sleeves up for male vaccinators.” With up to 125,000 female health workers across Pakistan, who were earlier trained by Gavi for MR immunisation, which is a much more difficult vaccine to administer (being subcutaneous) as opposed to the HPV one (which is muscular), he said, this workforce can be engaged to get trained for this vaccination campaign too.

In the end, however, according to Chandio, “without a strong political will and leadership, a national HPV vaccination programme cannot become a reality in Pakistan to eliminate this largely preventable cancer among women”.

Fighting her cancer has changed Bhurgri in more ways than one. Her message to women is to “not put yourself aside; make yourself a priority.” While she continues to lead a healthy life – going to the gym, eating healthy, resting, she said, “You cannot go on and pick up where you left off”.

IPS UN Bureau Report


Follow IPS News UN Bureau on Instagram

© Inter Press Service (2023) — All Rights ReservedOriginal source: Inter Press Service



Check out our Latest News and Follow us at Facebook

Original Source

UN rights office — Global Issues

Social protection provides a safety net for the vulnerable through policies and programmes that offer financial assistance, healthcare coverage and social insurance.

“It helps prevent social exclusion and promotes social inclusion,” said Mahamane Cisse-Gouro, Director of the Human Rights Council and Treaty Mechanisms Division of human rights office OHCHR.

Long-term gender gap

The long-term gender gap has evolved due to social factors such as girls being forced into early marriages and early pregnancy, or the sheer burden of domestic work, leading inevitably to less access to formal employment and the inability to pay into national schemes like social security, insurance, or pension plans.

For migrant women, especially those who are undocumented, the situation is even more precarious.

“One of the key barriers for undocumented migrant women in accessing services or justice, is the fear that they might be detained and deported,” said Michele LeVoy, Director of the Platform for International Cooperation on Undocumented Migrants.

Even those women who are able to get work with benefits, tend to find themselves in the lowest-paid jobs, while their reproductive and care roles force them to opt-out of the job market, resulting in a gender pension gap when they are getting old.

And the COVID pandemic, climate emergencies, emerging conflicts, and increasing inequality, have made the gender gap even worse for social security.

Women participation needed

Mr. Cisse-Gouro stressed that to overcome all these problems, women themselves must have a say in decisions that impact them the most.

“That is the most effective way to find solutions and to secure their right to social protection is fully realized,” he said. “Yet, men continue to be over-represented in national parliaments and women continue to be under-represented in leadership positions in the private sectors and trade unions.”

“There is a lack of women’s participation in public and political life in relation to shaping and influencing social protection policies,” he emphasised.

One young activist, 17-year-old Yamikani from Malawi, knows the struggles faced by her community first hand.

Chronic poverty

Poverty levels in Malawi are alarmingly high, with many families unable to afford three meals a day. According to Yamikani, 60 percent of children in her homeland live in poverty, and families struggle to provide basic needs for their children.

Only 12 percent of children in poverty are covered by social cash transfers in Malawi, and for all children under five, that number falls to just 2.1 percent, Yamikani explained, during a Human Rights Council panel discussion

“I am particularly concerned that participation of girls and women in social protection decision making processes is not adequate, and it is not taken seriously,” she said

“By empowering us and valuing our perspectives, we can contribute to the creation of social protection policies and programmes that genuinely address our needs, decide right approaches, prioritize and target children who are in real need.”

Economic empowerment

Monica Ferro, Director of the Geneva Office of the UN Population Fund (UNFPA), echoes Yamikani’s sentiments, emphasizing gender equality is a prerequisite for women’s participation and leadership.

“We need a global economy that removes all obstacles and empowers women to choose their future, to own their decisions,” Ms. Ferro said.

“Social Protection schemes play a pivotal role in doing so. In turn, a gender equal society and economy – one where women enjoy equal opportunities and outcomes in the labour market and the public and private sectors – will make social protection systems more inclusive and sustainable.”

Check out our Latest News and Follow us at Facebook

Original Source

Rights experts denounce discriminatory travel policy — Global Issues

Under the policy, all women and girls are mandated to fill out a detailed form providing personal information, reasons and previous history of traveling without a male guardian. Those who refuse to complete or submit the form are denied exit.

“Not only is this policy discriminatory, but it also restricts the freedom of movement of women and girls, including students who leave the country to study abroad,” the experts said in a statement.

Rights defenders intimidated

The experts voiced their deep concern about the negative impact of the discriminatory procedure on the fundamental rights and freedoms of women and girls “in contradiction with Libya’s international and national obligations on non-discrimination, equality and the right to privacy.”

They were also concerned about reported attempts by the Libyan Internal Security Agency (ISA) to intimidate human rights defenders, including women, who have spoken out against these policies.

Appeal to authorities

The experts urged the authorities to withdraw this discriminatory requirement, and to prevent all intimidation, harassment and attacks against women and human rights defenders who have protested against the policy.

“The restriction marks a further erosion of the rights of women and girls in Libya and sends the wrong signal,” they said. “Women’s equality and dignity must be ensured.”

The experts who issued the statement were appointed by the UN Human Rights Council in Geneva.

They are not UN staff and are not paid for their work.

Check out our Latest News and Follow us at Facebook

Original Source

Lawmakers’ Vital Roles in Ensuring Dignity for Aging Populations — Global Issues

Dr Rintaro Mori, Regional Adviser, Population Ageing and Sustainable Development at UNFPA, told the conference it was crucial to invest to improve social security, health, and well-being. Credit: APDA
  • by Cecilia Russell (bangkok & johannesburg)
  • Inter Press Service

BANGKOK & JOHANNESBURG, Jul 19 (IPS) – Countries with falling population growth face twin dilemmas: Ensuring their aging population live healthy and fulfilling lives and removing barriers to parenthood.

This was the focus of a recent workshop in Thailand reviewing the ICPD30 process and preparation for the Summit for the Future slated for next year (2024).

The workshop was opened by Professor Keizo Takemi, MP Japan and Chair of AFPPD, who contextualized the issue.

“In the Asia Pacific region, a profound shift awaits us. By 2050, one in four individuals will be about the age of 60, with a majority of them being women. The empowerment and the well-being of these women become essential for their meaningful and independent participation in the socio-economic development.”

The meeting sought to highlight what is required from lawmakers to ensure a dynamic and balanced aging society where older people will be physically, mentally, and economically self-reliant as possible, with a sustainable healthcare system.

Dr Rintaro Mori, Regional Adviser, Population Ageing and Sustainable Development at UNFPA, in an interview with IPS, said parliamentarians’ role included “macro level policy planning to prepare for the coming population aging and low fertility including both economic and human rights perspectives.”

Their role was to lead the governments’ reform policies and systems of the country to adjust for “the emerging population trend, such as pension reform and education sector reforms to accommodate all ages,” and “investing in early and later years to take preventative measures to improve social security, health, and well-being.”

Mori said this was possible using a life-cycle approach with a strong emphasis on prevention:

“Prevention is the most cost-effective way to promote healthy and active aging. Life-long investment in social security, health promotion, and psychological well-being (relationship) is the key.”

Parliamentarians and experts met in Bangkok to discuss the ICPD30 process and preparation for the Summit for the Future 2024. Credit: APDA

Boosting fertility was crucial for countries facing declining and aging populations. Dr Victoria Boydell from the University of Essex in the UK said it is vital to remove barriers to parenthood but not through the trend of reducing access to sexual and reproductive health services.

According to research by UN Women and the International Labour Organization, 1.6 billion hours a day are spent in unpaid care work – representing 9 percent of global GDP, and women carry out at least two and a half times more unpaid household work than men. These factors needed to be considered by lawmakers.

Boydell said policy responses to boost fertility and remove barriers to parenthood included supporting early childhood development, enrollment in quality childcare from an early age, compensation for the economic cost of children through the allocation of benefits, tax exemptions, and other subsidies.

Other practices include fostering employment, especially amongst mothers, for example, part-time and flexible working conditions, promoting equal pay, equal sharing of paid and unpaid work, and allocating benefits to low-income families.

Regarding SRH services, there could be an increase in access to infertility treatment, fertility targets and policies to support the higher number of children, cash or tax exemptions, and access to contraception and abortion. Choice was a key right that needed protection.

In a case study, Chalermchai Kruangam, an MP from Thailand, said it was expected that a growing number of older people would need institutional long-term care – with considerable costs to the fiscus. It was, therefore, crucial to encourage governments and stakeholders to support modifications of living arrangements for older people and provide access to knowledge and training on new technologies, particularly digitalization and information technology. This would ensure that older people remained independent for longer periods, especially if supported health facilities near their homes.

Willie Mongin, an MP from Malaysia, said governments needed to formulate and implement necessary measures to ensure that social systems are ready to meet the older adult’s needs, improve their lives and the well-being of their families and communities – so they can live their lives with dignity. With the World Bank, Malaysia was formulating a strategic plan or blueprint to address an aging population’s impact, including economic growth, productivity, social protection, and health care.

Mori told IPS it was important to note that “older persons are a quite diverse population. Some of the wealthiest persons are among the older population. The health status of older persons is quite different depending upon the individual. Any country should have basic social security infrastructure based on the needs and demands of the population, not solely on the age of a person.”

He also said governments should take into account the older persons’ diversity in their plans to, for example, encourage them to remain in the workplace beyond traditional retirement ages.

“The health, skills, and knowledge of older individuals are diverse, and governments should not plan such economic and labor market policies based on the assumption that older persons are homogenous, Mori said. Recently in Japan, trends show that small and frontline jobs seem to be suitable for older persons (Sakamoto 2022).

Note: The workshop was organized by the Asian Population and Development Association (APDA) and supported by the United Nations Population Fund (UNFPA)

IPS UN Bureau Report


Follow IPS News UN Bureau on Instagram

© Inter Press Service (2023) — All Rights ReservedOriginal source: Inter Press Service



Check out our Latest News and Follow us at Facebook

Original Source

UN teams up with FIFA at Women’s World Cup in score for gender equality — Global Issues

The tournament is expected to be watched by more than two billion people – the largest audience for a single women’s sport in history – offering an opportunity to celebrate women’s achievements in all sports and advocate for gender equality more generally.

Women players continue to struggle with fewer professional opportunities, fewer brand sponsorships, less media coverage, unequal playing conditions and a large pay gap, compared to the men’s game.

When women players do succeed, they regularly face abuse both online and in person, underscored the UN gender equality agency.

Eyes on the prize

To address some of these challenges, FIFA has increased the prize money for the 2023 Women’s World Cup to $150 million, tripling the amount awarded in 2019.

FIFA and the UN have also launched their Football Unites the World campaign aiming to highlight major gender equality issues both on and off the field.

Under this umbrella, UN Women has partnered with FIFA on two calls to action that will feature prominently throughout the tournament. The first, Unite for Gender Equality, seeks to recognize gender equality as a fundamental human right and as critical for a peaceful and sustainable world. The second, Unite for Ending Violence against Women, serves as a call to end violence and abuse worldwide.

Unite for Gender Equality will be the featured message on the third day of competition while the call to action again violence will be front and centre during the semi-finals.

The two calls to action will be promoted via the team captains’ armbands, pitch-side digital LED boards, and social media.

Five other UN agencies have also joined the campaign in addition to UN Women, including UNESCO, UNHCR, UN Human Rights Commission, the World Food Programme, and the World Health Organization.

‘Inspirational’ strength and skill

“The women competing in this World Cup are role models for every girl on this planet,” said UN Women Executive Director Sima Bahous.

“Their strength and skills are inspirational. At the same time, this tournament is a reminder that there are too many women and girls who are excluded from the world of sport, and that even for those who do participate, too often experience discriminatory treatment and, even in some cases, abuse”, added the UN gender equality champion.

“The Women’s World Cup shows us how much not only they but the whole world misses out on when we fail to afford women and girls the same opportunities as men and boys. Our partnership with FIFA, including on the global ‘Football Unites the World’ campaign, reflects a serious commitment and ambition to address that for everyone’s benefit.”

Donations towards these initiatives that will help UN Women in the fight for gender equality and the empowerment of women and girls in sport, can be made here.

Check out our Latest News and Follow us at Facebook

Original Source

Marginalising Key Populations Impacting Efforts to End HIV/AIDS Epidemic — Global Issues

A transgender person participates in health services provided by the Khmer HIV/AIDS NGO Alliance (KHANA) in Phnom Penh, Cambodia, December 2019. Credit: UNAIDS
  • by Ed Holt (bratislava)
  • Inter Press Service

BRATISLAVA, Jul 14 (IPS) – A report released this week has highlighted how continuing criminalisation and marginalisation of key populations are stymying efforts to end the global HIV/AIDS epidemic.

The report from UNAIDS, entitled ‘The Path that Ends AIDS’, says that ending AIDS is a political and financial choice, and that in countries where HIV responses have been backed up by strong policies and leadership on the issue, “extraordinary results” have been achieved.

It points to African states that have already achieved key targets aimed at stopping the spread of HIV and getting treatment to people with the virus. It also points out that a further 16 other countries, eight of them in sub-Saharan Africa which accounts for 65% of all people living with HIV, are close to doing so.

But the report also focuses on the devastating impact HIV/AIDS continues to have and how alarming rises in new infections in some places are being driven largely by a lack of HIV prevention services for marginalised and key populations and the barriers posed by punitive laws and social discrimination.

“Countries that put people and communities first in their policies and programmes are already leading the world on the journey to end AIDS by 2030,” said Winnie Byanyima, Executive Director of UNAIDS.

Estimated adults and children living with HIV. Credit: UNAIDS

Experts and groups working with key populations have long warned of the effect that the stigmatisation, persecution and criminalisation of certain groups has on the AIDS epidemic.

They point to how punitive laws can stop many people from accessing vital HIV services.

Groups working with people with HIV in Uganda, which earlier this year passed anti-LGBTQI legislation widely considered to be some of the harshest of its kind ever implemented (it includes the death penalty for some offences), say service uptake has fallen dramatically.

“The law has had a very negative effect in terms of health,” a worker at the Ugandan LGBTQI community health service and advocacy organisation Icebreakers told IPS.

“Community members are threatened by violence and abuse by the public; many are afraid to go out. HIV service access points are now seen by LGBTQI community members as places where they will be arrested or attacked,” he said.

Speaking on condition of anonymity, the worker added: “This is going to affect adherence to treatment and will be bad for the spread of HIV. Some people are being turned away at service centres, including places where people go for ARV refills, because although the president has declared that treatment will continue for members of the community, there are individuals at some centres who say the law has been passed, and so they don’t need to give treatment to members of the community.”

Estimated number of adults and children newly infected with HIV. Credit: UNAIDS

Groups working with people with HIV in other countries where strict anti-LGBTQI laws have been introduced have also warned that criminalisation of the minority will only worsen problems with the disease.

In Russia, which has one of the world’s worst HIV/AIDS epidemics, anti-LGBTQI legislation brought in last year has effectively made outreach work illegal, potentially severely impacting HIV prevention and treatment. Widespread antipathy to the community also forces many LGBTQI people living with HIV to lie to doctors about how they acquired the disease, meaning the epidemic is not being properly treated.

A worker at one Moscow-based NGO helping people with HIV told IPS: “What this means is that the right groups in society are not being targeted , and so the epidemic in Russia is what it is today.”

Harsh legislation, conservative policies and state-tolerated stigmatisation also impact another key population – drug users.

Countries in regions where drug use is the primary or a significant driver of the epidemic, such as Eastern Europe and Central Asia and Asia and the Pacific, drug users often struggle to access harm reduction and HIV prevention services. They fear arrest at needle exchange points, attacks from a general public which often views them negatively, and prejudice and stigmatisation from workers within the healthcare system.

At the same time, in states with harsh laws targeting the LGBTQI community, drug users, sex workers or other vulnerable groups, civil society organisations helping those populations are also affected by the legislation, meaning that vital HIV prevention and treatment services they provide are hampered or halted completely.

And these problems are not confined to a handful of states. The UNAIDS report states that laws that criminalize people from key populations or their behaviours remain on statute books across much of the world. The vast majority of countries (145) still criminalize the use or possession of small amounts of drugs; 168 countries criminalize some aspect of sex work; 67 countries criminalize consensual same-sex intercourse; 20 countries criminalize transgender people; and 143 countries criminalize or otherwise prosecute HIV exposure, non-disclosure or transmission.

Consequently, the HIV pandemic continues to impact key populations more than the general population. In 2022, compared with adults in the general population (aged 15-49 years), HIV prevalence was 11 times higher among gay men and other men who have sex with men, four times higher among sex workers, seven times higher among people who inject drugs, and 14 times higher among transgender people.

Ann Fordham, Executive Director at the International Drug Policy Consortium, told IPS there was an “urgent need to end the criminalisation of key populations”.

“Data shows HIV prevalence among people who use drugs is seven times higher than in the general population, and this can be directly attributed to punitive drug laws which drive stigma and increase vulnerability to HIV. It is devastating that despite evidence that these policies are deeply harmful, the majority of countries still criminalise drug use or the possession of small quantities of drugs,” she said.

But it is not just minorities which are disproportionately affected by HIV.

Globally, 4,000 young women and girls became infected with HIV every week in 2022, according to the report.

The problem is particularly acute in the sub-Saharan Africa region, where there is a lack of dedicated HIV prevention programmes for adolescent girls and young women and where across six high-burden countries, women exposed to physical or sexual intimate partner violence in the previous year were 3.2 times more likely to have acquired HIV recently than those who had not experienced such violence.

Research has suggested that biological, socio-economic, religious, and cultural factors are behind this disproportionately high risk of acquiring HIV. Many girls and young women in the region are economically marginalized and therefore struggle to negotiate condom use and monogamy. Meanwhile, a predominantly patriarchal culture exacerbates sexual inequalities.

“For girls and women in Africa, it is general inequalities which are driving this pandemic. It is social norms which don’t equate men and women, girls and boys, it is norms which tolerate sexual violence, where a girl is forced to have unprotected sex, and that is then dealt with quietly rather than tackling the abuser,” Byanyima said at the launch of the report.

UNAIDS officials say that promoting gender equality and confronting sexual and gender-based violence will make a difference in combatting the spread of the disease, but add that specific measures aimed at young women and girls, and not just in sub-Saharan Africa, are also important.

“ services are not designed for young women in many parts of the world – for instance, girls cannot access HIV testing or treatment without parental consent up to a certain age in some countries,” Keith Sabin, UNAIDS Senior Advisor on Epidemiology, told IPS.

“A lack of comprehensive sexual education is a tremendous barrier in many places. It would go a long way to improving the potential for good health among girls,” he added.

But while the report highlights the barriers faced by key populations, it also shows how removing them can significantly improve HIV responses.

It cites examples from countries from Africa to Asia to Latin America where evidence-based policies, scaled-up responses and focused prevention programmes have reduced new HIV infections and AIDS-related deaths, while some governments have integrated addressing stigma and discrimination into national HIV responses.

It also noted that progress in the global HIV response has been strengthened by ensuring that legal and policy frameworks enable and protect human rights, highlighting several countries’ removal of harmful laws in 2022 and 2023, including some which decriminalized same-sex sexual relations.

“Studies strongly suggest a better uptake of services among men who have sex with men (MSM) in countries where homosexuality has been decriminalised or is less criminalised. A certain policy environment can improve uptake and outcomes,” said Sabin.

The UNAIDS report calls on political leaders across the globe to seize the opportunity to end AIDS by investing in a sustainable response to HIV, including effectively tackling the barriers to prevention and services faced by key populations.

Experts agree this will be crucial to ending the global epidemic.

“We have long known that we will not end AIDS without removing these repressive laws and policies that impact key populations. Today, UNAIDS is once again sounding the alarm and calling on governments to strengthen the political will, follow the evidence and commit to removing the structural and social barriers that hamper the HIV response,” said Fordham.

IPS UN Bureau Report


Follow IPS News UN Bureau on Instagram

© Inter Press Service (2023) — All Rights ReservedOriginal source: Inter Press Service



Check out our Latest News and Follow us at Facebook

Original Source

Security Council urged to address ‘most silenced and least condemned crime’ — Global Issues

“Every new wave of warfare brings with it a rising tide of human tragedy, including new waves of war’s oldest, most silenced and least condemned crime,” she said.

The Council meeting to examine implementation of its resolutions on conflict-related sexual violence was convened by the United Kingdom, which holds the rotating presidency this month.

Meetings survivors in DRC

Ms. Patten presented data from her latest report, published last month, which documented 2,455 UN-verified cases of wartime rape committed during 2022. Women and girls accounted for 94 per cent, with six per cent against men and boys.

The Democratic Republic of the Congo (DRC) was again the country with the highest number of cases, 701. The UN expert visited the country in June and was horrified by the testimonies of women and girls, many of whom had been very recently raped.

“So many of them stressed the daily risk of sexual violence while carrying out livelihood activities around the camps, such as searching for food, collecting wood or water. Just imagine facing the reality each day that you are likely to be raped, yet having no choice,” she said.

Visit to Ukraine

Ms. Patten also conducted her first field visit to Ukraine last year. She was struck by both the occurrence of sexual violence in conflict zones and the vulnerability of women and children forced to flee to countries such as Poland and Moldova.

“I witnessed first-hand the extraordinary toll on women, children and the elderly, including their vulnerability to unscrupulous individuals and criminal networks for whom the rapid and unprecedented mass displacement of people is not a tragedy but an opportunity for trafficking and sexual exploitation,” she said.

Impunity going unpunished

Ms. Patten’s annual report also detailed horrors committed in other countries, such as Haiti, Ethiopia and Iraq. Serious allegations of conflict-related sexual violence in Sudan have also surfaced since fighting erupted in April.

The report also clearly demonstrates the emboldening effects of impunity, she said. Nearly 50 parties, mostly non-State actors, are listed for systematically committing sexual violence. More than 70 per cent have appeared on the list for five years or more.

“The reality is that until we effectively raise the cost and consequences for committing, commanding or condoning sexual violence, we will never stem the tide of such violations,” she said.

Resolve and resources

Ms. Patten called for greater political resolve and resources. She said there is more knowledge today about what motivates sexual violence, who the perpetrators are, and the response required by survivors.

It is essential that prevention efforts are grounded in this enhanced knowledge, she said, which is at the heart of a strategy launched by her office last September.

She advised that the international community must ensure implementation of Security Council resolutions while adapting actions to today’s conflicts and emerging global challenges, such as cyber threats and climate-related insecurity.

“The time is now to double down on the institutional and accountability frameworks put in place by successive resolutions,” she said. “We must act urgently, and with sustained resolve, to save succeeding generations from this scourge.”

Check out our Latest News and Follow us at Facebook

Original Source

Scourge of racism haunts Black women and girls seeking healthcare — Global Issues

“The scourge of racism continues for Black women and girls in the Americas, many of whom are descendants of the victims of enslavement,” Natalia Kanem, Executive Director of the UN Population Fund (UNFPA), said in a news release.

“Too often, Afrodescendent women and girls are abused and mistreated, their needs are not taken seriously, and their families are shattered by the preventable death of a loved one during childbirth. Justice and equality will only be possible when our healthcare systems see these women and provide them with respectful, compassionate care.”

From abuse to denial of care

According to UNFPA, the mistreatment faced by Afrodescendent women when receiving health care ranges from verbal and physical abuse to denial of quality care and refusal of pain relief.

As a consequence, they face increased complications during pregnancy and delayed interventions, which too often result in death.

These findings are contained in the report Maternal Health of Women and Girls of African Descent in the Americas, developed in collaboration with the Pan American Health Organization, the National Birth Equity Collaborative, and UN agencies UNICEF and UN-Women.

The report also noted that Afrodescendants experience disproportionate levels of mistreatment in health settings, some of which is based on unscientific, racist and slave-era beliefs still present in medical training practices.

Disparity ‘most extreme’ in the US

According to the report, the disparity is most extreme in the United States, where Black women and girls are three times more likely to die while giving birth or within six weeks of giving birth compared to non-Afrodescendent and non-Hispanic women.

Maternal deaths also persist regardless of income and education levels, with maternal deaths among African American college graduates still 1.6 times higher than among white women with less than a high school diploma.

In the wider Americas region, where are there are an estimated 209 million people of African descent, only 11 out of 35 countries collect maternal health data broken down by race.

Call to address racist ideology

To address the situation and save lives, UNFPA urged governments to collect and analyze robust health data broken down by race and ethnicity.

It also called on medical schools to address racist ideology in training curricula and calls on hospitals to establish policies to end physical and verbal abuse damaging Afrodescendent women and girls.

Check out our Latest News and Follow us at Facebook

Original Source

UN calls for gender equality push, central to SDGs — Global Issues

“Halfway to the 2030 deadline the Sustainable Development Goals are dangerously off track,” he warned. “Gender equality is almost 300 years away. Progress on maternal health and access to family planning has been glacial.”

World Population Day is commemorated annually on 11 July and this year’s focus is on unleashing the power of gender equality and giving greater voice to women and girls.

Invest in women

Although they comprise half of all people on the planet, women and girls are often ignored in discussions on demographics, with their rights violated in population policies, according to the UN.

As a result, women and girls can be limited in their ability to make decisions about their own health and sexual and reproductive lives, which in turn heightens their vulnerability to violence, harmful practices, and preventable maternal death.

The Secretary-General said gender-based discrimination harms everyone, while investing in women uplifts all people, communities, and countries.

“Advancing gender equality, improving maternal health, and empowering women to make their own reproductive choices are both essential in themselves, and central to achieving all the Sustainable Development Goals (SDGs),” he added.

Mr. Guterres called for standing with women and girls fighting for their rights and for intensifying efforts “to make the Sustainable Development Goals a reality for all 8 billion of us”.

Harness the power

What women and girls want matters, according to the UN’s sexual and reproductive health agency, UNFPA.

World Population Day is a reminder that a more prosperous, peaceful, and sustainable future can be achieved “if we harness the power of every human being on the planet”, said Dr. Natalia Kanem, the UNFPA Executive Director.

Her message for the Day highlighted that over 40 per cent of women around the world cannot exercise their right to make decisions as fundamental as whether or not to have children.

Gender equality benefits all

“Empowering women and girls, including through education and access to modern contraception, helps to support them in their aspirations and to chart the path of their own lives,” she said.

Dr. Kanem stressed that advancing gender equality is a crosscutting solution to many social problems.

She said for ageing societies worried about labour productivity, achieving gender equality in the workplace represents the most effective way to improve output and economic growth.

“Meanwhile, in countries experiencing rapid population growth, women’s empowerment through education and family planning can bring enormous benefits by way of human capital and inclusive economic growth,” she added.

Dr. Kanem said the solution is clear, as “accelerating the advancement of gender equality – through access to sexual and reproductive health and rights, improved education, appropriate labour policies, and equitable norms in the workplace and home – will result in healthier families, stronger economies, and resilient societies.”

Check out our Latest News and Follow us at Facebook

Original Source

Wood Smoke Continues to Make Women Sick in El Salvador — Global Issues

Cecilia Menjivar, a tortilla maker in San Salvador, the capital of El Salvador, takes a break from cooking corn in a pot that is one meter high and 50 centimeters in diameter, heated by a wood stove. Many women in urban and rural areas run these small businesses, aware of the damage to their health caused by the smoke, but the economic situation forces them to use firewood, which is much cheaper than liquefied gas. CREDIT: Edgardo Ayala / IPS
  • by Edgardo Ayala (san luis la herradura, el salvador)
  • Inter Press Service

SAN LUIS LA HERRADURA, El Salvador, Jul 04 (IPS) – Using a few dry sticks as fuel, Margarita Ramos of El Salvador lit the fire in her wood stove and set about frying two fish, occasionally fanning the flame, aware that the smoke she inhaled could affect her health.

“I know that the smoke can damage my lungs, because that’s what I’ve heard on the news, but what can I do?” Ramos told IPS, standing next to her stove in the courtyard of her home in El Zapote, a village of 51 families in the coastal municipality of San Luis La Herradura, in the southern Salvadoran department of La Paz.

Firewood, the fuel of the poor

“I cook with firewood out of necessity, because I don’t always have a job or money to buy gas,” added Ramos, 44, referring to liquefied gas, a petroleum derivative used for cooking in 90.6 percent of Salvadoran homes, according to official data.

This is the situation faced by many women in El Salvador and other parts of the world, especially in the countryside, where dire economic conditions as well as ingrained habits and traditions lead families to cook with firewood, with negative repercussions on their health.

The World Health Organization (WHO) estimated that in 2019 approximately 18 percent of global deaths were due to chronic obstructive pulmonary disease and 23 percent to acute respiratory infections.

Ambient pollution, including wood smoke, plays a decisive role in respiratory diseases, especially among rural women, who do the cooking in line with the roles of patriarchal culture.

Back in 2004 the WHO warned that about 1.6 million people were dying annually from charcoal and wood smoke used in cooking stoves in many developing countries.

In El Salvador, 29,365 cases of acute respiratory infections per 100,000 inhabitants were reported in 2022, well above the 19,000 reported in 2021. Pneumonia reached 365 cases per 100,000 inhabitants in the same period, and the case fatality rate stood at 13.6 percent, up from 11.4 percent the previous year.

Ana Margarita Ramos fries two fish for dinner on a wood stove in El Zapote, a coastal village located in the municipality of San Luis La Herradura, in the Salvadoran department of La Paz. Due to economic difficulties she frequently has to cook with firewood, and she fears that she might get asthma from exposure to the smoke. CREDIT: Edgardo Ayala / IPS

Ramos showed IPS the gas stove she has inside her house, with a cylinder that lasts approximately 40 days.

But when the gas runs out and she can’t afford to refill the cylinder, she has to cook with her wood stove. In her courtyard she has a table in a makeshift shed, where she keeps the wood and a metal structure that holds her pots and pans.

Official figures indicate that 5.9 percent of households in this Central American country use firewood for cooking.

However, in rural areas the proportion rises to 12.9 percent, while 84.4 percent cook with gas and the rest use electricity and other systems.

Ramos, 44, has no steady job and as a single mother, scrambles to provide for the needs of her two children.

Twice a week she cleans upscale apartments at a resort near her home, in Los Blancos, a well-known beach on El Salvador’s Pacific coast, also in La Paz. When she does well she cleans two a day, earning 24 dollars.

Sometimes she also washes other families’ clothes.

“Right now I have run out of gas, I have to use firewood,” she said. A cylinder of liquefied gas costs between 12 and 14 dollars.

She generally collects firewood on the banks of the estuary, from the branches of mangrove trees, since hers and other poor families live in a shantytown located between the Pacific Ocean and the Jaltepeque estuary, one of the country’s main wetlands.

Poverty affects 26.6 percent of the population at the national level in this small Central American country of 6.7 million inhabitants, according to official figures. But in rural areas the proportion rises to 29.6 percent, and of these, 10.8 percent live in extreme poverty.

At her house in the coastal village of El Zapote, Ana Margarita Ramos luckily has a yard where she has set up her wood stove, thus reducing her exposure to smoke, in a country like El Salvador where many women suffer from respiratory diseases due to the effects of cooking with firewood. CREDIT: Edgardo Ayala / IPS

Cutting costs with firewood

Meanwhile in San Salvador, the country’s capital, Cecilia Menjívar runs her small tortilla-making business partly by using firewood, which she collects from tree branches around the Los Héroes community where she lives.

She also uses wood left over from construction sites and sometimes buys it as well, at a cost of one dollar for about three “rajas” or axe-cut tree branches.

Tortillas are round flat bread made from corn dough, which are baked on metal plates generally heated with the flame from liquefied gas.

But Menjívar does not use gas to cook the 68 kg of corn she uses daily to run her business, as she can’t afford it.

“That’s why we prefer firewood. We don’t like it, first of all because of the damage to our health, and also because our clothes are impregnated with the smell of smoke and the walls of the house too, they look dirty,” Menjívar, 58, told IPS.

“We do it to save on the cost, which would be very high, and we wouldn’t make any profit,” she added, while behind her the 68 kg of corn for the day rattled in a boiling pot, black from the wood smoke.

Tortillas are part of the staple diet of the Salvadoran population. Most households cook their food on gas stoves, but they don’t make their own tortillas, because it is a complex and time-consuming process.

That is why so many women, like Menjívar, go into the tortilla business to meet the high level of demand, cooking the corn on wood stoves, usually located in the open air in their courtyards.

But during the May to November rainy season, they cook the corn inside the house, in a back room.

Because of the amount of corn and the size of the pot, the improvised wood stove made of wood and a metal structure has to be set on the floor.

The tortilla business has shrunk, she added, due to the increase in the cost of corn, which climbed from 15 dollars per quintal (45 kg) to 32 dollars.

“With this business we earn enough to buy our food and other basic things, but not for other expenses,” she said.

One of Ana Margarita Ramos’ two sons, in El Zapote, a coastal settlement in southern El Salvador, stands near the firewood that is always on hand in case they can’t afford to buy liquefied gas. About 13 percent of rural Salvadoran households cook with firewood, which poses serious health risks. CREDIT: Edgardo Ayala / IPS

Chronic bronchitis and pneumonia

Menjívar said that she fell ill with pneumonia in 2022, and she did not rule out that the cause could have been precisely the smoke she has been inhaling for decades, although she pointed out that the doctors who treated her did not inquire about it.

“Since I was a little girl I have been exposed to smoke, because my mother also used to make tortillas using firewood,” she said. “When she couldn’t find dry branches, my mom would burn anything: old shoes, old clothes or paper.”

When she got pneumonia, she had to stop working for three months, and she had to leave the business in the hands of her teenage daughter.

Burning firewood releases toxic gases and polluting particles that end up causing ailments that in medical terminology are grouped together as chronic obstructive pulmonary disease, pulmonologist Carmen Elena Choto told IPS. These gases include carbon monoxide and nitrogen dioxide.

“We also see other harmful particles, there may even be hydrocarbons, because they not only burn wood, but also dry cow dung, corncobs, paper, anything to make the fire,” said the expert.

Damage to the bronchi, or chronic bronchitis, and to the alveoli in the lungs, or pulmonary emphysema, are some of the diseases associated with exposure to smoke, including tobacco smoke, she added.

“Due to the burning of biomass (firewood and other products), the most frequent disease is chronic bronchitis,” said Choto, and older women are the main victims.

People with bronchitis have a constant cough “or wheezing or shortness of breath because there is obstruction due to mucus plugs in the airway,” she said.

Patients, she added, feel tired and suffer from dyspnea or shortness of breath from low oxygen levels, which in severe cases requires hospital care.

Menjívar began to feel these symptoms after spending years making tortillas.

“I felt very tired, I suffered from hot flashes, I was short of breath, I felt like I was having a hard time breathing,” she said.

After she was diagnosed with pneumonia, Menjívar stopped working for three months.

“That’s why I try to stay farther away from the smoke now,” she said. “But the smoke spreads through the house.”

For her part, Ramos, in her coastal village, has put her stove in the yard outdoors, to reduce exposure to smoke. She worries that she could suffer from asthma, like her sister.

A resident of the coastal hamlet of El Salamar, in the municipality of San Luis La Herradura in southern El Salvador, cooks pasta for lasagna on an ecological stove called a “rocket”, which is much more efficient in producing heat and emits less smoke. This kind of stove has been used for decades in rural communities in the country, with good results in alleviating the health risks posed by wood stoves. But they have not become widespread, due to a lack of government investment and campaigns to encourage their use. CREDIT: Edgardo Ayala / IPS

Eco-stoves, an alternative

One possible answer to reduce exposure to smoke, especially in rural areas, is the spread of eco-stoves, which due to their combustion mechanism are more efficient in producing energy and release less smoke.

These stoves have been around for decades in developing countries, including El Salvador, but they have not yet become widespread enough to make a difference, at least in this country.

There are socio-cultural aspects that hinder the expansion of the stoves and lead to the continued use of wood-burning stoves, environmentalist Ricardo Navarro, of the Salvadoran Center for Appropriate Technology, a local affiliate of the international organization Friends of the Earth, told IPS.

For example, he mentioned the practice by small farmers of placing corn or beans on bamboo or wooden platforms on top of wood stoves, so that the smoke prevents insects from eating the food.

“The problem is that sometimes we approach the issue as an energy or health problem, without considering these socio-cultural aspects,” Navarro said.

© Inter Press Service (2023) — All Rights ReservedOriginal source: Inter Press Service

Check out our Latest News and Follow us at Facebook

Original Source

Exit mobile version