Complete Wellness

“Migration is a right,” read the handkerchiefs held by two women at a demonstration in the Argentine capital for migrants’ rights. At left is Natividad Obeso, a Peruvian who came to Buenos Aires in 1994, fleeing political violence in her country. CREDIT: Camilo Flores / ACDH

BUENOS AIRES, Jul 27 2023 (IPS) – Remi Cáceres experienced gender-based violence firsthand. She struggled, got out and today helps other women in Argentina to find an escape valve. But because she is in a wheelchair and is a foreign national, she says the process was even more painful and arduous: Being a migrant with a disability, it s two or three times harder. You have to empower yourself and it s very difficult.

When she came to Buenos Aires from Paraguay, she was already married and had had her legs amputated due to a spinal tumor. She suffered violence for several years until she was able to report her aggressor, got the police to remove him from her home and raised her two daughters watching after parked cars for spare change in a suburb of the capital “The places where women victims of gender-based violence are given assistance are not accessible to people who are in wheelchairs or are bedridden. And the shelters don’t know what to do with disabled women. Recently, a woman told me that she was sent back home with her aggressor.” — Remi Cáceres

On the streets she met militant members of the , one of the central unions in this South American country, who encouraged her to join forces with other workers, to create cooperatives and to strengthen herself in labor and political terms. Since then she has come a long way and today she is the CTA s Secretary for Disability.

The places where women victims of gender-based violence are given assistance are not accessible to people who are in wheelchairs or are bedridden. And the shelters don t know what to do with disabled women. Recently, a woman told me that she was sent back home with her aggressor, Remi told IPS.

From her position in the CTA, Remi is one of the leaders of a project aimed at seeking information and empowering migrant, transgender and disabled women victims of gender violence living in different parts of Argentina, for which 300 women were interviewed, 100 from each of these groups.

The data obtained are shocking, since eight out of 10 women stated that they had experienced or are currently experiencing situations of violence or discrimination and, in the case of the transgender population, the rate reached 98 percent.

Most of the situations, they said, occurred in public spaces. Almost 85 percent said they had experienced hostility in streets, squares, public transportation and shops or other commercial facilities. And more than a quarter (26 percent) mentioned hospitals or health centers as places where violence and discrimination were common.

One of the trainings held by the Wonder Women Against Violence project. On the left is Remi Cáceres, who escaped domestic violence and today is Secretary of Disability at the Central de Trabajadores Argentinos central trade union. CREDIT: María Fernández / ACDH

Another interesting finding was that men are generally the aggressors in the home or other private settings, but in public settings and institutions, women are the aggressors in similar or even higher proportions.

The study was carried out by the , an NGO that has been working to prevent violence in Argentina since 2002, with the participation of different organizations that represent disabled, trans and migrant women s groups in this Southern Cone country.

It forms part of a larger initiative, dubbed , which has received financial support for the period 2022-2025 from the . Since 1996, this fund has supported projects in 140 countries for a total of 215 million dollars.

The initiative includes trainings aimed at providing tools for access to justice to the most vulnerable groups, which began to be offered in 2022 by different organizations to more than 1,000 women so far.

Courses have also been held for officials and staff of national, provincial and municipal governments and the judiciary, with the aim of raising awareness on how to deal with cases of gender violence.

María José Lubertino, president of the Citizen Association for Human Rights, takes part in a feminist demonstration in Buenos Aires. Lubertino coordinates the project on violence against disabled, transgender and migrant women in Argentina that runs from 2022 to 2025. CREDIT: Camilo Flores / ACDH

Fewer complaints

Argentina has made great progress in recent years in terms of laws and public policies on violence against women, but despite this, one woman dies every day from femicide (gender-based murders), ADCH president María José Lubertino told IPS.

In this case, we decided to work with forgotten women. We were struck by the fact that there were very few migrant, trans and disabled women in the public registers of gender-violence complaints. We discovered that they do not suffer less violence, but that they report it less, she added.

Lubertino, a lawyer who has chaired the governmental , argues that these are systematically oppressed and discriminated groups that, in her experience, face their own fears when it comes to reporting cases: migrants are afraid of reprisals, trans women assume that no one will believe them and disabled women often want to protect their privacy.

Indeed, the research showed that 70 percent of trans, migrant and disabled women who suffered violence or discrimination did not file a complaint.

Many spoke of wanting to avoid the feeling of wasting their time, as they felt that the complaint would not have any consequences.

Each group faces its own particular hurdles. Migrant women experience discrimination especially in hospitals. Transgender people, in addition to suffering the most aggression (sometimes by the police), suffer specifically from the fact that their chosen identity and name are not recognized. Disabled women say they are excluded from the labor market.

More than three million foreigners live in this country of 46 million people, according to last November s data from the . Almost 90 percent of them are from other South American countries, and more than half come from Paraguay and Bolivia. Peru is the third most common country of origin, accounting for about 10 percent.

Of the total number of immigrants, 1,568,350 are female and 1,465,430 are male.

As for people with disabilities, the official registry included more than 1.5 million people by 2022, although it is estimated that there are many more.

Since 2012, a recognizes the legal right to change gender identity in Argentina and by April 2022, 12,665 identification documents had been issued based on the individual s self-perceived identity. Of these, 62 percent identified as female, 35 percent as male and three percent as non-binary.

Women participate in one of the trainings on gender-based violence in Buenos Aires. The project is carried out by the Citizen Association for Human Rights with financial support from the UN Trust Fund to End Violence against Women. CREDIT: Camilo Flores / ACDH

Different forms of violence

Yuli Almirón has no mobility in her left leg as a result of polio. She is president of the Argentine Polio-Post Polio Association (APPA), which brings together some 800 polio survivors. Yuli is one of the leaders of the trainings.

Through the trainings, those of us who participated found out about many things, she told IPS. We heard, for example, about many cases related to situations of power imbalances. Women with disabilities sometimes suffer violence at the hands of their caregivers.

The most surprising aspect, however, has to do with the restrictions on access to public policies to help victims of gender-based violence.

The runs the Acompañar Program, which aims to strengthen the economic independence of women and LGBTI+ women in situations of gender-based violence.

The women are provided the equivalent of one monthly minimum wage for six months, but anyone who receives a disability allowance is excluded.

We didn t know those were the rules. It s a terrible injustice, because disabled victims of violence are the ones who most need to cut economic dependency in order to get out, said Almirón.

Another of the project s partner organizations is the H. Its founder is Natividad Obeso, a Peruvian woman who fled the violence in her country in 1994, during the civil war with the Shining Path guerrilla organization.

Back then Argentina had no rights-based immigration policy. There was a lot of xenophobia. I was stopped by the police for no reason, when I was going into a supermarket, and they made me clean the whole police station before releasing me, she said.

Natividad says that public hospitals are one of the main places where migrant women suffer discrimination. When a migrant woman goes to give birth they always leave her for last, she said.
Migrant women suffer all kinds of violence. If they file a complaint, they are stigmatized. That s why they don t know how to defend themselves. Even the organizations themselves exclude us. That is why it is essential to support them, she stressed.

Zoltán Kálmán is Permanent Representative of Hungary to the Rome-based UN agencies (FAO, IFAD, WFP). He was President of the WFP Executive Board in 2018.

ROME, Feb 10 2020 (IPS) – Reducing poverty and inequalities, eliminating hunger and all forms of malnutrition and achieve food security for all – these are some of the most important objectives of the Sustainable Development Goals. Still, the rate of poverty and inequalities is increasing and over 820 million people are going hungry. In addition, 2 billion people in the world are food insecure with great risk of malnutrition and poor health. This alarming situation is further aggravated by current trends such as the rate of population growth, impacts of climate change, loss of biodiversity, soil degradation and many others. Transition to more sustainable food systems can provide adequate solutions to all these challenges. Pulses could play an important role in this transition, having nutritional and health benefits, low environmental footprint, and positive socio-economic impacts as well. What is required to promote and support the production and consumption of more pulses? This question is particularly relevant now, since 10 February is the World Pulses Day.

Following the successful implementation of the International Year of Pulses (IYP) 2016, the Government of Burkina Faso took the initiative and proposed the establishment of World Pulses Day (WPD). Under Resolution A/RES/73/251, the UN General Assembly (UNGA) designated 10 February as World Pulses Day to reaffirm the contribution of pulses for sustainable agriculture and achieving the 2030 Agenda. WPD is a new opportunity to heighten public awareness of the multiple benefits of pulses. Pulses are more than just nutritious seeds, they contribute to sustainable food systems and a ZeroHunger world. The UNGA has invited FAO, in collaboration with other organizations, to facilitate the observance of WPD.

The topic of this year’s WFD celebration is “Plant proteins for a sustainable future”. According to FAO data, pulses are an important source of plant-based protein, providing on average two to three times more protein than staple cereals such as rice and wheat on a gram-to-gram basis. Additionally, the amino acids found in pulses complement those found in cereals. Protein is crucial for physical and cognitive development during childhood. Pulses are nutrient-dense, providing substantial amounts of micronutrients that are essential for good health. They are a good source of iron and can play an important role in preventing iron deficiency anaemia. They also provide other essential minerals such as zinc, selenium, phosphorous and potassium and are an important source of B vitamins, including folate (B9), thiamine (B1) and niacin (B3). The high B vitamin content of some pulses is of particular benefit during pregnancy as it supports the development of the foetus’ nerve function.

Pulses have a number of well-known agronomic benefits as well. They can fix nitrogen, improving soils’ organic content and reduce fertilizer needs, thus contributing to mitigating climate change impacts. Pulses increase productivity through appropriate crop rotation or intercropping. Producing a wide variety of pulses has an important role in preserving biodiversity. Pulses have very low water footprint, which is an essential feature particularly in dry areas.

These are well-known scientific and empirical evidences and I think we can simply say pulses are good both for the health of people and for the health of the planet.

Pulses are important also from socio-economic point of view, including income diversification, providing employment opportunities, improving livelihood in rural areas, etc.

Having all the nutritional and health benefits, having a numerous positive agronomic impacts, as well as the favourable socio-economic implications, why pulses do not have appropriate place in our production and consumption patterns? I can give you my answer: because of the lack of appropriate policy environment for the production and consumption of pulses.

As we know, farmers, in particular family farmers are the producers of our food and they are the best custodians of our land and other natural resources, including biodiversity, to preserve them for future generations. Family farmers have the traditional knowledge and experience, combined with innovative solutions to do farming sustainably. At the same time, farmers are also very clever and smart: their decisions to follow one or another farming method depends on the profit they can realize. To some extent farmers’ profit is linked to the markets, but their profit is mainly the consequence of governments’ policies, to provide subsidies (or policy incentives) to orient farmers’ choices, to ensure the economic viability of farming.

It is generally accepted that governments provide policy incentives to shape their food systems, including orienting farmers’ and consumers’ choices. The important question is whether the appropriate food systems are promoted and supported by these incentives?

As a current prevailing practice, high percentage of farm subsidies supports unsustainable, input-intensive, monoculture farming, with all the well-known negative consequences (biodiversity loss, soil degradation, etc.).

On the other hand, policy incentives can and should promote sustainable solutions, better reflecting the real interests and priorities of governments to preserve soil health and biodiversity, through crop diversification, including the production of a variety of pulses.

To take the right decisions policy makers should be provided with appropriate information, giving due attention to all the positive and negative impacts (the so-called environmental and human health externalities) of the various food systems. These externalities are translated in dollar terms and there are existing scientific studies showing the real costs of environmental damage and the enormous costs of public health expenditure in national budgets, as a consequence of unsustainable food systems.

This true cost accounting principle, based on solid scientific evidence, provides a good basis for taking appropriate decisions which food systems (including production and consumption patterns) should be promoted by national policy incentives. While providing assistance and policy advice to countries, UN organizations (including FAO) should pay due attention to the real costs of food and suggest national policy makers to support and promote sustainable solutions, including the production and consumption of pulses.

Pulses should also receive appropriate attention during the elaboration of the Voluntary Guidelines on Food Systems and Nutrition. This process is going on now, and the Guidelines will be adopted in October this year by the Committee of World Food Security (CFS).

It would also be desirable if the Food System Summit in 2021 could help promote pulses as important elements for the transition towards more sustainable food systems.

Africa is grappling with managing diseases like malaria, HIV/AIDS, and tuberculosis as health systems that are unable to cope with both this and the coronavirus pandemic. Sleeping under a net and taking antimalarial pills helps prevent malaria. Credit: Mercedes Sayagues/IPS

BULAWAYO, Zimbabwe, May 11 2020 (IPS) – Experts across Africa are warning that as hospitals and health facilities focus on COVID-19, less attention is being given to the management of other deadly diseases like HIV/AIDS, tuberculosis and malaria, which affect millions more people.

“Today if you have malaria symptoms you are in big trouble because they are quite close to COVID-19 symptoms, will you go to the hospital when it is said we should not go there?” Yap Boum II, the regional representative for Epicenter Africa, the research arm of Doctors Without Borders, told IPS.

“Hospitals are struggling because they do not have the good facilities and equipment; it will be hard to take in a patient with malaria because people are scared. As a result the management of malaria is affected by COVID-19,” Boum, who is also a Professor of Microbiology at , said, pointing out that HIV/AIDS and tuberculosis were also being ignored.
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In fact, the has warned that four times as many people could die from malaria than coronavirus.

“With COVID-19 spreading, we are worried about its impacts on health systems in Africa and that this may impact negatively on the delivery of routine services, which include malaria control. The bans on movement will affect the health workers getting to health facilities and their safety from exposure,” Akpaka Kalu, team leader of the Tropical and Vector-borne Disease Programme at the WHO Regional Office for Africa, told IPS.

The has urged member countries not to forget malaria prevention programmes as they race to contain the COVID-19 spread. Without maintaining prevention programmes, i.e. should all insecticide-treated net campaigns be suspended and if access to effective antimalarial medicines is reduced because of lockdowns, malaria deaths could double to 769,000 in sub-Saharan Africa this year.  At the same time the agency has predicted that some .

, as of today, May 11, Africa has recorded over 63,000 confirmed COVID-19 cases with 2,283 deaths in 53 affected countries in the region.

Though preventable and treatable, Africa is battling to eliminate malaria despite a decline in cases over the last four years.
The continent has the highest malaria burden in the world, accounting for 93 percent of all cases of the disease.
Malaria is one of the top ten leading causes of death in Africa, killing more 400 000 people annually.

Poorly equipped and understaffed national health services in many countries in Africa could compromise efforts to eliminate the malaria scourge, noted Kalu.

Africa must cope with COVID-19 without forgetting malaria

Mamadou Coulibaly, head of the Malaria Research and Training Center at the University of Bamako, Mali, concurred that the pandemic was straining health systems in developing countries. He urged malaria-endemic countries not to disrupt prevention and treatment programmes.

“To avoid this catastrophic scenario, countries must tailor their interventions to this challenging time, guaranteeing prompt diagnostic testing, treatment, access and use of insecticide-treated nets,” Coulibaly, who is also the principal investigator of Target Malaria in Mali, told IPS. 

Mali is one of the top 10 African countries with the high incidence of malaria.

Malaria needs more national money

Kalu stressed that domestic financing for malaria was needed. He commended the Global Fund to Fight AIDS, Tuberculosis and Malaria and other private sector partnerships that have provided funds for malaria. But he pointed out that this was neither ideal nor sustainable unless national governments contributed a lion’s share to malaria control.

There is a $2 billion annual funding gap when it comes to malaria prevention, which should be closed to sufficiently protect people in malaria affected countries, according to the RBM Partnership to End Malaria, a global private sector initiative established in 1998. The partnership has sourced funding and equipment for malaria prone countries, providing mosquito nets, rapid diagnostic tests and antimalarials.
More action, less talk

While pleased with progress made towards eliminating malaria in Africa since 2008 when the Abuja Declaration on Health investment was signed, Kalu said Africa could do better.

In 2001 African governments drew up the to invest 15 percent of the national budgets in improving health care services.

In countries like Malawi, there are simply not enough mental health professionals to go around. The local faith community can help fill this void. Credit: Unsplash /Melanie Wasser.

BLANTYRE, Malawi, Oct 14 2020 (IPS) – The world is actually in the throes of two pandemics. The first is COVID-19. The second is the wave of stress and anxiety, depression and substance use it has unleashed around the world. Most mental health disorders are treatable.

This so called “” is raging in poor and wealthy countries alike. But across Africa, and in much of the Global South, people facing mental health crises have nowhere to turn.

The reason is that governments and aid agencies are not making the investments needed to provide these services. In the lead up to “World Mental Health Day,” the recently released new statistics on the share of health budgets that nations and international donors devote to mental health.

Fear, and the loss of the livelihoods, loved ones, and companionship, that give life meaning and purpose, are leaving people bereft. The need for mental health counseling and care far exceeds what we are equipped to give. The question is what is to be done?

It is miniscule – between one and two percent – even though the calculates that every US$ 1 invested in scaled-up treatment for common mental disorders such as depression and anxiety returns US$ 5 in improved health and productivity.

On the African continent, the consequences of underinvestment are especially glaring. Here, at least 90% of those with mental health problems are not getting the . My own country, Malawi, illustrates the chasm between what is needed and what we are able to provide. I am one of four registered clinical psychologists here and there are just three psychiatrists.

Malawi has a population of 18 million.

The consequences of untreated mental health problems are serious. According to the released for World Mental Health Day, one person dies every 40 seconds by suicide. And in Malawi, the police have just released new statistics showing suicides between January and August of this year have by 57% compared with the same period last year.

Fear, and the loss of the livelihoods, loved ones, and companionship, that give life meaning and purpose, are leaving people bereft. The need for mental health counseling and care far exceeds what we are equipped to give. The question is what is to be done?

I believe the best, and perhaps only, viable option is to invest in the networks and social support systems that already help troubled people endure suffering and make sense of their lives.

In countries like mine, it is faith leaders that they turn to.

This safety net is already firmly in place. Here, and in many other parts of Africa, faith is woven into everything. Churches or mosques can be found in every village and often on every street corner. Public meetings begin with prayers.

When they encounter personal problems, including depression, anxiety or substance use, people ask faith leaders to help them cope. Faith can often offer strength and solace. Indeed, the link between faith and mental health is well established. Researchers have found correlations between religious faith, and hope, optimism, satisfaction, self-esteem, and a sense of .

But bipolar disorder, clinical depression, and many other ailments require a level of care and intervention that faith leaders are not prepared to offer. Many tell me they are grappling with complex and frightening problems that worry them. One lamented, “all I can do is pray for them and I don’t know what else to do.”

Others perform exorcisms for mental illnesses, trying to get rid of the demons they believe are to blame. The idea that people with psychological or neurological disorders are possessed by demons them further. In these cases, faith traditions can deepen people’s suffering, force them to endure in secret, or be cast out of their communities, and access to treatments that could change or even save their lives.

Faith leaders are already on front lines in countries like mine and this is not about to change. So why not give them the tools to navigate this treacherous terrain? With basic mental health they could learn to recognize, understand, manage, and even prevent mental health disorders. They would know the symptoms of anxiety, depression, or psychosis, the resources available, and where people can go for treatment.

Would African clerics, steeped in religious doctrine and faith, be amenable to this? Those who talk with me not only need, but want this knowledge. Elsewhere, like this are already proving . Studies show that faith leaders have welcomed and benefitted from this kind of training, and that it has the kind of advice they give.

Mental health literacy training already empowers primary care providers to provide patients with the care, information, support, skills, and resources needed to mental health challenges. Governments, aid agencies, and NGOs should create and fund these trainings. Umbrella religious councils and associations should work with them to ensure that the trainings are as useful, relevant, and widely accessible as possible.

The need is overwhelming. In countries like Malawi, there are simply not enough mental health professionals to go around. The local faith community can help fill this void. Armed with more knowledge, faith leaders can play a pivotal role in promoting global mental health and reaching those who desperately need mental health services. The theme of this year’s World Mental Health Day, is “.”

We do need to invest much more, and training faith leaders in mental health literacy is one way we can do it now.

Chiwoza Bandawe is a clinical psychologist with the University of Malawi, College of Medicine. He has several publications in international journals and has published three mental health education books.

Credit: Unsplash /Melanie Wasser.

ABUJA, Jan 22 2021 (IPS) – Dealing with COVID-19-related city lockdowns has been exceptionally stressful, particularly for those parents who have had to balance work, personal life, children and elderly, providing home schooling or facilitating virtual learning, managing infection control within the home, and more, all while being disconnected from support services.

Beyond all this, other play a key role in outcomes for parents and children, including their function and adaptation sociodemographic, exposure, negative events, personality traits, and the experience of death among close family and friends.

It is therefore unsurprising the results of C.S. Mott Children’s Hospital National Poll on .

Clear links exist between mental health indicators and child-parent conflict and closeness, with anxious parents being particularly vigilant to responding to cues of children’s distress by encouraging them to express their opinions and providing support and acceptance of their decisions
The poll is a national sample of parents to rate the top health concerns for U.S. children and teens aged 0-18 years. A breakdown of the results shows the top ten concerns as follows: overuse of social media/screen time (72%); bullying/cyberbullying (62%); Internet safety (62%); unhealthy eating (59%); depression/suicide (54%); lack of physical activity (54%); stress/anxiety (54%); smoking/vaping (52%); drinking or using drugs (50%); and COVID-19 (48%).

The findings also show that parents biggest concerns for young people are associated with changes in lifestyle and mental health consequences of the pandemic.

There are fewer similar studies from the Global South; one study from showed that the quarantine s impact on children’s emotion and behaviour is mediated by the parents’ individual and group stress, with a stronger effect from the latter.

Parents who reported more difficulties in dealing with quarantine showed more stress, which in turn, increased the children s problems. A study from explored work-family balance and social support and their links with parental stress. It revealed that lockdowns can be detrimental to parenting and marital harmony, especially for parents with poor work family balance and weak social support.

Clear exist between mental health indicators and child-parent conflict and closeness, with anxious parents being particularly vigilant to responding to cues of children’s distress by encouraging them to express their opinions and providing support and acceptance of their decisions.

Previous studies have revealed that family structures who hold on their own in difficult times will best thrive and get past pandemic and other similar situations.

India’s lockdown declared without advance notice, saw for economic reasons. The lack of jobs, particularly in the informal sector, lack of resources to enroll children in online schooling and being cut off from health services and public transport made families shift back into joint family structures to support one another in times of uncertainties.

In Nigeria, the most severe impact of the pandemic on parenting is the loss of livelihoods among low-income families who earn daily within the informal economy . Most of them do not own bank accounts and may not have savings. The lockdown impacted these informal sector workers the most and consequently their ability to parent effectively.

Thus, the impact of pandemics on the mental health outcomes of children and their families must be explored as a distinct phenomenon. We suggest three ways to enable this:

Improve access to psycho-social support for families, parents and children during lockdowns in pandemic situations. Globally, there is second wave of the pandemic. In the United Kingdom, the country is in total lockdown. This implies that families continue to deal with the challenges identified by the C.S. Mott Children’s Hospital National Poll.

Governments, civil society organisations, public health administrators must begin to assign social workers to visit families and help them deal with the mental health consequences of lockdowns. Conduct outreaches to provide emotional and mental health support for children and families in low-income communities with poor internet access.

An example from India is the , that developed a unique mental health initiative that has a strong focus on empowering local communities and implementing mental health services through more than a thousand volunteers who run the community service.

Use technology to provide remote to support to parents and children. When families are informed on how lockdowns could affect them, they are better prepared to deal with such challenges. Nigeria’s leading non-profit organization providing mental health support, Mentally Aware Nigeria Initiative, has been reaching out to individuals through social media to help them deal with mental health consequences of the pandemic.

They do this via the . Services provided include mental health assessment and linkage to counsellors, monthly virtual conversation café using WhatsApp to discuss coping skills and providing support to keep isolation journals. Such organisations are few in the global south and should be supported by government, international donors and the private sector to take their services to scale.

Finally, COVID-19 has changed the workplace and it is no longer business as usual. A significant amount of stress is attributed to juggling work life and home, employers should better support their employees to ease some of the pressure.

Companies should promote frequent check-ins and flexibility, more relaxed patterns of work schedules, incorporate breaks between intense work meetings, encourage recreational online family gatherings, time offs and financial incentives etc. Company health plans should include mental health care. Connecting families to mental health services is another great way to support parents, and therefore families.

COVID-19 is a reminder that countries must invest in epidemic preparedness. These investments should be family-centred to ensure that parents and caregivers are equipped to provide the best parenting possible.

Dr. Ifeanyi McWilliams Nsofor is a graduate of the Liverpool School of Tropical Medicine. He is a Senior New Voices Fellow at the Aspen Institute and a Senior Atlantic Fellow for Health Equity at George Washington University. Ifeanyi is the Director Policy and Advocacy at Nigeria Health Watch.

Dr Shubha Nagesh works for the Latika Roy Foundation in Dehradun, India. She is a senior Atlantic Fellow for Health Equity at George Washington University. Shubha strives to make childhood disabilities a global health priority.

Credit: Defenders Coalition

NAIROBI, Kenya, Dec 9 2020 (IPS) – On 10 December every year, we celebrate Human Rights Day, marking the anniversary of the adoption of the Universal Declaration of Human Rights. The Universal Declaration guarantees a spectrum of human rights that belong to each of us equally, and unite us as a global community and upholds our humanity.

This year, 2020, has been one of unprecedented challenges and has underscored the need for renewed action to promote and protect human rights. The COVID-19 pandemic has tested societies across the globe, and set back human rights gains and progress towards the Sustainable Development Goals. In Kenya, the multi-faceted impacts of the pandemic – on gender equality, health, education, livelihoods, rule of law and the economy – have tested efforts by the Government, United Nations, development partners and civil society to deliver on the 2030 Agenda, Vision 2030 and the Big 4 development agenda, and challenged us to ensure that we leave no one behind.

The crisis has hit the poorest and most vulnerable communities the hardest, and entrenched existing inequalities, discrimination and human rights challenges. Gender-based violence has skyrocketed; loss of employment and livelihoods have put further strain on families; the right to education is at risk for many children, particularly girls; and inequalities in access to water, adequate housing and health services have heightened vulnerabilities.

In this context, the theme of Human Rights Day 2020 is “Recover Better – Stand Up for Human Rights”, highlighting the need to build back better from the COVID-19 crisis by putting human rights at the heart of recovery efforts. This is a call to action and for unity of purpose to tackle discrimination, address inequalities, encourage participation and solidarity, and promote sustainable development for the benefit of all.

As the United Nations Secretary-General, Mr. António Guterres, once remarked, “The pandemic has demonstrated the fragility of our world”. The crisis has exposed and exacerbated deep inequalities, entrenched discrimination and gaps in human rights protection. Only measures to close these gaps and advance human rights can ensure we fully recover and build back a world that is more resilient, just and sustainable.

COVID-19 has created an opportunity to build back a more equal and sustainable world – based on a “new social contract” that respects the rights and freedoms of all, and addresses the inequalities exposed by the pandemic. This “new social contract” – uniting Governments, the people, civil society and private sector – is the only way that we will meet the Sustainable Development Goals.

In this Decade of Action to deliver upon the Sustainable Development Goals by 2030, it is imperative to prioritise participation and inclusion, to ensure that we leave no one behind. Successful COVID-19 recovery efforts require the robust participation of civil society and inclusion of communities, to ensure the voices and priorities of the most affected, vulnerable and marginalised inform the recovery efforts. Public participation is a key tenet of the Constitution of Kenya, and has a key role to play in the COVID-19 recovery.

It is clear that this pandemic cannot be surmounted by a single actor. It is against this backdrop that the United Nations Country Team and the Government of Kenya, in line with the motto Umoja ni Nguvu (Unity is Strength), have identified strategic areas of cooperation and engagement under the United Nations Development Assistance Framework, as well as the Socio-Economic Response Plan, that target COVID-19 recovery needs and continue the trajectory towards the Sustainable Development Goals. This is underpinned by a human rights-based approach that prioritises equality and non-discrimination, participation and inclusion, and accountability.

The COVID-19 pandemic has shown that we are all in this together – and solidarity is the only way forward. Everyone has a role to play in building a better post-COVID world for present and future generations, and we must harness the active participation of communities, civil society, private sector, Government and the international community.

On this Human Rights Day, let us all commit to Stand Up for Human Rights to build back a more equal and sustainable society that advances the rights and freedoms of all. This unity of purpose will pave the way to meeting the Sustainable Development Goals and delivering upon Kenya’s Vision 2030.

is the United Nations Resident Coordinator in Kenya

The writer is Executive Director of UNAIDS and Under-Secretary-General of the United Nations.

A woman is vaccinated against COVID-19 in the indigenous community of Concordia, Colombia. Meanwhile, UN Secretary-General Antonio Guterres repeated his call for the G20 to establish a Task Force “able to deal with the pharmaceutical companies and other key stakeholders”, which would address equitable vaccine distribution through the global initiative. Credit: WHO/Nadege Mazars

GENEVA, May 27 2021 (IPS) – In this time of intersecting crises – the Covid crisis, the HIV crisis, the inequality crisis, and more – progress on all these crises is being blocked by another crisis: finance.

Right now, most of the world’s countries are facing brutal financial constraints, during a raging pandemic, and during the biggest crisis since World War II. The majority of countries look set to slash investment in essential public services. Such austerity would be literally fatal.

As world leaders exchange proposals for joint financial action for recovery in the build-up to the series of G7 and G20 meetings fast approaching, they need to break free from the discredited and damaging financing model that is choking social and economic recovery.

It’s important to acknowledge, of course, the vital initial steps towards recovery that world leaders, including the G20 finance ministers, and the IMF council, have taken, including at the recent Spring Meetings of the World Bank and IMF. But the scale of the financial measures taken is dwarfed by the scale of need.

Put simply, if leaders do not go much further, fast, to find and allocate the finances required, the effects will include the return of levels of deprivation that we had thought we had defeated, and spiraling social and political catastrophe.

To be clear, this is not a counsel of despair, but a call to leaders to make a wiser choice, and to the public to press them to do so. The really good news is this: if the will is there, we can find the money.

On debt, leaders have agreed to extend the Debt Suspension Initiative; but they have done so only until the end of this year, and private creditors have again been merely invited to collaborate.

As a result, repayments over $30bn are set to flow from the poorest nations to banks, investments funds, Governments and multilateral banks in 2021. Only the IMF among those has announced debt relief to 28 countries.

Cancelling debt repayments of the poorest nations is essential, and vulnerable middle-income countries need approaches that allow for cancellation too.

No debt service payments should be made or asked for until the investments necessary for achieving the UN Sustainable Development Goal on health are secured.

Indebted poor countries must not be pushed into new debts to pay for vaccine imports, but should rather be allowed to produce their own at much lower cost.

The very welcome statements from key leaders on a patent waiver need to be turned into a formal decision urgently, reinforced by technology sharing by companies through the WHO.

Cervical cancer is the most common cancer among women living with HIV. The likelihood that a woman living with HIV will develop invasive cervical cancer is up to five times higher than for a woman who is not living with HIV. The overall risk of HIV acquisition among women is doubled when they have had a human papillomavirus (HPV) infection. Credit: UNAIDS

On aid by traditional donors, OECD figures report a small increase overall of barely $10 billion, a drop in the ocean compared to the $17 trillion that rich countries have used to support themselves.

No agreement has been reached on expanding ODA now when it is most needed. All developed countries should honour the pledge of at least 0.7%. A pandemic is the most damaging time to back away.

Emerging countries with a strong financial capacity must step up too with their own upgraded contributions.

On Special Drawing Rights (SDRs), the IMF currency, a historical issuance of the equivalent of $650bn has been reached. But only 3.3% of those resources, $22bn, are set to flow to Sub Saharan Africa, the region most in need. Indeed, the amounts that low-income countries are set to receive through the SDR issuance are smaller than the unsuspended external debt repayments scheduled for 2021.

There is an active discussion about rich countries reallocating perhaps 10% or so of their own share of SDRs. But a strong case has been made that rich countries should reallocate the majority of their own SDRs to low and low middle-income countries.

That would indeed represent the largest ever financing for development operation; but that scale of action is what our current scale of crisis requires.

Of course, what countries most need is to grow their own domestic resourcing. Right now, we lose a nurse’s yearly salary to tax havens every second.

World leaders’ dialogue on tax evasion has been rightly acknowledged as historic, with proposals to establish a minimum global corporate tax, something that would enable billions in public investment across countries, seriously reducing extreme inequality.

An agreement will be under discussion soon at the G20 and with the OECD. Leaders need urgently to move from discussion to agreement and action.

We need a compact that includes taxation on excess profits, wealth, and negative climate impacts, invested to fund the scrapping of user fees and the expansion of health and education so that they are finally experienced as universal rights.

Global pandemic preparedness, stability and prosperity all require us to fight inequality.

Gordon Brown´s proposal for G7 countries to immediately share the burden of the $60 billion needed in funding for vaccines and vital medical supplies, diagnostics and medical oxygen is both essential and achievable – now.

It would kickstart recovery for every country and could help set the world on a pathway to a new approach to global financing.

Now is the moment to consign to the dustbin old worn-out ideas that we can’t afford to overcome our crises. The reality is that we can’t afford not to.

The Covid-19 crisis has seen a transfer of wealth from workers to billionaires of almost $4 trillion. This moment could, like other crises before, become a moment for rebuilding a fairer world – but only if we seize it.

Achieving a more equal world is essential for our health. The financing solutions are there. The principal challenge is not technical, it is courage.

NEW DELHI, India, Aug 31 2021 (IPS) – With elections right round the corner in Canada, Prime Minister Justin Trudeau recently said that a re-elected Liberal government would spend billions in the coming years to hire family doctors. This says, Justin Trudeau promised that the Liberals would spend $3 billion over four years starting in 2022 to hire 7500 family doctors and nurses as well as tax and student loan incentives for health professionals who set up shop in rural or remote communities and also pledges an extra $6 billion to wrestle with wait lists.

Dr. Shafi Bhuiyan

A 2019 states that there were 91,375 physicians in Canada, representing 241 physicians per 100,000 population. According to the Canadian Medical Association, around five million Canadians don’t have a primary care physician, or family health care team.

Canada’s overburdened healthcare system is yet to tap into its advantage all the untapped talent and skills available to it, as seen during the significant role Internationally Trained Medical Doctors, pandemic, supporting the vaccination clinics, working as contact tracing managers and mental health advisors.

Canada is losing out by not involving and including ITMDs, says Dr. Shafi Bhuiyan, a health professional and Chair of ITMDs Canada Network (iCAN). “Over 4.5 million Canadians are not able to find their family physician, as a result the wait time to see a doctor has been increasing continuously, which is also resulting in social peace and justice disruption.”

Canada currently has ITMDs, and the visa process, Bhuiyan says, has “a very thorough and rigorous screening program by the Canadian CIC, where medical experience plays a key role along with other requirements to enter the country, but once they come to Canada, due to multiple reasons, they lose out on securing a residency position”.

Saida Azam

Saida Azam is one such ITMD who moved to Canada almost three years ago with her husband for better career opportunities. Azam, a medical professional with experience working in India and Oman, says, “I have performed a number of surgeries and deliveries, I worked as a family physician for three years, but right now I am waiting to be able to do that here.

“The knowledge that I have in this field is really good, the only difference in relation to the Canadian context, with medicine, is that when I move from one territory or one country to another, things will be different, from the patients to the region and other such things. That doesn t mean that I have less knowledge or the local doctors here have more. What would help people like me is, if there were a training program in place for Internationally Trained Medical Doctors to integrate us better into the Canadian healthcare system.

“Canada is home now, I wouldn t say I am completely disappointed, but I hope that I will be able to share my expertise and pursue my career, says Azam.

One of the key challenges for ITMDs remains cost associated with licensing examinations, the CaRMS application process is often a barrier for newcomers. According to this , 47 % of foreign-educated health professionals are either unemployed or employed in non-health related positions that require only a high school diploma.

The on-going Pandemic has been a time of crisis all over the world, and with shortage and with the under-utilization of health-care workers in Canada, the country is only creating a strain on its health care system by not including and leveraging on its ITMDs.

The (COVID19) report says, “by encouraging the creation of new jobs in the health sector globally, the report suggested a unique opportunity both to respond to the growing global demand for health workers and to address the projected shortages. During the COVID-19 pandemic, many OECD countries have recognised migrant health workers as key assets and introduced policies to help their arrival and the recognition of their qualifications.”

In 2020, Canada, where annual to around 300,000 new immigrants, announced its , saying it would target the highest level of immigration in its history by welcoming 401,000 immigrants in 2021, 411,000 immigrants in 2022, 421,000 immigrants in 2023.

“The only time Canada welcomed over 400,000 immigrants in a year was in 1913, when it admitted 401,000 newcomers. It has never come close to this figure again,” this .

The International Labour Organization (ILO) says developing countries host more than one-third of international migrants in the world and most immigrants are migrant workers and are employed either formally or more often informally in their countries of destination.

This by the ILO states the importance of immigrants and how “immigration plays a key role in the destination countries development and public policies can play an important role in enhancing its contribution to the development of destination countries. Excluding immigration from development strategies can represent missed opportunities for host countries.”

“The Canadian government is missing out by not including a pool of talent it has to its access, if these hurdles can be removed, and instead replaced by a more simpler and transparent process towards obtaining approved medical licence, it would be a win-win situation for all,” says Bhuiyan.

If Canada is able to overcome these systemic barriers and inequity towards its ITMDs, with a pool of talented immigrants, it has the potential that will not only impact the countries economic prosperity, immigrants alter the country’s income distribution and influence investment priorities and as taxpayers contribute to the public budget and benefit from public services.

Africa can expect new spikes in COVID-19 every six months, a report by the Tony Blair Institute for Global Change. The continent with its low vaccination rates could continue to be vulnerable. Credit: USAID/South Africa

New York, Mar 11 2022 (IPS) – Countries on the African continent have a pattern of a six-month break before a new COVID-19 spike happens, researchers at the Tony Blair Institute for Global Change have said in a newly released report.

Marvin Akuagwuagwu, a data analyst in the Africa COVID-19 Policy unit at the Institute, told IPS that it’s the countries with the lowest vaccination rate that are most at risk.
Related IPS Articles

According to from the African Union CDC, the Central African Republic, South Sudan, and Chad are among the countries with the lowest percentage of the vaccinated population – some as low as less than one percent.

These other countries on the continent can learn from Rwanda’s approach, which Akuagwuagwu said is a success story.

“Rwanda has significantly ramped up its vaccination and testing programmes which has reduced their case numbers and the overall impact of COVID-19,” he said.

“With their vaccination rate at almost 60 percent and a positive case rate of less than 10 percent, Rwanda is a good example for other African countries to emulate, particularly for countries in Sub-Saharan Africa that face similar challenges.”

However, vaccine rollout isn’t an issue of supply but a result of wealthier countries , contributing to a grave vaccine inequity. Africa has received six percent of the world’s vaccines, despite the continent hosting seventeen percent of the world’s population, according to the Brooking’s report.

And this only exacerbates the pattern that Akuagwuagwu and his co-author Adam Bradshaw discovered in their report.

Excerpts from the interview follow.

Inter Press Service (IPS): You mentioned there is a pattern of a new wave hitting Africa roughly every six months. How does this affect the continent of Africa specifically?

Marvin Akuagwuagwu (MA): We identified a trend that about every six months, a Covid-19 wave impacts Africa. This was the case with Beta, Delta, and Omicron.

Omicron was like a flash flood – it did some serious damage but thankfully didn’t lead to mass deaths. However, we may not be so lucky next time – the next variant may be more severe, especially in countries with low levels of protection, such as in Africa.

This means we now have a six-month window of opportunity to vaccinate Africa against Covid-19 before the next variant appears – we need to make progress towards achieving the WHO target of vaccinating 70% of the population. TBI is working with a number of countries across Africa to support their vaccine rollout to help get there.

IPS: Why do you believe lockdowns are being approached more cautiously and are “not always the best course of action”?

MA: Lockdowns are effective, but they are not always the best course of action to tackle Covid-19 due to their negative economic and social impacts.

As the virus evolves and we learn more, countries in Africa are gradually moving away from blanket lockdowns. We now have a range of tools in the toolbox to tackle Covid-19 and lockdown is only one of many options.

When the pandemic first started, no one had ever been exposed to Covid-19 – now billions of people have been infected or vaccinated, so it’s a different ballgame, and we need to adapt with it.

IPS: With the six-month window between variants, are there spill-over effects? (For example, even though Omicron wasn’t as bad as Delta, were any Delta effects that spilled over to the phase where Omicron was present)?

MA: The low testing and vaccination in Africa during the Delta wave spilled over to the Omicron wave. African countries have just started ramping up their vaccination and testing programmes, which were significantly lower in the Delta wave.

Without a continued acceleration of vaccination programmes, Africa will remain behind other regions in vaccination rates. International actors, donors, and partners should listen and respond to African countries to adequately support their vaccination and community engagement programmes and enhance their data management systems and associated human resources required.

IPS: How does the current financial inflation affect the measures you’ve proposed?

MA: The current financial inflation impacts the measures we have proposed as they require adequate funding. However, strong political will and community engagement are catalysts to enhancing these measures and curbing health and social inequalities caused by the pandemic.

IPS: One of the recommendations suggests: “increase testing and genomic sequencing to reduce transmission.” How many countries have the economic capacity and manpower to ensure this? How realistic is this goal?

MA: We understand that this is a significant challenge for low- and middle-income countries, but the alternative is far worse – serious illness, lockdowns, and deaths which also affect the economy and society at large.

It goes back to global cooperation – the Tony Blair Institute for Global Change is working in Africa to build long-term resilience in data, vaccine, and testing infrastructure and provide greater institutional strength to withstand future Covid-19 waves. We support governments to build their capacity and deliver for their populations.

We are calling for global leadership to develop a global pandemic plan to support the Global South to vaccinate their populations and increase testing.

IPS UN Bureau Report

The 24th International AIDS Conference is taking place in Montreal, July 29 to August 2.

A man is tested for HIV at a health centre in Odienné, Côte d’Ivoire. Credit: UNICEF/Frank Dejongh

MONTREAL, Aug 2 2022 (IPS) – This week, the global HIV response community is to address the crisis of stalling progress that is putting .

Delegates here are clear on two things: first, the world is not on track to end AIDS, second, the world can still get on track and end AIDS as a public health crisis by 2030, but only if leaders are bold. This includes removing laws which are perpetuating the pandemic.

Punitive and criminalizing approaches to law have been catastrophic for the AIDS response. They need urgently to be repealed.

When people are targeted by punitive laws, they fear the government, and many hide from it. And this lack of trust spills quickly over into responding to a pandemic: a government that proposes to lock a person up one day is unlikely to be trusted when it sends them to an HIV test the next. When people fear public shaming, many try not to be seen. Too often, this means people miss out on HIV prevention, treatment, and care.

The evidence is clear: punitive laws that push people into the shadows are continuing to drive HIV.

In countries that criminalize consensual same-sex sexual activity, the evidence is clear that the risk of acquiring HIV is higher, access to HIV testing is lower and populations remain hidden, underground.

We know that men who have sex with men living in countries where they are not criminalized are half as likely to be living with HIV compared to countries where they are criminalized, and eight times less likely to be living with HIV compared to countries with extreme forms of criminalization.

Gay men and other men who have sex with men are three times more likely to know their HIV status if they live in a country that does not criminalize same-sex sexual behaviour. Population size estimates for gay men and other men who have sex with men are also more likely to be implausibly low where such criminal laws exist.

So too, laws which criminalize gender identity, HIV status, drug use, and sex work, discourage and obstruct people from accessing vital health services: the costs of these laws remaining on statute books would include millions of lives lost and the perpetuation of the AIDS pandemic.

The laws described above that criminalize same-sex sexual conduct have also been utilized to target trans people in many countries, alongside laws prohibiting cross-dressing or “impersonating the opposite sex” as well as petty offence laws.

The use of these criminal laws perpetuates transphobia, discrimination, hate crimes, police abuse, torture, ill-treatment and family and community violence. It obstructs trans people from access to HIV prevention, treatment and care.

In 36% of countries with available data, more than 10% of transgender people reported avoiding healthcare in the last 12 months due to stigma and discrimination. Studies show that transgender people who have experienced stigma in health care settings are three times more likely to avoid health care than transgender people who have not experienced stigma.

Criminalization of HIV non-disclosure, exposure or transmission undermines effective HIV prevention, treatment, care and support because fear of prosecution discourages people from seeking testing and treatment, and deters people living with HIV – and those most at risk of HIV infection – from talking openly to their medical providers, disclosing their HIV status or accessing available treatment services.

Criminalization of drug possession for personal use propels new HIV cases. The presence of criminal laws and associated enforcement has been associated with higher rates of needle sharing, increased HIV risk behaviours, reduced access to HIV services and increased prevalence of HIV.

Where sex work is criminalized, HIV rates are seven times higher than in countries where it is partially legalized. In jurisdictions with enabling legal environments, prevalence of HIV among sex workers is similar to the rest of the population, indicating it is not involvement in sex work that creates HIV risk, but the lack of an environment that enables sex workers to protect their health and wellbeing.

Criminal laws prevent sex workers from being able to screen clients, negotiate condom use, or access the protection of law enforcement if they are in danger of, or experience, physical and sexual violence. Fear of stigma or arrest can also prevent sex workers from being able to access HIV services on an equal basis with others.

Studies have long shown that decriminalization of sex work could avert between 33-46% of new HIV infections among sex workers and their partners.

The criminal law is one of the harshest tools that governments wield, and one of the most blunt. Punitive approaches are harm where help is needed. They ferment stigma, fear and hatred and are perpetuating a health disaster.

We have powerful reasons to hope, however, that with a strong push, punitive approaches to HIV can end.

We have the high-level political declaration agreed last year at the United Nations General Assembly High-Level Meeting on AIDS. One of the critical commitments that countries made was to reform laws that create barriers to accessing HIV services or increase stigma and discrimination, in order to end AIDS as a public health threat by 2030.

We have support available on how to most effectively reform laws so they support rather than undermine the HIV response. The Global Partnership for Action to Eliminate all forms of HIV Related Stigma and Discrimination, is bringing together governments, civil society and the United Nations, to exchange learning on what works.

One key lesson is that for law reform to have maximum success, changes should be shaped by the communities most affected, from the start through to implementation.

We are seeing that law reform is not only possible, it is happening across all continents. In recent years sparked, by court judgements and law reform efforts, punitive laws are continuing to disappear.

Last year the Bhutanese Parliament passed a reform which ended the criminalization of same sex relationships, Botswana s Court of Appeal upheld a ruling that decriminalized same-sex relationships, and Angola began implementing their new criminal code which no longer criminalizes same-sex relationships.

This year already both Belgium and Victoria, Australia have removed laws criminalizing sex work, and Zimbabwe has decriminalized HIV exposure, non-disclosure and transmission.

We have the evidence of what works. It is no coincidence that the government of New South Wales, Australia, a jurisdiction that does not criminalize sexual orientation, gender identity, HIV status, or sex work, recently announced it is on track to eliminate new HIV infections by 2025.

Decriminalization is happening, but it is too slow. In 2022, of the countries reporting to UNAIDS: 14% criminalize gender expression, 36% criminalize consensual same-sex sexual relations, 62% criminalize HIV exposure, non-disclosure and transmission, 90% criminalize possession of drugs for personal use and all reporting countries criminalize some aspect of sex work.

In 2021, 70% of new HIV infections were among groups who are affected by these laws. Eastern Europe and central Asia, Middle East and North Africa and Latin America have all seen increases in annual HIV infections over several years.

In Asia and the Pacific UNAIDS data now shows new HIV infections are rising where they had been falling. Without movement on societal enablers, and on criminal laws in particular, we will struggle to reverse this trend, let alone end AIDS as a public health threat by 2030.

We can end AIDS, but to do so we must end the punitive laws perpetuating the pandemic. Now.

Suki Beavers is UNAIDS Director of the Equality and Rights for All Global Practice.

IPS UN Bureau