Thembeni Mkingofa, a woman living with HIV, visits the PMTCT section of the Makhume District Hospital, Zimbabwe. She has three children - 14, 10 and 2 who are all HIV negative. This is her fourth pregnancy. Her husband is also on HIV treatment. Here she is pictured with her two-year-old daughter, Hilda Chakiryizira. 5 November 2019. Credit: UNAIDS/C. Matonhodze

By Winnie Byanyima and Sir Michael Marmot
BRASILIA, Brazil, Jun 5 2023 (IPS)

The COVID-19 crisis has shone a light on the danger of pandemics; social crises have shone a light on the danger of inequalities. And the reality is that outbreaks become the pandemics they do because of inequality. The good news is that both can be overcome – if they are confronted as one.

Scientific and medical breakthroughs in the treatment and prevention of HIV should have brought us to the point of ending AIDS. Tragically, however, although the number of new HIV infections is falling fast in many countries, it is still rising in dozens of countries and the goal of ending AIDS by 2030 is in danger.

The reason: economic and social inequalities within countries and between them increase people’s risk of acquiring disease and block access to life-saving services.

Letting inequality grow is driving pandemics and prolonging emergencies that drain economies and health systems. This makes all of us vulnerable to the next pandemic, while placing entire countries and communities of people in harm’s way.

In too much of the world we see policy approaches which leave inequalities to widen, and even, in some cases, deliberately exacerbate inequalities.

On a global level when wealthy countries quickly invest billions in their own medical and social response, while leaving other countries so burdened by debt they have no fiscal space to do so, that undermines the world’s capacity to fight AIDS and pandemics.

During COVID-19 while wealthy countries poured in billions to protect their economies, reduce economic and social hardship and fight the pandemic, almost half of all developing countries cut health spending and about 70% cut spending on education.

Shanenire Ndiweni, has a consultation to receive pre-exposure prophylaxis at the Centre for Sexual Health and HIV/AIDS Research Zimbabwe (CeSHHAR Zimbabwe) clinic, Mutare, Zimbabwe, 6 November 2019. Credit: UNAIDS/C. Matonhodze

Viruses do not respect borders, so when the vaccines, drugs, and tests intended to stop those viruses go to powerful countries in excess, while other countries have little or nothing and are held back from producing medicines themselves, that perpetuates pandemics everywhere.

Similarly, social and economic conditions that perpetuate pandemics in low- and middle-income countries present a global threat. Much as with COVID-19 the same has happened with the MPox virus.

In recent years twice as many people have died of MPox in the Democratic Republic of Congo as the entire rest of the world combined but, as of today, zero vaccines for MPox had been delivered to the DRC.

Social and legal determinants that make people vulnerable to pandemics must be tackled. Globally almost 5,000 young women and girls become infected with HIV every week. Dismantling barriers to sexual and reproductive health and rights services, investing in girls’ education, and combating gender-based violence to remove gender inequity is key to ending the AIDS pandemic and protecting women’s health.

Laws that criminalize and marginalize LGBT communities, sex workers and people who use drugs weaken public health approaches and prolong pandemics such as HIV. In sub-Saharan African countries where same sex relations are criminalized, HIV prevalence is five times higher among gay men and men who have sex with men than in countries where same sex relations are not criminalized.

Even within countries that are making substantial progress against HIV, advances may not be shared equally. Here in Brazil for example, HIV infections are falling dramatically among the white population as access to treatment is widened and new prevention tools such as PrEP are rolled out.

That shows what can be achieved; but HIV infections among the black population in Brazil are still on the rise. A similar story runs in the United States where gay white people are more likely to have access to good health care than gay black people.

We emphasize that it is not only access to health care that perpetuates these inequalities, but the social determinants that increase the risk of infection.

To overcome inequalities in accessing essential services, communities must be empowered to demand their rights. The AIDS movement is one of the best examples of how groups of people experiencing intersecting inequalities can unite to overcome them, leading to millions of lives being saved.

Successive Commissions on Social Determinants of Health have brought together evidence on how the conditions in which people are born, grow, live, work and age are powerful influences on health equity.

To bring together these two strands of knowledge over the coming months we will be convening global experts from academia, government, civil society, international development and the creative arts to build a Global Council to advance evidence-based solutions to the inequalities which drive AIDS and other pandemics.

The council will unite experts from disparate fields of economics, epidemiology, law, and politics and will include ministers, mayors, and former heads of state, researchers and clinicians, health security experts, community leaders and human rights activists.

The work of the Global Council will harness essential evidence for policymakers. It will elevate political attention to the need for action. Most crucially, it will help equip the advocacy of the frontline communities fighting for their lives, with what they need to shift policies and power.

Appropriately, the Global Council is launching in Brazil. Whilst Brazil has exemplified the challenges of intersecting inequalities, Brazil’s social movements have been pioneers in confronting them, and Brazil’s new government under President Lula has committed to tackle inequalities in Brazil and worldwide.

To fight tomorrow’s pandemics, we need inequality-busting approaches to today’s pandemics. The world’s leaders now face a clear choice: stand by whilst the dangers mount or come together to tackle inequalities for a world that is not only fairer, but safer too.

Winnie Byanyima is the Executive Director of UNAIDS and an Under-Secretary-General of the United Nations. Before joining UNAIDS, she served as Executive Director of Oxfam International, a confederation of 20 civil society organizations working in more than 90 countries worldwide, empowering people to create a future that is secure, just and free from poverty.

They will launch the Global Council on Inequalities, HIV and pandemics in Brazil on June 5. The authors are founder members of the Global Council on Inequality, AIDS and Pandemics and are in Brazil for its announcement.

IPS UN Bureau

Follow @IPSNewsUNBureau
  

Young girls chat while sitting under a mosquito net in Bienythiang, South Sudan. Credit: UNICEF/Mark Naftalin
 
World Malaria Day, April 25, is an occasion to highlight the need for continued investment and sustained political commitment for malaria prevention and control. It was instituted by WHO Member States during the World Health Assembly of 2007.

By Arthur Ng'etich Kipkemoi Saitabau
KUALA LUMPUR, Malaysia, Apr 24 2023 (IPS)

For centuries, malaria has remained one of the deadliest diseases, inflicting great suffering on families and perpetuating the cycle of poverty in many communities and nations. The African region currently accounts for 95% of malaria cases and 96% of malaria deaths globally, with women and girls disproportionately affected by the disease.

Women are at higher risk of malaria due to biological, social, economic, and gender factors. They have limited access to healthcare, less decision-making power and control over household resources, which increases their susceptibility.

Gender-based economic disparities further worsen the situation by limiting women’s access to malaria prevention and treatment.

While significant progress has been made in the past decades in combatting malaria through the development of life-saving treatment regimens and the implementation of cutting-edge technologies to accelerate the discovery and development of new malaria vaccines, deaths due to malaria remain high.

In 2021 alone, an estimated 619,000 deaths were caused by malaria, highlighting the need for continued efforts to combat this disease.

In addition, COVID-related disruptions in the delivery of malaria curative and preventive services during the two peak years of the pandemic (2020-2021), led to approximately 13 million more cases of malaria and an additional 63,000 deaths caused by the disease compared to the pre-COVID-19 year of 2019.

To date, malaria cases and deaths have primarily been reduced through disease-focused approaches that tend to be reactive rather than proactive often initiated in response to malaria outbreaks.

This narrow focus on treating individual cases of malaria overlooks broader social, economic, environmental risk factors including gender-based inequalities.

As Member States work towards ambitious goals set during the 2015 World Health Assembly of reducing the global malaria burden by 90% by 2030, efforts need to prioritise the underlying factors that drive transmission through a multifaceted approach, particularly recognising the social determinants like gender inequalities.

The concept of people-centred health care is based on fundamental principles that prioritize human rights, dignity, participation, equity, and partnerships.

This approach aims to create a health care system where individuals, families, and communities receive humane and holistic care, while also having the opportunity to actively engage with the health care system.

As we work towards leaving no one behind and achieving the last mile, developing and adopting more people-centred approaches, that address gender and intersectionality concerns through an analysis of power dynamics, will be critical to make significant strides towards eradicating malaria for good.

This can involve engaging with communities and stakeholders to identify their needs and develop evidence-based malaria control strategies that promote equity and inclusion.

Additionally, promoting participation of marginalized groups in decision-making and ensuring malaria interventions respect human rights and promote social justice.

Not only will this help advance Sustainable Development Goals towards gender equality but importantly will also contribute to decolonising global health and empowering communities that remain most impacted by the disease.

Unpacking the Gendered Dimensions

A people-centred approach to malaria prevention aims to prioritize the well-being of individuals and communities by establishing reliable health systems. However, power dynamics must be taken into account to prevent the perpetuation of power imbalances, hierarchies, and inequalities.

This means engaging with communities and other stakeholders to identify their needs and priorities and working together to develop evidence-based malaria control strategies.

The Community Directed Intervention (CDI) approach exemplifies the importance of extensive community engagement to identify local needs and priorities for malaria control. This includes community meetings, involving leaders and women groups, and conducting surveys on malaria burden and risk factors.

Developing evidence-based strategies through community engagement results in increased community ownership and participation, leading to higher uptake of interventions and reducing malaria transmission.

Addressing the power dynamics associated with malaria prevention requires acknowledging and tackling gendered dimensions linked with malaria prevention.

Women in some communities may lack access to education, employment, and decision-making power, which can limit their ability to protect themselves from malaria.

Additionally, cultural beliefs and practices may contribute to the unequal distribution of resources for malaria prevention and control, with men accessing more resources than women.

This underscores the importance of addressing gender roles in malaria control initiatives and empowering women to take an active role in protecting themselves and their families.

Intersectionality also has important implications for malaria control as gender intersects with other social categories to create specific vulnerabilities and challenges. For instance, women from lowest income groups are least likely to get access to healthcare.

To address these challenges, it is important for more malaria control programs to conduct systematic social and gender analysis, hearing from those affected, to better understand the subtle nuances of gendered and intersectional dimensions of power both within households and communities.

This approach can then help to identify the specific barriers and opportunities for women’s participation in malaria control initiatives. By unpacking the gendered dimensions in communities, public health officials can design targeted interventions that promote women’s empowerment, address gender inequalities, and increase women’s involvement in malaria control programs.

Confronting not Reinforcing Power Dynamics

A people-centred approach to malaria control can empower individuals by providing education and training on malaria prevention and control. It can emphasize inclusivity and centre the experiences and knowledge of those who have been historically excluded or marginalized due to factors such as racism, sexism, classism, and other systems of power.

To avoid reinforcing power dynamics in malaria control, it is crucial to involve and empower marginalized groups in decision-making. This involves consulting communities to identify their needs and priorities, promoting participation of women and marginalized groups, and designing interventions that promote equity and inclusion.

The foundation for improving community dialogue and community-led actions towards malaria elimination has been established over the years.

A case in point is the successful elimination of malaria in Cambodia’s last mile, which relied on communities in high-risk areas agreeing to increased testing, regular fever screening, and in some cases, taking preventive antimalarial medication.

A people-centred approach recognizes the significance of communities in designing and implementing malaria control programs, considering their unique social, cultural, and environmental contexts that can impact malaria transmission and control.

One illustration is the use of local languages and cultural practices to build trust and improve communication on malaria prevention and control measures through empowerment of community health workers who understand and can tailor interventions to their specific contexts.

On the other hand, a people-centred approach, which does not consider power dynamics, can unintentionally reinforce social hierarchies and exclude vulnerable populations from accessing preventative and curative treatment for malaria.

For instance, a malaria control program that only involves male community leaders and village chiefs in decision-making when distributing bed nets reinforces patriarchal power and favour wealthier households, while excluding marginalized groups such as women and those from lower socio-economic backgrounds.

In conclusion, achieving malaria elimination through people-centred approaches requires a holistic approach that actively considers issues of gender, intersectionality, and balance of power. It is crucial to ensure that these approaches do not perpetuate existing inequalities, but instead centre the experiences and knowledge of marginalized groups.

By acknowledging and addressing the ways in which different forms of oppression intersect and compound to create experiences of marginalization and exclusion, we can make meaningful strides towards malaria elimination.

To achieve this, sustaining a commitment to inclusivity, equity, and social justice is imperative in all efforts aimed at eradicating malaria and improving the health and well-being of communities affected by this disease.

This includes actively involving marginalized groups in decision-making processes, addressing social determinants of health, tailoring interventions to specific cultural and contextual factors, and promoting gender equality and women’s empowerment.

By taking a proactive and inclusive approach, we can ensure that malaria control efforts are effective, equitable, and sustainable, leading to more just and healthier communities.

Arthur Ng’etich Kipkemoi Saitabau is Post-Doctoral Fellow of the United Nations University – International Institute for Global Health.

IPS UN Bureau

Follow @IPSNewsUNBureau
  

The removal of Mughal history from textbooks is seen as a political move which downplays the rich diversity of the Indian subcontinent. This artwork stems from this period. Credit: Govardhan. Jahangir Visiting the Ascetic Jadrup. ca. 1616-20, Musee Guimet, Paris

By Ranjit Devraj
NEW DELHI, Apr 20 2023 (IPS)

The removal from school textbooks of chapters covering the Mughal period of Indian history spanning three centuries has raised a storm of protests from academics.

The Mughals, who ruled much of the Indian sub-continent between the 16^th and 19^th centuries, left behind an indelible stamp on science, art, culture, and overall development. Their legacy is visible today mainly in a number of monuments recognised as UNESCO World Heritage Sites, including the Agra Fort, Fatehpur Sikri, Red Fort, Humayun’s Tomb, Lahore Fort, Shalamar Gardens, and the Taj Mahal.

UNESCO’s India representative, Hezekiel Damani, said the organisation advises that the curriculum represents a conscious and systematic selection of knowledge, skills and values that shape the way teaching, learning and assessment processes are organised by addressing questions such as what, why, when and how students should learn.

“Therefore, a quality curriculum must pave the way to the effective implementation of inclusive and equitable quality education,” Damani says. “Subject-specific curriculum development, reform and revision are entirely the decision of member states; they must be conscious of today’s curriculum, and future needs while making any intervention.”

“The issue here is that Mughal rule does not align well with present-day politics — it is no surprise that chapters that refer to that period are being deleted by the National Council for Education Research and Training (NCERT),” says Ruchika Sharma, who teaches history at the Delhi University.

Sharma says that from an academic point of view, the Mughal period presents a well-researched part of Indian history because of the rich documentation they left behind. “Removing an entire chapter dealing with such an important period of history from class XII textbooks would certainly affect students’ career choices — they will see a mismatch between visible legacy and the curriculum.”

Sharma referred in particular to the chapter titled ‘Kings and Chronicles, the Mughal Courts,’ from the NCERT history book Themes of Indian History-Part II, which describes how the Mughals encouraged peasants to cultivate cash crops such as cotton grown over a “great swathe of territory that spread over central India and the Deccan plateau.”

The Mughal period saw India becoming the world’s biggest exporter of cotton as well as cotton manufactures such as calico and fine muslins that were shipped to the European markets by the Dutch and English East India Companies that were allowed to set up ‘factories’ or fortified trading posts along the Indian coasts.

Other revenue-generating crops included sugarcane and oilseeds such as mustard and lentil that were grown alongside staples like rice, wheat and millets, the deleted chapter said. The section on ‘Irrigation and Technology’ noted that under the Mughals, cultivation rapidly expanded with the help of artificial irrigation systems and the introduction of crops from the new world, such as tomatoes, potatoes and chilli.

Swapna Liddle, historian and author, says that much of India’s built heritage, language, arts, agriculture and land tenure systems are a legacy of the Mughal period. “It is important to study how India was also progressing in the scientific fields during that period,” says Liddle.

The Mughal period saw a flowering of the sciences, especially astronomy, mathematics, medicine, architecture and engineering, that had an impact long after the dynasty ended in 1857. Akbar’s reign (1556—1605), for example, saw the establishment of medical schools and dispensaries, while his successor, Jehangir, patronised the study of mathematics and astronomy.

On April 7, a group of ‘Concerned Historians’ issued a statement saying: “We are appalled by the decision of the NCERT to remove chapters and statements from history textbooks and demand that the deletions from the textbooks be immediately withdrawn.”

“The decision of the NCERT is guided by divisive motives. It is a decision that goes against the constitutional ethos and composite culture of the Indian subcontinent. As such, it must be rescinded at the earliest,” said the statement, which has been endorsed by hundreds of academics.

According to the statement, the textbooks were designed to be inclusive and provide a sense of the rich diversity of the human past both within the subcontinent as well as the wider world. “As such, removing chapters/sections of chapters is highly problematic not only in terms of depriving learners of valuable content but also in terms of the pedagogical values required to equip them to meet present and future challenges.”

The director of the NCERT, Dinesh Kumar Saklani, has stated that the chapters were removed as part of “rationalisation aimed at reducing the burden on schoolchildren following the COVID-19 pandemic.” He claimed that the rationalisation was vetted by experts and denied that there was any political agenda behind the move.

Says Ajay K. Mehra, a political scientist currently attached to the independent think tank, the Observer Research Foundation: “It would have been far better to modify the chapters on the Mughal and Islamic periods than delete them altogether — this way a very large and important period of mediaeval Indian history is going to be lost to impressionable young students and to future generations.”

The changes to the textbooks, says Mehra, are deliberate and part of a larger, declared political agenda to restore the past glory of Hindu dynasties that existed before the arrival of Islam in India. This can be seen in the renaming of roads and cities, he said, citing the renaming of Allahabad city in 2018 to Prayagraj to reflect its importance as a Hindu pilgrimage site at the confluence of the sacred Yamuna and Ganges rivers.

“What is lost here is the fact that Mughal rule saw enormous economic advancement that lasted three centuries because of a compact with Hindu Rajput (princely) feudatories. “Rajput princes not only led Mughal armies but also entered into marital alliances — two of the important Mughal emperors, Jehangir and Shah Jahan, were born of Rajput princesses, for example,” Mehra said.

Makkhan Lal, distinguished fellow at the Vivekananda International Foundation, a think tank considered close to the government, says that there is a case for the Mughal period getting “disproportionate description and allotment of space” in history textbooks and this needed to be rectified.

Lal, who has taught history at the Banaras Hindu University and worked with the NCERT, said the “correction being made now is a step in the right direction and should have been taken earlier.”

Apart from academics, leaders of opposition parties have also denounced the changes to the textbooks. Sitaram Yechury, general secretary of the Communist Party of India, said the changes made to class textbooks were regrettable because of India’s diversity.

“The lands of India have always been the churning crucible of civilisational advances through cultural confluences,” Yechury says.

Pinarayi Vijayan, who leads a communist party government in the southern Kerala state, Tweeted: “They resort to rewriting history and masking it with lies. So, we must strongly protest the decision of the BJP government to delete certain sections from NCERT textbooks. Let the truth prevail.”

IPS UN Bureau Report

Follow @IPSNewsUNBureau
  

A woman with tuberculosis in Pakistan went undiagnosed for five years because she could not afford the $2 transportation cost from her village to the Civil Hospital in Tharparkar. Credit: OCHA/Zinnia Bukhari
 
Each year, the UN commemorates World TB Day—March 24-- to raise public awareness about the devastating health, social and economic consequences of tuberculosis (TB) and to step up efforts to end the global TB epidemic. The date marks the day in 1882 when Dr. Robert Koch announced that he had discovered the bacterium that causes TB, which opened the way towards diagnosing and curing this disease.

By Nyuma Mbewe and Swati Krishna
LUSAKA / PUNE, Mar 22 2023 (IPS)

Despite being both curable and preventable, the TB pandemic is a global health crisis and a leading cause of death worldwide. COVID-19 brought into sharp focus how women bear the brunt of pandemics. In 2021, over three million women and girls fell ill with TB, resulting in 450,000 needless deaths.

As women leaders in global health, on this 2023 World TB Day, we believe that systematic and sustained investment to tackle gender-related barriers is essential to get the world back on course and end TB by 2030.

We must confront the root causes of gender inequality and reshape the power dynamics across health systems, promoting the voice of women in their own care, to reach our global goals, for a safer, healthier world for all.

To better understand how gender norms and inequalities increase the burden, stigma and discrimination on women resulting in the failure to prevent, detect and treat TB infection, adopting an intersectional lens is a necessary step.

Differentiating the impact of TB based on the intersection of different determinants such as sex, gender, ethnicity, age, location and socioeconomic status can improve health planning, along with confronting legal, cultural and social barriers that are preventing improved health outcomes.

Using evidence-based knowledge, we can tailor interventions and care strategies for populations with increased vulnerabilities and curb the spread of the disease.

The Global Fund data has shown that women often face additional barriers to accessing TB diagnosis and treatment in countries with high rates of TB. Women generally wait longer than men for diagnosis and treatment, and may be discouraged from seeking care by a lack of privacy or child-care facilities in health services.

In some contexts, women have been less likely to undergo sputum smear examinations due to cultural norms and perceptions about femininity as well as gender dynamics of service provision. Young women in high HIV burden settings face increased TB risk.

The stigma, discrimination and exclusion associated with HIV amplifies and is amplified by TB-related stigma, especially for key populations. This impacts TB detection, access to reliable health services and treatment adherence.

It is past time to prioritize measures that emphasize women’s fundamental role in building resilient health systems and workforce. Globally, women are 90% of frontline health workers, and 70% of the overall health workforce.

Despite challenging working conditions, and lack of formal representation, women continue to show outstanding leadership across the health sector. Evidence shows that community-based and ambulatory care results in better TB outcomes compared to hospital-based or inpatient care. Yet their contribution is often undervalued, underpaid, and they occupy less than one quarter of management roles.

Women are the vast majority of nurses and community health workers (CHW) that play a vital role in the delivery of TB care and people-centered approaches to treatment, yet their voices are more often than not absent from decision-making fora. Valuing women, working at all levels of health, including CHWs is essential for the prevention, detection and treatment success of TB.

Making health systems fit for purpose means promoting gender parity in management, leadership, and governance. Mechanisms that harness the talent and expertise of women in the health workforce will result in better health systems, and support improved health governance.

Women in Global Health is committed to work with global health institutions to ensure that structural gender barriers are addressed and promote accountability for resilient health systems that improve health at every level.

Recent history has taught us that pandemic responses have often overlooked the specific needs of diverse women. Health leaders must promote and create opportunities for gender transformative leadership to strengthen health systems and ensure quality services. It is urgent to both recognize and include women and people of all gender identities for more impactful health interventions.

As we commemorate World TB Day, we appeal for increased efforts and stronger commitments to promote gender parity in decision-making across the health sector. This must be matched with sustained investments in gender transformative policies and programs to build resilient health systems and a workforce that adequately represents the diverse communities it serves.

Dr Nyuma Mbewe, a member of the Women in Global Health, Zambia Chapter, is an Infectious Diseases Physician with Zambia’s National Public Health Institute and is based in Lusaka, Zambia.

Dr Swati Krishna, a member of the Women in Global Health, India Chapter, is Young Investigator at KEM Hospital Research Centre and consultant to the iDEFEAT TB project of the International Union Against Tuberculosis and Lung Disease. She is based in Pune, India.

IPS UN Bureau

Follow @IPSNewsUNBureau
  

The Asia-Pacific SDG Progress Report will be launched on Wednesday, 22 March 2023, 11:00-12:00 hours (Bangkok time, UTC+7), at the Foreign Correspondent’s Club of Thailand, and Online via Zoom.

By Armida Salsiah Alisjahbana
BANGKOK, Thailand, Mar 20 2023 (IPS)

As we reach the midpoint of the 2030 Agenda for Sustainable Development, it is an opportune moment to reflect on the Asia-Pacific region’s progress and accelerate efforts to achieve our goals.

This year’s Asia-Pacific SDG Progress Report published by ESCAP features pace-leaders of the region who have successfully implemented evidence-based policies to accelerate progress. For instance, Pakistan has made great strides in increasing the number of skilled birth attendants. India has taken concrete steps to reduce child marriages.

Timor-Leste has implemented a national remittance mobilization strategy to leverage remittances as an innovative financial diversification tool, and Cambodia is implementing an evidence-informed clean air plan.

These national achievements across the 17 Sustainable Development Goals are grounded in evidence-based approaches and provide hope and valuable lessons for other countries in the region to follow. By learning from one another’s successes and building on them, the region can collectively accelerate its progress towards achieving the SDGs.

However, the report presents a sobering reminder of how much work remains. While a few nations have made remarkable strides in achieving some of the targets, none of the countries in Asia and the Pacific are on course.

The region has achieved less than 15 per cent of the necessary progress, which puts us several decades away from accomplishing our SDG ambitions. In the absence of increased efforts, the region will miss 90 per cent of the 118 measurable SDG targets.

It is unsettling to observe that progress towards climate action (Goal 13) is slipping away. The region is both a victim of the effects of climate change and a perpetrator of climate change.

Countries are not on track to achieve greenhouse gas emissions reduction targets, and more countries must report emission levels for all sectors to properly monitor their contribution towards global climate agendas.

Goals 5 (Gender equality) and 16 (Peace, justice, and strong institutions) also require urgent attention from all countries to fill the persistent data gaps. Unfortunately, the report shows that since 2017 there has been almost no progress in the region in the availability of data for these two goals with the most significant data gaps.

Investment in data systems is crucial to closing this gap, but more is needed. A data-driven approach to implementing the SDGs is critical to measure progress accurately. To progress towards SDG 5, collecting gender-disaggregated data and investing in education, promoting participation in decision-making, and ensuring access to essential services is crucial.

To achieve SDG 16, countries need to strengthen the rule of law, promote human rights and good governance, and foster civic participation.

As we face a multitude of challenges, including climate change, human-made disasters, military conflicts, and economic difficulties, progress towards the SDGs becomes increasingly critical. Governments must act quickly, invest wisely, enhance partnerships and prioritize populations in the most vulnerable situation.

We must renew our commitment to producing high-quality data and use every means available to ensure sustainability across social, economic, and environmental dimensions. National plans must align with the 2030 Agenda to guide development at the national level.

Despite significant challenges, we must not give up the ambition to achieve the SDGs. There are many inspiring examples of national achievements in carrying out data-informed actions in the region.

These successes give hope for Asia and the Pacific, and there is a need to leverage them more effectively for change. Our collective commitment to the SDGs will serve as a compass towards achieving a sustainable, prosperous and inclusive future for all.

Produced by the United Nations Economic and Social Commission for Asia and the Pacific (ESCAP), the Asia-Pacific SDG Progress Report 2023 will shine a spotlight on countries that have demonstrated commitment and progress towards the 17 global goals. Their strong performance deserves recognition, and their experiences provide important lessons and illuminate pathways for progress in the years ahead.

Unfortunately, this year’s report also reveals that the Asia-Pacific region has achieved less than 15 per cent of the necessary progress, which could result in substantial delays in accomplishing our 2030 ambitions. While the full impact of COVID-19 has yet to be quantified, data on a limited number of indicators are beginning to reveal impacts on people, planet and prosperity.

IPS UN Bureau

Follow @IPSNewsUNBureau
  

Excerpt:

Benson Musyoka rides his motorcycle from Kamboo health centre to transport vaccines to Yindalani village. Photo Joyce Chimbi/IPS

By Joyce Chimbi
NAIROBI, Mar 13 2023 (IPS)

Up until 2019, nurses in three health facilities located in the semi-arid south-eastern Kenya region of Makueni County struggled to bring critical health services closer to a hard-to-reach population scattered across three remote, far-flung villages.

“Kamboo, Yindalani and Yiuma Mavui villages are located 17 and 28 kilometres away from Makindu sub-county hospital, and 10 and 22 kilometres away from the nearest electricity grid,” Benson Musyoka, the nurse in charge of Ndalani dispensary in Yindalani village tells IPS.

Without a cold chain capacity to store vital vaccines and drugs, health facilities records show vaccination coverage across these villages was well below 25 percent.

Babies were delivered at home because mothers could not raise 6 to 12 USDs to hire a boda boda or motorbike taxi, which is the only means of transportation in the area. Others could not reach the hospital in time to deliver.

“Every morning, I would collect vaccines at Makindu sub-county hospital and transport them inside a vaccine carrier box to Ndalani dispensary. Once the vaccines are inside the carrier box, they are only viable for up to six hours, at which point whatever doses will have remained unused must be returned to storage at Makindu sub-county hospital for refrigeration or thrown away,” Musyoka expounds.

In February 2019, a groundbreaking donation of a solar-powered freezer to the Kamboo health centre significantly improved availability and access to vaccinations as well as maternal health services across the three villages and surrounding areas.

Francis Muli, the nurse in charge of Kamboo health centre, tells IPS that without a fridge or freezer, “you cannot stock Oxytocin, and without Oxytocin, you cannot provide labour and delivery services.”

He says it would be extremely dangerous to do so because Oxytocin is injected into all mothers immediately after delivery to prevent postpartum haemorrhage. Oxytocin is also used to induce labour.

As recommended by the World Health Organization, Oxytocin is the gold standard for preventing postpartum haemorrhage and is central to Kenya’s ambitious goal to achieve zero preventable maternal deaths.

In 2017, the Ministry of Health identified sub-standard care in 9 out of 10 maternal deaths owing to postpartum haemorrhage. Overall, postpartum haemorrhage accounts for 25 percent of maternal deaths in this East African nation.

Usungu dispensary and Ndalani dispensary are each located 10 kilometres away from Kamboo health centre in different directions. Nurses in charge of the facilities no longer make the long journey of 28 kilometres to and another 28 kilometres from Makindu to collect and return unused vaccine doses on vaccination days.

“We collect vaccine doses from Makindu sub-county hospital at the beginning of the month and store them in the freezer at Kamboo health centre. The freezer is large enough to store thousands of various vaccine doses collected from the sub-county hospital for all three facilities,” says Antony Matali, the nurse in charge of Usungu dispensary in Yiuma Mavui village.

Two to three times a week, Matali and Musyoka collect doses of various vaccines, including all standard routine immunization vaccines, with the exception of Yellow Fever. The vaccines are transported to their respective dispensaries in a carrier box that can hold up to 500 doses of different vaccines, including the COVID-19 vaccines. All three facilities have recorded significant improvement in immunization coverage from a low of 25 percent.

At Kamboo health centre, where the freezer is domiciled, records show measles immunization rate has surpassed the target of 100 percent to include additional clients outside the catchment population area of 4,560 people. Overall immunization coverage is at 95 percent, well above the government target of 90 percent.

At Ndalani dispensary, the immunization rate for measles has also surpassed the target of 100 percent as additional patients, or transit patients from four surrounding villages and neighbouring Kitui County, receive services at the dispensary. The overall vaccination rate for all standard vaccines is 50 to 65 percent.

In the Usungu dispensary, the vaccination rate for measles is at 75 percent, and for other vaccines, coverage is hovering at the 50 percent mark.

“Usungu and Ndalani have not reached the 90 percent mark because we suffer from both missed opportunities and dropouts. Missed opportunities are patients who drop by a facility seeking a service and find that it is not available at that very moment. Dropouts are those who feel inconvenienced if they do not find what they need in their subsequent visits, so they drop out along the way,” Musyoka explains.

A cold chain or storage facility such as the solar-powered freezer, Muli says, is the cornerstone of any primary health unit in cash-strapped rural settings, and all services related to mother and child are the pillars of any health facility. Without these services, he emphasizes, all you have is brick and mortar.

“At Usungu and Ndalani, we are currently not offering labour and delivery services because we do not have Oxytocin in the facility at all times due to lack of storage, and we cannot carry it around in the hope that a delivery will materialize that day due to the six-hour time limit,” Musyoka expounds.

Still, pregnant women receive the standard tetanus jabs and all other prenatal services, but close to the delivery period, Ndalani and Usungu refer the women to the Kamboo health centre and follow-up to ensure that they receive referred services. Facility records show zero infant and maternal mortality.

Annually, the Ministry of Health targets to vaccinate at least 1.5 million children against vaccine-preventable diseases such as measles, polio, tuberculosis, diarrhoea and pneumonia. Currently, one in six children under one year does not complete their scheduled vaccines.

Only one in two children below two years have received the second jab of Measles-Rubella, and only one in three girls aged 10 have received two doses of the HPV vaccine which protects against cervical cancer.

Ongoing efforts are helping address these gaps. For instance, the HPV vaccine was introduced in Makueni in March 2021. Musyoka vaccinated 46 girls aged 10 years with the two doses of HPV vaccine in 2021, and another 17 girls received their first HPV dose in 2022 and are due for the second dose in November 2022.

Healthcare providers say the freezer has transformed the delivery of mother and child services in the area by bringing critical immunization services closer to a marginalized and highly vulnerable community.

IPS UN Bureau Report

Follow @IPSNewsUNBureau
  

The WHO working group met to consider 307 amendments proposed by governments to update current regulations. February 2023. Credit: World Health Organization (WHO)

By Ashka Naik and Nicoletta Dentico
GENEVA, Mar 13 2023 (IPS)

As countries recently gathered in Geneva for the fourth round of negotiations on the WHO proposed pandemic treaty or accord, close examination of the current text by civil society experts has revealed significant gaps.

Critical concerns about the underlying vision of the draft text have been highlighted in a public statement led and endorsed by civil society organizations globally. The statement has been shared with the Intergovernmental Negotiating Body (INB4) that is mandated with the pandemic treaty negotiation.

These concerns still stand true. And it is urgent that the INB begins to tackle them before the next round of negotiations are upon us.

First and foremost, our analysis focuses on the fact that several parts of the text rely on voluntary arrangements, and that the binding regime of the text appears discouragingly vague and weak. One such instance relates to the principle of “common but differentiated responsibilities in pandemic prevention, preparedness and response,” which the draft borrows from the climate instruments.

This notion is extremely important to avoid pandemics, and it cannot be made voluntary, if the world is serious about the goal of reaching systemic capacity to respond to future health crises.

The draft text’s failure to provide safeguards or an accountability framework regarding the role of the corporate sector is another major source of concern. The WHO negotiation places the new UN’s ‘whole of society’ approach – which has been pushed in other negotiating fora – at its core through multistakeholderism, against the backdrop of striking and unfettered geopolitical power asymmetries. The involvement of the private sector in the COVID-19 response has been extremely problematic.

Countries desperately needing a concerted effort to tackle the pandemic were held ransom to the whims of power and profits of both the philanthropic and pharmaceutical industry.

The proposed treaty or accord mustn’t make the same mistakes, and all attempts to bring the corporate sector into the negotiation of any pandemic prevention, preparedness, or response must be strictly regulated at best, and prevented whenever there is a risk of public interest health policies being hijacked for profit.

It is clear that the financing approach outlined in the draft text blatantly ignores that the global financial system has historically prevented low- and middle-income countries from investing in public health.

Tax dodging by corporations, lack of fiscal and policy space for domestic resource mobilization, and crippling national debts are major barriers that prevent many countries from strengthening their public health services and institutions.

In low-income countries, debt has increased from 58% to 65% between 2019 and 2021. Thirty nations in sub-Saharan Africa have seen a debt-to-GDP ratio exceeding 50% just in 2021.

While the current draft misses taking into account the challenges of the global financial architecture, there is a blind spot with no substantive acknowledgement that public health crises are often engendered or exacerbated by a systematic destruction of the planet, at the intersection of the climate and environmental crises, food insecurity, and the mounting inequality crisis enshrined in gender and racial discrimination.

So far, the draft text hardly does justice to the urgency of preventing pathogen spillover at the animal-human interface. A narrow focus on the biomedical approach to dealing with future pandemics, without considering these intrinsic systemic factors, is bound to remain largely insufficient in dealing with any future pandemics.

Way Forward

Governments and various relevant socio-political actors engaged in the WHO diplomatic initiative on the pandemic treaty or accord have different and diverging interests and the Intergovernmental Negotiating Body (INB), which has done impressive work to keep pace with the agreed negotiations’ roadmap, has to reckon with these diverse political demands and conflicting pressures.

However, it is clear that to carry out the original intent of the new pandemic treaty or accord, unambiguous wording is needed that conveys a binding character of the agreement. This also means that the multistakeholder model under which the entire process of the treaty is being managed has to be re-examined and re-imagined instead of its current ‘whole of society’ form.

In future, none of the promises made by member states in the WHO pandemic treaty or accord will result in the desired change needed if the robust and reliable compliance mechanisms that enable governments to be held accountable are absent.

These demands are not unique to this treaty, but have similarly been made by civil society in ongoing negotiations in the UN on climate change and in the UN treaty on business and human rights. These were also incorporated into the tobacco control binding policy that the WHO established nearly 20 years ago.

At the same time, public health, public governance, public systems, and public funding must be at the center of the pandemic planning, prevention, and response. It is important to finally recognise that the global financial architecture must be overhauled, especially for low income and developing countries to have sovereign control over their fiscal and policy space, and to resource their public health needs through progressive taxation policies.

It is imperative to understand that the private sector cannot fulfill the current funding gaps and needs no leveraging by international development and financial institutions. Healthcare privatization is not the way to go to face the health challenges of the present and the future.

Lastly, all efforts must be made to make sure that the text creates a deliberate interconnection between the right to health and the right to a healthy environment, now explicitly adopted as a human right by the United Nations, as well as the rights of nature to exist and thrive.

It is about time that this global public health discourse reckons with the reality of populations and the environments from the ground, rather than from the ivory towers of corporate investors and vested policy-making.

Ashka Naik is the Director of Research and Policy at Corporate Accountability, and directs its food program, which focuses on structural determinants of food systems, nutrition, and public health

Nicoletta Dentico leads the Global Health Justice program at Society for International Development and co-chairs the Geneva Global Health Hub (G2H2)

IPS UN Bureau

Follow @IPSNewsUNBureau
  

Delegates at the Youth Empowerment: Education, Employment and Sexual and Reproductive Health and Rights forum held in Phnom Penh, Kingdom of Cambodia. Credit: APDA

By Cecilia Russell
JOHANNESBURG, Mar 8 2023 (IPS)

With more than 600 million youth aged between 18 and 24 in the Asia and Pacific region, putting their issues front and center is crucial. Speakers at a recent forum, Youth Empowerment: Education, Employment and Sexual and Reproductive Health and Rights, held in Phnom Penh, Kingdom of Cambodia, agreed that policy development and implementation should be youth-centered.

Professor Keizo Takemi, MP (Japan) and Chair of the Asian Forum of Parliamentarians on Population and Development (AFPPD), reminded parliamentarians of the work ahead when he noted in his opening address that while youth were “innovative thanks to global digitalization, half are unemployed or underemployed. Therefore parliamentarians have a vital role to play.”

The extent of the challenges emerged during the discussions. Raoul Danniel A Manuel, MP Philippines, said teenage pregnancy was higher in rural areas than urban, and there was also an education differential.

“The rate is 32 percent among teenagers without education, 14% among teenagers with primary education, and 5% among teenagers with a secondary education,” Manuel said, noting that the Philippines was the only country in Southeast Asia where the teenage pregnancy rate is increasing in girls aged 10 to 14.

“It is important to raise awareness among young people so that they know how to take care of themselves before they marry. We also need to continue to strengthen services, especially user-friendly services, by focusing on vulnerable groups and young women who do not go to school because this group is at a very high risk of pregnancy, and pregnancy can be risky.”

Lisa Chesters, MP (Australia), reminded conference delegates that “comprehensive sexual education has a positive impact on young people. It has been credited with delaying sexual debut can reduce unwanted pregnancies and STDs.”

Benefits included preventing intimate partner violence, developing healthy relationships, and preventing sexual abuse.

Australia learned after an online petition went viral in 2021 the extent to which students had been subjected to sexual harassment at schools. Following this, ministers for education throughout the country agreed on sexual education at school.

Chesters said it was crucial to include comprehensive, well-planned engagement of young people at the center of any advertising and social media campaigns.

The discussion also centered around employment. Felix Weidenkaff, the Youth Employment Expert for the ILO’s regional office for Asia and the Pacific, told the conference that while digitalization was a key strategy to increase youth employment, it wasn’t a one-off. Aspects lawmakers should consider would include TVET and skill development (including understanding the needs of those with disability), infrastructure, connectivity, and equipment to create an inclusive system.

Delegates at the Youth Empowerment: Education, Employment and Sexual and Reproductive Health and Rights forum held in Phnom Penh, Kingdom of Cambodia. Credit: APDA

Sophea Khun, Country Program Coordinator of UN Women, said changing gender norms required comprehensive and sustained strategies that engage multiple stakeholders at all levels: households, communities, institutions, and governments.

Girls and young women needed to be given the opportunity for training in STEM (science, technology, and mathematics) to close the digital divide.

“In addition, harmful social norms that contribute to controlling women and girls’ access to communications and technology also need to be tackled,” Khun said.

Hun Many, MP (Cambodia) and Chair of the Commission, reiterated in his closing remarks that to create a more elaborate and innovative policy, “youth need to be able to be part of the decision-making process and the discussions.”

Ahead of the conference, IPS interviewed Cambodian MP Lork Kheng, chair of the commission on public health, social works, vocational training, and women’s affairs. Here are excerpts from the interview.

Lork Kheng, Cambodian MP and chair of the commission on public health, social works, vocational training, and women’s affairs.

IPS:  A tremendous amount of work is to be done to improve SRHR for all and youth-friendly services. How can young MPs play an enhanced role in developing policy, ensuring services are adequately financed and delivered to the communities where required?

LK: With regards to the role of Parliament, we can oversee the implementation of policies related to education, the provision of safe counseling on sexual and reproductive health, family planning, abortion, HIV/AIDS prevention and care, and local monitoring of child marriages, which are challenges for our Asia-Pacific region. In addition, the National Assembly always provides opportunities for development partners to contribute ideas and proposals for consideration through close cooperation in organizing educational forums and disseminating discussions and exchanges at national and sub-national levels (in their constituencies). We can establish effective monitoring and evaluation mechanisms and coverage of the actual implementation of practitioners and service providers and the effectiveness of policies to ensure that they are providing the anticipated outcomes. Working with think tanks and civil society organizations to conduct research, assessment, and evaluation that informs policymaking and improves service delivery from all stakeholders’ perspectives.

Another important role is to communicate directly with the people and sub-national authorities in the constituencies where they are based. Young MPs and MPs often use the forum to meet and visit local administrations, etc., to mainstream the information and raise awareness of the importance of youth and family life planning, as well as to share good local and global political experiences and best practices that can be implemented within the existing framework of national and sub-national policies to stakeholders, especially local authorities who work directly with the youth.

In particular, in overseeing the financing, every year, MPs actively participate in the discussion of the draft budget law, in which the whole House closely monitors the progress and changes in the budget allocation according to each program. Furthermore, MPs also provide feedback to the executive branch during the initial consultation phase until the full house passes the draft budget. In this regard, the review of budget allocations for youth health care, such as increased attention to the prevention and control of non-communicable diseases, tobacco control, food safety and diet in general, and sexual issues in particular, has been addressed frequently and has been noted and considered by the relevant ministries as well as the Government.

The Ministry of Posts and Telecommunications has prioritized students who pass the upper secondary national examination with good grades to study digital skills with the support of a student loan that must be repaid when they get a job. This is to strengthen human resources with digital capabilities.

IPS: While Asia and the Pacific are home to more than 60% of the world’s youth aged between 15 and 24, the COVID-19 pandemic acted to disadvantage youth in poorer and rural communities, especially where schooling was interrupted, and children did not have access to the technologies for remote learning. How can youth MPs ensure that those children (who may even now be young adults) are given the opportunities to complete their education? Secondly, how should policy, infrastructure, and finance be directed at children still disadvantaged by a lack of technology?

LK: We all truly recognize that the COVID-19 pandemic is an extraordinary challenge that has plagued all socio-economic sectors, requiring the Government and authorities to respond with unusual means in these difficult circumstances. In developing countries like Cambodia, when schools were closed to prevent the spread of COVID-19 in its early stages, we did not have the right digital infrastructure for teaching and learning. Students in rural areas and those considered to be disadvantaged groups were the ones who faced barriers to accessing education at that stage. But if we look at the immediate solution of the Head of the Royal Government of Cambodia, we can measure the outcome of solving the challenges with this decision. The Government quickly rolled out vaccinations, especially prioritizing vaccinations for front-line medical workers and educators. That ensured that these two environments gained immunity as soon as possible so that students could return to class quickly with a high sense of security.

IPS: Youth are considered a vital resource for the country’s economic development, but they face high unemployment. What are young MPs working on to ensure that youth can get decent jobs and support young entrepreneurs? What are the policy directions needed to foster youth employment?

LK: Specifically in Cambodia, the unemployment rate for youth may be slightly lower than 14 percent. Nevertheless, youth are also facing other major challenges, such as skill mismatches with the job markets and vulnerabilities of international labor migration, which are the major concerns of the Parliament and the Government. As Cambodia is riding high on development in all areas, the labor market has expanded, especially in areas that benefit youth. In response to such demands, the Government has paid close attention to education and vocational training by prioritizing promoting science, technology, engineering, and mathematics (STEM) to encourage young people to acquire high-demand skills.

In this new academic year, the Government has encouraged youth to pursue vocational skills at the primary and secondary levels by giving monthly allowance to approximately 1.5 million students, in addition to their free tuition.

To support the promotion of young entrepreneurship, we have also established a number of mechanisms – both under state supervision and public-private partnerships – that have created entrepreneurship and incubation centers. In particular, during the COVID-19 pandemic, these mechanisms also played an important role in providing much-needed assistance to those businesses through loans and free training to the entrepreneurs so that they could utilize the technology for their businesses against the backdrop of a changing lifestyle in the new normal.

Note: Asian Forum of Parliamentarians on Population and Development (AFPPD), Asian Population and Development Association (APDA), and the Japan Trust Fund supported the hybrid conference.

IPS UN Bureau Report

Follow @IPSNewsUNBureau
  

Mangroves in Tai O, Hong Kong. Coastal wetland protection and restoration is an example of the kind of multifunctional solution that is needed to address multiple global crises together. Credit: Chunyip Wong / iStock

By Paula Harrison, Pamela McElwee and David Obura
BONN, Mar 2 2023 (IPS)

When global crises are interlinked, they overlap and compound each other. In such cases, the most effective solutions are those that work at the nexus of all these challenges.

In September, almost every Government on Earth will gather at the UN Sustainable Development Summit in New York to take stock at the halfway mark of the Sustainable Development Goals (SDGs) of what has been achieved and what remains to be done.

Despite some progress, global development efforts have been hamstrung by unprecedented environmental, social and economic crises, in particular biodiversity loss and climate change, compounded of course by the COVID-19 pandemic.

Tackling these interlinked challenges separately risks creating situations even more damaging to people and communities around the world, and exacerbates the already high risk of not meeting the goals and targets of the 2030 Agenda for Sustainable Development.

This is especially true because the myriad drivers of risk and damage affect many different sectors at once, across scales from local to global, and can result in negative impacts being compounded. For example, when demands for food and timber combine with the effects of pollution and climate change, they can decimate already degraded ecosystems, driving species to extinction and severely reducing nature’s contributions to people.

The global food system offers another example of this negative spiral of interlocking crises – where food that is produced unsustainably leads to water overconsumption and waste, pollution, increased health risks and loss of biodiversity. It also leads to excessive greenhouse gas emissions, contributing to climate change.

Yet policies often treat each of these global threats in isolation, resulting in separate, uncoordinated actions that typically address only one of the root causes and fail to take advantage of the many potential solution synergies. In the worst cases, actions taken on one challenge directly undermine those needed to tackle another because they fail to account for trade-offs, resulting in unintended consequences, or the impacts being externalised, as someone else’s problem.

This is why almost 140 Governments turned to the Intergovernmental Platform on Biodiversity and Ecosystem Services (IPBES) – requesting IPBES to undertake a major multiyear assessment of the interlinkages among biodiversity, water, food and health in the context of the rapidly-changing climate. This ‘Nexus Assessment’ is among the most complex and important expert assessments ever undertaken – crossing key biophysical domains of climate and biodiversity and elements central to human wellbeing like food, water and health. It will also address how interactions are affected by energy, pollution, conflict and other socio-political challenges.

To fully address this ‘nexus’, the assessment is considering interactions across scales, geographic regions and ecosystems. It also covers past, present and future trends in these interlinkages. And, most importantly, it will offer concrete options for responses to the crises that address the interactions of risk and damage jointly and equitably – providing a vital set of possible solutions for the more sustainable future we want for people and our planet.

One example of the mutifunctional solutions that will be explored is nature-based solutions – such as coastal wetland protection and restoration. When coastal wetland ecosystems are healthy – whether conserved or where necessary, restored – they are a refuge and habitat for biodiversity, improving fish stocks for greater food security and contributing to improve human health and wellbeing. They can also sequester carbon, helping to mitigate climate change, and protect adjacent communities and settlements from flooding and sea level rise.

To develop and implement these kinds of multi-functional solutions, responses for dealing with the major global crises need to be better coordinated, integrated, and made more synergistic across sectors, both public and private. Decision-makers at all levels need better evidence and knowledge to implement such solutions.

Work on the nexus assessment began in 2021 – with the final report expected to be considered and adopted by IPBES member States in 2024. A majority of the 170 expert authors and review editors from around the world are meeting in March in the Kruger National Park in South Africa to further strengthen the draft report, responding to the many thousands of comments received during a first external review period.

The assessment will also include evidence and expertise contributed by indigenous peoples and local communities – whose rich and varied direct experiences and knowledge systems that consider humans and nature as an interconnected whole have embodied a nexus approach for generations.

The Paris Agreement on Climate Change and the recently-agreed Kunming-Montreal Global Biodiversity Framework provide the roadmaps for tackling the climate and biodiversity crises. The IPBES nexus assessment will offer policymakers a practical guide to bridge the vital interlinkages across the two challenges, to other relevant frameworks, and link to the sustainable development agenda.

For more information about IPBES or about the ongoing progress on the nexus assessment, go to www.ipbes.net or follow @ipbes on social media.

Prof. Paula Harrison is a Principal Natural Capital Scientist and Professor of Land and Water Modelling at the UK Centre for Ecology & Hydrology, United Kingdom.

Dr. David Obura is a Founding Director of CORDIO (Coastal Oceans Research and Development – Indian Ocean) East Africa, Kenya.

IPS UN Bureau

Follow @IPSNewsUNBureau
  

Cooperative members in southern Lebanon make a rare, traditional bread called Mallet El Smid to be sold at the MENNA shop in Beirut. Women are central to meeting the SDGs, say parliamentarians. Credit: UN Women/Joe Saade

By IPS Correspondent
JOHANNESBURG, Feb 23 2023 (IPS)

The post-COVID-19 period has been a crucial one for members of parliament who have their work cut out to ensure that issues that arose during the pandemic are addressed, especially concerning the ICPD25 commitments and programmes of action for universal access to sexual and reproductive rights, gender-based violence and building peaceful, just and inclusive societies. Across the world, progress toward achieving the SDGs by 2030 was impacted during the pandemic.

As Dr Samar Haddad, a former member of the Lebanese Parliament and head of the Population Committee at the Bar Association in Lebanon commented at a recent meeting of the Forum of the Arab Parliamentarians  for Population and Development (FAPPD): “The main theme for this year is combating gender-based violence, which is a scourge that the entire world suffers from, and its rate has risen alarmingly in light of the economic crisis, bloody stability, wars, and displacement.”

IPS was privileged to interview two members of parliament from the region about how they are tackling GBV, youth empowerment, and women’s participation in politics, society, and the economy.

Here are edited excerpts from the interviews:

Pierre Bou Assi, MP from Lebanon

Pierre Bou Assi, MP from Lebanon

IPS: What legislation, budgets, and monitoring frameworks are in place or planned for combating GBV in Lebanon?

Pierre Bou Assi (PA): Lebanon has launched a project to support protection and prevention systems to prevent gender-based violence within the framework of continuous efforts aimed at responding to social and economic challenges in Lebanon and aims to strengthen prevention and monitoring mechanisms for gender-based violence, and support the efforts made by the Public Security Directorate through the Department Family and juvenile protection.

IPS: One of your speakers at a recent conference spoke about rapid population growth, youth, and high urbanization rates. Youth are often impacted by unemployment or low rates of decent employment. What are parliamentarians doing to assist youth in ensuring that the country can benefit from its demographic dividend?

PA: Youth are the pillar of the nation, its present and future, and the means and goal of development. They are the title of a strong society and its future, stressing that the conscious youth (educated and mindful) armed with science and knowledge are more than capable of facing the challenges of the present and the most prepared to enter the midst of the future.

I would like to say that the Youth Committee in the Lebanese Parliament is working on developing a targeted and real strategy that includes advanced programs that are agreed upon by experts and active institutions in this field to consolidate the principles of citizenship, the rule of law and patriotism, and empower the youth politically and economically to achieve their potential and develop and expand their horizons.

In addition, we are expanding youth participation in public life by providing them with opportunities for practical training in legislative and oversight institutions, and refining the participants’ personal skills by informing them of the decision-making process in the Council.

IPS: Looking back at the COVID-19 situation, most countries experienced two clear issues, an increase in GBV and its impact on children’s education. There was also an issue with high levels of violence experienced by children. Are parliamentarians concerned about the COVID impacts on children, and what programs have been implemented to support them?

PA: There is no doubt that Lebanon, like other countries in the world, was affected by the coronavirus pandemic in all aspects of life, including children and its impact on the quality of education, as well as the high level of violence that children were exposed to during that period, as I would like to take a look at the more positive side. We note a number of measures Lebanon took during the pandemic – which included the release of children who were in detention, the strengthening or expansion of social protection systems through cash assistance, and an overall decrease in levels of violence in conflict situations.

Lebanon has a plan that includes the following points:

• The continuity and safety of learning for all school children, including bridging the digital divide and creating low-cost technology.
• Implementing a basic package for equitable access to primary health care for children and mothers.
• Expanding the scope and appropriateness of infant and young child feeding programs and general educational messages.
• Expanding social protection systems to reach the most affected children and families through cash transfer programmes.
• Enhancing government budgetary allocations and public funding for social sectors, with a special focus on health care and education.

Hmoud Al-Yahyai, MP from Oman.

Hmoud Al-Yahyai, MP from Oman

Al-Yahyai spoke to IPS about the development of a human-rights-based framework. The interview followed a meeting with the theme “Human Rights and their relationship to the goals of sustainable development. The meeting was held by the Omani Parliamentary Committee for Population and Development in cooperation Omani National Commission for Human Rights, the Forum of Arab Parliamentarians for Population and Development (FAPPD), and the Asian Population and Development Association (APDA) on “Human Rights and their relationship to the goals of sustainable development.”

IPS: How is Oman working towards a human rights-based legislative framework, and what role are parliamentarians taking to ensure implementation? What role does Oman Vision 2040 play in this?

Hmoud Al-Yahyai (HY): The government of the Sultanate of Oman has integrated the sustainable development goals into national development strategies and plans and made them a major component of the long-term national development strategy components and axes known as Oman Vision 2040. The strategy is enhanced by broad societal participation when designing and implementing it and evaluating the plans and policies set. And we, as parliamentarians, make sure, as stated in the voluntary national report, (to provide oversight of) the government’s commitment to achieving the goals of sustainable development, with its three dimensions, economic, social, and environmental, within the specified time frame.

I commend the efforts of the Sultanate of Oman in implementing the goals of sustainable development through several axes, including the pillars of sustainable development, implementation mechanisms, progress achieved, and future directions for the localization of the sustainable development agenda in the short and medium term, and the consistency of Oman Vision 2040.

The Sultanate of Oman reviewed its first voluntary national report on sustainable development at the United Nations headquarters as part of its participation in the work of the UN Economic and Social Council.

Sustainability is crucial to Sultanate, emphasizing that development is not an end in itself, but aimed at building up its population.

Future directions for the localization of the SDGs in the short and medium term are represented on five axes, which include raising community awareness, localizing sustainable development, development partnerships, monitoring progress and making evidence-based policies, and institutional support.

The axes for sustainable development are human empowerment, a competitive knowledge economy, environmental resilience through commitment and prevention, and peace. These form the pillars for sustainable development through efficient financing, local development, and monitoring and evaluation.

Oman has adopted a coordinated package of social, economic, and financial policies to achieve inclusive development based on a competitive and innovative economy. This is being worked upon toward Oman Vision 2040 and its implementation plans, through a set of programs and initiatives that seek to localize the development plan toward achieving the SDGs 2030 and beyond.

IPS: What role do women play in your legislative framework, and do they play a role in ensuring, for example, SRHR rights?

HY: The Sultanate has taken many positive measures to sponsor women. The Sultanate’s policies towards accelerating equality between men and women stem from the directives of the Sultan and his initiatives to appoint women to high positions, to feminize the titles of positions when women fill them, and to grant them political, economic, and social rights.

Women benefit from support in the

• Social field: through comprehensive social insurance and social security system.
• Political field: through the appointment of female ministers, undersecretaries, and ambassadors, and in the field of public prosecution.
• Economic field: through labor and corporate law.
• Cultural field: through the system of education and grants.

There are many programs geared or dedicated to women. The government has begun to circulate and implement a program to support maternal and childcare services at the national level to reduce disease and death rates by providing health care for women during pregnancy, childbirth, and postpartum and encouraging childbirth under medical supervision.

IPS: What are the achievements of Oman in reaching SDG Target 3.7 (Sexual and reproductive health by 2030, ensure universal access to sexual and reproductive healthcare services, including family planning, information and education, and the integration of reproductive health into national strategies)?

HY: In this regard, a campaign was launched on sexual and reproductive health in the Sultanate due to its positive impact on public health and society. This campaign confirms that reproductive health services are an integral part of primary health care and health security in the country and that it has long-term repercussions on health and social and economic health. Family planning is one of the most important of these services because, if it is not organized, it constitutes a social bomb that can hit everyone, whether a citizen or an official. Therefore, we must take proactive preventive steps.

IPS UN Bureau Report

Follow @IPSNewsUNBureau
  

Farmer using tablet to contact customer/ iStock

By Hsiao Chink Tang and Anne Cortez
BEIJING, The People’s Republic of China, Feb 21 2023 (IPS)

Digitalization is a key driver of competitiveness and development. As the world takes the path to unprecedented digital advancement, Asia continues to be a powerhouse of digital transformations in a wide range of areas from microchip manufacturing to electric vehicles, from digital currency to e-commerce.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

IPS UN Bureau

Follow @IPSNewsUNBureau
  

Young people from small towns are now able to work close to home thanks to co-working spaces that opened up during the COVID-19 pandemic. Credit: Rina Mukherji/IPS

By Rina Mukherji
PUNE, INDIA, Feb 8 2023 (IPS)

While a 2017 study by the Confederation of Indian Industry Jones Lang LaSalle India and WeWork noted the potential in India’s co-working segment, it took COVID-19 for people to transition to co-working spaces close to home.

The study, Future of Work – The Co-working Revolution, which saw the potential market size of the co-working segment standing at 12-16 million, anticipated 400 million USD in investments by 2018, triggering a 40-50 percent growth in 2017 itself.

This was to be driven by India’s emerging start-ups (given that India is currently the world’s largest start-up hub) and India’s freelance workforce (with India having the 2nd largest freelancer workforce in the world, more than 15 million professionals).

In 2020, India was hit by the pandemic. Owing to a forced lockdown in operations, many companies faced heavy losses. On resumption, they had to operate at 50 percent capacity (as per government directives), which meant curtailment in operations. Layoffs and salary cuts were invoked to survive. Barring manufacturing operations, the attendance of many employees was deemed unnecessary in the office. This ushered in the work-from-home culture.

Salary cuts, and work-from-home options, saw many employees move out of expensive metropolitan centres and return home to smaller towns and cities. Some who faced layoffs and salary cuts opted to launch start-ups. This gave further impetus to the demand for commercial spaces in small towns and Tier-2 or Tier-3 cities for co-working spaces.

Over the last few decades, small-town India has seen professional education pick up in a big way, with several reputed engineering and management institutions nurturing brilliant students. However, conservative values continue to rule here, unlike cosmopolitan metropolitan centres. Since many youngsters are first-generation professionals and belong to rural families of modest means, moving to a metropolitan city can be a big financial strain for a fresher. Internships, too, are difficult to come by for a student straight out of college.

As a result, many remain confined to low-paid jobs in their towns and end up frustrated in the long run.

This is where the pandemic has helped.

Take the case of the pilgrim city of Tirunelveli in the state of Tamil Nadu at the southern tip of the Indian peninsula. Adjoining the port town of Tuticorin, it has many engineering, management and science colleges. Tirunelveli is close to Nagercoil town in Kanyakumari district, which is the southernmost district of the Indian mainland and boasts a high rate of literacy. Yet, students from these parts have always had to move to either Chennai or Bangalore for a suitable job or internship.

Ronaldsen Solomon of Virudhunagar, though, has been lucky. A final-year student of Engineering studying at Francis Xavier College in Tirunelveli, he has landed an internship with an IT infrastructure company with local offices in a co-working space.

“I am acquiring hands-on experience, even as I attend college lectures for my degree,” he tells me of his job at 3i Infotech.

For Jenima Hyrun of Chermahadevi town in Tirunelveli district, landing a job was an uphill task, despite her Computer Science degree, owing to opposition from her conservative Muslim family.

“I had a job offer from Chennai. But although my father has always encouraged me, my aunts and others would not allow it. Being part of a joint family, living alone in a metropolitan city was unthinkable for me.”

When 3i Infotech acquired dedicated premises under Mikro Grafeio, Hyrun’s prayers for a suitable opening were answered. She easily traverses the short distance to work from her home using public transport.

When Vijay Roshan acquired his Bachelor of Computer Applications degree from MDT Hindu College in Tirunelveli, his faltering English made him unsure of himself. As a farmer’s son, he felt uncertain about moving to a metropolitan city either. However, when the same IT infrastructure company launched its office through a dedicated space, Roshan was immediately recruited as a promising fresher.

For those who would rather not travel a long distance to work, low-cost rentals are not too difficult to come by in Tier-2 and Tier-3 cities.

Take the case of college-mates Vignesh M and Ashwin S.C from Thiruvananthapuram in the adjoining state of Kerala, who completed their degrees at the Nurul Islam Institute of Higher Education. Taking up lodgings in Tirunelveli is far cheaper than if they had moved to metropolitan centres like Bangalore or Chennai.

“We pay Rs 1500 per head, sharing a room among three colleagues in a nearby home. The place is only a 15-minute walk from our workplace, saving commuting time and money,” Ashwin says.

The same is true of Shiny Evangeline and Abarnadevi from the neighbouring district of Nagercoil (in Tamil Nadu), Tamilselvi of Thenkasi, and Sahanya Wilson of Kanyakumari. This ensures a better take-home salary for these freshers, who would have needed to spend upwards of Rs 10,000 for a co-living space in a metropolitan city. Shared rentals also nurture better camaraderie among colleagues, which is essential for better project teamwork.

When blue chip companies move into Tier-2 and Tier-3 cities, it can mean a lot for specially-abled persons like V Saumya, who has battled many odds to emerge as a Human Resources Head today. Victim of an accident as an infant, Saumya had to fall back on help from her parents all through her school and college years, fighting despite her physical disability to complete her Master’s in Business Administration. Proximity to her workplace in Tirunelveli has helped her secure a job, and she too works for 3i Infotech and is appreciative of the facilities at Mikro Grafeio.

“For the first time, I was greeted by a disabled-friendly toilet that I could use.”

The world has opened up for Saumya, who now looks forward to travelling far and wide, even as she travels up and down to work on her motorised wheelchair.

Although Mikro Grafeio intends to develop co-working spaces for individual use in small towns eventually, it currently confines itself to operating dedicated areas for companies. Chief Growth Officer Sundar Rajan tells IPS, “We are still exploring the market; in small towns, the concept is yet to catch up. However, Mikro Grafeio operates co-working spaces within cafes and breweries in cities like Coimbatore, Pondicherry and Bangalore and has Memoranda of Understanding in place with Café Coffee Day in Tamil Nadu, Kerala and Karnataka.”

It has several clients, 3i Infotech, CIT Services, Sotheby’s International Realty, and others that are slated to follow suit.

Indiqube has followed a similar pattern by handing over dedicated spaces and co-working offices. According to Indiqube Co-Founder Rishi Das, 85 percent of their clientele have dedicated spaces, while 15 per cent belong to the co-working segment.

IPS UN Bureau Report

Follow @IPSNewsUNBureau
  

Few policymakers ever claim credit for causing stagnation and recessions. Yet, they do so all the time, justifying their actions by some supposedly higher purpose.

Now, that higher purpose is checking inflation as if it is the worst option for people today. Many supposed economists make up tall tales that inflation causes economic contraction which ordinary mortals do not know or understand.

Jomo Kwame Sundaram

Recent trends since mid-2022 are clear. Inflation is no longer accelerating, but slowing. And for most economists, only accelerating inflation gives cause for concern.

Annualized inflation since has only been slightly above the official, but nonetheless arbitrary 2% inflation target of most Western central banks.

At its peak, the brief inflationary surge, in the second quarter of last year, undoubtedly reached the “highest (price) levels since the early 1980s” because of the way it is measured.

After decades of ‘financialization’, the public and politicians unwittingly support moneyed interests who want to minimize inflation to make the most of their financial assets.

War and price
Russia’s aggression against Ukraine began last February, with retaliatory sanctions following suit. Both have disrupted supplies, especially of fuel and food. The inflation spike in the four months after the Russian invasion was mainly due to ‘supply shocks’.

Price increases were triggered by the war and retaliatory sanctions, especially for fuel, food and fertilizer. Although no longer accelerating, prices remain higher than a year before.

To be sure, price pressures had been building up with other supply disruptions. Also, demand has been changing with the new Cold War against China, the Covid-19 pandemic and ‘recovery’, and credit tightening in the last year.

There is little evidence of any more major accelerating factors. There is no ‘wage-price spiral’ as prices have recently been rising more than wages despite government efforts ensuring full employment since the 2008 global financial crisis.

Despite difficulties due to inflation, tens of millions of Americans are better off than before, e.g., with the ten million jobs created in the last two years. Under Biden, wages for poorly paid workers have risen faster than consumer prices.

Higher borrowing costs have also weakened the lot of working people everywhere. Such adverse consequences would be much less likely if the public better understood recent price increases, available policy options and their consequences.

With the notable exception of the Bank of Japan, most other major central banks have been playing ‘catch-up’ with the US Federal Reserve interest rate hikes. To be sure, inflation has already been falling for many reasons, largely unrelated to them.

Making stagnation
But higher borrowing costs have reduced spending, for both consumption and investment. This has hastened economic slowdown worldwide following more than a decade of largely lackluster growth since the 2008 global financial crisis.

Ill-advised earlier policies now limit what governments can do in response. With the Fed sharply raising interest rates over the last year, developing country central banks have been trying, typically in vain, to stem capital outflows to the US and other ‘safe havens’ raising interest rates.

Having opened their capital accounts following foreign advice, developing country central banks always offer higher raise interest rates, hoping more capital will flow in rather than out.

Interestingly, conservative US economists Milton Friedman and Ben Bernanke have shown the Fed has worsened past US downturns by raising interest rates, instead of supporting enterprises in their time of need.

Four decades ago, increased servicing costs triggered government debt crises in Latin America and Africa, condemning them to ‘lost decades’. Policy conditions were then imposed by the International Monetary Fund and World Bank for access to emergency loans.

Globalization double-edged
Economic globalization policies at the turn of the century are being significantly reversed, with devastating consequences for developing countries after they opened their economies to foreign trade and investment.

Encouraging foreign portfolio investment has increasingly been at the expense of ‘greenfield’ foreign direct investment enhancing new economic capacities and capabilities.

The new Cold War has arguably involved more economic weapons, e.g., sanctions, than the earlier one. Trump’s and Japanese ‘reshoring’ and ‘friend-shoring’ discriminate among investors, remaking ‘value’ or ‘supply chains’.

Arguably, establishing the World Trade Organization in 1995 was the high water mark for multilateral trade liberalization, setting a ‘one size fits all’ approach for all, regardless of means. More recently, Biden has continued Trump’s reversal of earlier trade liberalization, even at the regional level.

1995 also saw strengthening intellectual property rights internationally, limiting technology transfers and progress. Recent ‘trade conflicts’ increasingly involve access to high technology, e.g., in the case of Huawei, TSMC and Samsung.

With declining direct tax rates almost worldwide, governments face more budget constraints. The last year has seen these diminished fiscal means massively diverted for military spending and strategic ends, cutting resources for development, sustainability, equity and humanitarian ends.

In this context, the new international antagonisms conspire to make this a ‘perfect storm’ of economic stagnation and regression. Hence, those striving for international peace and cooperation may well be our best hope against the ‘new barbarism’.

IPS UN Bureau

Follow @IPSNewsUNBureau
  

As the year 2022 drew to an end, the United Nations Conference on Trade and Development (UNCTAD) warned, “Developing countries face ‘impossible trade-off’ on debt”, that spiralling debt in low and middle-income countries (LMICs) has compromised their chances of sustainable development.

Anis Chowdhury

Debt on the rise
Debt build-up accelerated in the wake of the 2008-2009 global financial crisis (GFC). The World Bank’s, Global Waves of Debt reveals that total (public & private; domestic & external) debt in emerging market and developing economies (EMDEs) reached an all-time high of around 170% of GDP ($55 trillion) – more than double the 2010 figure – by 2018, before the onset of the COVID-19 pandemic.

Total debt in low-income countries (LICs), after a steep fall from the peak of around 120% of GDP in the mid-1990s to around 48% ($137 billion) in 2010, increased to 67% of GDP ($270 billion) in 2018.

Pandemic debt
The COVID-19 pandemic greatly lengthened the list of EMDEs in debt distress as rich nations and institutions dominated by them, e.g., the World Bank, failed to provide any meaningful debt reliefs or increase financial support to adequately respond to the health and economic crises.

The World Bank’s chief economist advised, “First fight the war [pandemic], then figure out how to pay for it”. The IMF’s managing director counselled, “Please spend, spend as much as you can. But keep the receipts”.

The World Bank’s International Debt Statistics 2022 reveals that the external debt stock of LMICs in 2021 rose to $9.3 trillion (an increase of 7.8% compared to 2020) – more than double a decade ago in 2010. For many countries, the increase was by double digit percentages.

Riskier debt
Over the past decade, the composition of debt has changed significantly, with the share of external debt owed to private creditors increasing sharply. At the end of 2021, LMICs owed 61% of their public and publicly guaranteed external debt to private creditors—an increase of 15 percentage points from 2010.

The private creditors charge higher interest rates, and offer little or no scope for restructuring or refinancing at favourable terms, as they maximise profit. The private creditors also usually offer credits for shorter duration, while development financing needs are for longer-terms.

Failed aid promises
Development needs of developing countries have increased many-folds, especially for meeting internationally agreed development goals, such as the Millennium Development Goals (MDGs) and now Sustainable Development Goals (SDGs). The LMICs’ estimated aggregate investment needs are $1.5–$2.7 trillion per year—equivalent to 4.5–8.2% of annual GDP— between 2015 and 2030 to just meet infrastructure-related SDGs. But the rich nations spectacularly failed to honour their promises of finance made at the 2015 UN conference on financing for development (FfD) in Addis Ababa.

In fact, they failed all their past aid promises, e.g., to provide 0.7% of their gross national income (GNI) as aid, a promise made over half a century ago. While aid hardly reached half the promised percentage of GNI, it in fact declined from the peak of around 0.55% of GNI in the early 1960s to around 0.34% in recent years. Oxfam estimated 50 years of unkept promises meant rich nations owed $5.7 trillion to poor countries by 2020!

At their 2005 Gleneagles Summit, G7 leaders pledged to double their aid by 2010, earmarking $50 billion yearly for Africa. But actual aid delivery has been woefully short. G7 and other rich OECD countries also broke their 2009 pledge to give $100 billion annually in climate finance until 2020.

Promoting private finance
Meanwhile institutions dominated by rich nations – the World Bank and OECD, in particular – promoted private financing of development. The World Bank, the IMF and multilateral regional development banks, e.g. Asian Development Bank jointly released From billions to trillions, just before the 2015 FfD conference.

The document optimistically but misleadingly advised governments to “de-risk” development projects for enticing trillions of dollars of private capital in public private partnerships (PPPs). While de-risking effectively meant governments bearing financial risks, or socialise private investors’ loss, PPPs are found to have dubious impacts on SDGs, especially poverty reduction and enhancing equity.

Meanwhile the OECD donors advocated “blended finance” (BF) to use aid money to leverage, again trillions of dollars of private capital. But as The Economist noted, BF is struggling to grow, stuck since 2014 “at about $20 billion a year…far off the goal of $100 billion set by the UN in 2015”, despite suspected double counting. Like PPPs, BF has effectively transferred risk from the private to the public sector. On average, the public sector has borne 57% of the costs of BF investments, including 73% in LICs.

Collateral damage
In the wake of the GFC the rich countries followed so-called unconventional monetary policies that kept interest rates exceptionally low – in some cases at zero – for a decade. This saw capital flowing from rich countries to EMDEs in search for higher returns, as exceptionally low interest rates enticed EMDE governments and businesses.

The opportunity to borrow at low rates also made the EMDE governments lazy in their domestic revenue mobilisation efforts. Such policy complacency was rewarded by the donor community, especially the World Bank, through its now discredited Doing Business Report, encouraging a harmful race to the bottom tax competition among countries to cut corporate and other direct taxations. The World Bank and IMF also advised to remove or lower easier to collect indirect taxes, e.g., excise duties in exchange for regressive and difficult to implement goods & services or value-added tax in poorer countries.

Bleeding revenues
Meanwhile transnational corporations (TNCs) continue to avoid and evade paying taxes using creating accounting, aided by tax havens, mostly situated in rich nations’ territories. Developing countries lost approximately $7.8 trillion in illicit financial flows from 2004 to 2013, mostly through TNCs’ transfer mispricing, or the fraudulent mis-invoicing of trade in cross-border tax-related transactions.

African countries received $161.6 billion in 2015, primarily through loans, personal remittances and aid. But, $203 billion was extracted, mainly through TNCs repatriating profits and illegally moving money out of the continent.

International tax rules are designed by the rich nations. They continue to oppose developing countries’ demand for an inclusive international tax regime under the auspices of the UN.

Perfect storm
Global supply-demand mis-matches due to the pandemic, the Ukraine war and sanctions are a perfect recipe for a perfect storm. The advanced countries’ inflation fight is causing adverse spill-over on developing countries.

Higher interest rates have slowed the world economy, and triggered capital outflows from developing countries, depreciating their currencies, besides lowering export earnings. Together, these are causing devastating debt crises in many developing countries, similar to what happened in the 1980s.

In October 2022, a United Nations Development Programme (UNDP) report estimated that 54 countries, accounting for more than half of the world’s poorest people, needed immediate debt relief to avoid even more extreme poverty and give them a chance of dealing with climate change.

Rich nations fail again
As pandemic debt distress became obvious, the G20 countries devised the so-called Debt Service Suspension Initiative (DSSI) for 75 poorest countries, supposedly to provide some modest relief between May and December 2020. DSSI does not cancel debt, but only delays re-payments, to be paid fully later with the interest cost accumulating – thus effectively “kicks the can down the road”. As the private lenders refused to join the G20’s initiative, unsurprisingly only 3 countries expressed interest in DSSI. Moreover, the G20 initiative does not address debt problems facing MICs, many of which also face debt servicing, including repayment issues.

Although the IMF acted innovatively at the start of the pandemic debt distress with debt service cancellation for 25 eligible LICs (estimated at $213.5 million), the World Bank’s Chief refused to supplement, let alone complement the IMF’s debt service cancellation for the most vulnerable LICs. Nonetheless, the Bank’s President hypocritically advocates debt relief as “critical”. He wants to have the cake and eat it too; apparently wanting to increase lending, but without sacrificing the institution’s AAA credit rating.

China debt trap diplomacy?
Meanwhile the rich nations accuse China of “debt trap diplomacy” that China is deliberately pushing loans to poorer countries for geopolitical and economic advantages. Less than 20% of LICs external debt is owed to China as against more than 50% to the commercial lenders.

Most Chinese loans are concessional, and China has provided more debt relief than any other country, bilaterally negotiating around $10.8 billion of relief since the onset of the pandemic.

Unsurprisingly, independent studies debunked the Western accusation. And China has emerged as a major source of development finance for poorer countries. A recent IMF study concluded, “Beijing’s foreign assistance has had a positive impact on economic and social outcomes in recipient countries”.

Damaging trade-off
Rising debt servicing in the face of higher import costs, falling export revenues and declining remittances, are forcing developing countries to a damaging trade-off. They are forced to service external debt owed to rich nations and international financiers at the cost of development.

For many African nations, the increased cost of debt repayments is the equivalent of public health spending in the continent, according to the UNCTAD. But, “No country should be forced to choose between paying back debts or providing health care”.

IPS UN Bureau

Follow @IPSNewsUNBureau
  

The African Pharmaceutical Technology Foundation will be hosted by Rwanda. It is part of the African Development Bank’s commitment to spend at least USD 3 billion over the next ten years to support Africa's pharmaceutical and vaccine manufacturing sector. Medical and pharmaceutical experts pose for a group photo with their colleagues during the forum to introduce the newly launched African Pharmaceutical Technology Foundation last month in Kigali. Credit: Aimable Twahirwa/IPS

By Aimable Twahirwa
KIGALI, Jan 25 2023 (IPS)

A few months after German biotechnology company BioNTech announced the establishment of the first-ever local vaccine manufacturing in Rwanda, experts believe the successful implementation of such initiatives across the continent will require countries to acquire know-how while encouraging potential industrial partners in the pharmaceutical industry.

Experts emphasise the need to prioritise technology transfer to revamp Africa’s pharmaceutical industry with a key focus on vaccine manufacturing capacity and building quality healthcare infrastructure.

This is because, while pharmaceutical products are manufactured in countries such as South Africa, Kenya, Morocco and Egypt, the latest estimates by the World Health Organization (WHO) show that the continent currently imports more than 80 percent of its pharmaceutical and medical consumables.

During the forum, which took place recently in Kigali, experts elaborated on some challenges and current opportunities to boost the health prospects of a continent battered for decades by the burden of several diseases and pandemics such as COVID-19, with very limited capacity to produce its medicines and vaccines.

Participants at the forum, which focused mainly on operationalising the first-ever African Pharmaceutical Technology Foundation discussed how the African Union should achieve its target of having 60% of vaccines needed on the continent by 2040.

While the continent imports more than 70% of all the medicines it needs, gulping $14 billion annually, Dr Yvan Butera, Rwandan Minister of State in the Minister of Health, emphasised the need to mobilise additional financial resources for African countries that need them most to procure vaccine.

“The new initiative comes as a solution since most of [African] countries still face a challenge in receiving them on time,” the senior Rwandan Government official told the forum.

As current efforts to expand the manufacturing of essential pharmaceutical products, including vaccines, in developing countries, particularly in Africa, experts argue that concerted efforts to promote technology transfer are urgently needed. According to official estimates, Africa imports more than 70% of all the medicines it needs, gulping $14 billion annually.

Commenting on this situation, Professor Padmashree Gehi Sampath, Special Adviser to the President on Pharmaceuticals and Health, African Development Bank and Director of Global Access in Action, Harvard University, told delegates that technology transfer is critical, and the new initiative will help African countries to look at what are their technology needs.

“Most pharmaceutical companies in Africa are using different kinds of technology (…) it is important to boost their capacity, which has been hampered by intellectual property rights protection and patents on technologies, know-how, manufacturing processes and trade secrets,” the senior bank official told IPS.

Yet Africa’s public health challenges are well known; some experts believe that enhancing access to these technologies for pharmaceutical companies is critical to addressing numerous challenges facing the continent’s pharmaceutical industry.

According to Dr Hanan Balkhy, Deputy Director General World Health Organization (WHO), the continent faces many challenges before it can produce its medicines.

“Africa suffers from the repetitive occurrence of preventable diseases and epidemics, and the large part of medicines and vaccines to treat or prevent these diseases are imported from outside the continent,” Balkhy told delegates.

When fully established, the African Pharmaceutical Technology Foundation, which the bank has already approved, will be staffed with world-class experts on pharmaceutical innovation and development, intellectual property rights, and health policy.

The foundation also has the mandate as a transparent intermediator advancing and brokering the interests of the African pharmaceutical sector with global and other southern pharmaceutical companies to share IP-protected technologies, know-how and patented processes.

Dr Precious Matsoso, a co-chair of the international negotiating body of the WHO on Pandemic Prevention, Preparedness and Response, stressed the importance of ensuring the African health system is resilient.

“Establishing the African Pharmaceutical Technology Foundation, by the bank, is a milestone to address these barriers we are facing, such as health equity,” she said.

Although the foundation is being established under the auspices of the African Development Bank, it will operate independently and raise funds from various stakeholders, including governments, development finance institutions, and philanthropic organisations.

Dr Richard Hatchett, Chief Executive Officer of the Coalition of Epidemic Preparedness Initiative (CEPI), told delegates that this foundation was initiated in timeously since Africa needs to learn from the lessons pandemic, which can be an important step to build resilience of its health system.

“These health care innovative solutions will help in saving lives on the continent,” he said.

So far, Rwanda has been selected to host the African Pharmaceutical Technology Foundation. A common benefits entity, the foundation will have its own governance and operational structures. It will also promote and broker alliances between foreign and African pharmaceutical companies.

However, some experts also emphasised the need to prioritise the African patent pharmaceutical industry to implement the new initiative successfully.

Professor Carlos Correa, Executive Director, South Centre, Geneva, pointed out that it was important for the region to have their own framework.

“Manufacturing capacity [in Africa] is there, but technology capacity is crucial to develop vaccines for Africa (….) Timely transfer of technology is also important,” he said.

During the forum, some panellists also stressed the need to establish a partnership between African pharmaceutical companies with their counterparts from other continents, such as Europe.

According to Brigit Pickel, Director General for Africa in the Germany Federal Ministry for Economic Cooperation and Development, this partnership is important for vaccine manufacturing. It applies to the production and supply of other pharmaceutical products.

“We recognise the importance of promoting local pharmaceutical products across the value chain in Africa,” she said.

Apart from technology transfer, Professor Fredrick Abbott, Edward Ball Eminent Scholar Professor, Florida State University, USA, pointed out that this initiative cannot work without sustainable funding.

“Countries need to develop domestic resources because providing funding is a critical step to ensure the continuity of promising clinical development programs of vaccines and drugs,” Abbott told IPS.

IPS UN Bureau Report

Follow @IPSNewsUNBureau
  

Inflation worries topped Ipsos’s What Worries the World survey in 2022 overtaking COVID concerns. The return of inflation caught major central banks, e.g., the US Federal Reserve (Fed), Bank of England, European Central Bank “off guard”. The persistence of inflation also surprised the International Monetary Fund (IMF). The return of inflation and its persistence exposed the poverty of the economics profession, unable to agree on its causes and required policy responses. It also exposed the profession’s anti-working class biases.

Anis Chowdhury

The US Fed was not alone in failing to see inflation coming. The Governor of Australia’s central bank – the Reserve Bank of Australia (RBA) – was so confident of low inflation that he declared in March 2021 that the interest rate would remain at a historic low until at least 2024. Inflation in advanced economies during 2021 exceeded the average of forecasters’ expectations by around 5–8 percentage points. The IMF’s forecasts have badly and repeatedly undershot inflation.

There was a widespread view among most central bankers and leading economists that the price increases (or inflation) that began in mid-2021 were temporary, and price increases would slow or inflation would drift downwards in 2022. Some, of course, insisted otherwise, and wanted immediate anti-inflationary measures. Thus, policy confusion ruled.

Inflation phobia and dogma
Soon inflation phobia overtook and central banks were advised to act decisively with interest rate hikes even if it meant slowing the economy or a rise in unemployment. Exaggerated claims were made without evidence that not acting now would be more costly later.
References to rare episodes of hyperinflation were made to justify tough policy stances.

The dogmatic inflation hawks ignored the fact that, in most cases, inflation does not accelerate to become harmful hyperinflation, but remains moderate. They also ignored their own neo-classical macroeconomic model, which suggests small welfare loss from moderate inflation.

Notwithstanding the IMF’s Article IV preamble which provides that economic policies should aim to foster “orderly economic growth with reasonable price stability, with due regard to [country specific] circumstances”, a one-size-fits-all policy of steep interest rate hikes became the only medicine to be applied to achieve a universal inflation target of 2%, a figure plucked from thin air. Yet, central bankers and mainstream economists boast their credibility!

Inflation excuse for class war
Inflation is primarily an expression and outcome of conflicting claims over the distribution of national output and income, e.g., firms’ profit mark-ups vis-à-vis workers’ wages. Thus, no sooner inflation spiked early in the year due to slow adjustment of COVID-induced supply shortages to pent-up demand, exacerbated by war and sanctions, leading central bankers and mainstream economists found an excuse to weaponise economic policies against the working class.

Stoking the fear of wage-price spirals, they advocate the use of an interest rate sledgehammer to create unemployment and, in turn, discipline labour. This is despite research within the IMF and the Reserve Bank of Australia which found no evidence of wage-price spirals since the 1980s due to declines in labour’s bargaining power. Thus, Bloomberg headlined, “Fattest Profits Since 1950 Debunk Wage-Inflation Story of CEOs”.

Research conducted by the IMF also found increases in firms’ or corporations’ market power, resulting in higher prices and profit margins. Yet, the IMF does not think such factors “are contributing in any sizeable way to the current inflationary environment”. Instead, it justifies such fattening of profits on the ground that “they provide flexible buffers between general wage and general price increases” and that it is only a catching-up “after taking a hit in 2020”!

But no such compassion is extended to the working people who have lost their lives and livelihoods. The calls for “front-loaded interest rate hikes simply got louder. The Bank for International Settlements (BIS) warned, “With the prospect of higher wages as workers look to make up for the purchasing power they lost, inflation could be high for long”.

Labour a clear loser
Labour is a clear loser. Labour’s income share in the GDP has been in decline since the early 1970s. Casualisation, off-shoring, anti-union legislation and technological progress have greatly reduced labour’s bargaining power, while privatisation and dilution of anti-monopoly legislation hugely strengthened corporate power and their collusive anti-competitive behaviour. Meanwhile, CEO compensation packages swelled to obnoxious levels, rising 940% since 1978 in the US as opposed to a 12% rise for workers during that period. Profiting from the pandemic, CEO pay increased by 16% in 2020 when workers suffered, and to a record level in 2021.

Leading central bankers and mainstream economists conveniently created a dogma around a 2% inflation target to justify their anti-labour stance. The 2% inflation target has become a global norm akin to the law of gravity, even though it has no theoretical or empirical basis. The law of gravity differs depending on altitude, but the 2% target is said to be universal regardless of circumstances!

Collateral damage
Meanwhile, the advanced countries’ inflation fight is causing adverse spillover into developing countries. Higher interest rates have slowed the world economy, and triggered capital outflows from developing countries, thereby depreciating their currencies and lowering their export earnings.

Together, these are causing devastating debt crises in many developing countries, similar to what happened in the 1980s. The rating agency S&P estimates that central bank rate rises could land global borrowers with US$8.6t in extra debt servicing costs in the coming years.

Instead of providing genuine debt-relief, the G20 kicked the can down the road. As wealthy nations failed the poor countries during the pandemic, the IMF is moving to debt-distressed countries with conditionality-laden one-size-fits-all austerity packages. Thus, a Foreign Policy op-ed asked, “The International Monetary Fund: Holy Grail or Poisoned Chalice?”

Meanwhile, the chiefs of the World Bank and the BIS urged “supply-side” policies professed to increase labour force participation and investment. These are code words for further labour market deregulation, privatisation and liberalisation.

IPS UN Bureau

Follow @IPSNewsUNBureau
  

Anti-Austerity protests in 2006-2020. Credit: World Protests Platform

By Isabel Ortiz and Sara Burke
NEW YORK, Jan 13 2023 (IPS)

This week world leaders meet in Davos to discuss cooperation to address multiple crises, from COVID-19 and escalating inflation to slowing economic growth, debt distress and climate shocks.

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

Isabel Ortiz

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

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

Sara Burke

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

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

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

Unless policymakers change course, we shouldn’t be surprised to see increasing waves of protests all over the world. Clashes in the street are likely to intensify if governments continue to fail to respond to people’s demands and persist in implementing harmful austerity policies. Governments need to listen to the demands of citizens that are legitimately protesting the denial of social, economic and civil rights. From jobs, public services and social security to tax and climate justice, the majority of protesters’ demands are in full accordance with United Nations proposals and the Universal Declaration of Human Rights. Leaders and policymakers will only generate further unrest if they fail to act on these legitimate demands.

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

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

IPS UN Bureau

Follow @IPSNewsUNBureau
  

Medical equipment supplied by the World Food Programme (WFP) arrives in Beijing. Meanwhile, as COVID-19 infections surged in China, coronavirus experts gathered at the UN health agency in Geneva on January 3, to discuss next steps. Photo courtesy of Yingshi Zhang

By Jan Servaes
BRUSSELS, Jan 4 2023 (IPS)

Three years after the coronavirus first emerged in the Chinese city of Wuhan, the Chinese government began in December to abruptly scrap its harsh containment policy known as “zero-Covid.”

This zero-Covid policy relied on strict lockdowns, use of a Covid tracking app, domestic travel restrictions, and quarantining those who test positive along with their close contacts. But the strategy isolated the country from the rest of the world and dealt a severe blow to the world’s second-largest economy.

The government announced that from January 8 onwards, mandatory quarantine on arrival for travelers to China will end and Chinese people will be able to travel abroad again after three years.

The switch followed unprecedented protests against the policies championed by President Xi Jinping, marking the strongest display of public defiance in his decade-long presidency and reminiscent of the 1989 Tiananmen tragedy in many minds.

“What matters is that we reach consensus through communication and consultation. When the 1.4 billion Chinese work with one heart and one mind, and stand in unity with a strong will, no task will be impossible and no difficulty insurmountable”, Xi stated in his nationally broadcast New Year’s message.

“We have now entered a new phase of COVID response where tough challenges remain. Everyone is holding on with great fortitude, and the light of hope is right in front of us. Let’s make an extra effort to pull through, as perseverance and solidarity mean victory.”

The question is: how many Chinese are still being taken in by this tough language now that hospitals have been hit by a tidal wave of mainly elderly patients since the lifting of the zero-covid policy, crematoriums are overloaded and many pharmacies no longer have anti-virus and fever medication.

Initially, photos and video fragments of these harrowing conditions were still censored, but recently even the China Daily reported on them. The magnitude of the outbreak remains unclear for now, and the lack of transparency can be attributed to strict censorship and the fact that government officials have stopped reporting asymptomatic cases and introduced a new definition of covid-related deaths.

Only patients with the virus who die due to pneumonia and respiratory failure now meet the criteria, according to China. The National Health Commission (NHC) further announced that it is no longer releasing an official daily Covid death toll.

In addition, the state news agency Xinhua reported that from January 8, China will lower its priority management of Covid-19 cases and treat it as a class B infection rather than a more severe class A infection. Liang Wannian, head of the expert panel for the COVID-19 response under the NHC, said the shift does not mean China is letting go of the virus, but instead is focusing more resources on rural areas to contain the epidemic.

According to Nikola Davis, science correspondent for The Guardian, China is experiencing this surge for a number of reasons. The relaxation of restrictions has allowed the virus to spread more. Plus, the slow vaccination campaign in much of China, coupled with the use of the less effective locally produced Sinovac vaccine, means the population has little protection and many vulnerable people are still at risk from the virus.

In addition, the tight restrictions previously in place mean few people have contracted Covid before. That means there is little natural immunity at play in the current wave.

As a result, many people are now simultaneously getting Covid and requiring hospital care, leading to increasing pressure on the healthcare system. In addition, the inadequate medical infrastructure (there remains a major shortage of intensive care beds and well-trained staff) as well as substandard general hygiene (clean toilets, washing hands, etc.) must also be added.

So the ink of my contribution on ‘China: From A Health Crisis to A Political Crisis?’ was barely dry before my fears came true: China is in the middle of a relentless covid wave. Chinese authorities estimate that about 250 million people, or 18 percent of the population, were infected with the COVID-19 virus in the first 20 days of December.

Despite this increase, the government insists it has the rising infections and circulating variants under control. Yet these ‘official’ figures do not seem to correspond with the reality on the ground.

People will continue to grope in the dark about the correct figures. The Chinese government and the so-called worldometers are still counting only 5250 covid deaths, while the World Health Organization (WHO) recently published the number of 31,585.

Some academic friends and former students, though not epidemiologists, whisper that up to 60% of the Chinese have or have been exposed to covid.

Airfinity, a UK-based company that analyzes health risks worldwide, also comes with worrying figures. They currently estimate 11,000 daily deaths and 1.8 million infections per day in China, while it expects 1.7 million fatalities by the end of April 2023.

The researchers say their model is based on data from China’s regional provinces, before changes in infection reporting, combined with case growth rates from other former zero-Covid countries.

It is feared that the numbers will rise even more in the coming weeks. Especially around the Chinese New Year on January 22, when almost every Chinese goes to visit friends and family.

Is Xi Jinping firmly in the saddle?

Xi Jinping secured a historic third term as leader in October, emerging as China’s most powerful ruler since Mao Zedong. He thus further consolidated his power in a process that began a decade ago, a concentration that has steered China in a more authoritarian direction and which critics warn increases the risk of policy missteps.

The year 2022 ended with unprecedented street protests, followed by the sudden reversal of its zero-Covid policy and coronavirus infections sweeping through the world’s most populous country. This, together with the sluggish economy, has damaged his image considerably.

For decades, China has been the world’s leading economic growth engine and the hub of industrial supply chains. The World Bank and other experts expect the reopening of the Chinese economy to boost growth to 4.3% in 2023, compared to the forecast of 2.7% for 2022.

This is still reasonable by international standards, but remains below the official target of about 5.5%. Choked consumption and disrupted supply chains continue to weigh on the crisis in the huge real estate sector. A prolonged economic slowdown or new logistical concerns, whether due to COVID or geopolitical tensions, could reverberate globally.

Beijing’s relations with the West deteriorated over Xi’s partnership with Moscow just before Russia’s February invasion of Ukraine, as well as rising tensions over US-backed Taiwan, which China considers part of its territory.

Xi traveled abroad for the first time since the pandemic began in September, where he met with Russian President Vladimir Putin. In November, he met US President Joe Biden at the G20 in Indonesia, where both sides sought to cement relations.

According to Chinese diplomacy, a recent phone call between China’s new foreign minister Qin Gang (the outgoing ambassador to Washington and Xi’s confidant) and US secretary of state Antony Blinken has ironed out the folds.

Diplomatically, Xi appears to be trying to ease some of the tension that has made relations with the West increasingly fraught, even as Beijing tries to strengthen its position as a counterweight to the post-World War II US-led order. Xi’s recent visit to Saudi Arabia and meetings with representatives of Gulf states could be viewed in this context.

But things are also rumbling within the government and the almighty Communist Party (CCP). Leaked excerpts of an internal policy brief published in the Sydney Morning Herald, discussed at a recent Politburo, state that “the zero-Covid dynamic was an unqualified success and demonstrated the superiority of the Chinese communist system over the cowardly and immoral West, but that it can now be brushed aside because omicron is ‘just like the flu’”.

“We must resolutely follow the line of the party. We must never deviate from the notes,” Xi told the Politburo during the “self-criticism” session, a Maoist practice that is back in vogue.

Authoritarian regimes with near-absolute control over the media can sometimes facilitate breathtakingly destructive policies. It is difficult to think of a more unhinged policy than suddenly exposing an inadequately vaccinated population to massive infection in the middle of winter, just before the great Chinese New Year inland migration.

Fortitude appears to be one of Xi Jinping’s principles, as his New Year’s letter affirmed: “Everyone stands firm with great fortitude, and the light of hope stands right before us.”

Jan Servaes was UNESCO-Chair in Communication for Sustainable Social Change at the University of Massachusetts, Amherst. He taught ‘international communication’ in Australia, Belgium, China, Hong Kong, the US, Netherlands and Thailand, in addition to short-term projects at about 120 universities in 55 countries. He is editor of the 2020 Handbook on Communication for Development and Social Change.
https://link.springer.com/referencework/10.1007/978-981-10-7035-8

IPS UN Bureau

Follow @IPSNewsUNBureau
  

Africa needs to urgently invest in health programmes to reduce maternal deaths, which is more than five times above the 2030 SDG target of fewer than 70 maternal deaths per 100 000 live births. Measures include ensuring women access to skilled birth attendants. Credit: Ernest Ankomah/IPS

By Francis Kokutse
ACCRA, Jan 3 2023 (IPS)

As the effects of COVID-19 on Africa’s health sector become clearer, it looks the continent will need to take urgent steps to overcome the disruptions suffered in the breakdown in antenatal and postnatal care for women and newborns and neonatal intensive care units. The pandemic brought some setbacks to the gains achieved in maternal mortality over the past decade.

Consequently, the continent needs to race against time to improve its health sector to meet the Sustainable Development Goals against the backdrop of a new report, the Atlas of Health Statistics 2022, which called for increased investment to avert the growing number in maternal mortality across the continent.

The report said that inadequate investment in health and funding for programmes were some of the major drawbacks to meeting the SDG in the sector.

“For example, a 2022 WHO survey of 47 African countries found that the region has a ratio of 1.55 health workers (physicians, nurses, and midwives) per 1000 people, below the WHO threshold density of 4.45 health workers per 1000 people needed to deliver essential health services and achieve universal health coverage.”

It noted that 65% of births in Africa are attended by skilled health personnel – the lowest globally and far off the 2030 target of 90%, adding that “skilled birth attendants are crucial for the well-being of women and newborns. Neonatal deaths account for half of all under-5 mortality. Accelerating the agenda to meet its reduction goal will be a major step toward reducing the under-5 mortality rate to fewer than 25 deaths per 1000 live births.”

The Ghanaian authorities might have taken note of the trend last year and launched a national campaign to avert all preventable deaths related to pregnancy dubbed “Zero Tolerance for Maternal Deaths.”

Director of the Ghana Health Service (GHS), Dr Patrick Kuma-Aboagye, said the campaign was to remove all barriers and unfair treatments that increased the vulnerability of pregnant women and girls to maternal mortality and also push those with unintended pregnancies to indulge in unsafe abortions and other risky action.

Kuma-Aboagye said the campaign was critical to accelerating the decline of maternal mortality from 308 out of every 1,000 live births to 70 by 2030, in line with the United Nations Sustainable Development Goals (SDGs). “The slow decline in maternal mortality in Ghana is of great concern to the Ministry of Health, the GHS, and its partners.”

Reacting to the Atlas report, WHO Regional Director for Africa, said Dr Matshidiso Moeti, said: “This means that for many African women, childbirth remains a persistent risk and millions of children do not live long enough to celebrate their fifth birthday.”

She asked governments to take note.

“It is crucial that governments make a radical course correction, surmount the challenges, and speed up the pace towards the health goals. These goals aren’t mere milestones, but the very foundations of a healthier life and well-being for millions of people.”

The report estimated that, in sub-Saharan Africa, 390 women will die in childbirth for every 100 000 live births by 2030. This is more than five times above the 2030 SDG target of fewer than 70 maternal deaths per 100 000 live births and much higher than the average of 13 deaths per 100 000 live births witnessed in Europe in 2017.

“It is more than double the global average of 211. To reach the SDG target, Africa will need an 86% reduction from 2017 rates, the last time data was reported, an unrealistic feat at the current rate of decline,” the report said.

The region’s infant mortality rate is 72 per 1000 live births. At the current 3.1% annual rate of decline, there will be an expected 54 deaths per 1000 live births by 2030, far above the reduction target of fewer than 25 per 1000.

The report assessed nine targets related to the Sustainable Development Goal (SDG) on health and found that at the current pace, increased investment is needed to accelerate progress on the targets. Among the most difficult to achieve will be reducing maternal mortality.

Physician and chief executive officer of Medway Health, Dr Omotuyi Mebawondu, has expressed concern that despite the worldwide reduction in maternal mortality rate, sub–Saharan Africa still accounts for two third of an average of 800 daily deaths of women from pregnancy and its complications.

Mebawondu said one of the key interventions is to ensure that pregnant women have access to antenatal care principally to identify danger signals early and enjoy delivery with the assistance of skilled birth attendants.

Accordingly, he has suggested that another way of reducing maternal mortality is to look into the use of technology. “The challenge of human resources for health in sub-Saharan Africa imposes a great responsibility on policymakers to explore technology in delivering health interventions to hard-to-reach populations.

Mebawondu said this must be preceded by adequate internet penetration and access, especially in rural areas, as such technology will help update and upgrade the health workers’ skills and educate the women on the challenges of pregnancy.

“A database of all pregnant women in poor rural localities must be collated and followed up through such technology. In addition, technology can be used to enhance emergency response to common causes of maternal deaths like bleeding, sepsis, and eclampsia. It can also be used to deliver most needed family planning services,” he said.

IPS UN Bureau Report

Follow @IPSNewsUNBureau
  

2022 has been a year of great uncertainty when it seemed the world perilously reached the brink of self-destruction – be it human-induced climate change or military conflict. Welcoming 2022, we had enough reasons to be optimistic; but it was another ‘year of living dangerously’ – Tahun vivere pericoloso in the words of Soekarno, or an annus horribilis in the words of the late Queen Elizabeth.

Anis Chowdhury

New cold war turns into proxy war
Whereas the global pandemic required extraordinary global unity, unfortunately, a ‘new cold war’ quickly turned into a ‘hot war’, bringing the world to the verge of a devastating nuclear war for the first time since the 1962 Cuban missile crisis. Russia, finding itself cornered by an expanding NATO, decided most foolishly to invade Ukraine, believing it could overrun the country without any resistance. While the heroic Ukrainians continue to defend their motherland, Russia seems to have become bogged down in a proxy war with NATO.

If the proxy war with Russia was not enough, the US is recklessly provoking China towards another ‘hot war’, following Trump’s trade war. Clearly the monopoly capital of the US and its military-industrial complex are pushing the US to a ‘Thucydides Trap‘. More than 60 years ago, President Eisenhower, in his farewell address to the nation, warned about the military-industrial complex, a formidable union of defence contractors and the armed forces. Eisenhower, a retired five-star Army general, who led the allies on D-Day, saw the military-industrial complex as a threat to democratic government and global peace. Alas, his dire warning fell on deaf ears.

Western hypocrisy exposed
The Russian invasion of Ukraine exposed Western pretence. The Western mainstream media unashamedly declared the dislocation of Ukrainians intolerable because the victims are blue-eyed, blond-haired Europeans, not “uncivilized” third world inhabitants or “barbaric” Arabs. Western duplicity is nowhere as blatant as it is in the case of the Palestinian plight. To them, Russia’s occupation and annexation of parts of Ukraine is illegal; but Israel’s occupation and annexation of Palestinian land as well as gross human rights violations are justified on various professed grounds, e.g., right to protection from “terrorist acts”.

Leadership vacuum
The world now needs Eisenhower to resist the military-industrial complex; it needs Teddy Roosevelt to break monopoly capital’s stranglehold and to protect consumers, workers and the environment; it needs Franklin Roosevelt to promote multilateralism and social justice; it needs Kennedy to defuse crises. At the height of the ‘old cold war’, Kennedy ate humble pie by quietly removing the security threat to the USSR posed by offensive weapons (Jupiter MRBMs) deployed in Turkey, and publicly pledging that the US would never invade Cuba or attempt another Bay of Pigs operation. Eisenhower was magnanimous enough to bear the lion’s share of financing the USSR’s proposal for global efforts to eradicate smallpox – the leading cause of death and blindness then.

Alas, we see no such signs in a world of Trump, Biden, Johnson, Marcon and Scholz. Even ‘out of touch‘, billionaire Sunak does not inspire any hope, despite being the first coloured person of colonial descent to occupy the 10 Downing Street. Sunak will probably try to prove himself holier than the Pope, instead of promoting the interest of former colonies or descendants of colonial subjects or downtrodden.

No better leadership in the South
The South is also devoid of visionaries, such as Nkrumah or Nehru who promoted non-alignment and Southern unity. Nehru’s land is now overtaken by Modi’s Hindutva movement, openly promoting violence against minorities. Unsurprisingly, Modi was in sync with Trump; but he equally cosies up to Biden professing to promote democracy and human rights. Sadly, Mandela’s South Africa is mired in scandal after scandal.

Although many, including myself, eagerly looked forward to Lula’s victory in Brazil, neither his return to power nor the so-called ‘second pink tide’ in Latin America should make one overly joyous. The Left has demonstrated its propensity to fracture or implode easily, e.g., contributing to Correa’s defeat in Ecuador, or aiding the Right to strike back in Peru. In Colombia, Finance capital, mining giants and the elite have already ganged up on Petro’s vow to tackle inequality with tax and land reforms and his proposed ban on new oil and gas exploration. Chile’s Boric has faced setbacks including the rejection of a new constitution, forcing his concessions to the Centre-Right. Constitutional coup is a common strategy of the established vested interest.

Some inspirations down under
Down under, the Australians soundly defeated an increasingly autocratic and unaccountable conservative government in May. It was the government that implemented inhumane off-shore detention centres for people seeking to escape persecution and starvation in their own countries (about to be emulated by the UK Tory Govt.). It also was cruel enough to pursue vulnerable people on social security payments with a robotic program whilst cutting taxes for the wealthy and letting them evade tax. It was the government which created plumb jobs for the boys. It was the government which continued to deny climate science and refused to act.

Finally, the Australians got rid of it. Labor showed extraordinary discipline in opposition, and in government, it stood up to big business and vested interests. It has quickly moved to put in place the processes to:

• set up an independent anti-corruption body with real teeth;
• recognise the voice of First Nations people;
• respect human rights of asylum seekers languishing in detention centres;
• address environmental degradation & achieve 43% emissions reduction target by 2030;
• restore labour rights, fair and decent wages;
• review RBA’s performance to ensure monetary policy serves broader national interest, not the finance; and
• balance geo-political alliances.

Its progressive agenda is quite long. Let me end here, wishing the Australian Labor Government success to inspire other nations – large and small, developed and developing; and with best wishes for you to be safe and remain healthy, even if not quite bright-eyed and bushy-tailed.

IPS UN Bureau

Follow @IPSNewsUNBureau
  

A year that started with Russia’s invasion of Ukraine and is ending with famine in Africa, while still spreading death and misery through an enduring pandemic and a deteriorating climate crisis — 2022 has been an apocalyptic warning of the frailty of our planet and the woeful shortcomings of humankind.

Farhana Haque Rahman

Tens of thousands of soldiers and civilians (numbers given by the UN and involved parties vary enormously) have been killed in Ukraine since Russia launched war on February 24. More than 7.8 million Ukrainians have fled the country. Billions of dollars have been spent on armaments.

But the impact of the war has been felt worldwide, driving up prices of basic commodities such as oil, gas, grain, sunflower oil and fertilisers. Somalia, now in the grip of the worst drought to hit the Horn of Africa in 40 years, used to import 90 per cent of its wheat from Russia and Ukraine.

Commodities have been weaponised. Countries slipped back into recession, just as they were slowly recovering from the economic distress of Covid-19 lockdowns. A deepening relationship between sanctioned Russia and an energy- hungry China exacerbated existing tensions with the US over Taiwan. The result? China broke off climate cooperation efforts with the US in the run-up to the COP27 climate conference hosted by Egypt in November with 200 countries and 35,000 people attending.

Against the backdrop of devastating floods in Pakistan and West Africa, and with 2022 on its way to becoming one of the five hottest years on record, agriculture and food security joined the COP27 agenda. Talks ran into extra time, as they tend to, and countries of the global South emerged with the landmark creation of a special fund paid by wealthier countries to address the Loss and Damage caused by climate change in the most vulnerable nations.

“After 30 contentious years, delayed tactics by wealthy countries, a renewed spirit of solidarity, empathy and cooperation prevailed, resulting in the historic establishment of a dedicated fund,” said Yamide Dagnet, director for climate justice at the Open Society Foundations, reflecting a sense of hard fought victory among developing countries.

Still unresolved however is which countries will give money and to whom. China in particular seems uneasy over which category it belongs to. However COP27 joined its 26 forerunners since 1995 in not reaching a binding agreement on cutting fossil fuel burning which has continued to rise globally, except for a brief pandemic dip. For this, many branded it a failure. “Humanity has a choice: cooperate or perish. It is either a Climate Solidarity Pact – or a Collective Suicide Pact,” UN Secretary-General Antonio Guterres told the opening plenary session. By the end, many felt the conference had concluded with the latter. Rather than falling, the latest estimates from the Global Carbon Project show that total worldwide CO2 emissions in 2022 have reached near-record levels.

Victims of devastating floods, heatwaves and forest fires, and severe drought in Central Sahel and East Africa surely needed no confirmation from the final decision text of COP27 which recognises “the fundamental priority of safeguarding food security and ending hunger” and the vulnerability of food production to climate change.

In this respect, COP27 recognised the importance of nature-based solutions – a theme driven by the International Union for Conservation of Nature (IUCN) in ringing alarm bells on the degraded soil, water sources and eco-systems caused by intensive agriculture with overuse of fertilisers and pesticides. According to FAO, more than 25 percent of arable soils worldwide are degraded, and the equivalent of a football pitch of soil is eroded every five seconds. The planet’s bio-diversity is being devastated as a result. As highlighted by the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES) in stressing the vital connections between Nature and people, a landmark report in July found that 50,000 wild species provide food, cosmetics, shelter, clothing, medicine and inspiration. Many face extinction. As international agencies and NGOs (and media outlets) jostled and competed for funding to deal with the fallout from wars and climate emergencies, the International Fund for Agricultural Development (IFAD) which is active in the Sahel cautioned that only 1.7 per cent of all climate finance reaches small-scale producers in developing countries and as little as 8% of overseas aid goes to projects focused primarily on gender equality. Women’s empowerment has been made a major focus of ASAP+, IFAD’s new climate change financing mechanism.

Women and girls are paying “an unacceptably high price” among communities hit by severe drought in the Horn of Africa, according to the UN Population Fund (UNFPA). It launched a $113.7 million appeal to scale-up life-saving reproductive health and protection services, including establishment of mobile and static clinics in displacement sites.

Also overshadowed by wars and pandemics in 2022 were marginalised communities lacking a voice, suffering diseases such as leprosy or exploited in the form of child labour.

Yohei Sasakawa, WHO Goodwill Ambassador for Leprosy Elimination, says many issues have been sidelined because of the Covid-19 pandemic. Society has the knowledge and means to stop and cure leprosy, he says in the ‘Don’t Forget Leprosy’ campaign by the Sasakawa Leprosy Initiative.

“When people are still being discriminated against even after being cured, society has a disease. If we can cure society of this disease—discrimination—it would be truly epoch-making,” he told IPS.

A similar message was delivered by Nobel Laureate Kailash Satyarthi who told the 5th Global Conference on the Elimination of Child Labour that a mere $53 billion per annum – equivalent to 10 days of military spending – would ensure all children in all countries benefit from social protection. International Labour Organisation and UNICEF statistics from 2020 show at least 160 million children are involved in child labour, a surge of 8.4 million in four years. Children denied education became a burning issue in Afghanistan in March when the Taliban declared that girls would be banned from secondary education. The UN said 1.1 million girls were affected. The late-night reversal of a decision by Taliban authorities to allow girls from grades 7 to 12 to return to school was met with outrage and distress, inside and outside Afghanistan. Denial of human rights to girls and women has fuelled the desire of many to get out of Afghanistan and seek a better life elsewhere, adding to the millions around the world forced to flee their homes because of conflict, repression or disaster. The Ukraine conflict has displaced more than 14 million people, about a third of the population.

A UN Office on Drugs and Crime report on trafficking warns that refugees from Ukraine are at risk of including sexual exploitation, forced labour, illegal adoption and surrogacy, forced begging and forced criminality.

As they come over border crossings into Poland, refugees – including victims of rape – are greeted with posters and flyers carrying warnings about jail terms for breaking local abortion laws, images of miscarried foetuses, and a quote from Mother Theresa saying: “Abortion is the greatest threat to peace”.

UNDP, which is assisting the Ukraine government in getting access to public services for IDPs, says in its 2022 report, Turning the tide on internal displacement, that earlier and increased support to development is an essential condition for emerging from crisis in a sustainable way.

“More efforts are needed to end the marginalization of internally displaced people, who must be able to exercise their full rights as citizens including through access to vital services such as health care, education, social protection and job opportunities” said Achim Steiner, UNDP Administrator.

Nearly one million Rohingya refugees languishing in refugee camps in Bangladesh after being driven out of Myanmar in waves since 2016 would surely agree.

Asif Saleh, executive director of BRAC, said to be the world’s largest NGO and founded by Sir Fazle after the independence of Bangladesh in 1972, says work needs to “shift towards a development-like approach from a very short-term humanitarian crisis-focused approach”. But the only solution for the Rohingya refugees is their sustainable and voluntary repatriation to Myanmar. As 2022 closes, that unfortunately looks highly unlikely as the military junta that seized power in 2021 fights ethnic armed organisations on multiple fronts.

There was one seismic milestone event that happened in late 2022 although no one is quite sure exactly where and when. The few people to witness it were not aware either – not that it prevented the UN from declaring it a special day. The birth of the 8 billionth person was celebrated on November 15. The world’s population has doubled from 4 billion in 1974 and UN projections suggest we will be supporting about 9.7 billion people in 2050. Global population is forecast to peak at about 10.4 billion in the 2080s.

Inger Andersen, executive director of the UN environment programme, sent a message to the baby, and the rest of the world, as countries meet in Montreal for the COP15 biodiversity conference this month.

“We’ve just welcomed the 8 billionth member of the human race on this planet. That’s a wonderful birth of a baby, of course. But we need to understand that the more people there are, the more we put the Earth under heavy pressure,” she said.

Farhana Haque Rahman is Senior Vice President of IPS Inter Press Service and Executive Director IPS Noram; she served as the elected Director General of IPS from 2015-2019. A journalist and communications expert, she is a former senior official of the United Nations Food and Agriculture Organization and the International Fund for Agricultural Development.

IPS UN Bureau

Follow @IPSNewsUNBureau
  

Patients seeking treatment at the Redemption Hospital in Monrovia, Liberia. Credit: World Bank/Dominic Chavez
 
The UN agency devoted to ending AIDS as a public health threat has called on top politicians and governments across the world to ensure the right to quality healthcare is upheld, and not just a privilege to be enjoyed by the wealthy.

By A.H. Monjurul Kabir
NEW YORK, Dec 20 2022 (IPS)

Promoting innovation and technology to promote inclusive development means using new technologies to enhance equal access to services, eliminate discrimination, increase transparency, and create a stable and just future for all – especially the most vulnerable and marginalized.

Obviously, the rule of law is a key driver of inclusive, equitable, and sustainable development, and empowers people from all strata of life to seek and obtain justice. Doing more with less is posing a challenge here. We are operating in an increasingly connected yet complex global and national settings and fiscally fragile environment.

Our traditional structures, systems and processes are proving to be inadequate to deal with new developmental challenges, pandemics, inaccessibility and exclusions, conflicts, and humanitarian crisis. Our governance and justice systems are not the most transparent and data friendly domain. Bringing that information to light is no easy task.

Barriers to Governance and Rule of Law

As indicated before, there are many barriers to accessing public services and ensuring accessible public health, rule of law, especially where there are high levels of poverty, marginalization, and insecurity. Governance institutions – formal and informal – may be biased or discriminatory. Public governance systems may be ineffective, slow, and untrustworthy.

In the last 3 years of pandemic, we also realized our public health system is often crippled by lack of investment, inclusive and accessible initiatives, and innovation. Discriminatory decision making and exclusivity further complicated the situation at all levels. People may lack knowledge about their rights.

Often legal assistance and consumer protection are out of reach, leaving people with little recourse to formal mechanisms for protection and empowerment. There may be a culture of impunity for criminal acts, unacceptable level of tolerance for exclusionary practices.

Other discriminations, injustices, and abuses in the family, or through deprivation and labour exploitation, may go unaddressed. Despite all these, more can be done to ensure that they benefit from the inclusive governance and public health work, and, rule of law practices, which expand their opportunities and choices.

Quest for New Ideas …

Despite all these, more can be done to ensure that the most vulnerable and disadvantaged groups benefit from inclusive public health, legal empowerment, and access to justice, which expand their opportunities and choices.

We need fresh ideas, resources, and unconventional ways of collecting and analyzing data, such as using micro-narratives or innovative, accessible public hearings, targeted consultations, to complement traditional mechanisms including surveys. But innovation is rapidly becoming the new buzzword, so I would be careful in applying it here:

• Innovation is not cost-free and takes time so it should be mainstreamed:
• Innovation is both science and arts. And it should be seen as a standalone practice. one of the biggest problems that public sector innovation faces today is that governments have de facto created a ‘class of innovators,’ rather than making innovation an inclusive process that is open to anyone who has the motivation and capacity to influence change. This must change.
• Repackaging or reproduction is not innovation unless it caters to the specific needs of vulnerable and marginalized communities which are not supported by existing mechanisms and services.
• What is innovative in Bangladesh, Turkey, and Tanzania may not be so in India, Turkmenistan, Senegal, or Mexico;
• Big data is important but harnessing it for the right cause should be central consideration. Linking it with better evidence base is of critical significance. The COVID-19 challenges amply demonstrated it.
• Going beyond social networking is key – while Facebook, Twitter and other Social Media outlets play an admirable role in connecting people, these are not enough to solving a protracted problem and sustaining a solution. We must also be mindful of the recent trend of using social media to silence public defenders, journalists, and whistle blowers. The twitter is a case in point (December 2022).
• Innovative ideas, while refreshing, need to be pragmatic so that they can be implemented. They mast be part of a solution, not the overall problem.
• Evidence of impact is more important than the novelty factor.

Innovation and New Technologies for Solutions

My own take is that ideas do not need to be always transformational or revolutionary. Our platforms can replicate or even recycle what already works by introducing successful models to new actors and environments.

Even seemingly ordinary things can become innovative in different terms, approaches, or settings. linking inclusion to innovation is not only about looking at how it can advance policies and create better impact for governments, but also about giving people, public servants, and citizens alike, the self-efficacy, power, and freedom to direct change in the way they see necessary. This contributes directly to the making of inclusive development.

New technologies are changing the lives of people around the world. In the same way that they make daily tasks simpler, they can make official and routine interactions with government institutions, service providers easier and can provide innovative solutions to a host of public sector governance, public health, and rule of law challenges.

Technology has an immense untapped potential to strengthen inclusive practices for governance including public health governance, and the rule of law. Technological innovation must provide equal access to services, help to eliminate discrimination, and assure more transparency and accountability. They must not be used to silence voices, deny human rights, or create justifications for maladministration, inaccessibility, and exclusions.

As we are approaching 2023 in a few days, let us hope for a more inclusive and diverse public sector governance rooted in human rights values and practices.

Dr. A.H. Monjurul Kabir, currently UN System Coordination Adviser and Global Team Leader for Gender Equality, Disability Inclusion/Intersectionality at UN Women HQ in New York, is a thought leader, political scientist and senior policy and legal analyst on global issues and regional trends. For policy and academic purpose, he can be contacted at monjurulkabir@yahoo.com. He can be followed in twitter at mkabir2011

IPS UN Bureau

Follow @IPSNewsUNBureau
  

In 2019, when the President-elect of the European Union (EU) Ursula von der Leyen had presented a list for her soon-to-be European Commission, and on that list was a portfolio called “Protecting the European way of life”, a lot of noise was made questioning what that meant. “Protection” was later changed to the “Promotion” of the European Way of Life. It’s been over three years since this very controversial, much debated and widely criticised portfolio as many continue to question what uniquely is the ‘European way of life’?

Shada Islam

“The European way of life, for many it’s about being christian and about being white. So anyone who doesn’t fall into those categories is seen as not belonging to Europe,” says Shada Islam, Brussels based specialist on European Union affairs.

“There are about 50 million people of colour, European of colour across the European Union, that’s a huge number of people, not just a small minority, and that means, migrants are part of that & refugees are part of that. The narrative of Europe is so out of date and out of touch with the reality of the diverse and multicultural Europe that there is today,” says Islam.

Over the years Europe has seen an increase in securitization of the migration, severe pushback and disturbing patterns of threat, intimidation, violence and humiliation at the borders leading to human rights violations, the closure of borders due to the COVID-19 pandemic, growing Islamophobia, racism and the rise of right-wing in Europe, all leading up to being very strong indicators of the continuously growing anti-immigrant sentiment.

Russia’s ongoing invasion of Ukraine has created one of the biggest refugee crises of the modern times. Just a month into the war, more than 3.7 million Ukrainians fled to neighbouring countries seeking safety, protection and assistance – this is known to be the sixth-largest refugee outflow over the past 60- plus years. While most European countries have displayed an exceptionally generous stance on arriving refugees, unlike the 2015 refugee crisis when the EU called for detaining arriving refugees for up to 18 months.

Islam says while Europe has opened its arms, homes, schools and hospitals to millions of Ukrainian refugees, migration policies continue to remain hardened by European leaders against refugees especially from the Middle East and Africa. “It’s a sense of compassion, empathy and solidarity that we see towards refugees from Ukraine, but why can’t we show that to people fleeing wars, hunger and climate change from other parts of the world? Why are they kept in camps, why are they pushed back from Frontext, our border control. Why can’t they be welcomed with the same sense of compassion and empathy,” Islam says.

Earlier in March, in response to the Ukrainian crisis, the government of Bulgaria took the first steps to welcome Ukrainian refugees. At a time of one of the worst humanitarian catastrophe, this move by Bulgaria was most welcomed by all, however many human rights activists raised questions of discrimination and double standards when Prime Minister Kiril Petkov said, “these are not the refugees we are used to. This is not the usual refugee wave of people with an unclear past. None of the European countries are worried about them,”.

In February 2022, the refugee crisis on the Polish-Belarusian border had worsened with reports of migrants staying in a camp being forced out, pushed back by security forces with water cannons and tear gas.

According to this report in 2021 thousands of people fleeing conflicts in the Middle East and other areas tried to enter the European Union through Lithuania, Latvia and Poland from neighbouring Belarus. The situation at the borders had become critical during the winter months, with hundreds of people stranded for weeks in freezing conditions. According to Polish border guards, 977 attempts to cross the border were recorded in April 2022 and nearly 4280 since the beginning of 2022, far fewer than November 2021 when between 3000 – 4000 migrants had gathered along the border in just a few days. All at a time when the European Union had promised to accept everyone coming from Ukraine.

In Italy, life was tough for asylum seekers, as most were denied refugee status, barred from legal employment and regularly faced discrimination. In the lead-up to the recent elections, there were reports of several violent attacks against asylum seekers and migrants, including the killing of Alika Ogorchukwu, a Nigerian man living in Italy had sent shockwaves across the country and sparked a set of debates on racism.

Earlier in November, the Italian government refused to allow about 250 people to disembark from two non-governmental rescue ships docked in Catania. Human Rights organisations called out the move by the Italian government that gave the directive to the rescue ships to take them back to international waters stating it put people at risk and violated Italy’s human rights obligations.

Hungarian Prime Minister Viktor Orban has been quiet vocal about his anti-refugee views and stance, when he refused to take in refugees in 2018 and calling them “Muslim invaders”. His most recent comments said that countries “are no longer nations” if different races mix.

The current refugee crisis clearly highlights what the problem really is – it’s accepting the unavoidable gap between the inclusive logic of universal human rights and Europe’s prerogative to exclude those whom it believes to be outsiders. Despite international laws and obligations, or the very concept of political asylum, “Europe has displayed the arbitrariness of its borders, both internal and external”. Creating a system that others individuals based on colour, race, and religious background, it continues to reinforce the bias towards human lives.

People who flee their country of origin, flee for a reason, either due to armed conflicts, economic distress, war or political instability, and International law guarantees to each person fleeing persecution the right to request asylum in a safe country. Asylum laws differ in each European state because the EU considers immigration law a matter of national sovereignty. Except what we see being used for people fleeing and reaching out to European countries are terms like “invasion”, “flooding” and “besieging”.

Integration and inclusivity is a mind set, a long term process that requires accommodation from all sides. Refugee social integration is also in line with the United Nations Sustainable Development Goal 16, which includes integration into the economic, health, educational and social context. How Europe tackles its racism, discrimination and asks itself uncomfortable questions, including it’s legacy of colonialism and participation in the Atlantic Slave trade, will take it one step closer to creating a more racially diverse and inclusive Europe – which “lives up to its ideals and values”.

“Europe needs foreign labour, Europe needs the talents of all its citizens, we are going into a recession, an economic slowdown, and we need all hands on the deck. If you are going showing so much discrimination at home, you are hardly in a position as the EU to stand on the global stage and talk about human rights, and the rights of women and ethnic minorities. You are losing your geopolitical influence and edge that you could have in this very complicated world,” says Islam.

IPS UN Bureau Report

Follow @IPSNewsUNBureau
  

"Not one woman less, respect our lives” writes a Peruvian woman on the effigy of a woman in a park in front of the courthouse, before a demonstration in Lima over the lack of enforcement of laws against femicides and other forms of violence against women. CREDIT: Mariela Jara/IPS

By Mariela Jara
LIMA, Nov 24 2022 (IPS)

Violence against women has failed to decline in the Latin American region after the sharp rise recorded during the COVID-19 pandemic, while preventing the causes of such violence remains a major challenge.

This is what representatives of the United Nations, feminist organizations and women’s movements told IPS on the occasion of the commemoration of the International Day for the Elimination of Violence against Women on Nov. 25."We attack the problem but not its causes. I have been talking for 30 years about the importance of preventing violence against women by fostering major cultural changes so that girls and boys are raised in the knowledge that it is unacceptable in any form." -- Moni Pizani

This date, established in 1999 by the United Nations, was adopted in 1981 at the first Latin American and Caribbean feminist meeting held in Colombia to promote the struggle against violence against women in a region where it continues to be exacerbated by high levels of ‘machismo’ or sexism.

The day was chosen to pay tribute to Patria, Minerva and Maria Teresa Mirabal, three sisters from the Dominican Republic who were political activists and were killed on Nov. 25, 1960 by the repressive forces of the regime of dictator Rafael Trujillo.

The date launches 16 days of activism against gender violence, culminating on Dec. 10, Human Rights Day, because male violence against women and girls is the most widespread violation of human rights worldwide.

“It is not possible to confirm a decrease in gender violence in the region at this post-pandemic moment,” said Venezuelan lawyer Moni Pizani, one of the region’s leading experts on women’s rights. “I could say, from the information I have gathered and empirically, that the level has remained steady after the significant increase registered in the last two years.”

Pizani, who retired from the United Nations, currently supports the UN Women office in Guatemala after a fruitful career advocating for women’s rights. She was twice representative in Ecuador for UN Women and its predecessor Unifem, then worked for East and Southeast Asia and later opened the UN Women Office for Latin America and the Caribbean in Panama City as regional director.

“Before the pandemic we used to talk about three out of 10 women having suffered violence, today we say four out of 10. The other alarming fact is that the impact is throughout the entire life cycle of women, including the elderly,” she told IPS in a conversation in Tegucigalpa, Honduras during a Central American colloquium on the situation of women.

UN Women last year measured the “shadow pandemic” in 13 countries in all regions, a term used to describe violence against women during lockdowns due to COVID.

Seven out of 10 women were found to have experienced violence at some time during the pandemic, one in four felt unsafe at home due to increased family conflict, and seven out of 10 perceived partner abuse to be more frequent.

The study also revealed that four out of 10 women feel less safe in public spaces.

Pizani said the study showed that this violation of women’s human rights occurs in different age groups: 48 percent of those between 18 and 49 years old are affected, 42 percent of those between 50 and 59, and 34 percent of women aged 60 and over.

Venezuelan lawyer Moni Pizani, one of Latin America’s leading experts on gender issues, with a long career at UN Women and its predecessor Unifem, takes part in a Central American colloquium in Tegucigalpa on sustainable recovery with gender equality in the wake of the COVID pandemic. CREDIT: Mariela Jara/IPS

According to the same study, unemployed women are the most vulnerable: 52 percent of them experienced violence during the pandemic.

And with regard to mothers: one out of every two women with children also experienced a violation of their rights.

The expert highlighted the effort made by many countries to adopt measures during the pandemic with the expansion of services, telephone hotlines, use of new means of reporting through mobile applications, among others. But she regretted that the efforts fell short.

This year, the region is home to 662 million inhabitants, or eight percent of the world’s population, slightly more than half of whom are girls and women.

The level of violence against women is so severe that the Economic Commission for Latin America and the Caribbean (ECLAC) cites it as one of the structural factors of gender inequality, together with gaps in employment, the concentration of care work and inequitable representation in public spaces.

Governments neither prevent nor address violence

Peru is an example of similar situations of gender violence in the region.

It was one of the countries with the strictest lockdowns, paralyzing government action against gender violence, which was gradually resumed in the second half of 2020 and which made it possible, for example, to receive complaints in the country’s provincial public prosecutors’ offices.

The Public Prosecutor’s Office Crime Observatory reported 1,081,851 complaints in 2021 – an average of 117 per hour. The frequency of complaints returned to pre-pandemic levels, which in 2020 stood at around 700,000, because women under lockdown found it harder to report cases due to the confinement and the fact that they were cooped up with the perpetrators.

Cynthia Silva, a Peruvian lawyer and director of the non-governmental feminist group Study for the Defense of Women’s Rights-Demus, told IPS that the government has failed to reactivate the different services and that the specialized national justice system needs to be fully implemented to protect victims and punish perpetrators.

Lawyer Cynthia Silva, director of the Peruvian feminist institution Demus, poses for a picture at the headquarters of the feminist organization in Lima. She stresses the need for government action against gender violence to include not only strategies for attending to the victims, but also for prevention in order to eradicate it. CREDIT: Mariela Jara/IPS

She stressed the importance of allocating resources both for addressing cases of violence and for prevention. “These are two strategies that should go hand in hand and we see that the State is not doing enough in relation to the latter,” she said.

Silva urged the government to take action in measures aimed at the populace to contribute to rethinking socio-cultural patterns and ‘machista’ habits that discriminate against women.

Based on an experience they are carrying out with girls and adolescents in the district of Carabayllo, in the extreme north of Lima, she said it’s a question of supporting “deconstruction processes” so that egalitarian relations between women and men are fostered from childhood.

On Nov. 26 they will march with various feminist movements and collectives against machista violence so that “the right to a life free of violence against women is guaranteed and so that not a single step backwards is taken with respect to the progress made, particularly in sexual and reproductive rights, which are threatened by conservative groups in Congress.”

Adolescent women and men in Lima, the Peruvian capital, wave a huge banner during the march for the International Day for the Elimination of Violence against Women on Nov. 25, 2019, before the outbreak of the COVID-19 pandemic that exacerbated such violence in Latin America. CREDIT: Mariela Jara/IPS

An equally serious scenario

Argentina is another example of gender violence – including femicides – in Latin America, the region with the highest levels of aggression against women in the world, the result of extremely sexist societies.

This is in contrast to the fact that it is one of the regions with the best protection against such violence in national and even regional legislation, because since 1994 it has had the Inter-American Convention on the Prevention, Punishment and Eradication of Violence against Women.

The problem is that these laws are seriously flawed in their implementation, especially in the interior of the countries, agree UN Women, regional organizations and national women’s rights groups.

Rosaura Andiñach, an Argentine university professor and head of community processes at the Ecumenical Regional Center for Counseling and Service (CREAS), said it is worrying that in her country there are still high rates of femicide, despite the progress made in terms of legislation.

Between January and October 2022, there were 212 femicides and 181 attempted gender-based homicides in the country of 46 million people, according to the civil society observatory “Ahora que sí nos ven” (Now that they do see us).

She said the government still owes a debt to women in this post-pandemic context, as it fails to guarantee women’s rights by not adequately addressing their complaints.

“We do not want the same thing to happen as with a recent case: Noelia Sosa, 30 years old, lived in Tucumán and reported her partner in a police station for gender violence. They ignored her and she committed suicide that afternoon because she did not know what else to do. We are very concerned because the outlook is still as serious as ever in terms of violence against women,” Andiñach said.

It was precisely in Argentina that the #NiunaMenos (Not one woman less) campaign emerged in 2015, which spread throughout the region as a movement against femicides and the ineffectiveness of the authorities in the enforcement of laws to prevent and punish gender-related murders, because femicides are surrounded by a very high level of impunity in Latin America.

Moni Pizani, from UN Women, stressed that the prevention of gender violence should no longer fall short in the region.

“We attack the problem but not its causes. I have been talking for 30 years about the importance of preventing violence against women by fostering major cultural changes so that girls and boys are raised in the knowledge that it is unacceptable in any form,” she underlined.

This strategy, she remarked, “involves investing in youth and children to ensure that the new generations are free from violence, harassment and discrimination, with respect for a life of dignity for all.”

Excerpt:

Developing countries have long been told to avoid borrowing from central banks (CBs) to finance government spending. Many have even legislated against CB financing of fiscal expenditure.

Central bank fiscal financing
Such laws are supposedly needed to curb inflation – below 5%, if not 2% – to accelerate growth. These arrangements have also constrained a potential CB developmental role and government ability to respond better to crises.

Anis Chowdhury

A few have pragmatically suspended or otherwise circumvented such self-imposed prohibitions. This allowed them to borrow from CBs to finance pandemic relief and recovery packages.

Such recent changes have re-opened debates over the urgent need for counter-cyclical and developmental fiscal-monetary policy coordination.

Monetary financing rubbished
But financial interests claim this enables national CBs to finance government deficits, i.e., monetary financing (MF). MF is often blamed for enabling public debt, balance of payments deficits, and runaway inflation.

As William Easterly noted, “Fiscal deficits received much of the blame for the assorted economic ills that beset developing countries in the 1980s: over indebtedness and the debt crisis, high inflation, and poor investment performance and growth”.

Hence, calls for MF are typically met with scepticism, if not outright opposition. MF undermines central bank independence (CBI) – hence, the strict segregation of monetary from fiscal authorities – supposedly needed to prevent runaway inflation.

Jomo Kwame Sundaram

Cases of MF leading to runaway inflation have been very exceptional, e.g., Bolivia in the 1980s or Zimbabwe in 2007-08. These were often associated with the breakdown of political and economic systems, as when the Soviet Union collapsed.

Bolivia suffered major external shocks. These included Volcker’s interest rate spikes in the early 1980s, much reduced access to international capital markets, and commodity price collapses. Political and economic conflicts in Bolivian society hardly helped.

Similarly, Zimbabwe’s hyperinflation was partly due to conflicts over land rights, worsened by government mismanagement of the economy and British-led Western efforts to undermine the Mugabe government.

Indian lessons
Former Reserve Bank of India Governor Y.V. Reddy noted fiscal-monetary coordination had “provided funds for development of industry, agriculture, housing, etc. through development financial institutions” besides enabling borrowing by state owned enterprises (SOEs) in the early decades.

For him, less satisfactory outcomes – e.g., continued “macro imbalances” and “automatic monetization of deficits” – were not due to “fiscal activism per se but the soft-budget constraint” of SOEs, and “persistent inadequate returns” on public investments.

Monetary policy is constrained by large and persistent fiscal deficits. For Reddy, “undoubtedly the nature of interaction between [fiscal and monetary policies] depends on country-specific situation”.

Reddy urged addressing monetary-fiscal policy coordination issues within a broad common macroeconomic framework. Several lessons can be drawn from Indian experience.

First, “there is no ideal level of fiscal deficit, and critical factors are: How is it financed and what is it used for?” There is no alternative to SOE efficiency and public investment project financial viability.

Second, “the management of public debt, in countries like India, plays a critical role in development of domestic financial markets and thus on conduct of monetary policy, especially for effective transmission”.

Third, “harmonious implementation of policies may require that one policy is not unduly burdening the other for too long”.

Lessons from China?
Zhou Xiaochuan, then People’s Bank of China (PBoC) Governor, emphasized CBs’ multiple responsibilities – including financial sector development and stability – in transition and developing economies.

China’s CB head noted, “monetary policy will undoubtedly be affected by balance of international payments and capital flows”. Hence, “macro-prudential and financial regulation are sensitive mandates” for CBs.

PBoC objectives – long mandated by the Chinese government – include maintaining price stability, boosting economic growth, promoting employment, and addressing balance of payments problems.

Multiple objectives have required more coordination and joint efforts with other government agencies and regulators. Therefore, “the PBoC … works closely with other government agencies”.

Zhou acknowledged, “striking the right balance between multiple objectives and the effectiveness of monetary policy is tricky”. By maintaining close ties with the government, the PBoC has facilitated needed reforms.

He also emphasized the need for policy flexibility as appropriate. “If the central bank only emphasized keeping inflation low and did not tolerate price changes during price reforms, it could have blocked the overall reform and transition”.

During the pandemic, the PBoC developed “structural monetary” policy tools, targeted to help Covid-hit sectors. Structural tools helped keep inter-bank liquidity ample, and supportive of credit growth.

More importantly, its targeted monetary policy tools were increasingly aligned with the government’s long-term strategic goals. These include supporting desired investments, e.g., in renewable energy, while preventing asset price bubbles and ‘overheating’.

In other words, the PBoC coordinates monetary policy with fiscal and industrial policies to achieve desired stable growth, thus boosting market confidence. As a result, inflation in China has remained subdued.

Consumer price inflation has averaged only 2.3% over the past 20 years, according to The Economist. Unlike global trends, China’s consumer price inflation fell to 2.5% in August, and rose to only 2.8% in September, despite its ‘zero-Covid’ policy and measures such as lockdowns.

Needed reforms
Effective fiscal-monetary policy coordination needs appropriate arrangements. An IMF working paper showed, “neither legal independence of central bank nor a balanced budget clause or a rule-based monetary policy framework … are enough to ensure effective monetary and fiscal policy coordination”.

Appropriate institutional and operational arrangements will depend on country-specific circumstances, e.g., level of development and depth of the financial sector, as noted by both Reddy and Zhou.

When the financial sector is shallow and countries need dynamic structural transformation, setting up independent fiscal and monetary authorities is likely to hinder, not improve stability and sustainable development.

Understanding each other’s objectives and operational procedures is crucial for setting up effective coordination mechanisms – at both policy formulation and implementation levels. Such an approach should better achieve the coordination and complementarity needed to mutually reinforce fiscal and monetary policies.

Coherent macroeconomic policies must support needed structural transformation. Without effective coordination between macroeconomic policies and sectoral strategies, MF may worsen payments imbalances and inflation. Macro-prudential regulations should also avoid adverse MF impacts on exchange rates and capital flows.

Poorly accountable governments often take advantage of real, exaggerated and imagined crises to pursue macroeconomic policies for regime survival, and to benefit cronies and financial supporters.

Undoubtedly, much better governance, transparency and accountability are needed to minimize both immediate and longer-term harm due to ‘leakages’ and abuses associated with increased government borrowing and spending.

Citizens and their political representatives must develop more effective means for ‘disciplining’ policy making and implementation. This is needed to ensure public support to create fiscal space for responsible counter-cyclical and development spending.

IPS UN Bureau

Follow @IPSNewsUNBureau
  

Data Entry by Specially Trained Community Health Worker in Bangladesh. Credit: Abdullah Al Kafi

By Morseda Chowdhury
DHAKA, Bangladesh, Oct 31 2022 (IPS)

The digital transformation of thousands of community health workers in Bangladesh has dramatically enhanced their work, while enabling the creation and tracking of a healthcare database covering 64 million people. The resulting model holds remarkable promise for the health of the world, especially in the context of evolving pandemics.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

IPS UN Bureau

Follow @IPSNewsUNBureau
  

Widespread adverse reactions to the UK government’s recent ‘mini-budget’ forced new Prime Minister Liz Truss to resign. The episode highlighted problems of macroeconomic policy coordination and the interests involved.

Macro-policy coordination
But macroeconomic, specifically fiscal-monetary policy coordination almost became “taboo” as central bank independence (CBI) became the new orthodoxy. It has been accused of enabling CBs to finance government deficits. Critics claim inflation, even hyperinflation, becomes inevitable.

Anis Chowdhury

Fiscal policy – notably variations in government tax and spending – mainly aims to influence long-term growth and distribution. CB monetary policy – e.g., variations in short-term interest rates and credit growth – claims to prioritize price and exchange rate stability.

By the early 1990s, the ‘Washington consensus’ implied the two macro-policy actors should work independently due to their different time horizons. After all, governments are subject to short-term political considerations inimical to monetary stability needed for long-term growth.

Claiming to be “technocratic”, CBs have increasingly set their own goals or targets. CBI has involved both ‘goal’ and ‘instrument’ independence, instead of ‘goal dependence’ with ‘instrument independence’.

CBI was ostensibly to avoid ‘fiscal dominance’ of monetary policy. Meanwhile, government fiscal policy became subordinated to CB inflation targets. For former Reserve Bank of Australia Deputy Governor Guy Debelle, monetary policy became “the only game in town for demand management”.

Debelle noted that except for rare and brief coordinated fiscal stimuli in early 2009, after the onset of the global financial crisis, “demand management continued to be the sole purview of central banks. Fiscal policy was not much in the mix”.

Jomo Kwame Sundaram

Adam Posen found the costs of disinflation, or keeping inflation low, higher in OECD countries with CBI. Carl Walsh found likewise in the European Community.

For Guy Debelle and Stanley Fischer, CBs have sought to enhance their credibility by being tougher on inflation, even at the expense of output and employment losses.

Committed to arbitrary targets, independent CBs have sought credit for keeping inflation low. They deny other contributory factors, e.g., labour’s diminished bargaining power and globalization, particularly cheaper supplies.

John Taylor, author of the ‘Taylor rule’ CB mantra, concluded CB “performance was not associated with de jure [legislated] central bank independence”. De jure CB independence has not prevented them from “deviating from policies that lead to both price and output stability”.

The de facto independent US Fed has also taken “actions that have led to high unemployment and/or high inflation”. As single-minded independent CBs pursued low inflation, they neglected their responsibility for financial stability.

CBs’ indiscriminate monetary expansion during the 2000s’ Great Moderation enabled asset price bubbles and dangerous speculation, culminating in the global financial crisis (GFC).

Since the GFC, “the financial sector has become [increasingly] dependent on easy liquidity… To compensate for quantitative easing (QE)-induced low return…, [holders of safe long-term government bonds] increased the risk profile of their other assets, taking on more leverage, and hedging interest rate risk with derivatives”.

Independent CBs also never acknowledge the adverse distributional consequences of their policies. This has been true of both conventional policies, involving interest rate adjustments, and unconventional ones, with bond buying, or QE. All have enabled speculation, credit provision and other financial investments.

They have also helped inefficient and uncompetitive ‘zombie’ enterprises survive. Instead of reversing declining long-term productivity growth, the slowdown since the GFC “has been steep and prolonged”.

Workers’ real wages have remained stagnant or even declined, lowering labour’s income share and widening income inequality. As crises hit and monetary policies were tightened, workers lost jobs and incomes. Workers are doubly hit as governments pursue fiscal austerity to keep inflation low.

Dire consequences
The pandemic has seen unprecedented fiscal and monetary responses. But there has been little coordination between fiscal and monetary authorities. Unsurprisingly, greater pandemic-induced fiscal deficits and monetary expansion have raised inflationary pressures, especially with supply disruptions.

This could have been avoided if policymakers had better coordinated fiscal and monetary measures to unlock key supply bottlenecks. War and economic sanctions have made the supply situation even more dire.

Government debt has been rising since the GFC, reaching record levels due to pandemic measures. CBs hiking interest rates to contain inflation have thus worsened public debt burdens, inviting austerity measures.

Thus, countries go through cycles of debt accumulation and output contraction. Supposed to contain inflation, they adversely impact livelihoods. Many more developing countries face debt crises, further setting back progress.

Needed reforms
Sixty years ago, Milton Friedman asserted, “money is too important to be left to the central bankers”. He elaborated, “One economic defect of an independent central bank … is that it almost invariably involves dispersal of responsibility… Another defect … is the extent to which policy is … made highly dependent on personalities… third … defect is that an independent central bank will almost invariably give undue emphasis to the point of view of bankers”.

Thus, government-sceptic Friedman recommended, “either to make the Federal Reserve a bureau in the Treasury under the secretary of the Treasury, or to put the Federal Reserve under direct congressional control.

“Either involves terminating the so-called independence of the system… either would establish a strong incentive for the Fed to produce a stabler monetary environment than we have had”.

Undoubtedly, this is an extreme solution. Friedman also suggested replacing CB discretion with monetary policy rules to resolve the problem of lack of coordination. But, as Alan Blinder has observed, such rules are “unlikely to score highly”.

Effective fiscal-monetary policy coordination requires appropriate supporting institutions and operating arrangements. As IMF research has shown, “neither legal independence of central bank nor a balanced budget clause or a rule-based monetary policy framework … are enough to ensure effective monetary and fiscal policy coordination”.

Although rules-based policies may enhance transparency and strengthen discipline, they cannot create “credibility”, which depends on policy content, not policy frameworks.

For Debelle, a combination of “goal dependence” and “instrument or operational independence” of CBs under strong democratic or parliamentary oversight may be appropriate for developed countries.

There is also a need to broaden membership of CB governing boards to avoid dominance by financial interests and to represent broader national interests.

But macro-policy coordination should involve more than merely an appropriate fiscal-monetary policy mix. A more coherent approach should also incorporate sectoral strategies, e.g., public investment in renewable energy, education & training, healthcare. Such policy coordination should enable sustainable development and reverse declining productivity growth.

As Buiter urges, it is up to governments “to make appropriate use of … fiscal space” created by fiscal-monetary coordination. Democratic checks and balances are needed to prevent “pork-barrelling” and other fiscal abuses and to protect fiscal decision-making from corruption.

IPS UN Bureau

Follow @IPSNewsUNBureau
  

Civil society organisations at the Finance in Common Summit. Credit: Noel Emmanuel Zako

By Bibbi Abruzzini
ABIDJAN, Ivory Coast , Oct 21 2022 (IPS)

A coalition of civil society organisations is demanding public development banks (PDBs) to take radical and innovative steps to tackle human rights violations and environmental destruction. No project funded by PDBs should come at the expenses of vulnerable groups, the environment and collective liberties, but should instead embody the voices of communities, democratic values and environmental justice.

The demands, part of a collective statement signed by more than 50 civil society organisations, come as over 450 PDBs gather in Abidjan, Ivory Coast, from October 19th, for a third international summit, dubbed Finance in Common.

The COVID-19 pandemic and climate emergency, coupled with human rights violations and increasing risks for activists worldwide, is bringing the need to change current practices into even sharper focus. While public development banks may drag their feet on addressing intersecting and structural inequalities, civil society organisations are taking actions aimed at creating dignified livelihoods by embedding development with concrete affirmative measures towards climate, social, gender, and racial justice.

PDBs cannot be reluctant to act. They need to hit the target when it comes to supporting the transformation of economies and financial systems towards sustainability and addressing the most pressing needs of citizens worldwide – from food systems to increasing support for a just transition towards truly sustainable energy sources. PDBs must recognise that public services are the foundation of fair and just societies, rather than encouraging their privatisation and keep austerity narratives alive.

9 out of 10 people live in countries where civic freedoms are severely restricted, and with an environmental activist killed every two days on average over the past decade, development banks have an obligation to recognize and incorporate human rights in their plans and actions, following a “do not harm” duty.

Civil society organisations at the Finance in Common Summit. Credit: Noel Emmanuel Zako

Communities cannot be left out of the door. They need to be given the space to play the rightful role of driving forces in the answers to today’s global challenges, without them PDBs will move backwards rather than forward – and this means more environmental degradation, less democratic participation, and to put it bluntly an even greater crisis than the one we are facing today. And nobody needs that.

The recommendations in the collective civil society statement emerge from a three-year process of engagement and exchange, involving civil society networks in an effort to shape PDBs policies and projects. You can find some of their words and messages below.

As the call for accountability grows, the Finance in Common summits are an opportunity for PDBs to show moral leadership and help remedy the lack of long-term collaborations with civil society, communities and indigenous groups, threatening to curtail development narratives and practices.

Here’s the messages from civil society organisations from around the globe directed at public development banks.

Oluseyi Oyebisi, Executive Director of Nigeria Network of NGOs (NNNGO) the Nigerian national network of 3,700 NGOs said: “The Sahara and Sahel countries especially have been facing the most serious security crisis in their history linked with climate change, social justice and inequalities in the region. Marked by strong economic (lack of opportunities especially for young people), social (limitation of equitable access to basic social services) and climatic vulnerabilities, the region has some of the lowest human development indicators in the world – even before the covid pandemic. Access to affected populations is limited in some localities due to three main factors: the security situation, the poor state of infrastructures and difficult geographic conditions. PDBs must prioritise civil society organisations and Communities initiatives supporting state programs of decentralization, security sector reforms and reconciliation. This will help reduce the vulnerability of populations and prevent violent extremism.”

Mavalow Christelle Kalhoule, Forus Chair and President of Spong, the NGO network of Burkina Faso said: “Development projects shape our world; from the ways we navigate our cities to how rural landscapes are being transformed. Ultimately, they impact the ways we interact with one another, with plants and animals, with other countries and with the food on our plates. The decisions taken by public development banks are therefore existential. Such responsibility comes with an even greater one to include communities directly concerned by development projects, those whose air, water and everyday lives are affected for generations to come. For this to happen, public development banks must reinforce their long-term efforts to create dialogue with civil society organisations, social movements and indigenous communities in order to fortify the democratic principles of their work. We encourage them to listen, to ask and to cooperate in innovative ways so that development stays true to its original definition of progress and positive change; a collective, participative and fair process and a word which has a meaning not for a few, but for all.”

Tity Agbahey, Africa Regional Coordinator, Coalition for human rights in development said: “Many in civil society have expressed concerns about Finance in Common as a space run by elites, that fails to be truly inclusive. It is a space where the mainstream top-down approach to development, instead of being challenged, is further reinforced. Once again, the leaders of the public development banks gathered at this Summit will be taking decisions on key issues without listening to those most affected by their projects and the real development experts: local communities, human rights defenders, Indigenous Peoples, feminist groups, civil society. They will speak about “sustainability”, while ignoring the protests against austerity policies and rising debt. They will speak about “human rights”, while ignoring those denouncing human rights violations in the context of their projects. They will speak about “green and just transition”, while continuing to support projects that contribute to climate change.”

Comlan Julien AGBESSI, Regional Coordinator of the Network of National NGO Platforms of West Africa (REPAOC), a regional coalition of 15 national civil society platforms said: “Regardless of how they are perceived by the public authorities in the various countries, non-governmental organisations (NGOs) contribute to covering the aspects and spaces not reached or insufficiently reached by national development programmes. Despite the undeniable impact of their actions on the living conditions of populations, NGOs remain the poor cousins of donor funding, apart from the support of certain philanthropic or charitable organisations. In such a context of scarce funding opportunities, aggravated by the health crisis due to COVID-19 and the subsequent economic crisis, Pooled Finance, which is in fact a paradigm shift, appears to be a lifeline for CSOs. This is why REPAOC welcomes the commitments made by both the Public Development Banks and the Multilateral Development Banks to directly support CSO projects and programmes in the same way as they usually do with governments and the private sector. Through the partnership agreements that we hope and pray for between CSOs and banks, the latter can be assured that the actions that will be envisaged for the benefit of rural and urban communities will certainly reach them with the guarantees of accountability that their new CSO partners offer”.

Frank Vanaerschot, Director of Counter Balance, said: “As one of this year’s organisers of the Finance in Common Summit, the EIB will brag about the billions it invests in development. The truth is the bank will be pushing the EU’s own commercial interests and promoting the use of public money for development in the Global South to guarantee profits for private investors. Reducing inequalities will be second-place at best. The EIB is also co-hosting the summit despite systemic human rights violations in projects it finances from Nepal to Kenya. Instead, the EIB and other public banks should work to empower local communities by investing in the public services needed for human rights to be respected, such as publicly owned and governed healthcare and education – not on putting corporate profits above all else.”

Stephanie Amoako, Senior Policy Associate at Accountability Counsel said: “PDBs must be accountable to the communities impacted by their projects. All PDBs need to have an effective accountability mechanism to address concerns with projects and should commit to preventing and fully remediating any harm to communities”.

Jyotsna Mohan Singh, Regional Coordinator, Asia Development Alliance said: “PDBs should have a normative core; they should start with the rights framework. This means grounding all safeguards into all the various rights frameworks that already exist. There are rights instruments for indigenous people, the elderly, women, youth, and people living with disability. They are part and parcel of a whole host of both global conventions and regional conventions. Their approach should be grounded in those rights, then it will be on a very firm footing.

Asian governments need to support, implement, and apply strict environmental laws and regulations for all PDBs projects. The first step is to disseminate public information and conduct open and effective environmental impact assessments for all these projects, as well as strategic environmental assessments for infrastructure and cross-border projects.”

IPS UN Bureau

Follow @IPSNewsUNBureau
  

Maldives Minister for Gender, Family, and Social Services, Aishath Mohamed Didi, in her keynote address said her island country faced unique development challenges and is vulnerable to economic shocks and climate change.

By Cecilia Russell
Johannesburg, Oct 18 2022 (IPS)

An aging population needn’t be a burden, experts told Parliamentarians at a conference co-hosted by UNFPA Asia Pacific Regional Office and the Asian Population and Development Association (APDA).

Two National Transfer Account (NTA) experts told the session that with good planning and policy, it was possible to change the trajectory so that those in retirement were not only reliant on the state.

NTAs provide a coherent accounting framework of economic flows from one age group or generation to another.

UNFPA’s short video outlined the impact of an aging population in Thailand. Currently, adults take care of three elders and two children, but with the aging population in 2025, this will increase to four elders and three children, but by 2035, the number of dependents will increase to six elders and three children.

Professor Sang-Hyop Lee of the East-West Center and the University of Hawaii, succinctly in an “elevator pitch,” explained his interests in population. These included “looking at how a changing population structure affects society and economy, current and future,” and “what public policies could be pursued to influence the outcome.”

Lee said that using NTA tools with disaggregated data, including consumption (both private and public sector) and other variables like income and savings, could assist with policy development.

By 2080, he said, the whole Asia Pacific region would have an aging population – and public policy could change the outcomes by including evidence and knowledge-based policy to influence labor patterns of the female, youth, and elderly labor force; increasing productivity through effective education, health investments, training and finally to improve the work-to-retirement transition.

Eduardo Klein, Regional Representative of HelpAge International, who chaired the session, commented that the key takeaway was that the NTAs were a crucial tool for developing strategies to adapt to population aging.

In her keynote address, Maldives Minister for Gender, Family, and Social Services, Aishath Mohamed Didi, said that her country, which was a small island state the country, faced “unique development challenges and is vulnerable to economic shocks and climate change.”

The population is about 500 000 people, 70% of whom are Maldivians and the rest foreigners; 64% are working age, and more than 37% are under 25; those 65 and older account for 3.4% of the population.

“The Maldives entered the window of opportunity in 2010 when the majority of the population was working, and it’s estimated that the democratic transition will be completed by 2030,” Didi said. “Due to a rapid fertility decline and increased life expectancy, it’s estimated it will become an aging population by 2030.”

She outlined various policy changes in the Maldives, including addressing the investment in children, which was lower than in other economies with similar fertility or development levels. The country had included free basic education from ages four to 16 and also spent US$ 30 million supporting 15,000 students to achieve their first degrees. This has been expanded to include zero-interest rate loans. In the past two to three years, the Maldives had spent over US$ 64 million to support about 2000 students studying abroad in 31 countries. Other efforts to improve education included investing in technical and vocational education and providing skill development opportunities for youth, including apprenticeship programmes, particularly in the outer regions away from the capital or the central areas.

Didi said the Maldives depended highly on tourism, but foreign workers (primarily men) comprised 60% of the workforce. Women only play a small role in the industry and hold the most informal sector jobs.

“Young people are required to become skilled and equipped to compete with foreign workers in the domestic economy,” Didi said, adding that the demographic dividend transition was expected to create both opportunities and challenges. “The aggregate public spending on healthcare and other social protection needs to grow by more than 2 percent per year until 2050 to maintain the same level of service enjoyed by the population in 2022 – even with per capita benefits, the government’s budget needs to grow substantially.”

Klein noted that Didi’s overview showed how the Maldives was in the demographic dividend and was investing in the future and that investment had a “return in improved health and a better educated, more productive, more engaged, and a healthier population living in a harmonious society.”

Rikiya Matsukura, Associate Professor at Nihon University, noted that opportunities arose with planning and strategic policymaking. While an aging population was “inevitable” and “wasn’t curable,” policymakers played a crucial role in changing the trajectory.

Matsukura outlined four demographic dividends: The first demographic was achieved through the expansion of the workforce. The second demographic dividend is achieved through investing in human capital – leading to higher productivity. The third demographic dividend, which he termed the “longevity dividend” or “silver dividend,” was achieved through investing in longevity and longer working life. Finally, the fourth dividend would be achieved by investing in education, especially in the STEM fields.

While people aged 55 to 70 may not be working, if they are healthy, they could work, Matsukura said, that this could create an additional workforce.

“In the case of Japan, the income generated by additional elderly workers could correspond to 3.2 to 6 percent of Japan’s real GDP,” he noted.

This elderly workforce could be assisted by technology – artificial intelligence (AI) and robotics and the economy could grow by 35% if technology could make housework easier.

Lee noted that there was no easy answer but what was required was short and long-term planning which took into account crises. This aging population issue will not go away.

Klein too, noted said future planning was complex. For example, India (among other countries) had invested in education, but because of the COVID-19 pandemic, children could not attend school for two years, which would have consequences for the future workforce. Climate change, in addition to aging, would need to be planned for in Bangladesh.

During the discussion, parliamentarians were concerned about the impact of the COVID-19 pandemic. Dr Jetn Sirathranont, an MP from Thailand, noted that policymakers needed to use the NTA tools, but post-pandemic, every country, including Thailand, was experiencing a situation where there was “less income and less revenue but high expenses.”

Sirathranont asked how one could apply NTA tools in these circumstances.

While Klein quipped that this was a million-dollar question, Lee said what was required was short and long-term planning which took into account crises like the pandemic. However, he noted, “this aging population issue will not go away.”

IPS UN Bureau Report

Follow @IPSNewsUNBureau
  

Informal sector only received 4 percent of post pandemic funds even though the sector accounts for more than 2 billion workers, many of whom are women. Credit: IITA

By Ed Holt
BRATISLAVA, Oct 12 2022 (IPS)

Governments and international financial institutions must adopt new ways of providing post-pandemic support, say campaigners after a report found that in many poorer countries, big business benefitted most from Covid-19 recovery funds. At the same time, vulnerable communities have been “left behind.”

They say the level and distribution of support of these funds has been poor, with the most vulnerable in society, such as informal workers and women, among others, having been especially failed by relief programmes.

And they warn that the measures have actually only deepened inequalities at a time when the UN has warned that up to 95 million additional people could soon fall into extreme poverty in comparison with pre-Covid-19 levels.

Matti Kohonen, Director of the Financial Transparency Coalition (FTC), which was behind the report, told IPS: “The elite have been sheltered from the worst effects of the pandemic. Nearly 40 percent of Covid-19 recovery funds went to large corporations, through measures like loans and tax cuts. This means that social protection for, in particular, women and informal workers, has been inadequate.”

The FTC’s research found that in 21 countries in the Global South, large corporations received 38 percent of recovery funds while small and medium-sized enterprises (SMEs) got 20 percent. Social protection measures accounted for 38 percent.

Meanwhile, informal workers received only 4 percent of the funds in the countries surveyed, and the research showed that in many of those states, they actually received nothing at all.

Studies have shown that informal workers, and especially women, were globally hit hardest by the Covid-19 pandemic, and that economic policy measures taken in response have largely been gender-blind, exacerbating existing gender inequality and economic precarity in the sector.

According to the International Labour Organisation (ILO), of the 2 billion informal workers worldwide, over 740 million are women. However, there is a higher share of women than men in informal employment in many of the world’s poorest regions: in more than 90 percent of countries in sub-Saharan Africa, 89 percent of southern Asian countries, and almost 75 percent of Latin American countries.

These women also often have jobs most likely to be associated with poor conditions, limited or non-existent labour rights and social protection, and low pay.

The FTC report points out that while the COVID-19 pandemic has had a huge impact on women’s employment, working hours, and increases in unpaid domestic and care work duties, it found that women received half the funds than men received as most money provided to corporates and also smaller companies predominantly went to men (representing over 59 percent of funds).

Klelia Guerrero, Economist at The Latin American Network for Economic and Social Justice (LATINDADD), who helped with research into the FTC report, said that just doing work collecting data on the distribution of recovery funds underlined how little thought had been given to women in Covid-19 response policies.

It was only in a handful of the countries surveyed (Guatemala, Honduras, Bangladesh, Brazil, and Costa Rica) that partial gender-disaggregated data on Covid-19 grants were made available to analyze Covid-19 support.

“Most countries did not have disaggregated gender data; it was only partial. This in itself should be a red flag – it shows that the people who were implementing these support schemes did not think of women as a priority,” Guerrero told IPS.

And while the report shows that women did receive the majority of social protection funds in the countries surveyed, even some of those programmes “had discriminative aspects”.

“For example, here in Ecuador, we had a scheme where people had to register online and then go at certain times to receive their aid products. This was difficult for a lot of women who had to be in the home at those times, or there was no public transport to get to the places to receive aid. So, women were disadvantaged,” she said.

“Some groups of the population did benefit from Covid relief measures, but the most vulnerable not as much. It was difficult for them to access the aid. The criteria under which aid is given out should include a gender perspective.” she added.

Other equality campaigners agree.

“Numerous research has shown how, especially in Africa, women make up the majority of the informal sector. One of the big takeaways of the report is the poor targeting of women in the support response. Programmes going forward need to take into account the gender dimension of any policy,” Ishmael Zulu, Tax and Policy Officer at the Tax Justice Network Africa (TJNA), told IPS.

Groups like the FTC and its members, including the TJNA, say the report’s findings are important not just in terms of the post-pandemic recovery but in highlighting the need to change how support is given to the most vulnerable communities in developing countries in the long-term future.

Ishmael pointed out that in one scheme in Zambia, the government introduced stimulus to help SMEs and informal workers, but the money was channelled through commercial banks that set specific requirements to access that money, including the need to provide bank statements.

“Of course, that is very difficult for many informal workers. They just couldn’t provide those documents. So, in the end, even money meant for vulnerable groups ended up in the hands of big corporations, which are the ones that can provide those documents,” he explained. “It speaks of the weakness of the system.”

The FTC report has also warned that policies pursued by international financial institutions, such as the International Monetary Fund (IMF), of pushing countries to introduce austerity measures and cut funding for basic public services in return for debt restructuring is making things worse.

It cites the example of the cuts in public spending and rises in Value-Added Taxes (VAT) being imposed as part of an IMF loan program in Zambia, saying this will have the greatest impact on the poor.

Ishmael said: “Our current financial structures have perpetuated inequality in the way, for instance, financial institutions give loans: several countries have had to reform their tax systems … and these financial institutions say subsidies and spending should be channelled into some areas and not others, and it ends up that money is targeted towards large corporates, and vulnerable communities are left behind.”

He added: “We saw growing inequality [before the pandemic], and so when Covid-19 hit, we saw how these vulnerable communities were left behind without safety nets. Governments must put in place sustainable social protection systems providing safety nets to help lift people out of poverty and which won’t just respond to a pandemic or an emergency, but respond to fighting poverty and inequality.”

The FTC is planning to present its findings at the IMF/World Bank Annual Meetings later this month.

The FTC’s report calls for all countries and international institutions, including the IMF and World Bank, to implement what it describes as “alternative policies to bring a people-centered recovery instead of austerity”.

These include, among others, taxing excess windfall corporate profits, introducing progressive levels of income and wealth taxes, and increasing social security contributions and coverage.

Kohonen said informal workers and women should be at the heart of any such policies.

“Informal sector and women workers really pulled us through the pandemic, and it is wrong to now impose austerity on them. Support needs to be in place for informal and women workers, people on the front lines, before a pandemic so that support can be then scaled up if needed, in the form of loans, grants or other aid,” he said.

IPS UN Bureau Report

Follow @IPSNewsUNBureau
  

The Graduation approach's impact goes well beyond that of the individual participant. Not only does the household greatly benefit from its various interventions, but now studies show subsequent generations are able to stay out of the poverty trap. (Rangpur, Bangladesh). Credit: BRAC/2021

By Gregory Chen
WASHINGTON DC, Oct 10 2022 (IPS)

As we approach 2030, the Sustainable Development Goals look harder than ever to achieve. Shocks to the global economy caused by climate change, COVID-19, and conflict threaten humanity’s survival. For the most vulnerable, trends are moving in the wrong direction with an additional 75 to 95 million people now living in extreme poverty compared to pre-pandemic World Bank projections. By the end of this year more than 657 million people will still be living in extreme poverty substantially more than in 2018.

Though we cannot blame the recent crises alone. Even before the crises of the past few years the globe was beginning to realize addressing extreme poverty required new approaches. Economic growth alone remains insufficient and conventional anti-poverty policies and programs were not addressing the root problems affecting the most marginalized.

What can countries do to end the most severe forms of poverty?

While private organizations like BRAC (where I work) have a role to play, it is governments that are best positioned to take the lead tackling extreme poverty at scale. Governments have the mandate, the infrastructure, and the financing to transform the lives of the most vulnerable people.

Governments increasingly recognize a growing body of research which tells us people in extreme poverty face multiple reinforcing barriers – a lack of nutrition, education, and social exclusion which contribute to a deficit of hope and self-confidence. Together, these multiple factors create a poverty trap that is challenging to escape. Addressing only a few of these barriers at a time is insufficient for people out of poverty traps. Many governments have begun to recognize this in the past decade as growth lifted many out of poverty but large pockets of people remained excluded.

Women gather to discuss social issues and add to their group savings as part of the Bab Amal (Door of Hope) Graduation project in Upper Egypt (Sohag, Egypt). Credit: BRAC/Robert Irven 2022

Escaping a poverty trap requires a “big push” – a significant transfer of resources and\ support that can address multiple barriers in one go. One “big push” proven to break the poverty trap is referred to as the Graduation approach (though it may be called different things in diverse settings). Graduation is a sequenced set of interventions that address the unique circumstances of poverty within the local context. This approach meets participants’ day-to-day needs, provides training and assets for income generation, financial literacy and savings support, and social empowerment through community engagement and life skills training – all facilitated through coaching that calls for regular interactions with participants.

A period of intense coaching enables participants to build resilience and self-confidence by empowering them to save, diversify their sources of income, access safety nets, and develop coping mechanisms to major shocks and build up self confidence. These combined interventions are delivered in a 2-3 year time bound period, empowering participants to begin an upward trajectory out of extreme poverty and with greater ability to link to wider government support.

Graduation programs are designed to positively impact all household members, but the approach focuses on direct engagement with working age women. These women are disproportionately affected by extreme poverty and most likely to use their greater capacities to reinvest in their households’ development.

At its core, Graduation is about recognizing that when empowered with the right tools and resources, people can be agents of change for themselves, their households, and their communities.

A high return on investment

The Graduation approach is an investment with returns that grow over time. Rigorous evaluations report that four years after participants start, Graduation delivered benefits that began to exceed program costs. Compared to standalone narrower interventions like lump sum cash transfers, after 3 to 4 years after the initial intervention, Graduation programs deliver greater household benefits – including greater consumption, income, and savings. Research from India shows that ten years after starting the program, participants see approximately 400% ROI, and projections suggest this return could reach 1100% over the participant’s lifetime. Since the investment is time limited and may not be repeated its ROI over the longer term can save costs and build resilience.

Many Government are Adopting Graduation

Due to Graduation’s proven impact, many governments are investing in the approach, integrating it into existing programs. It is estimated that more than 15 government programs have developed Graduation approaches across Latin American, Africa, and Asia. Among them include governments in Kenya, the Philippines, and India. These are most often not new standalone programs but integrated within existing Graduation programs, where the Graduation package is particularly emphasized for certain target populations.

Yolanda, a participant of the DSWD’s Padayon SLP Graduation project, is visited by her coach Julius, who helps ensure she is making steady progress and has the tools and knowledge she needs to overcome any challenges or shocks. (Iloilo City, Philippines). Credit: BRAC/Robert Irven 2022

In the Philippines, despite the many challenges created by COVID-19 in 2020, participants in the Philippines’ Department of Labor and Employment (DOLE) Graduation program had more resilient livelihoods and better savings and financial management, according to Asian Development Bank (ADB). The Government of the Philippines is now on its second iteration of Graduation integration offered through the Department of Social Welfare and Development with support from ADB and the Australian government.

The Government of Kenya is also investing in Graduation with the Kenya: Social and Economic Inclusion Project (KSEIP) in partnership with Global Development Incubator, BOMA Project, Village Enterprise, the World Bank, and the UK government (FCDO). Following a successful pilot in 2019, KSEIP will transition from a narrower unconditional cash transfer to a fuller package of Graduation.

A Few Leading Governments are Implementing at Scale

Some governments have moved beyond testing to delivering at scale. In the Province of Bihar in India, a large rural development program (called JEEViKA) established a special window for a Graduation program known as Satat Jevvikoparjan Yojana (SJY), which has reached 140,000 households in extreme poverty since 2018. Other Provinces in India may follow suit expanding their own Graduation programs as well. Additionally, countries such as Ethiopia and South Africa are looking to further adapt their already large scale programs with more Graduation elements added that can deliver long term results.

As governments implement scaled programs we have reasons to be confident that these investments will bring durable results. While we must address today’s crises, our work to dramatically reduce and eliminate extreme poverty will not happen with slipshod short-term band-aids. Governments can begin to fully address extreme poverty with smart investments that will over time lead to permanent changes that eliminate extreme poverty.

While governments will lead, they cannot do it alone. The international community, particularly multilateral institutions, can provide the financing required to operate at scale. NGOs and community-based institutions can be partners in last mile delivery assisting the government where needed. Researchers can focus their methods more on how scaled programs operate (rather than on repeat small scale impact evaluations) so that we can make wider decisions on adapting for scale.

It is high time for us to lean on the evidence, evolve programmatically, put government in the lead, and benefit from all the testing and research that has led us to solutions that can work.

IPS UN Bureau

Follow @IPSNewsUNBureau
  

Excerpt:

By External Source
Oct 5 2022 (IPS-Partners)

Sigrid van Aken is the CEO of Novamedia/Postcode Lottery Group, a private company with a social purpose, that brings together business and ideals. It sets up and operates Postcode Lotteries worldwide to raise funds for charity. With a lucky winning postcode (zipcode), neighbours win together. At the same time, thanks to these player communities, vital funding is raised for charities and good causes (yearly €825 million), making the Postcode Lottery Group the 3rd largest private charity donor in the world after the Bill & Melinda Gates Foundation and the Wellcome Trust.

Since 2013, Sigrid has been a member of the international Executive Board. Postcode Lotteries are operated in the Netherlands, Great-Britain, Sweden, Germany and Norway.

Sigrid has extensive international managerial experience as a (non-)executive board member in a public-private context. She also has expertise in areas such as the financing of charities, corporate governance, international lottery-legislation, public affairs and stakeholder management.

ECW: With September’s UN General Assembly, Transforming Education Summit, Global Citizen Festival and ECW’s High-Level Steering Group Meeting recently concluded, what key lessons should we take forward to accelerate the delivery of education in emergencies?

Sigrid van Aken: We live in unprecedented times. The continuing hangover from COVID-19 along with never ending conflicts, increased climate-related disasters and growing food and fuel insecurity, are taking their toll. Society’s most vulnerable suffer the most, with 222 million school-age children and adolescents in crisis situations needing access to education or better quality education. Now more than ever, investment and a united approach is urgently needed to provide education to the millions of children out of school.

We have learned from our partners, reiterated at the recent meetings and summits on education, that alongside access to education, a focus is needed on ensuring children and youth are achieving minimum standards in their learning. Only one in ten crisis-impacted children attending primary or secondary education are achieving basic levels in reading and mathematics.

At the Postcode Lottery Group, our vision is that the civil society is a force for good, and for positive change. Our mission is to strengthen the civil society. We set up and operate Postcode Lotteries worldwide to raise funds for a wide range of charities, addressing areas like education and human rights, frequently focused on women and children. Players of the Postcode Lotteries have raised over €12 billion for more than 11,000 charities and social organisations around the world.

We enter into long-term partnerships with charities, trusting them as the experts to spend the money where it is most needed. We understand that being flexible in how funding can be used, provides the freedom to flex with need and try new innovative ways of working which could have greater impact to enable real change. The freedom of unrestricted funding provides an opportunity for our partners to leverage support from elsewhere.

We can commit to long-term partnerships thanks to the millions of players in our subscription-based community lotteries across five European countries: the Netherlands, Sweden, Great Britain, Germany and Norway. The Postcode Lottery is a unique format; tickets relate to the players own postcode (or, in the US zip code). This way everyone playing in the same street or area can win together, while raising money for good causes. It is all about strengthening community and engaging people from all walks of life in a safe and responsible lottery which even when you don’t win, your community through the charities supported, does.

Many of our charity partners, such as Theirworld, Plan International, Red Cross, Save the Children, UNICEF and Action Against Hunger are providing support to those in need of humanitarian assistance through centres for psychosocial support, trauma counselling and school feeding programmes so that displaced and refugee children stay safe. And we know from our charity partners that this whole child approach, which includes social and emotional well-being for each child, is crucial. This can only be achieved through diverse partners on all levels and types, that actively look for sustainable and locally led solutions.

We must accelerate the delivery of education in emergencies, and it was clear to all attendees at these gatherings in September that we cannot afford to leave these children behind and must be held accountable to Education Cannot Wait’s commitment.

ECW: Today, 222 million crisis-impacted children urgently need education support. Why is it important for other private sector partners to invest in Education Cannot Wait’s work to deliver quality education to children left furthest behind to help realize their 222 Million Dreams?

Sigrid van Aken: We know that the poorest households are the least resilient to crisis situations. Added to this, women and girls are unfairly disadvantaged, with school attendance reducing and girls being pulled out of schools too early. We all know the impact of education beyond the school classroom is undeniable. On behalf of donors, Education Cannot Wait is committed to ensuring learning remains a key focus, and with more partners, they can make education a reality rather than the dream it is for so many children.

Despite the increase in humanitarian funding for education in emergencies, the funding gap for education is widening more than in other sectors. More private donors are needed to help place education within the reach of every child, everywhere.

The Postcode Lottery Group is supporting initiatives that drive positive change for those who have less opportunity or chance in life. Our lotteries are enablers of change, and we use our communication channels to encourage and share with others, reaching millions of people every day.

In addition to the support we provide to the work of Education Cannot Wait, thanks to our millions of players, many civil society organizations working on education are supported each year with flexible support that they can invest wherever the need is greatest.

ECW: The Postcode Lottery Group, with Theirworld, has provided funding for ECW’s COVID-19 education in emergencies response in the Greek Islands. Why is it important for the Postcode Lottery to invest funding into education responses to refugee crises in places like Greece?

Sigrid van Aken: Nations like Greece host hundreds of thousands of refugees and asylum-seekers, a third of whom are children, many of these are girls or children with disabilities. We provided €1.35 million to fund emergency education so that despite the turmoil they faced, education remains available to them.

Without access to education, refugee children, wherever they are, face an uncertain future. We believe that even in a crisis, learning should never stop and thanks to the support of our lottery players we were able to put our funds behind this. We are committed to supporting those who share this belief such as our partners UNICEF, UNHCR and Theirworld to provide education with inclusion and equity for refugee children in the Greek Islands and elsewhere so that no one is left behind.

ECW: From a broader perspective, why is funding for education in places like Colombia, Democratic Republic of the Congo, Ethiopia, Mali, Nigeria, Pakistan, Somalia, South Sudan, Sudan, Ukraine and Yemen important for the private sector and businesses worldwide?

Sigrid van Aken: Children in these countries should have access to the same possibilities offered by education. Education offers a different future for them and can provide protection against early marriage, reduce exposure to gender-based violence, and prevent them from becoming a child soldier.

In these places in particular, funding of safe learning spaces, smaller classrooms, inclusive learning environments, school nutrition programmes, psychosocial support services and training for educators is urgently needed. While for the individual it improves their life chances, it also supports communities, the environment and opportunities for the next generation.

The Postcode Lottery Group believes in long-term investment without which continuity of learning cannot happen and help the millions of children living in the toughest parts of the planet.

ECW: As the CEO of Novamedia/Postcode Lottery Group, you are an inspiring, dynamic leader. How can we best empower girls to become inspiring, engaging women leaders of tomorrow?

Sigrid van Aken: By providing strong role models. For every child, role models play an important part in developing their own dreams for the future. I wish that every child will come across these individuals and have the confidence to think big, to pursue their dreams and fully develop their talents. Young girls in particular benefit from inspiring women in leadership positions, so they can see themselves doing something similar in the future. I am personally inspired by young woman who fearlessly work towards their goals and mission in life, and I am lucky to meet many in my daily work.

ECW: Through our 222 Million Dreams campaign, ECW calls on donors, private sector, high-net-worth individuals and philanthropic foundations to mobilize US$1.5 billion for ECW so we can reach 20 million children over the next four years. Why should donors invest in ECW as our High-Level Financing Conference approaches in February 2023?

Sigrid van Aken: As Education Cannot Wait has outlined, this call is not just about accessing education, it is about turning crisis-affected children and adolescents’ dreams into reality.

Access to a quality education in times of humanitarian crisis is the right of every child and Education Cannot Wait is already working with over 7 million children across 40 crisis-affected countries.

Supporting ECW and its holistic approach to education – and addressing the barriers to education through multi-year programmes – will have impact on those who are let the furthest behind in the most challenging of situations. Without education these children can never meet the challenges they face now or will in the future.

ECW: Our readers would like to know a little about you on a personal level. As a dynamic leader, we would like to know what are some of the books that have most influenced you and why would you recommend them to others?

Sigrid van Aken: Recently I attended the UN Transforming Education Summit and Theirworld dinner. I was privileged to be seated next to the President of the Republic of Sierra Leone, Dr. Julius Maada. He told me he grew up in a village far from the city. His mother could not read. And it is education that got him where he is today. As President, he made education a policy priority and has launched the National Education Sector Plan 2022-2026 under the theme, “Transforming Education for All.” His government has provided substantial levels of funding to meet the needs of the education sector, and to free access to quality education.

This inspires me greatly because it expresses hope about what drives people in their lives, on being there for others and making something of it together. I felt similar hope reading the book of the Dutch author Rutger Bregman, ‘Humankind.’ An inspiring tribute to humankind’s better natures. He shows that at root humans are friendly, peaceful and healthy, and that there is a high degree of cooperation and communal spirt when times get rough.

What drives people in their lives, being there for their fellow man and making something of it together, is also strongly expressed in the latest book by Nobel laureate, world-renowned doctor, and noted human rights activist Dr. Denis Mukwege, ‘The Power of Women: A Doctor’s Journey of Hope and Healing.’ An impressive book on women, survivors of sexual violence during conflict, and their resilience, enduring strength and power. The strength of women gives hope for the potential of individuals to turn the tide. And Dr. Mukwege also hopes to inspire men to speak out and join the struggle, rather than leaving women to fight the battle alone. A powerful read.

Credit: United Nations Office for South-South Cooperation

By Deepali Khanna and Siddharth Chatterjee
BANGKOK / BEIJING, Sep 12 2022 (IPS)

The world today faces a future that is in peril. Our challenges have become more complex and interconnected, as we see the impacts of the COVID-19 pandemic, an uneven economic recovery, a climate emergency, growing inequalities, and an increase in conflicts globally. This year also marks a grim milestone, with over 100 million people forcibly displaced.

These events accompany increasing division in the community of nations which threatens to push the achievement of the Sustainable Development Goals (SDGs) further out of reach for the Global South.

Adding to these crises, rising food and energy prices driven by the conflict in Ukraine, could push 71 million people into poverty, according to UNDP. The Global South, typically comprised of countries in South America, Africa, Asia, and Oceania, was already grappling with economic issues now exacerbated by the triple planetary crisis.

With limited resources, high vulnerability, and low resilience, people in the Global South will bear the brunt of our inaction, on climate and elsewhere. Solely depending on external aid from the Global North or G7 countries cannot be the panacea. Here, countries of the Global South can empower themselves and combine efforts to achieve sustainable development.

Cooperating to catalyse change

In the face of global threats, international cooperation remains vital, as highlighted by the International Day for South-South Cooperation. South-South cooperation seeks to complement traditional development models by throwing light on the transformations needed to deliver on priorities, including the SDGs. It offers possible solutions from Global South to Global South.

Countries of the Global South have contributed to more than half of global economic growth in recent times. Intra-South trade is higher than ever, accounting for over a quarter of world trade. It is time to further leverage these partnerships in the development space.

We already saw this while many countries were trying to obtain COVID-19 vaccines. Citizens of low and middle-income countries faced systemic discrimination in the global COVID-19 response, leaving millions without access to vaccines, tests, and treatments. India sent over 254.4 million vaccine supplies to nations across the world, under Vaccine Maitri – a vaccine export initiative.

Likewise, China has supplied over 200 million doses of vaccines to the COVAX Facility, in addition to providing millions of dollars in medical supplies to countries in the Global South, including in Africa, throughout the pandemic.

Informing partnership models with Africa & China

To advance development priorities, partnerships need to be rooted in shared interests that can lead to shared gains, as seen in traditional development models and assistance from the Global North. This dynamic needs to be at the core of the China-Africa relationship as well.

China, an economic powerhouse, has the potential to advance development in the Global South, especially in Africa, by bringing its experience, expertise, and resources to bear, and its assistance must advance both its interests and those of the countries where it operates.

Investments in shared goals are reflected in efforts by China to improve public health in Africa, including in the construction of the Africa Centers for Disease Control and Prevention in Ethiopia, and in clean energy, through projects such as the Kafue Lower Gorge Power Station in Zambia.

China promises to invest US$60 billion cumulatively in Africa by 2035, directed at agriculture, manufacturing, infrastructure, environmental protection, and the digital economy. This is most welcome, and those planned investments must answer the needs of the local economies and societies.

What works in one country may not work elsewhere, but true collaboration allows for learning from mistakes and sharing successes. This is where the UN’s expertise can ensure cooperation is demand-driven, in line with local expectations and needs, national development priorities, and relevant international norms and standards.

Platforms like the Forum on China-Africa Cooperation (FOCAC) can work to improve that essential partnership. This mechanism has identified shared priorities like climate change, agriculture/food systems, global health, and energy security, among others, between China and Africa.

For the first time in FOCAC’s history and with support from The Rockefeller Foundation, the UN in China is engaged as a strategic partner in this bilateral mechanism between China and Africa. The UN in China is continuing similar efforts in close consultation with relevant counterparts, including the China International Development Cooperation Agency.

For The Rockefeller Foundation, it is a nod to its legacy in China dating back to 1914, rooted in redesigning medical education to improve healthcare and its current priorities to advance Global South collaboration, especially in public health, food, and clean energy access—all global public goods.

Beyond the Global South: Action Together

With less than eight years to achieve the SDGs, truly international cooperation is our only hope. Emerging trends in technology and innovation can get us there, along with enhanced South-South cooperation efforts. But doing so requires us to “flip the orthodoxy”, as UN Deputy Secretary-General Amina J. Mohammed advised.

The Ebola crisis is an example of where global cooperation, including South-South cooperation, enabled Sierra Leone to defeat the disease’s spread, notably through a brigade of 461 health workers sent to Sierra Leone to support their overburdened system. Later, other countries made similar efforts to support Sierra Leone and nearby countries, such as Guinea and Liberia. This example shows the potential of South-South cooperation, but also triangular cooperation and North-South partnerships. Public-Private Partnerships (PPPs) are another mechanism for financing and capacity building.

This can be seen in Kenya, where the Government and the UN System convened an SDG Partnership Platform with companies such as Philips, Huawei, Safaricom, GSK, and Merck. The outcomes include a downward trend of maternal and child mortality in some of the country’s most remote regions. Similar PPPs can hold promise in unlocking global progress on the SDGs.

Today, while we face a more volatile world, the spirit of South-South cooperation shows a core value that we need: solidarity. As UN Secretary-General António Guterres said, “The last two years have demonstrated a simple but brutal truth – if we leave anyone behind, we leave everyone behind”.

Deepali Khanna is Vice-President of the Asia Region Office at The Rockefeller Foundation. Siddharth Chatterjee is the United Nations Resident Coordinator in China.

IPS UN Bureau

Follow @IPSNewsUNBureau
  

By Lily Meyersohn
NEW YORK, Sep 9 2022 (IPS)

This week––nearly ten months after the emergence of the Omicron variant––the United States is rolling out Covid-19 booster vaccines that specifically target newer, now-dominant strains of the virus.

The Centers for Disease Control and Prevention (CDC) has estimated that 209 million Americans over the age of 12, or 74 percent of that population, will be eligible for the shots.

Unfortunately, the last year and a half are a stark reminder that it takes much more than even the miracle of “lightning speed” science to ensure widespread vaccination in this country.

In late July, the Kaiser Family Foundation found that the share of people living in counties designated by the CDC’s guidelines as medium or high risk had grown significantly due to the spread of the BA.5 variant.

At that time, 87 percent of the entire population lived in a medium or high risk area. KFF estimated that the number of people living in those counties who were not up to date on their Covid-19 vaccinations had also jumped––to 198 million. This jump represented a 65 percent increase since the start of June alone.

Despite that data, many Americans have nonetheless accepted a faulty narrative that assumes that high-risk Americans are already safely vaccinated and boosted. Older Americans, in particular, have widely been considered “all set.”

But Benjy Renton, a researcher on Covid-19 vaccine delivery, notes that although older people were prioritized during the initial rollout, achieving nearly 91 percent coverage, by this summer there were already more than 15 million Americans over the age of 65 who had not received their first booster.

This spring, a nationwide survey by the COVID States Project found that a higher number of older Americans are unvaccinated and un-boosted compared to the widely reported CDC data used by most public health officials––calling the CDC data “clearly significantly flawed.”

Matthew Baum, a professor of public policy at Harvard University’s John F. Kennedy School of Government and an author on the study’s preprint, said that it has been difficult for the federal government to figure out exactly how many shots have been administered to each individual. “States are uneven in reporting data,” said Baum. Poor vaccination record linkage in the US has exacerbated the problem.

On Sept. 1, new research presented at the CDC’s Advisory Committee on Immunization Practices meeting regarding booster doses showed that more than 30 percent of people over the age of 50 have received no booster. Many people in that cohort have not been boosted simply because they believe they are protected from severe outcomes from the virus since they were “fully vaccinated” back in the first round.

Vaccine uptake for the other Covid-19 boosters has been relatively low. That means millions of Americans currently have waning—no, waned—immunity to a virus that quickly learned to evade the protection offered by initial vaccines.

The new bivalent boosters are thus a way for our immune systems to “upgrade” their response to new forms of the virus, explains Rob Swanda, an mRNA biochemist and science communicator known for his popular online educational videos. The boosters allow our cells to “remember what both the ancestral strain” of the virus looks like and “what the Omicron variant looks like.”

Experts are clear on the fact that these updated boosters will be a “key tool for those at high risk of severe disease,” said Renton. Unfortunately, with every successive booster, uptake has decreased—even among the most vulnerable.

Megan Ranney, a practicing emergency physician, researcher, and public health advocate at the School of Public Health at Brown University, hopes that even “25 to 30 percent of the population, especially immunocompromised and older folks,” get these shots. “That could potentially be really impactful.”

Various studies have shown that increased boosting this round could save many thousands of lives. In late July, the Commonwealth Fund released an analysis estimating that an extensive fall booster vaccination campaign could save 160,000 lives and avert $109 billion in medical costs. Their researchers examined the impact of an early fall vaccination campaign––one that should be right around the corner but has yet to appear.

Even if the campaign’s coverage were slightly less widespread—similar in reach to that of the 2020–2021 influenza vaccination campaign—it would nonetheless prevent nearly 102,000 deaths and more than 1 million hospitalizations, and save $63 billion in direct medical costs by the end of next March. Either of these scenarios could prevent deaths from exceeding 1,000 per day.

Without such a campaign, the authors estimate that a surge could lead to more than 260,000 additional deaths by the end of March. That is, of course, in addition to the 1.04 million deaths the country has already experienced––a figure that has contributed to the nation’s staggering decline in life expectancy last year and the biggest two-year drop in almost 100 years, reported STAT.

What would an effective outreach campaign actually look like?

This week, Renton insisted on Twitter that we especially need to focus on “better outreach to the uninsured,” given that the uninsured represent the “least-vaccinated demographic group” in the US.

Others advocate for institutions to conduct more effective community outreach; Taison Bell, an assistant professor of medicine at the University of Virginia, told me that we need a “multipronged campaign––on the bus, subway, radio––but also a targeted campaign in higher-risk communities” that allows for communication and coordination with local places of worship and community leaders.

I’m convinced. But I cannot say that I am optimistic.

In 2021, as a researcher for the Stanford Internet Observatory’s Virality Project––a team that collected data about online vaccine misinformation and disinformation––I heard from passionate, inspiring doctors, public health experts, and health care advocates who fiercely believed that when provided with the right tools––in the forms of access to the vaccine, accurate information, time off work, childcare, and/or supportive community members with whom they could talk through hesitations and concerns––the vast, vast majority of Americans were open to getting vaccinated and then boosted for Covid-19. I trusted those doctors and advocates.

I still do.

But those tools take time, and they all take a lot of money. As Bell and Renton and others have reminded me, Covid funding has continued to dry up from Congress this summer. In the last few months, Americans have witnessed the ending of a slew of supportive pandemic economic policies, from the Expanded Child Tax Credit to the Uninsured Program and paid pandemic sick leave.

And the Biden administration just announced it will discontinue its free at-home rapid test mailing program due to a lack of funding. The program was critical to detection and prevention last winter and spring during the height of the first two Omicron waves. Americans had until Sept. 2 to order their last batch. After that, Congress is saying––as it has for months, like a terrible rallying cry, or maybe a death chant––“you’re on your own now.”

Lily Meyersohn is a researcher at the Institute for Public Accuracy, where she covers pandemic policy and American health care issues. Prior to that, she was an associate researcher and writer for the Stanford Internet Observatory’s Virality Project, a coalition of research entities that investigated online Covid-19 vaccine misinformation. The group’s work supported information exchange between the research community, public health officials, government agencies, civil society organizations, and social media platforms. She can be reached for more information at lilymeyersohn@gmail.com or @LMeyersohn.

IPS UN Bureau

Follow @IPSNewsUNBureau
  

A medical officer preparing to give a COVID-19 vaccine in Somalia in May 2021. Credit: Mokhtar Mohamed/AMISOM

By Juliet Morrison
UNITED NATIONS, Sep 8 2022 (IPS)

With the outbreak of Monkeypox in non-endemic countries leading to a scramble for vaccines, global health advocates are again calling for equity to be prioritized in the international response.

Equity was a top concern during the initial stages of the COVID-19 pandemic emergency health response. The World Health Organization (WHO) helped spearhead several initiatives in an attempt to reduce disparities between nations, notably COVAX, the vaccines pillar of the Access to COVID-19 Tools (ACT) Accelerator.

Yet, despite these efforts, figures from Our World in Data show that only one in seven people are fully vaccinated in low-income countries. In contrast, almost three in four people have been fully vaccinated for a year in high-income countries.

Fatima Hassan, human rights lawyer and founder of South African-based civil society group Health Justice Initiative, sees the current disparity in Monkeypox vaccine access as the latest example of the Global South, and Africa especially, being disadvantaged in the global health space.

“We still as Africa don’t have any supplies of monkeypox vaccines, even though as a continent, we’ve been dealing with this disease for a number of years. So on one level, now that it’s become a Global North problem, the vaccines have been found for them, but not for us.”

Monkeypox can be combated with smallpox vaccines, which are 85 percent effective against the virus. Since the disease was eradicated in 1980, the WHO has had 31 million doses set aside for a rapid response in case smallpox should re-emerge. The organization is currently assessing the potency of this stockpile and whether it can be deployed against Monkeypox.

However, these doses have never been distributed in Africa, where Monkeypox has circulated since the 1970s. The continent is also facing a much higher death rate. When the WHO declared a global health emergency, the only deaths recorded were from West and Central Africa, where 4.7 percent of people who contracted the disease had died.

In the case of COVID-19, many saw the international rules that allow pharmaceutical companies to protect their intellectual property (IP) as simply reinforcing existing disparities between countries.

Several wealthy countries signed contracts with pharmaceutical companies, helping finance private sector research and development, in exchange for prioritized access to vaccine supply. When companies eventually developed successful vaccines, the technology they used was restricted from being shared with the global community. Nations that lacked both the technology and the resources to purchase on the open market resources had to rely on vaccine donations from rich countries that came several months later.

Over 100 organizations and networks joined a coalition called The People’s Vaccine to call for the suspension of intellectual property rules and mandatory pooling of COVID-19-related data and technologies. Those supporting the alliance’s call include the current leaders of the Joint United Nations Programme on HIV/AIDS (UNAIDS), the UN Special Rapporteur on extreme poverty and human rights, and former Secretary-General Ban Ki-Moon.

For Hassan, intellectual property regulations were especially problematic given the participation of Africans in trial phases for Moderna and Pfizer’s COVID-19 vaccines.

“We did all those trials; we’ve contributed to the knowledge generation and to the scientific knowledge that allowed [pharmaceutical companies] to get emergency use authorization. But we were not guaranteed supplies or access or preferential access. So the deeper inequity in this entire setup was also that the Global South was asked to participate in the research and the trials, but there was no regulated way of ensuring […] genuine benefit sharing agreements.”

For countries worldwide, the COVID-19 pandemic has highlighted the importance of increased self-sufficiency in coping with global health emergencies.

“I think that was the lesson of COVID. For the global South, it was like, oh, okay, we need to actually figure this out by ourselves,” Hassan said.

Several initiatives have been created to fulfill this goal, including a new mRNA vaccine technology hub in South Africa.

The hub was launched by the WHO and COVAX in Afrigen, Cape Town, on June 21, 2022. It aims to bolster low and middle-income countries’ capacity to produce COVID mRNA vaccines by training scientists in developing mRNA vaccines and pooling all knowledge acquired by partners. The site in Afrigen will be run by a consortium that includes Biovac, Afrigen Biologics, and Vaccines, a network of universities, and the Africa Centers for Disease Control and Prevention (CDC).

When the hub launched, South African President Cyril Ramaphosa commended the initiative and its implications for Africa’s role globally.

“The COVID-19 pandemic has revealed the full extent of the vaccine gap between developed and developing economies and how that gap can severely undermine global health security. This landmark initiative is a major advance in the international effort to build vaccine development and manufacturing capacity that will put Africa on a path to self-determination.”

African scientists are heading the technology transfer hub. It has already produced the first batches of an mRNA vaccine with technology that will be transferred to 15 countries.

Reflecting on Africa’s response to COVID-19, Public Health Professor Flavia Senkubuge told IPS that she’s proud of how well the continent dealt with the caseload, especially as many predicted COVID-19 would “literally obliterate” the region.

The WHO has cited Africa as “one of the least affected regions of the world” throughout the pandemic. The number of total deaths from the continent, 256 555, makes up 3 percent of the world’s total, 6.49 million. In contrast, deaths from the Americas and Europe accounted for 46 and 29 percent, respectively.

Senkubuge told IPS that predictions that Africa would be completely overwhelmed overlooked the expertise Africa has garnered in combating public health crises, notably HIV and AIDS.

“If you look at South Africa, for people like me who trained and practiced as physicians during the HIV and AIDS period, we are used to those large numbers of very sick patients. Additionally, in South Africa, you must remember that we are a country that has a quadruple burden of disease, therefore which means we have a high volume of patients coming into our health establishments. We are therefore used to working differently, having an optimum triage system, and working in under-resourced and high-pressure environments.”

Being underestimated also extends to the work of African scientists. Both Hassan and Senkubuge told IPS that the work of Africans is often neglected and overlooked in global settings.

Yet, the pandemic has also highlighted their contributions to global health, Senkubuge said. She pointed to South Africa’s discovery and swift response to the emergence of the Omicron variant. She believes this has led to a shift in how African scientists are considering their work on the global stage.

“As African [scientists], […] I think we have kind of shifted the paradigm to say we are here, we are not going anywhere. We’re not going to try and convince anyone regarding the excellence of our work, we’ll just do our work, continue to share it with our communities, publish in the top journals and be part of the global discourse on our own terms. You’re welcome to retake, amend, recheck, but actually, we stand resolute in our unapologetic knowledge that the work we do here in Africa is excellent and contributes significantly to global health.”

IPS UN Bureau Report

Follow @IPSNewsUNBureau