Links: February 2016 Meetings


by Pietro Dionisio

Degree in Political Science, International Relations

Cesare Alfieri School, University of Florence, Italy

Links: February 2016 Meetings


Cell Biology and Immunology of Persistent Infection 

Self Neglect and Adult Safeguarding 

Arrhythmias & the Heart: A Cardiovascular Update 

Cell Culture 2016 

Measuring & Monitoring Clinical Quality 

1st International Thyroid NOTES Conference 

Advanced Technologies & Treatments for Diabetes (ATTD 2016) 

1st International Conference of Applied Pharmacology for Pharmacy and Clinical Practice (APPCP) 

International Symposium on Role of Herbals in Cancer Chemoprevention and Treatment 

Advances and Progress in Drug Design 

International Workshop on the World Wide Web and Population Health Intelligence (W3PHI) 

16th Annual International Symposium on Congenital Heart Disease 

Sixth International Conference on Metals in Genetics, Chemical Biology and Therapeutics (IGMC-2016) 

4th Systemic Sclerosis World Congress 

15th International CRS-IC Symposium 2016: Advances in Technology and Business Potential of New Drug Delivery Systems 

World CNS 2016

The Future of Healthcare 

ICHB 2016: 3rd International Conference on Heart and Brain 

4th International Congress on Cardiac Problems in Pregnancy 

International Conference Continued and On-Going Process Verification 

Breaking News: Link 176

Breaking News Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings


Breaking News: Link 176


UN Secretary-General’s High Level Panel on Access to Medicines 

Discovering New Medicines And New Ways To Pay For Them 

WHO Members Commit To SDGs For 2030, Despite Some Differences 

Seven ideas on how to finance the SDGs 

Evaluation Starts On WHO Global Strategy For Public Health, Innovation, IPRs 

138th WHO EB – Briefing – Addressing the global shortages of medicines, and the safety and accessibility of chidren’s medication. – Agenda Item 10.5 

138th WHO EB – Agenda Item 9.3 – Global Vaccine Action Plan 

138th WHO EB – Briefing – “From Ebola and Beyond: faulty governance of the health system in responding to medical emergencies and epidemics- Agenda Item 5 & 8.4 

What Ebola has Thought Us to Counter Mismanagement of Epidemic Outbreaks 

World’s most difficult task — ensuring UN sustainable development agenda 

3 ingredients to ensure health and well-being for all in emerging economies 

Human Rights: World Report 2016 

Congresso Internazionale Septimo Encuentro Multidisciplinar sobre Pueblos Indígenas (EMPI VII) Popoli Indigeni e disuguaglianze:fra crescita e crisi socio-economica 12-13 Maggio 2016 Università degli Studi di Milano Italia 

ICIC16 – 16th International Conference on Integrated Care, Barcelona 23-25 May 2016 

9th IAEN Pre-conference 

HEARD publications 

Gated Development Is the Gates Foundation always a force for good? 

Young People Are in Economic Crisis Worldwide. This Bank Aims to Help 

The Irvine Foundation Has It Exactly Right: The Poor Need Power to Not Be Poor 

The Faces Of China’s New Philanthropy 

Life after aid work: When the ground begins to shake 

The E15 Initiative: Strengthening the Global Trade and Investment System in the 21st Century 

With the AIIB, China is ready to rewrite Asia’s financial order 

The refugee crisis as seen from Davos 

Denmark approves controversial migrant assets bill 

Waste prevention in Europe — the status in 2014 

UN health agency convenes emergency meeting to address ‘dramatic’ spread of Zika virus 

As Zika Virus Rises, Vaccine Development Gets Attention 

City at center of Brazil’s Zika epidemic reeling from disease’s insidious effects 

Health Highlights: Jan. 28, 2016 

Non siamo un Paese normale 

Salute Globale in una prospettiva comparata tra Brasile e Italia 

Secondhand Smoke in Lawless Japan

Japan has the highest life expectancy worldwide but its leadership could come to an end since the country ranks third for smoking rate in Asia and the lack of strong legislation on passive smoking puts lots of people at health risk. The 2020 Olympic and Paralympic games are giving an impetus to the relevant debate and more fitting regulations could be ready by 2019


by Pietro Dionisio

Degree in Political Science, International Relations

Cesare Alfieri School, University of Florence, Italy

  Secondhand Smoke in Lawless Japan


According to WHO, 21per cent of the world population aged 15 and above smoked tobacco in 2012. Men smoked at five times the rate of women (36 per cent and 7 per cent average rates respectively). Smoking among men was highest in the WHO Western Pacific Region, with 48 per cent of men smoking some form of tobacco.

The high use of tobacco and cigarettes accounts for non-communicable diseases (NCDs) such as cancer, diabetes, cardiovascular and respiratory illnesses. As real killers, NCDs are responsible for almost 38 million deaths each year, including 17,5 million by cardiovascular diseases.

Though new data show a decrease in smokers worldwide, the governments are to be held accountable for ensuring far more drops in tobacco consumption.

In Japan smoking is a widespread practice, with available data showing a per person smoking rate  as high as 1,841 cigarettes per year in 2012. However, the percentage of adult smokers continues to drop: between 2003 and 2014 it declined from 27,7 per cent to 19,7 per cent, as confirmed by the cigarette market trend.

The stricter restriction on smoking, the rising awareness over health implications and an increase in the country consumption tax ( from 5 per cent in 2013 to 8 per cent a year later) making cigarettes more expensive, are among the main reasons.

In Japan smoking is a rooted practice free of any social stigma. In the past, smokers were allowed to light their cigarettes wherever they wanted to. Should others be unwilling to breath smoke, it was their job to find a smoke free place.

Fortunately, during the last decade things started changing. The “Nation’s Health Promotion Act 2002” was a first step wherein Article 25 states that “…those who are in charge of managing the facilities where many unspecified people gather shall make efforts in taking necessary measures to prevent passive smoking…” Facilities include schools, hospitals, government and municipal offices, restaurants, department stores, shops, hotels, trains and buses. However, violation of these duties does not entail any penalty.

In spite of this, smoking is not allowed in many public urban areas and is banned in public transports as well.

However, getting rid of cigarettes is not an easy task for Japan at a time when politicians are interested parties in the tobacco industry. Japan Tobacco inc. (JT), the only Japan tobacco manufacturer, was a government monopoly till privatization occurred in 1985. Currently,  the Japanese government holds a 33 per cent stake in JT and the Finance Ministry has a major role supervising the whole tobacco production, sale and cigarette price processes. What’s more, backers of the Liberal Democratic Party, serving as the majority party, include people involved in the tobacco production chain, from farmers to retail outlets. In short, these are credible reasons behind  the lack of a strictly regulated tobacco market yet.

Relevantly, even warning messages on cigarette packets are quite soft compared with other industrialized countries and only display a small size warning message without any image on it.

Against this, it is good news that, as Japan prepares for Tokyo Olympic games, the debate over smoking bans is intensifying while taking into account that heavy-smoking countries such as China and Russia introduced wider restrictions on tobacco when they hosted the Beijing 2008 summer games and the Sochi 2014 winter events, respectively.

Since last September, the Japanese government has been planning on enacting a secondhand smoke restrictive legislation. To this aim, the administration is about to swear in a special team tasked with figuring out measures to prevent passive smoking ahead of the 2020 Tokyo Olympic and Paralympic games. The team will lay down detailed measures and its first meeting is expected for later this month.

The aforesaid legislation, predictably to be implemented in 2019, will oblige public utilities, including sport facilities, schools and hospitals, to completely ban smoking, and operators of hotels, restaurants and other facilities to implement measures establishing separate smoking and nonsmoking areas. Additionally, the new regulations will include penalties to be imposed on violators.

The measures above do align with the International Olympic Committee requirements calling for “Tobacco Free Games”. Since the Athens games of 2004, all cities and countries hosting Olympic games have been enforcing laws and ordinances not allowing smoking or establishing separate smoking and nonsmoking zones. Most of them also included penalties on individuals and facility operators who violate the regulations.

As such, while Japan must align with, the creation of a tobacco free society would aim far beyond as an overarching target whereby the government should get rid of the vicious circle of self-interests in the tobacco industry and more effectively serve nationwide health priority needs.


What Ebola has Taught Us to Counter Mismanagement of Epidemic Outbreaks

Aligning with earmarked grants for fighting large scale epidemics in fragile contexts, more efforts and strategies are needed. They should come together and act in unison to address the spectrum of challenges these scourges pose to precarious systems


By Daniele Dionisio*

Policies for Equitable Access to Health (PEAH)

What Ebola has Taught Us to Counter Mismanagement of Epidemic Outbreaks


An Ebola outbreak of unprecedented scale broke out in Guinea in December 2013 and swiftly spread into Liberia and Sierra Leone totalling about 28,637 reported cases with 11,315 deaths – probable, confirmed and suspected – over a two-year almost uninterrupted course.

An now that the ravaged countries seemingly got rid of Ebola from mid-January 2016, staying at zero cases is hardly to be hoped for with the load of yet unsolved system gaps paving the way for Ebola reappearance.

Ineffective Policies

These countries are home, indeed, to precarious health systems, deep rates of illiteracy, poverty, social unrest, low-level trust in the governments and huge population mobility across wide-mesh boundaries. These add to weakness of  infrastructure, logistics, health information, surveillance, drug supply and governance systems, together with shortage of well-trained health workers and inadequate organization and functioning of health facilities.

Not to mention that laboratory services, maintenance of vital statistics and disease surveillance and monitoring are underfinanced in these  countries, and fundraising was late and insufficient during the whole Ebola outbreak.

This adds to evidence that WHO has fallen short of its mandate to stop Ebola spread mainly because the agency was slow to mount a response early .

Moreover, while the hit countries had no background tackling Ebola and no basic implementation of the international health regulations to curb epidemics, the African actors (like WHO Afro and involved country offices) did, as reported, a rather small and late job in terms of agenda setting.

Worse, since the incentives of current patent system are driven by profits, the lower-income countries lacking lucrative markets are all the more discriminated as regards the development of lifesaving medicines for neglected health scourges.

This may explain the lack of effective treatments and vaccines at the beginning of last epidemic in spite of a 50% average case fatality rate of previous Ebola outbreaks in Africa.

Hence, the just over Ebola crisis has largely depended on the shortcomings above as a reflection of the failure of global health policies to stop inequalities of access to lifesaving treatments and care.

And now that just rolled out effective drugs and vaccines allow treatments  and preventive vaccination campaigns to be finally within grasp, manufacturers are to be held accountable for making end products fully affordable and available in the needed quantities, while ensuring that distribution  is driven by needs, irrespective of where people live or the capacity of a country to pay. As such, excess vaccine doses for unexpected needs and stockpiling for timely response to future Ebola outbreaks are required.

Earmarked Grants as a Priority

Needless to say, things would be far better if outbreak contingency funding sources had already been at hand as an incentive to bring producers into developing  the necessary drugs and vaccines.

That’s why  a forward-looking call by the World Bank president should definitely be put in motion “…The world should come together to fund a permanent pool of money earmarked for fighting pandemics like Ebola… a mechanism like this could protect the global economy from the potential downside risk and the shock of another epidemic”.

While depending on commitment of governments and institutions (BRICS Bank, African Development Bank, International Monetary Fund, World Bank and International Finance Facility for Immunization, among others), an outbreak contingency fund would work as a callable capital at once for automatic disbursement whenever needed.

Drastic Changes on Agenda

Adding to earmarked grants as just highlighted, more efforts and strategies are needed. They should come together and act in unison to address the challenges that large scale epidemics pose to precarious systems.

This involves preventing  outbreaks by early warning systems as a cost-effective strategy  to timely discover and contain transmissible diseases. As would be the case for an “active case detection” approach based on mobile workers tasked with testing everyone in the population several times a year at their residence places.

Looking for this, a stronger WHO leadership cannot be given up.  Hence, it is good news that the Agency just entered shake-up to effectively  “…enable countries to strengthen their outbreak and emergency preparedness, while ensuring that its own experts and those of its partners can rapidly roll out the required response within the first 24–72 hours… and… subsequently, to …support countries in the recovery phase after an outbreak or emergency and help them “build back better” when health systems have been damaged …”

In such connection, adequate support, collaboration and funding by the member States would be instrumental to WHO good performance in outbreaks monitoring and response.

To these aims, multi-sector engagement is needed as well to induce governments to bring U-Turn changes into effect by measures that include:

-Seeking  synergies and coordination among global level institutions and humanitarian funding agencies  while avoiding overlapping and fragmentation.

-Ensuring that leading institutions and organizations enhance working with health ministries to strengthen national systems, invest in infrastructures and  improve transparency and accountability including by multi-sector participatory models.

-Reversing “brain drain”, health worker shortage by a transformation of the training approach, as to adapt curricula to local needs, promote strategies to retain expert faculty staff, expose trainees to community needs during training, promote multi-sector approach to education reforms, and strengthen links between the educational and health care delivery system.

-Ensuring that revenues from a Financial Transaction Tax (FTT), whose approval is in progress in Europe, will substantially be committed to development and for the fight against health scourges, diseases of the poor and epidemics.

Overall, the final success of this framework will depend on weak country governments’ leadership, commitment and accountability while partnering with administrations in wealthy countries, international institutions and organizations to implement a coordinated response to sustainably rebuild and strengthen health systems, the economy, agricultural and food security sectors, access to education, and trust and community empowerment.

Relevantly, it is good premise that Guinea, Liberia and Sierra Leone entered expenses in the budgets last year to rebuild their health systems and provide services through the end of December, 2017.



*Daniele Dionisio is a member of the European Parliament Working Group on Innovation, Access to Medicines and Poverty-Related Diseases. He is an advisor for “Medicines for the Developing Countries” for the Italian Society for Infectious and Tropical Diseases (SIMIT), and former director of the Infectious Disease Division at the Pistoia City Hospital (Italy). Dionisio is Head of the research project  PEAH – Policies for Equitable Access to Health. He may be reached at


Breaking News: Link 175

Breaking News Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings


Breaking News: Link 175


As EU-India free trade talks get closer to resuming, MSF warns access to medicines under threat 

Davos 2016: eight key themes for the World Economic Forum 

World of business must play part in achieving new Sustainable Development Goals – UN chief 

This Should Be The Biggest Issue At Davos 

Experts say inaction on climate change is top global risk for the next decade 

How the Green Climate Fund Could Promote REDD+ through a Cash on Delivery Instrument: Issues and Options 

Coal or no coal: A balancing act for MDBs 

We cannot have post-COP 21 depression 

A Quick Look at a Big New Effort to Help Africa’s Young People Find Jobs 

Medicare Part D’s Importance Extends Far Beyond The Drug Benefit It Provides 

Making Sense Out Of Differences In Per-Capita Medicare And Private Insurance Costs Within Geographic Settings 

Wide Differences In Rural Health Information Technology Adoption 

Low food prices but poor still go hungry 

62 people own the same as half the world, reveals Oxfam Davos report 

Capitalism, not Oxfam, is defeating poverty 

China launches new AIIB development bank as power balance shifts 

Human Rights Reader 378 

Aid Agencies Face Uphill Battle in Europe Migrant Crisis 

International Conference of Refugees & Migrants 26. – 28.2.2016 Hamburg/Germany, Kampnagel 

Smartphone batteries linked to human rights violations 

Health Policy Brief: Transparency In Clinical Research 

After Zika Virus Outbreak, CDC Advises Pregnant Women to Postpone Travel to Latin America 

5 facts about the Zika virus 

Ebola report: Aid chiefs must be more alert over global health scare warnings 

MSF reaction to announcement of Merck and Gavi, the Vaccine Alliance for future Ebola outbreak preparedness 

Digital fundraising: 15 popular crowdfunding sites for social causes 

About That Latest Big Gates Foundation Bet for HIV Prevention 

Gates Foundation accused of ‘dangerously skewing’ aid priorities by promoting ‘corporate globalisation’ 

Follow the Money: Using development finance to hold corporations accountable 




Breaking News: Link 174

Breaking News Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings


Breaking News: Link 174


Ebola virus: New case emerges in Sierra Leone 

Latest Ebola outbreak over in Liberia; West Africa is at zero, but new flare-ups are likely to occur 

Liberia Ebola epidemic ‘over’, ending West African outbreak 

Chinese scientists make Ebola breakthrough 

Speed of Ebola spread linked to poverty  

3 things to know about IMF quota reform 

Trade Commissioner Malmstroem Promotes TTIP, Warns Against Intolerance 

Obama Calls For TPP Approval On Eve Of ITC Hearing 

A Turn to Responsible Contracting: Harnessing Human Rights to Transform Investment 

The Effects of Current Trade Agreements and IP Standards on Access to Health Services and Appropriate, High-Quality Medicines in Resource-Limited Countries like Uganda 

Neoliberal Global Restructuring in Health, or the Fable of the Mongoose and the Snake 

Seven Development Policy Wishes for 2016 

WHO’s evaluation of the global strategy and plan of action on public health, innovation and intellectual property 

Annual European Union greenhouse gas inventory 1990–2013 and inventory report 2015 

Italian Greenhouse Gas Inventory 1990-2013. National Inventory Report 2015

CROME-LIFE: un Network mediterraneo per la salute e l’ambiente 

Air pollution at this level for 10 more years will put a generation at risk 

As Western Union Foundation Shifts its Education Giving, Refugees Loom Large 

EU aid budget to jump 35% in 2016 

Study On Highest-Markup Hospitals Leads The Pack Of Health Affairs 2015 Top-Ten List 

How Much Does Congress Care About Drug Prices? Less Than It Should 

#SOTU: Obama oversells U.S. Ebola response and teases malaria eradication push 

Central African Republic (CAR): MSF launches vaccination campaign of unprecedented scale 

Intramuscular Artesunate for Severe Malaria in African Children: A Multicenter Randomized Controlled Trial 

Kid-friendly TB medicine takes advice from Mary Poppins 

Zika virus infection and Zika fever: Frequently asked questions 

Where are the world’s 795 million undernourished people? 

Public Health and International Partnerships in the Democratic People’s Republic of Korea 

Request For Abstracts: Health AffairsCluster On Health Care Quality In India   








The Effects of Current Trade Agreements and IP Standards on Access to Health Services and Appropriate, High-Quality Medicines in Resource-Limited Countries like Uganda

 As a matter of life and death, governments in the LDC sector need to strive to ensure that they develop effective health policies including development of essential medicines lists in a bid to improve access to health care.  Also they need to live up their individual and collective commitments and adopt a human rights based approach to access to all medicines, not only essential medicines


By Bukenya Denis Joseph*

Human Rights Research Documentation Centre (HURIC) Kampala, Uganda

The Effects of Current Trade Agreements and IP Standards on Access to Health Services and Appropriate, High-Quality Medicines in Resource-Limited Countries like Uganda


Access to health care (medicines) is occasionally miss-conceived. Not only is it a matter of life and death, it also enhances the quality of life, and it is key to a life with dignity.

In the world over, billions of people have no access to essential health care. This is basically as a result of ills and clogs to mention but a few. These ills and clogs include: Intellectual property laws, lack of finances, weak health systems, poverty, inequality and discrimination among other factors contribute to lack of access to health care.

Access to health care (Medicines) involves public health, social justice and international human rights obligations. The International Covenant on Economic, Social and Cultural Rights requires States to take steps to the maximum of available resources to progressively realize the right to health, prohibits retrogressive measures, and necessitates immediate fulfillment of minimum core obligations. It also calls for international cooperation[1].

It is important to note that medicines in Africa are available but the challenge faced is that the laws that regulate the brands on market are weak and non-regulatory in nature. In a country like Uganda for example which is a capitalist economy, all sorts of medical brands are on the market and with this come the challenge of expired medicines, medicines exorbitantly priced, as an end result, inaccessibility of medicines (health care) to the poor people.

The governments themselves are faced with a dilemma of whether to crack the whip on the mushrooming pharmaceutical companies and frustrate employment or persist with the defective system of commercialization of the health care system. These pharmaceutical companies provide employment to the masses and yet the nation is grappling with unemployment. Also the laws are archaic to help control access.

Access to health care as a core national obligation should ensure that the medicines are affordable, acceptable, accessible, of good quality, and made available without discrimination.

In General terms access to health Care in LDC countries like Uganda is a complex and multidimensional issue calling for holistic solutions. In addition to the foregoing it is imperative to note that measures to improve the supply chain must be put in place, the underlying determinants of health must be addressed to the universally recommended standards, policy formulation coherent to primacy of human rights over international trade as a necessity, investment and intellectual property regimes and to ensure that health delivery systems are appropriate to those they serve. Inequities, including high costs borne by patients in many low and middle income countries must be eliminated.

As a point of emphasis, people’s agency and empowerment should be improved to enhance access to medicines especially for the poor. Procedural safeguards like participation and access to information must be upheld. Evidence-based guidelines and policies to promote access to appropriate healthcare services for all persons regardless of their economic status will help realize their right to health, and increase in disease assessments and formulations will strengthen access for all. Addressing stigma and discrimination and ensuring equitable access and effective treatment will help realize the rights to health.

Many a time governments like that of Uganda will always ignore the health sector and make arguments like, ‘when the ruling party came to power it found many of the health facilities dilapidated but after 30 years there is progressive realization of the right to health in Uganda and improved structural designs for the right to health to flourish.’  This is a total misconception of progressive realization of the right to health. Needless to say, resource constraints cannot be an excuse for failing to meet health needs. Reasons for disparities in health outcomes across States of similar socio-economic status must be understood and addressed.

Experience shows that publicly funded health systems are the best way to ensure equitable access to healthcare. Access can be improved through innovative financing mechanisms, enabling public policies, more health workers, technical support, better health data, administrators, transport and delivery, improved supply chains, local production and health education, and other means. Holistic, people-centered and community-driven policies and active local involvement help health systems strengthening.

Access to health is an explicit example of how economics and trade rules conflict with human rights, including the rights to life, health and development. All human beings by virtue of being human are entitled to enjoy human rights which include the benefits of being alive (right to life). In this day and error the benefit of being alive necessitates the enjoyment of the benefits of scientific progress, and traditional knowledge. This in the nutshell requires that pharmaceutical companies comply with their human rights responsibilities and ethical obligations. There is a need for several initiatives and good practices to be considered by these companies. New models of research and development must address needs, not simply manage markets and profits.

As a matter of life and death, governments in the LDC sector need to strive to ensure that they develop effective health policies including development of essential medicines lists in a bid to improve access to health care.  Also they need to live up their individual and collective commitments and adopt a human rights based approach to access to all medicines, not only essential medicines. International solidarity and collective action can support access for all.



*Bukenya Denis Joseph, a Legal practitioner with a bachelor’s degree from Makerere University faculty of Law and post graduate with the award of a Master of Arts in Human Rights from the Uganda Martyrs University. A degree with the International People’s Health’s University online (IPOL). Coordinator of the Human Rights Research Documentation Centre and also coordinating the People’s Health University Uganda Circle and also working as the Sub-regional leader of the East and Southern circle of the People’s Health Movement.


[1] Human Rights Council, Twenty-ninth session, Agenda item 5. Human rights bodies and mechanisms. Report of the 2015 Social Forum (Geneva, 18-20 February 2015)


Neoliberal Global Restructuring in Health, or the Fable of the Mongoose and the Snake

Globalization creates wealth for the few and depresses local wages and conditions of employment for the many. Globalization has brought about a shift in power: the nation state has weakened and there is a reduction in social accountability. This makes sovereign states row rather than steer in the process of development, i.e. if countries do not intensely participate in this paradigm set by the North, they are “out”. As a consequence, the poor countries’ very right to development is threatened by this unrelenting liberalization/globalization process. Globalization has put the fate of those many in the hands of large corporations. Although the corporocracy (or corporarchy of Robin Sharp) very well knows the negative effects of Globalization, few of them are committed to change. They tend to ignore the root causes of the social problems they see as patently as everyone else, but seldom address the negative social impacts of their activities. Since they lack the openness and transparency required, they pay only lip service to change and seldom change their practices (or change them in very marginal ways)

C Schuftan

By Claudio Schuftan*

People’s Health Movement – PHM

Topical: Past Century Nineties Forward-Looking Essay

 Neoliberal Global Restructuring in Health, or the Fable of the Mongoose and the Snake (Fableous Food for Thought)

What is history, but a fable agreed upon?
Peter Hoeg (1)


Globalization and its negative consequences:

  1. The peculiar current form of Capitalism rechristened as ‘free market economics’ rules in the vast majority of countries as our century draws to a close. This paradigm –at the core of the transnational liberal order– has become the current hegemonic development philosophy as well. It goes by the motto of “trade, not aid”, no matter how uneven the former may be.
  2. Globalization –the new Capitalism’s flagship– denotes the ability of international capital and transnational corporations to switch investments across the globe. In doing so, Globalization creates wealth for the few and depresses local wages and conditions of employment for the many.
  3. Globalization has brought about a shift in power: the nation state has weakened and there is a reduction in social accountability.

This makes sovereign states row rather than steer in the process of development, i.e. if countries do not intensely participate in this paradigm set by the North, they are “out”. As a consequence, the poor countries’ very right to development is threatened by this unrelenting liberalization/globalization process. (2) (3)

  1. Globalization has put the fate of those many in the hands of large corporations. Although the corporocracy (or corporarchy of Robin Sharp) very well knows the negative effects of Globalization, few of them are committed to change. They tend to ignore the root causes of the social problems they see as patently as everyone else, but seldom address the negative social impacts of their activities. Since they lack the openness and transparency required, they pay only lip service to change and seldom change their practices (or change them in very marginal ways). (4)
  2. Moreover –in the dealings of Globalization-its intricate connections are so patently disguised as to become almost invisible. Or worse, the deceptions are so brilliantly woven into its processes that falling for those deceptions is deemed as both fashionable and progressive. (5) (6)
  3. In the Globalization context, the privatization called for often ends up meaning denationalization with Globalization further pursuing a removal of trade barriers, (often dependence creating) technology change, and a rise in consumerism. This, on top of being rightly singled out as additionally creating and accelerating poverty, disparities, exclusion, unemployment, alienation, environmental degradation, exploitation, corruption, violence and conflict. (7) (8)
  4. Not by accident then, has Globalization been called “the imperialism of the 1990’s”. (What is different between imperialism and globalization is just the latter’s speed of expansion).
  5. Because the Globalization of the economy brings about marginalization on a massive scale and economic and political domination of a magnitude not seen since the days of colonialism, it is turning in to a process of Globalization of poverty and of an intensification of the plunder of the neo-colonies. The effects of Globalization are thus terribly uneven and produce big winners and losers. (9) (6) (2)
  6. Due to these negative consequences of Globalization, communities in many Third World countries are no longer able to cope –their previously successful coping strategies diminishing daily. The immediate challenge is to bolster the same communities’ coping strategies so they can continue to help themselves under the new set of rapidly changing circumstances. (10)
  7. Even business executives espousing Globalization are aware of its negative effects. An Asian executives poll carried out by the Far Eastern Economic Review in November of 1997 (p.38) showed 71% of the business leaders polled across the region agreeing that the benefits of Globalization had not been equitably distributed in their respective countries. 48% were of the opinion that Globalization had widened income disparities in their countries. 50% said that it was contributing to social tensions and 60% said their respective governments were not doing enough to help those hurt by Globalization.
  8. More surprising yet is the IMF’s very own overall view on Globalization. For them, the latter links labor, production and capital markets of economies around the world. They do accept that it leads to sharp ‘short-run’ changes in the distribution of income. They further accept that Globalization is to blame for growing inequalities in developed countries as well. For example, to them, Globalization limits the ability of union workers to bargain, as well as making it more difficult for governments to implement equitable policies. (11)
  9. Because they are unable to do the latter, governments in the Third World are simply assumed to be incapable of assuming a minimum level of welfare for their citizen. Fitting the ideology, it is then implied that it is necessary to look for alternatives in the private sector or to directly privatize services (and NGOs are occasionally a convenient form of privatization). Only that, often, such privatization strategies lower the quality of services for the poor and end up widening the gap between the rich and poor. The alternative that is being written off a-priori is the need to improve the state’s credibility, accountability and responsiveness to welfare matters.(*)

[(*): After all, the extraordinary and more equitable growth of Vietnam and China contradicts the view that a state control of the economy and the market is inimical to growth].

  1. One has to acknowledge that most governments have not adopted the right strategies. But let us not develop yet new ones; let us make governments adopt and adapt the right and proven pro-poor strategies providing them with a set of options, and not a single pathway. Sustainable solutions proposed need to be sound and appropriate both in the way things will be done as much as in what to be done. (8) (12)
  2. At this point, we hardly need to be reminded of the hard facts documenting the negative effects of Globalization. Tid bits of the evidence should suffice to close this quick, maybe caricaturized, review of its negative consequences:

– Under Globalization, the annual losses to developing countries run at an estimated $500 billion –an amount much higher than what they receive in foreign aid.

– As a consequence, developing countries have had a series of years of consecutive negative financial flows; this is equivalent to at least seven years of an economic hemorrhage.

– From 1960-99, there has been a 60% fall in the prices of commodities other than oil! This has resulted in a reduction of two thirds in the buying power of developing countries. (13)

– As a result, the number of hungry people around the world keeps rising every year and poverty is becoming increasingly feminized (70% of all the poor are women). Free trade has been free for business and industry, but not for women and the poor. New technologies have not shown to have intrinsic pro-poor or pro-women positive effects either, although they have such a potential (which unless we help steer in that direction will invariably continue favoring the already wealthy and male). Therefore, any genuinely poverty-redressing policy is bound to be a gender-oriented policy.

A dearth of workable solutions?

  1. There is no single universal solution in sight that will promote just the benefits of Globalization to all people: giving the same advice to everyone simply has not and will not work; this is what has been called “the fallacy of composition”.
  2. A balanced and realistic value-free response to Globalization is difficult, especially if one considers the current reality of a unipolar world with a North-centered and North/transnationals-dominated economic order. (14)
  3. On the one hand, the transnational corporations cannot be allowed to continue to duck and dive, invest in smoke screens, espouse gradualist solutions and attempt to derive maximum publicity from piecemeal changes. They must be persuaded, cajoled or even forced to change.

On the other hand , new insights are emerging as to the appropriate mix of market and government activities needed to complement each other. (4)

  1. Whatever the response, promoting the economic benefits of Globalization requires mechanisms to prevent its excesses, because there is a clear trade-off between market efficiency and the social welfare of workers and peasants.
  2. Turning again to the IMF, they see the policy responses to counter Globalization to include a mix of two elements:
  3. a) ‘safety net interventions’ such as targeted subsidies, cash compensations, severance payments to and retraining of sacked employees, wage subsidies, and public works programs, and
  4. b) ‘fiscal policies’ (the most direct tool of redistribution) such as levying highly progressive taxes, distribution of shares in privatized enterprises, and increased government spending in health and education (i.e. reallocation of spending to the social sector), as well as higher minimum wages, good unemployment benefits, job protection, keeping inflation low, subsidizing lower quality commodities, and giving better access to credit, justice and public services. (11)

How this is to be achieved, and whether the IMF plans to go for broke for these changes remains unsaid in the source here cited.

  1. The truth is that, in the real world, the more radical visions or sustainable solutions calling for deeper social and environmental change have been diluted or silenced further with the onslaught of Globalization. In a mix of insensibility and unresponsive, the prevalent attitude has been to selectively reject (depending on the bias) the main features of any criticism and to keep important issues from surfacing to critical consciousness. This is what has been called “the exclusion fallacy” (“…if we have not considered it, it is not important…”).
  2. In the international scene of (mercenary) technical development assistance, for example, issues of substance are turned into technical matters by paid consultants while underlying more structural issues get obfuscated. Or, what amounts to the same, aid agencies too often remain unwilling to respond politically to political situations. (3)

The Equity/Equality approach:

  1. Equal relations between unequals reinforces inequality!(3)
  2. To illustrate this, think for a while that equity under Globalization is a bit like the fight of the Mongoose and the Snake:

Both are of about the same strength, but invariably the mongoose wins –it is more resourceful and it organizes its strategy better to strike.

The First World is like the mongoose; the Third World is like the snake.

The lesson of this fable is that an asymmetry in the use of market power aggravates inequality. The affluent always end up having more political clout (and more wealth). Therefore, promoting self-interest (the soul of the market) is simply not enough. We have to put some heart into it; add solidarity to self-interest. (15) (16) [A modicum of anti-greed policing actions may help as well…].

  1. To achieve greater equity, a set of “equity modifiers” have been proposed. These include: targeting interventions (geographically and/or to vulnerable groups or individuals), land reform, educational/water and sanitation/health/nutrition and family planning interventions, employment generation, grassroots participation in setting priorities, development of the non-farm rural economy, aid to rural women, and the levying of taxes on polluters and degraders. (2)
  2. As pertains to gender, the latter has reached a unique status in the transnational liberal order. Gender equality is (finally) considered compatible with the basic tenets of the neo-liberal credo. But economic equality, not. (17)
  3. Remedies proposed to specifically increase equity and access to basic services thus include financial and non-financial approaches. To recap and add, among the former are the targeting of subsidies (i.e. selective subsidies of goods and services disproportionately consumed by the poor), prepayment plans (e.g. community-based health insurance), exemptions and the selective dropping of some fees (e.g. health and educational). Among the latter are a greater emphasis on decentralization, on the use of social marketing (*), on prevention and on improvements of the quality of care (in health), as well as on a fairer urban/rural distribution of resources.

[(*):Social marketing –one of the sweetheart companions of Globalization attempting to give it a human face– focuses on high-powered “Madison Ave-type” messages and communication strategies that pursue behavior modification and not informed choices. It is quite obvious that we should rather be trying to better understand what motivates people to change and why, and then letting them decide by themselves what steps to take to get there].

  1. Surprising as it may seem, the IMF thinks that more equity need not hamper growth, it could indeed reinforce it! (sic) They actually see a strong negative link between high unequal distribution of assets and subsequent rates of growth. They see equity only requiring ‘equality of opportunities’, though, not necessarily ‘equality of outcomes’. In that sense, they agree the poor need to increase their human capital. Equity, to them, is critical for the political viability of Globalization… (sic). Therefore, decentralization and changing the composition of public expenditure is for them a must. For instance, expenditures on health have to increase, they say, but to be equitable, they have to be concentrated on preventive activities in rural areas and should be targeted to the lower income quintile (*). (11)

[(*): Beware that valid arguments have been raised against ‘targetry’: Targeting misrepresents complex realities, involves big cost in monitoring, distorts policy and destroys political momentum for structural changes. (18) (19)

  1. Regardless of whether the IMF follows up with concrete actions on what they philosophize, we need not apologize to act with a more resolute equity bias beyond lip service since such a bias is an important corrective to the other more dominant inequitable value biases out there in the heartless market place. (One of them, for sure, is basing decisions on interventions on cost-benefit analyses only; cost-benefit analyses are understandable to economists and policy makers, but they are grounded in a different reality than most of us live in. Economists make decisions guided by what is ultimately measurable if convertible into monetary value only). (20)
  2. Is this more resolute equity bias a radical proposition? Yes. Is it necessary? Absolutely. Is it impossible? Possible. Is it likely? Not very likely based on my latest dispassionate reality check. But what, then, are the alternatives and could they do the job on time? (5)

The Human Rights approach:

  1. A human rights framework is the emerging UN response to foster development in the new millennium.
  2. Globalization may be inevitable, but what it looks like is not –there are forces that can shape it, and human rights must be one of those forces. (21)
  3. As someone said, human rights can set limits to the sways of the market. (22)
  4. To restate the dogma of Human Rights, they are indivisible; they do not apply some yes and some no, some today and some tomorrow, some to us and some to them, some to the rich and some to the poor, some to women and some to men. These obligations are universal for their implementation. We are therefore compelled to operationalize civil, political, economic, social and cultural rights in our daily work..
  5. We have to be on the lookout, though. There is still much righteousness and hypocrisy in this field. One can easily lose faith in those who preach human rights and have little to offer.

Actually, with Globalization, “Might is Right” has come back with a vengeance. And in a defeatist stance, we have so far accepted this fact and have bowed to the forces we think we cannot effectively oppose. (23)

  1. To make the human rights approach concrete and giving it substance is a political task. Their enforcement and holding governments accountable for their human rights record can only be achieved through political action. Soft approaches will not do. (24)
  2. Steps in the right direction, at this time, will be the establishment of National Human Rights Committees and the setting of concrete examples of rights-based programming. But bolder steps will have to follow.
  3. Furthermore, we have to fight the indifference of our youth to the present human rights situation. Our young and upcoming colleagues also remain largely indifferent to the overwhelming negative effects Globalization is having in the world. [It is during our youth –when we have faith in and fight for the ultimate answers– that we have to interest the upcoming generation in Globalization. Later, we cave-in and accept that we are always going to have to live with the big questions leaving the responses to undefined others]. We have thus to enroll the youth before they resign themselves to the fact that all they can do is pose the same unanswerable questions over and over again (even if in new ways), without sticking their own necks out to seek the right answers. (1)
  4. Our youth seems more interested in the information superhighway. As if Marshall Mc Luhan’s predictions were right, in terms of action orientation, the Internet has so far been more part of the problem than of the solution. There is a valid growing lament that wisdom, imagination and virtue are lost when messages double, information halves, knowledge quarters, and often deceiving noise without origin, quality and purpose is everywhere. We have to overcome this downward spiral by using the same medium to give more appropriate direction and guidance on options to counter Globalization and more aggressively foster human rights.
  5. Our endeavors to achieve the latter two in the new millennium will only succeed if and when the youth becomes more central in the process of intellectual rejuvenation (a role they are now not taking up), and women (whose gender roles are being explicitly suppressed) also move more to center stage. [We need to invert the M of Men to a W of Women beyond mere rhetoric…] (25)
  6. In sum, an effective challenge against Globalization and its negative effects on human rights is possible, but demands the same kind of intellectual commitment and vigor that characterized anti-colonial or independence fights.
  7. Questions of the relevance, accountability and utility of the social sciences in this process need to be explored. Are they confronting the real problems? Are the problems of Globalization and the violation of human rights being made focal points of the social sciences’ analyses and actions? Western intellectuals have simply abandoned their commitment to challenge the exploitation and oppression of the poor as they continue being brought about by Globalization. Concerted campaigns and struggles against poverty, tyranny any exploitation will form the only sustainable basis of an intellectual renaissance of our youth and of ourselves.

Bolder steps are needed:

  1. When we talk about Sustainable Development, we’re talking about what we should try to become today and in the future and what that compels us to do now.
  2. Taking a minimalist stand towards Globalization will do no harm, but neither will it do much good. Inertia in history (has) and will always work(ed) against the more visionary and radical changes deemed necessary when the same fall outside the ruling paradigm. (1)
  3. Development cooperation must thus become more political, because only structural reforms will deliver sustainable development.

In many an aid recipient country, conventional politics simply is increasingly losing its primacy over commerce and industry. [All too frequently we see the failure of elections as an instrument of political renewal… As somebody said, the problem with political jokes is they get elected. (26)]. Therefore, new, bolder approaches are needed. Solutions must be geared to control that which fuels the problem at its roots.

  1. The solutions to the consequences of Globalization on the health and nutrition sector, for example, cannot be medicalized any longer. Technical assistance focused on health/nutrition matters only is not enough to uproot the structural inequities underlying pervasive and unrelenting ill-health and malnutrition in the world.
  2. But the inertia is so great and our collective virtual view of reality so distorted and entrenched, in part due to Globalization, that the likelihood of us changing that reality remains dim. Neither greater individual responsibility nor containment strategies will do. A solution will somehow have to be imposed on us by some powerful or strategic force, either by fate or by design and it better be soon.
  3. In short, we need to give a larger intellectual and political scope to our discussions on Globalization. In doing so, we have to manage to develop a political program of more universal appeal. We need to set up the framework that will connect all the different social actors to come up with a focused common agenda.
  4. More than ever before, we need an overt political intervention, simply because economic violence is best counteracted by political antibodies, and what the people’s movements around the world want is simply “More”, from life, from history and from us.
  5. When economics has ceased to strengthen social bonds and its prescriptions are actually further pauperizing millions, it is time to start thinking in political terms again. This is one of my cherished iron laws. (27)

Three caveats:

1) As hinted above, intellectual and cultural imperialism now penetrates our minds by remote control via satellite links and the information superhighway and poses great danger to the production and development of local knowledge. But this is not a fatalistic statement. While not denying that the giant tentacles of Globalization reach into every corner of the world, this should not be equated with omnipotence.

2) Stereotyping the object of criticism (Globalization) risks to emotionalize the issue rather than objectively analyzing and diagnosing it. We have to give up our quick prescriptive impulses (saying what should have been done) and become more empirico-analytical (describing and dialectically interpreting what is actually happening). (25)

3) One can set morally desirable goals so high or set goals without following them with sincere, workable policies that they remain out of all realistic reach and lose all power to determine the direction of action. Even rules can be set or imposed more as a source of comfort than of good choice. (28)

In closing:

  1. As you finish reading this, make no mistake, these seemingly abstract issues about which we write papers are matters determining the lives of millions of people. We all know that, as Benjamin’s law says, when all is said and done, a lot more is said than done. It is therefore not enough to bring these issues under the spotlight; as someone else said, we need to make more light! (29) (30)
  2. The facts discussed here are more than enough to allow us to go negotiate (or struggle) for new more radical equitable/pro-poor/pro-women/human rights based strategies on the highest of moral grounds. (3)
  3. We need to awaken the ‘investigative reporter’ in us to constantly go after the human story behind the statistic. After all, journalism is the rough draft of history –and we want to be counted in shaping it. Those whose interests we claim to serve also expect it from us.


(1) P. Hoeg, ‘An experiment in the constancy of love’, in Tales of the Night, Panther Books, Haverhill Press, London 1998, pp.120-121.

(2) P. Hazel, IFPRI.

(3) Y. Tandon, ‘WTO: What strategies for the South?’, South Letter, 3:34, 1999, pp.14-16.

(4) R. Welford, UNRISD News, No.17, Autumn/Winter, 1997, p.7.

(5) C. Thomas, ‘You can’t skate into a buffalo herd’, WorldWatch, 12:4, Jul/Aug 1999, p.5.

(6) C.R. Bijoy, ‘Mismanaging health’, LINK (ACHAN), 13:2, Sept. 1995, pp.15-17.

(7) K. Bezanson, IDS, Univ. of Sussex.

(8) U. Jonsson, UNICEF, in SCN News, No.18, July 1999, p.81.

(9) S. Ramphal.

(10) J. Tagwireyi, MOH, Zimbabwe.

(11) Finance and Development, 35:3, Sept.1998, pp.2-5.

(12) E.A. Graffy.

(13) Human Development Report 1997, UNDP.

(14) LINK (ACHAN), 13:4, March 1996.

(15) A. Anderson.

(16) R. Ricupero, UNCTAD.

(17) J. Baudot, UNRISD News, No.20, Spring/Summer, 1999, pp-1-3.

(18) S. Maxwell, IDS, Univ. of Sussex.

(19) More on this forthcoming in C. Schuftan, and G. Dahlgren, ‘Can significantly greater equity be achieved through targeting?’ manuscript in preparation.

(20) P. van Esterik.

(21) L. Haddad, IFPRI, in SCN News, op.cit., pp.12-14.

(22) R. Jolly, SCN News, op.cit., p.11.

(23) President Mahatir Mohamad, Kuala Lumpur, 9/2/98.

(24) B. Ramcharan, UN High Commission for Human Rights, in SCN News, op.cit., p.16.

(25) N. Nieftagodien, ‘Globalization and social sciences in Africa’, CODESRIA Bulletin, Nos.1+2, 1999, pp.56-60.

(26) Henry Cate VII.

(27) D. Cohen.

(28) F. Nuscheler, D+C, March 1998, p.5.

(29) H.F. Johnson, Minister of International Development and Human Rights, Norway.

(30) W. Clay, FAO.


*Claudio Schuftan, M.D. (pediatrics and international health) was born in Chile and is currently based in Ho Chi Minh City, Vietnam where he works as a freelance consultant in public health and nutrition.

He is an Adjunct Associate Professor in the Department of International Health, Tulane School of Public Health, New Orleans, LA. He received his medical degree from the Universidad de Chile, Santiago, in 1970 and completed his residency in Pediatrics and Nutrition in the Faculty of Medicine at the same university in 1973. He also studied nutrition and nutrition planning at the Massachusetts Institute of Technology (MIT) in Cambridge, MA in 1975. Dr. Schuftan is the author of 2 books, several book chapters and over fifty five scholarly papers published in refereed journals plus over three hundred other assorted publications such as numerous training materials and manuals developed for PHC, food/nutrition activities and human rights in different countries . Since 1976, Dr. Schuftan has carried out over one hundred consulting assignments 50 countries in Africa, Asia, Latin America and the Caribbean. He has worked for UNICEF, WFP, the EU, the ADB, the UNU, , WHO, IFAD, Sida, FINNIDA, the Peace Corps, FAO, CIDA, the WCC (Geneva) and several international NGOs. His positions have included serving as Long Term Adviser to the PHC Unit of the Ministry of Health (MOH) in Hanoi, Vietnam under a Sida Project (1995-97); Senior Adviser to the Dept. of Planning, MOH, Nairobi from 1988-93; and Resident Consultant in Food and Nutrition to the Ministry of Economic Affairs and Planning, Yaounde, Cameroon (1981). He is fluent in five major languages. He is currently an active member ( of he Steering Group of the People’s Health Movement and coordinated PHM’s global right to health campaign for 5 years.



Breaking News: Link 173

Breaking News Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings


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Female Genital Mutilation in Nigeria: is it over?

Female Genital Mutilation (FGM) is a worldwide plague affecting 29 countries at least. In Africa it is ingrained in the society. Nigeria's Government outlawed it in May 2015, but doubts remain whether this will actually improve on Nigerian women's conditions and refresh the African debate on FGM


by Pietro Dionisio

Degree in Political Science, International Relations

Cesare Alfieri School, University of Florence, Italy

  Female Genital Mutilation in Nigeria: is it over?


In Nigeria almost 19,9 million out of 86,9 million girls and women underwent Female Genital Mutilation (FGM) in 2013.

In this Country the practice is deeply rooted in social beliefs and its origin is shrouded in uncertainty either as an initiation ceremony of young girls into womanhood or a tool to ensure virginity, curb promiscuity, and protect female modesty and chastity as well. Due to its strong religious nature, it is not easy to identify a single practice bound up with FGM.

Finally, the practice was banned on 25 May 2015 when the former President Goodluck Jonathan signed the “Violence Against Persons (Prohibition) Act, 2015” as a move aimed to eliminate violence in private and public life by banning any form of physical, sexual, psychological, and domestic assault, along with harmful and discriminatory practices, while inflicting proper punishment on offenders and providing maximum protection and effective remedies for victims.

As such, based on its 6th article stating that “the circumcision or genital mutilation of the girl child or woman is hereby prohibited”, the Act prohibits FGM in the whole Nigerian Federation.

Despite optimism that the Act will allow women and girls to escape FGM, doubts remain whether it will be enforced throughout Country and entail adequate punishment on offenders.

Admittedly, the May move is not new to many states in the Country which signed a bill criminalizing FGM several years ago. Since the Edo State outlawed the practice in 1999, other states, e.g. Rivers, Ogun, Osun, Cross River and Bayelsa among others, did the same, wherein  Section 34(1)(a) of the 1999 Constitution of the Federal Republic of Nigeria was the basis for banning the practice nationwide. It states, indeed, that “Every individual is entitled to respect for the dignity of his person, and accordingly; no person shall be subject to torture or to inhuman or degrading treatment”.

Unfortunately, available data show that FGM continues to be practiced at a constant frequency over the years. Indeed, despite legislation, this practice has been  uninterrupted  due to the lack of law enforcement and effective measures of punishment.

The prevalence of FGM significantly varies by state. In the states cited above,  the percentage of girls and women aged 15 to 49 years who have undergone FGM remains high (between 26 per cent  and 50 per cent), with the Osun State ranking higher (51 per cent to 80 per cent).

In the face of this, it is a ray of hope that the share of 15-19 years old girls who have undergone FGM is seemingly in decline recently.

Lev Tolstoj in his masterpiece “World and Peace”  says “writing laws is easy, but governing is difficult”. As can be seen in this instance, laws are not sufficient if they are not underpinned by a social framework that makes they sustainably work.

Since May 2015, Nigeria has taken a big steps, and  hopefully they will translate into a real improvement on Nigerian women’s conditions. Unfortunately, the previous experience of single states leaves more than a doubt for material change. Indeed, due to FGM’s strong religious/cultural nature, laws will expectedly fall short of non-discriminatory targets unless they are supported by  strategies  to change specific social behavior.

Hence, increasing awareness on health implications of FGM and equipping the law to effectively punish offenders could definitely serve as a deterrent against FGM and its practitioners.

The Nigerian’s ban of FGM could be instrumental to refreshment of the relevant African debate.

In fact, even though several countries passed legislation outlawing FGM (e.g. Benin, Chad, Cote d’Ivoire and Djibouti, among others), FGM still remains a social plague. As such, only 36 out of the 54 African countries have ratified so far the 2003 “Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Women in Africa” banning FGM  all over the Continent. Three of them (Botswana, Egypt and Tunisia) have neither ratified nor signed the “Protocol”, while other countries (such as Algeria, Burundi, Chad, Central Africa Republic, Eritrea, Ethiopia, Madagascar, Mauritius, Niger, Sahrawi Arab Democratic Republic, Sierra Leone, Somalia, South Sudan, Sudan and Sao Tome and Principe) have signed but not ratified it yet.

In view of all of the progress yet to be made, it is remarkable that things are  changing, even though. In fact, today, a greater percentage of women do not tolerate FGM any longer. Today 62 percent of Nigerian girls and women think that FGM should come to a stop, the ratio is even higher in other countries.

Overall, the framework described here shows that Nigeria’s Act against FGM formalizes the beliefs of arising population providing a credible basis for real change due to changing views  not only in the Country but in the whole Africa as well.