News Flash 582: Weekly Snapshot of Public Health Challenges

News Flash 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

Saddled seabream (Oblada melanura)

News Flash 582

Weekly Snapshot of Public Health Challenges

 

G2H2 Annual Report 2023

India alert after boy dies from Nipah virus in Kerala

Towards a Schistosomiasis-Free Future for Zanzibar, the Role of Primary Health Facilities

UNAIDS spells out the costs of missing global AIDS goals

Africa: ‘2030 Target Within Reach But Leaders Must Act Now’ #Aids2024

Donor Government Funding for HIV in Low- and Middle-Income Countries in 2023

Unfinished business: only the urgent and accelerated delivery of HIV services will keep the promise of ending AIDS in children by 2030

MSF calls on pharmaceutical corporation Gilead to make groundbreaking HIV prevention drug lenacapavir affordable for all

HIV progress raises life expectancy in Africa – UN

End Stigma To End AIDS – Once and For All

WHO Raises Alarm Over Polio Virus Detected in Gaza Sewage Water Samples

Sierra Leone: New approach radically improves diagnosis and treatment of children with TB

Sustaining the gains achieved by national neglected tropical disease (NTD) programs: How can we build NTD program country ownership and sustainability?

Tackling the antimicrobial Research and Development and access crisis: An overview

What Can Agri-Food Systems Do to Drastically Reduce Their Dependence on Antibiotic Use?

Clinical trial in Eastern Africa finds a shorter, safer, and more effective treatment for PKDL, a stigmatizing skin disease

Bulgaria failing to tackle medicine smuggling from Asia, putting patients at risk

More than Three-Quarters of People with Neurological Diseases in Low Income Countries Can’t Access Treatment

HRR 733: WHAT IS SUPERINTELLIGENCE? HOW, IN MANY WAYS, IT SHOULD WORRY US IN HUMAN RIGHTS WORK

To Advance Health Equity, Make Health Literacy A Priority At The Organizational Level

Under Azerbaijan’s repression, what’s civil society’s role at COP 29?

Developing countries face worst debt crisis in history, study shows

Coca-Cola’s Ongoing Olympic Sponsorship Is Bad for Everyone’s Health

Southern African Drought: Extreme Hardship, Hopefully Only in the Short Term

Hunger numbers stubbornly high for three consecutive years as global crises deepen: UN report

Lula rallies G20 nations against world hunger ahead of meeting

Climate, conflict, and debt keep hunger and malnutrition stubbornly high globally

Human Ethical Threshold of CO2 Emissions and Projected Life Lost by Excess Emissions  by Juan Garay

Methane emissions are the low-hanging fruit of the climate transition

South Africa passes its first sweeping climate change law

Traffic monitoring tech can help clean up Asia’s act

Climate summit host unveils new fund ahead of COP29

 

 

 

 

 

Human Ethical Threshold of CO2 Emissions and Projected Life Lost by Excess Emissions

IN A NUTSHELL
Author's Note
 An article which estimates the carbon footprint ethical threshold and the impact of excess emissions on human Life.

It is the first of 13 steps in updating the global burden of health inequity based on the recent UN population division trend and prospects

By Juan Garay

Professor of Global Health Equity Ethics and Metrics in Spain (ENS), Mexico (UNAChiapas), and Cuba (ELAM, UCLV, and UNAH)

Co-founder of the Sustainable Health Equity movement

Valyter.es

Human Ethical Threshold of CO2 Emissions and Projected Life Lost by Excess Emissions

 

Since 1850, nearly 2,600 billion metric tons of carbon dioxide (GtCO₂), equivalent to 702 billion tons of carbon, have been emitted into the atmosphere from fossil fuel combustion and land-use changes (1). In 2022, global carbon dioxide emissions from fossil fuels and industry totaled 37.15 billion metric tons (GtCO₂), and these emissions are projected to have risen by 1.1 percent in 2023, reaching a record high of 37.55 GtCO₂ (2).

There is a consensus among scientists that significant dangers will arise if the global mean temperature increases by more than 2 degrees Celsius (3). The relationship between cumulative carbon emissions and global warming indicates that one trillion tons of carbon emissions are linked to a 2-degree Celsius rise. To avoid exceeding this 2-degree increase, we can only emit an additional 300 billion tons of carbon, equivalent to 1,111 billion tons of carbon dioxide.

The United Nations estimates that the global population will grow from 8 billion in 2024 to 10.4 billion by 2100 (4), resulting in the accumulation of 640 billion life years over the remainder of the century. To keep global warming under 2 degrees Celsius during this century (SDG 13.1), the maximum annual average carbon dioxide emissions per person should be 1.73 tons.

If current emission trends continue, global emissions could double to 75 billion tons by 2100 (5), leading to cumulative emissions of 4.26 trillion tons from now until then, which is 3.8 times the remaining carbon dioxide budget. This increase in temperature could result in 218 million excess deaths and a loss of approximately 6,500 million life years, averaging about 20 years lost per excess death (5).

Excessive carbon emissions beyond ethical limits equate to about two months of life lost for every excess ton of carbon dioxide emitted annually. At current emission levels and trends, this translates to an average of one year of life lost for EU citizens and three years for those in the US.

The above estimates focus solely on the impact of climate change through temperature increase. However, global warming affects human health in many other ways, such as storms and floods, the disruption of food systems, increases in zoonoses and food-, water-, and vector-borne diseases, population displacements, and mental health issues.

 

References

1)https://www.statista.com/statistics/1267683/cumulative-co2-emissions-fossil-fuel-land-use-forestry-worldwide-by-country/

(2)https://www.statista.com/statistics/276629/global-co2-emissions/#:~:text=Global%20carbon%20dioxide%20emissions%20from,by%20more%20than%2060%20percent

(3)https://img.climateinteractive.org/2014/02/A-Trillion-Tons.pdf

(4)https://population.un.org/wpp/

(5)http://www.climate.gov/news-features/understanding-climate/climate-change-atmospheric-carbon-dioxide#:~:text=If%20global%20energy%20demand%20continues,close%20to%2050%20million%20years

(6)https://www.peah.it/2018/07/5498/

 

By the same Author on PEAH

Restoring Broken Human Deal  

Towards a WISE – Wellbeing in Sustainable Equity – New Paradigm for Humanity 

A Renewed International Cooperation/Partnership Framework in the XXIst Century

COVID-19 IN THE CONTEXT OF GLOBAL HEALTH EQUITY

Global Health Inequity 1960-2020

Health and Climate Change: a Third World War with No Guns

Understanding, Measuring and Acting on Health Equity

News Flash 581: Weekly Snapshot of Public Health Challenges

News Flash 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

Common octopus (Octopus vulgaris)

News Flash 581

Weekly Snapshot of Public Health Challenges

 

How much does the UK spend on health care compared to Europe?

Health Taxes Are an Ideal Policy Solution for the Polycrisis Era

People’s Health Dispatch Bulletin #80: Health at the intersection of war, climate, and inequity

Change without transformation: how narratives influenced the humanitarian cash agenda

World in flames: civil society lost in the impotence of international law

Overwhelmed Healthcare Systems in Gaza Struggle Through Evacuation Orders

Lack of African data causing ‘policy missteps’

HRR 732: WE OFTEN SAY THAT NUTRITION IS BOTH A MARKER OF DEVELOPMENT, A WAY OF TRACKING DEVELOPMENT, BUT ALSO A MAKER OF DEVELOPMENT

Interview to Ms. Gloria Nirere, Menstrual Health Training Lead in Uganda  by Daniele Dionisio 

Focus on: UGANDA’s HEALTH ISSUES 

The Gambia’s decision to uphold ban on FGM critical win for girls’ and women’s rights

From Trauma to Triumph: Kenyan Women’s Courageous Battle Against Female Genital Mutilation

Tailored Interventions Lower Blood Pressure for Underserved Patients

Pandemic Agreement: MSF Statement at INB10

New Blood for Resumed Pandemic Agreement Negotiations

DNDi 2023 Annual Report

MSF welcomes Indian Patent Office’s rejection of J&J’s application for paediatric formulation of lifesaving TB drug

There’s a new way to test kids for TB — but the NHLS cyberattack has delayed its roll-out

A new injectable could prevent malaria. What’s standing in its way?

A ‘new era’ in malaria control has begun with a vaccination campaign for children in Ivory Coast

Zero-infection HIV drug ‘must be affordable’

Nigeria Warns of Rising Epidemic Diseases Amid Cholera Outbreak

War is lead cause behind huge drop in global vaccinations, UN warns

Global childhood immunization levels stalled in 2023, leaving many without life-saving protection

Identifying and costing common gaps in Central and West Africa pharmaceutical regulation

Global Nutrition Financing: A Beginner’s Guide

Conservation Here and Now: Dr Paul Reillo

STOP TROPHY HUNTING – SAVE THE AMBOSELI ELEPHANTS

Political will and collaboration can revise plastics system

‘Heat Poverty’: A Growing Threat in India

 

 

Interview to Ms. Gloria Nirere, Menstrual Health Training Lead in Uganda

IN A NUTSHELL
Editor's note Menstruation matters in resource-limited countries where poverty substantially impacts menstruation health management. In this connection, PEAH had the pleasure to arrange a new interview to Ugandan stakeholder Ms. Gloria Nirere currently involved as Facilitator/Training lead, Research and Customer Service professional at AfriPads manufacturer (Kampala, Uganda).

First interview was made four years ago when she was serving as menstrual health management trainer at Kampala based WoMena NGO (find HERE). 

Previously, Ms. Nirere long served in poorly equipped Ugandan contexts where she performed tasks concerning clinical research, community health, humanitarian assistance, and project management at local and national level

  By Daniele Dionisio

PEAH – Policies for Equitable Access to Health

 INTERVIEW

Gloria Nirere, MBA, BDS

Facilitator/ Training lead, Research and Customer Service professional

AfriPads, Kampala, Uganda

 

Menstruation is one of the most common and uniquely female experiences. The average woman will have 400 periods in her lifetime. That means she will spend over 3,500 days of her life menstruating. Yet for millions, the monthly cost of single-use menstrual products is simply unaffordable.

Millions of girls and women rely on unhygienic materials to absorb their monthly menstrual flow. These include old cloth, pieces of mattress and even reusing a disposable pad. In addition to these make-shift materials having a harmful impact on an individual’s health, they are undignified, uncomfortable and can make completing simple daily tasks a challenge.

Source: AFRIpads

 

PEAH: Ms. Nirere, let’s begin with few remarks on menstruation challenges in Uganda and to what extent does poverty locally impact menstruation safe management.

Nirere: It is to a large extent that poverty enhances menstrual challenges. For example, if people are poor, they will not afford to take their children to school. We have the Universal Primary and Secondary Education which is free of charge but again, most families cannot afford to buy scholastic materials, pay fees for lunch and breakfast which are the basic necessities in school. Now when it comes to provision of menstrual products, it is a by the way that’s why most parents have no separate budget for menstrual products and materials such as pads, underwear, school bag and soap for their daughters.

Poverty has also greatly contributed to Gender Based Violence. For example, some women have reported being beaten when they ask for financial support to buy menstrual products while others report that their husbands marry many women because they say that women are unclean while on their periods.  Also, most girls opt for menstrual support from older men who in turn exchange it for sex leading to early marriages and unplanned pregnancies. It would take me a full day talking about Poverty, but be rest assured that its contribution greatly influences menstrual decisions and choices across the globe.

 

PEAH: Ms. Nirere, AFRIpads was established in Sub Saharan Africa in 2010 with the goal of overcoming key challenges that women and girls face whilst on their period in relation to access, affordability and sustainability of menstrual products. Since then, AFRIpads has grown from a 3-person start-up to an award winning social enterprise that remains committed to improving menstrual health for millions across Africa and beyond. Under this perspective, AFRIpads aims to ensure that women and girls, who receive an AFRIpads Menstrual Kit, are also equipped with the knowledge and skills for maintaining a happy and healthy menstrual cycle. In a nutshell, EDUCATION IS KEY. In this regard, please focus all-round on your professional engagement and methods. 

Nirere: For more than 5 years working in this field as an educator, I have found that we have a lot of misconceptions hoovering in many communities. Starting at household level, most parents think that providing menstrual products is the main solver. We need to understand that educating communities about how and why menstruation occurs will make them aware that this is a natural and normal occurrence that requires total emotional, physical and social support. For example, in my trainings I often ask partner organisations to start by holding stakeholder meetings to involve parents, local leaders and government about the scope of MHH (Menstrual Health and Hygiene). We ask questions about latrine/toilet facilities, soap and underwear provision, ease of carrying out menstrual discussions, cultural restrictions etc. A full detailed menstrual training is executed so that by the time this girl is trained, the parents are willing and ready to provide the necessary support. I HUMBLY SUGGEST! All families should look at menstrual needs at household expenses and they should have a separated budget.

I have also discovered that TRUST is a key component for successful menstrual education. Menstrual discussions have been and are still private talks between mother- daughter or any other female relative/peers. Normalizing menstruation starts with trust. Is the person providing education building trust? Are participants willing to share their experience? Do the trainers pay attention to body language? What language is the trainer using? (This can either ehnance myths or appear offensive if less attention is payed), Has the trainer carried out background research on participants? And many more. All these allow participants to feel comfortable around the trainer and positively improve post menstrual experiences.

 

PEAH: What do you think about the importance of male involvement in menstruation education initiatives in Uganda?

Nirere: Check out my blog post on male engagement HERE. You will discover how much you did not know about why males should fully engage in menstrual interventions. In short I would say, our communities even the modern ones have not digested or welcomed menstrual discussions and I think that’s why we are still finding it hard to have all menstrual products tax exempted in many nations and better menstrual services. Also, the power in political, social and cultural spheres are dominated by males making it difficult carry out healthy menstrual discussions and decisions. 

 

PEAH: Coherently with belief that menstrual health goes beyond menstrual products, AFRIpads provides partners, alongside reusable menstrual kits, with a range of resources including a MHH (Menstrual Health and Hygiene) Education Toolkit and a Monitoring and Evaluation framework, encompassing instruments like TRAINING OF TRAINERS HANDBOOK, E-LEARNING TRAINING OF TRAINERS, FLIP CHART PACKAGE, PARTICIPANT BOOKLET, INFORMATION POSTER, and EVALUATION TOOLS. Can you kindly enter into the merits of each?

 Nirere: Upon purchase of AFRIpads products, partner organisations are given free online education and access to the training materials. The training is delivered in a Train the Trainer format after which partner staff can sustainably contact menstrual health trainings. They are given certificates as competent MHH trainers and these are awarded after passing evaluation tests administered during the training.

Trainers are given the GirlTalk Handbook which is a trainers manual, they are required to read and understand the session. I keep following up on progress and answer questions.

FLIP CHART PACKAGE: these are charts hanged on the walls as the trainer is providing the education. We know that some participants easily relate to visuals rather than listening all the time, this tool makes trainings memorable as participants can relate to the information given with the displayed visuals.

PARTICIPANT BOOKLET: these are take home booklets given to participants so that they can keep refering to in case they need to remember. It contains practice questions and leads to communal knowledge sharing.

INFORMATION POSTER: this is displayed in strategic locations where anyone around can look at, interprete and learn from it. It also promotes menstrual knowledge in communities around.

EVALUATION TOOLS: participant knowledge is evaluated before and after the training. This is a key component for all trainers to get certificates. We want to have competent trainers who can deliver MHH trainings on behalf of their organisation.

DATA COLLECTION TOOLKIT: this booklet contains a 10 step guide on how to successfully collect MHH data. Data collection training is provided following this guide and this leads to making informed decisions before and after carrying out menstrual interventions.

 

PEAH: On this wavelength, something more about instruments like the Girl Talk Booklet and the Data Collection Toolkit?

 Nirere: The Girl Talk Booklet consists of Flipchart package, posters, Girl Talk handbook, participant booklet and Training evaluation while the Data collection Toolkit consists of Visual Aids, Surveys, Consent forms and Focus Group Discussing (FGD) Guides. 

 

PEAH: AFRIpads believes that pairing reusable menstrual kits with an education curriculum is essential for breaking menstrual barriers, addressing taboos and improving menstrual health and hygiene worldwide. As such, what about the global benefits of AFRIpads reusable menstrual kits?

Nirere: By pairing AFRIpads reusable pads with education and Data collection ensures it is an all round sustainable solver for menstrual barriers. The contribution of AFRIpads reusable pads globally has quite overwhelming positive results because now we have seen over 5 Africa based reusable pad manufacturers that have picked an inspiration from AFRIpads story, the product is more sustainable, cost effective and environmentally friendly, it is culturally acceptable and appropriate, it has no gells or scents added and it has quality certified. 

 

PEAH: This matches with the scope and aims of the AFRIpads Foundation, established in July 2010, to raise funds and distribute reusable sanitary pads for vulnerable, disadvantaged girls, who lack the means to buy an AFRIpads Menstrual Kit themselves. For instance, girls living in refugee camps, who may not have the means to purchase their own pads. For only 7,50 euro one girl can be provided with an AFRIpads Menstrual Kit, which can support her to manage her period for an entire year. Please, add information about.

 Nirere: AFRIpads company is a social profit making enterprise which uses its profits to sustain the comptent staff in the factory and in various offices within and outside Uganda. Thanks to the AFRIpads Foundation working tirelessly to pull funds to support many underprivileged communities and uplift the beautiful work of small NGO’s not only in Africa but across the globe. 

 

PEAH: In this connection, kindly tells us about The Use and Care sheet (available in English, Swahili, French, Portuguese, Kinyarwanda, Arabic and more languages upon request) as an hard laminated, waterproof guide to ensure users are informed on how to use AFRIpads reusable pads safely and effectively.

Nirere: The use and care instruction guide has steps to follow for proper use and care of the product. Once an organisation buys our products or gets a donation from AFRIpads Foundation, they receive the use and care laminated instruction sheet, the same sheet is designed as a leaflet inserted in all packaged AFRIpads packets (School girl kit, Standard 4 pack, Standard 6 pack and Custom Kit). Depending on the location of targeted users, the leaflet can be translated in the language that speaks well to them.

 

PEAH: Your duties imply training of trainers: let us know more as for your approach and tools.

 Nirere: As the train lead at AFRIpads, Training of trainers involves an approach of providing information on how to successfully execute effective MHH trainings. I make background checks about the organisation and participants requesting for the training, schedule in person and online meetings to identify and assess needs, organize tailored training materials, share tips of MHH trainings and make follow up to check successful execution of trainings provided by trainees.

The training has a lot of online and in person activities like group discussions, individual tasks, role plays, brainstorming and many more.

A 3 hour training is executed using the AFRIpads Girl Talk handbook which has 3 sessions. Participants get engaged and learn how to introduce the session, dos and don’ts. Their MHH knowledge is evaluated before and after the training.

 

PEAH: Once again, thank you Ms. Nirere for your exhaustive answers and very deserving commitment

 

Millions of women and girls worldwide still cannot afford menstrual products or access water and sanitation facilities to manage their menstrual health and hygiene. Periods make them miss school, work, and negatively impact their health, but it does not have to be that way.

 Source: UN Women Africa

 

 

 

 

 

 

 

 

 

 

 

 

 

 

News Flash 580: Weekly Snapshot of Public Health Challenges

News Flash 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

Ornate wrasse (Thalassoma pavo)

News Flash 580

Weekly Snapshot of Public Health Challenges

 

Health and Financing  by Francisco Becerra-Posada 

Making IDA21 Work for Africa 

How Should the New Labour Government Rebuild Britain’s Approach to International Development?

How a new Labour government can reconnect Britain at home and abroad

Fostering the SDGs through Health in the United Arab Emirates

How countries can ramp up global hepatitis testing

WHO prequalifies the first self-test for hepatitis C virus

Record-Breaking Dengue Infection Persists in the Caribbean

How to stay safe from dengue fever — and how your community can help too

Sustaining the gains achieved by national neglected tropical disease (NTD) programs: How can we build NTD program country ownership and sustainability?

Influence of COVID-19 on trust in routine immunization, health information sources and pandemic preparedness in 23 countries in 2023

MSF and Health Justice Initiative welcome J&J’s withdrawal of patents on lifesaving TB drug in South Africa

Paediatric malaria treatment developed in Brazil by not-for-profit organizations distributed to Indigenous children in the Amazon region

MeDevIS platform announced to boost access to medical technologies and devices

The effects of alcohol container labels on consumption behaviour, knowledge, and support for labelling: a systematic review

Out of pens: How pharma greed cuts people with diabetes off from lifesaving meds

Kenya rolls out contraceptives to reduce maternal deaths

Tens of thousands displaced in fresh violence in DR Congo

Land routes across Africa are twice as deadly for migrants as Mediterranean voyages, UN estimates

Unacceptable” patients can’t feel safe as children’s hospital in Kyiv attacked

HRR 731: DO WE ACCEPT THAT INDUSTRIAL AGRICULTURE AND THE-FOOD-SYSTEM-IT-SUPPORTS ARE SUSTAINABLE AND RESILIENT? NO

Can this new blended finance model work for conservation goals?

South Africa Seeks to Alter Coal Pact Tied to $2.6 Billion

World Bank official backs Japan to show regional climate leadership

India: Extreme weather fuels migration-related challenges

Ending Bottom Trawling: A Call for Real Protection of the Marine Environment

Dearth of agri-food research on climate-hit countries

 

 

 

 

 

 

 

 

Health and Financing

IN A NUTSHELL
Author's note
…if steady financing were to be secured through laws, maybe the health sector in all countries could improve and thrive. Is not only having the funds, is how wisely ministries spend these. Is there proper planning? Are priorities set and a clear plan devised to achieve these?...

 By Francisco  Becerra-Posada, MD, MPH, DrPH

Health and Financing

 

One of the fields that has an impact on the lives of populations is public health. The actions of policies and programs that seek to improve the population, not in the field of the clinic in one-to-one interactions, but through collective actions together with social improvements, have a positive impact expressed in a decrease in morbidity and mortality rates.

The region of the Americas is, among the six regions of the World Health Organization, the ones that have shown the best progress in one of the actions that is perhaps the most equitable to provide children with an equitable start in life, vaccines. The WHO established the Expanded Program on Immunization and PAHO endorsed it in 1977, just 2 years after we began our studies.

It was the Pan American Health Organization, which last year celebrated its 120th anniversary, that made the fastest progress with the Expanded Program on Immunizations. The research and development of vaccines led to the availability of biologics against measles, rubella and mumps in the 1960s, and then with the production of the vaccine against chickenpox and inactivated Japanese encephalitis in the 1970s. By then, most of our generation had already been vaccinated against smallpox and almost certainly most of us suffered from “childhood” diseases, as we used to write in our medical records.

It was our children and now our grandchildren, who have benefited from the development of vaccines. What was a vaccination scheme of six biologicals, we now have a vaccination perspective for the life course, from birth to reaching older adults, and that we now benefit from these new vaccines for those over 60 years of age.

I had the opportunity and honor to be selected to serve as PAHO’s Assistant Director between 2013 and 2018. An interesting period for the region in terms of health. The elimination of rubella and measles was achieved, the proposal towards universal health coverage and access was launched (before the WHO did so), the PAHO Public Health Review was strengthened, among many other initiatives approved by the countries of the Region.

Advances in public health and health systems in countries have come a long way, and PAHO’s role is not equal in all countries. However, the COVID pandemic demonstrated the fragility of health systems around the world. PAHO is now renewing efforts with countries to strengthen primary health care and encourage health financing.

Health financing depends on many factors, political and social decisions and commitment. However, if steady financing were to be secured through laws, maybe the health sector in all countries could improve and thrive. Is not only having the funds, is how wisely ministries spend these. Is there proper planning? Are priorities set and a clear plan devised to achieve these?

Having secure funding, would protect immunization programs, there must be financial space for incorporation of novel vaccines, and to save towards an emergency vaccine fund as a preparedness measure for when the next pandemic reaches us. We have to learn from the COVID-19 experience and the resources needed for vaccines and medical care that had to be taken from other programs to face the emergency.

Sadly, few governments have a limited vision, and rather than thinking on state policies and decisions, they are motivated by priorities set by the government in charge that sadly, are limited in time. Have we learned something from the pandemic? Will ministries continue to move as usual? Hopefully, we will see a change. Are you going to contribute to it?

 

By the same Author on PEAH

Immunization Programs and Health Services

Apropos of COVID-19: Shall We Question Ourselves?

Implications of Covid-19 Pandemic on Health Systems

Have Countries Forgotten about the Sustainable Development Goals? The Case of the Americas

 

News Flash 579: Weekly Snapshot of Public Health Challenges

News Flash 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

Red starfish (Echinaster sepositus)

News Flash 579

Weekly Snapshot of Public Health Challenges

 

Re-Orientation to Sustain Life on Earth: a PDF by George Lueddeke

World Trade Organization Members Embark on Review of the TRIPS Agreement

Policy approaches to health system performance assessment

Assessing health system performance

WHO: Public health round-up

WHO releases first-ever clinical treatment guideline for tobacco cessation in adults

The effects of alcohol container labels on consumption behaviour, knowledge, and support for labelling: a systematic review

Pandemic Agreement Talks Extended: One More Year to Resolve Critical Issues

To respond to the threat of avian influenza, look back at lessons learned from COVID-19

Progress Update: Expanding Access to Dolutegravir in Azerbaijan, Belarus, Kazakhstan, and Malaysia

Meeting highlights from the Committee for Medicinal Products for Human Use (CHMP) 24-27 June 2024

Europe’s drug monitoring agency updates mandate, rebrands as EUDA

People’s Health Dispatch  Bulletin #79: Alternative visions of health in Zambia and Europe emerge; Gaza crisis continues

HRR 730: ‘POLITICAL RELIGION’ IS THE CONVERSION OF A CONVENTIONAL RELIGIOUS CREED INTO AN ANTI-SECULARIST AND ANTI-PLURALIST POLITICAL IDEOLOGY

China UPR statement: Cease overseas mining and power plant construction and urgently address human rights violations

When the South ‘Swings’ Together on Health Equity New Possibilities Emerge

Oxfam reaction to Zucman report to Brazil’s G20 Presidency on taxing the super-rich

Education for girls is not a ‘minor issue’ for Afghans, nor for the world

Sierra Leone bans child marriage, enacts severe penalties for violations

Bumpy road ahead as battery fears hit global EV rollout

Hundreds decry closure of MSF unit that advocates for medical access

Secrets Cost Lives: Transparency and Access to Medical Products

Over 750,000 people in Sudan at risk of starvation: Global hunger monitor

True Solutions: Bottom-up approaches to the global food crisis

Will the Cattle Industry Be Made to Respect Brazilian Law?

Nigeria to ban single-use plastics from January

How a ‘bottom-up’ approach can help meet climate finance targets

A Warming Planet is Global, Adaptation is Local & Resilience People-Specific

Climate Change and Education: Building Momentum through a Shared Research Agenda

EU needs to double investment to meet climate goals: report

A fair share of biodiversity finance: apportioning responsibility for the $20 billion target by 2025

 

 

 

 

 

 

 

Re-Orientation to Sustain Life on Earth: a PDF by George Lueddeke

IN A NUTSHELL
Editor's note Under One Health perspective, a live PDF here PEAH just received from our acknowledged partner Dr. George Lueddeke.
 
Originally from Canada, now residing in the United Kingdom, George Lueddeke PhD MEd Dipl.AVES (Hon.) is an education advisor in Higher, Medical and One Health education and global lead of the International One Health for One Planet Education initiative (1 HOPE) in association with national, regional, and global organisations

George Lueddeke

By George LueddekePhD

Consultant in Higher, Medical, and One Health Education

Global Lead – International One Health for One Planet Education initiative (1 HOPE)

Re-Orientation to Sustain Life on Earth

A PDF by George Lueddeke

 

Just received from Dr. George Lueddeke, PEAH is  glad to bring to the attention of  its readership a live PDF poster  full of  hyperlinks aimed, under One Health perspective, at re-orienting practices and behaviours by governments, corporations and civil society for the sake of a sustainable living on Earth.

In this connection, excerpts from what already published by Lueddeke  can believably serve as an appropriate introduction:

...After billions of years of evolution, in just a few decades we have come to an inevitable turning-point. While we have made significant scientific / technological progress, we have failed to safeguard life on the planet including ours (we are but one of about 8.5 million species!). Although we have cognitive and affective capacities for achieving a harmonious world, our lives continue to be overridden by the self-interests, ambitions, and power of a few (1%?) -think  AI and technology! 

In the longer run, it appears that “a more just, sustainable and peaceful world” can only be achieved if we all realise the consequences of our short-term thinking (e.g., profits over survival, control or enslavement over freedoms) and learn to rise above the human-fabricated divisions and inequities that divide us (social, political, religious, economic, etc.). If we fail, so will future generations and humanity. Democratic societies depend on a shared belief in ‘something greater than themselves’ and holding ‘power to account’. 

https://www.peah.it/2022/05/11063/
...Whether we are able to achieve a “more just, sustainable and peaceful world” will depend on the decisions we make now as opportunities for social transformation are becoming increasingly time- limited. There is no question that new thinking is required and that both education and research are key in moving societies in new directions to ensure planet sustainability.  To these ends, here are a few re-orientations to consider by governments, corporations and civil society in general to sustain life on the planet shifting from:

human-centrism to eco-centrism;

subject fragmentation to disciplinary integration;

knowledge transfer to knowledge discovery;

intervention to prevention and a future consciousness;

individualism to ‘learning from and with others’:

those who ‘have‘ to those who ‘have not’;

thinking globally to acting locally;

profit margins to self-fulfilment and ‘doing something good’;

self-interests, ambition, power to understanding, compassion and  truth. 

https://www.peah.it/2022/05/11063/
Enclosed below is a link to an updated capacity-building publications poster (case study) originally prepared for UN SDG acceleration Summit last year

Click HERE to see the live PDF 
The  challenges  and ‘reflections’ articles (all live) might be informative for some PEAH readers (e.g., comments on?).

 

By George Lueddeke on PEAH

Betting on SDGs in a Disequal World

Holistic Systemic Change to Care for All Life on Earth

Earth Future: Time for a Global ‘Reset’!

Reflections on Transforming Higher Education for the 21st Century: PART 3 The international One Health for One Planet Education Initiative (1 HOPE) and the ‘Ecological University’

Reflections on Transforming Higher Education for the 21st Century: PART 2 Development of a Global ‘All Life’ Narrative

Reflections on Transforming Higher Education for the 21st Century: PART 1 The One Health & Wellbeing Concept

Planet Earth: Averting ‘A Point Of No Return’?

Tackling the Root Causes of Climate Change. If Not Now, WHEN?

Commentary on ‘More for The World Organisation for Animal Health (OIE) – Impakter’

Rebuilding Trust and Compassion in a Covid-19 World

The University in the early Decades of the Third Millennium: Saving the World from itself?

The World at Risk: Covid-19, Global Sustainability and 1 HOPE

Postscript – The World at Risk: Covid-19, Global Sustainability and 1 HOPE

 On this theme, see also

INTERVIEW – ‘Survival: One Health, One Planet, One Future’ – Routledge, 1st edition, 2019

News Flash 578: Weekly Snapshot of Public Health Challenges

News Flash 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

Smooth tubeworm (Protula tubularia)

News Flash 578

Weekly Snapshot of Public Health Challenges

 

MSF’s Access Campaign is an invaluable actor in global health; shutting it down is short-sighted

Another milestone towards the end of the Commercial Determinants of Health

Driving universal health reforms through crises and shocks

Betting on SDGs in a Disequal World  by George Lueddeke

29 years without Jonas Salk: against the normalization of the absurd

Namibian court overturns and declares unconstitutional a law criminalizing gay sex between men

HRR 729: THERE IS A CONVINCING ARGUMENT TO BE MADE THAT MAJOR CHANGE IS NOT ONLY VERY NECESSARY, BUT IS ALSO ORGANIZATIONALLY AND REALISTICALLY POSSIBLE

One of the world’s biggest fishing fleets doesn’t want you to watch this film. Find out why

Tax super-rich, says report commissioned by Brazil for its G20 presidency

We Must Safeguard the Health of Haiti’s Women and Girls

Lost in Translation: The Silent Struggle of Diabetes Self-management in Ethiopia

Member states agree on EU-wide rules for the welfare of cats and dogs

Twice-a-year injection gives women full protection against HIV, trial finds

Gilead Urged to Prioritise Access as Injection Trial Proves 100% Successful in Preventing HIV

‘Declare health emergency’ to end hepatitis in Asia

Bird flu outbreak highlights potential risks for global food security

SECURING OUR TB FREE FUTURE – EASTERN EUROPEAN AND CENTRAL ASIAN HEALTH LEADERS INCREASE POLITICAL COMMITMENT TO ENDING TUBERCULOSIS

Time for $5 campaign: Open letter to Danaher employees

Gavi Launches Replenishment and Commits to Accelerating African Vaccine Manufacturing

Gavi Includes Ebola, Meningitis, Rabies and Hepatitis B Vaccines in its Portfolio

Team Europe announces over €750 million to the African Vaccines Manufacturing

Assessing MEPs’ commitment to sustainable food systems: EU Food Policy Coalition’s scorecards unveiled

Creating Aspirations in Aspiration District Yadgir, a Pre-Industrial Pocket of India  by Veena S Rao

Women Warriors Winning Fight to Bring Back Indigenous Food Traditions

Food and Climate Crises: Right to Food and Nutrition Watch

Carbon Markets Undermine Peasant Autonomy and Self-Determination over Data

‘Urgent’ for Australia to protect Great Barrier Reef: UNESCO

Health consequences of air pollution on populations

World must summon urgency to hit new climate goals, Alok Sharma says

It Will Take More Than Money to Close Africa’s Roads Gap: The Case for Investing in New Materials

Making Plastic Polluters Pay: How Cities and States Can Recoup the Rising Costs of Plastic Pollution (June 2024)

Nyéléni Process: Challenging the financing behind green and blue grabbing

 

 

 

 

 

 

 

 

 

Creating Aspirations in Aspiration District Yadgir, a Pre-Industrial Pocket of India

IN A NUTSHELL
Author's note
...We are implementing a unique project to address malnutrition and provide rural livelihoods in Yadgir District, Karnataka, supported by the Department of Science and Technology, Govt. of India in partnership with Karnataka State Council for Science and Technology (KSCST) and Centre for Sustainable Technology (CST), Indian Institute of Science, Bangalore. Bharatiya Agro Industries Foundation (BAIF) Development Research Foundation are our field partners. Project details and progress are available at our website https://publicnutrition.aurosociety.org/

A valuable lesson that we have learnt so far in our journey for bringing about the much required behaviour change and belief systems change in the community and family is that children are the most aspirational and influential agents to create that change...

By  Ms. Veena S Rao, IAS (Retd)

Director,  Auro Centre for Public Nutrition, Public Health and Public Policy 

Bangalore, India 

Creating Aspirations in Aspiration District Yadgir, a Pre-Industrial Pocket of India

 

 General Background

The Government of India in 2018 initiated the Aspirational Districts Programme with the aim to transform 112 most under-developed districts of the country, quickly and effectively. The broad contours of the programme are convergence of State and Central programmes, collaboration of Central, State and District administrators, and competition among the districts through monthly delta ranking, all driven by a mass movement. The ranking is based on the incremental progress made across 49 Key Performance Indicators (KPIs) under 5 broad socio-economic themes – Health & Nutrition, Education, Agriculture & Water Resources, Financial Inclusion & Skill Development and Infrastructure.[1]

One such Aspiration District is Yadgir District in the state of Karnataka which is also the most backward district of the State. The policy of the Auro Centre for Public Nutrition, Public Health and Public Policy (ACPN) a vertical of Sri Aurobindo Society (SAS) Pondicherry, is to work in the most backward regions of the country.

We are implementing a unique project, “Establishing SHG/FPO[2] enterprises to address malnutrition and provide rural livelihoods in Yadgir District, Karnataka”, supported by the Department of Science and Technology, Govt. of India in partnership with Karnataka State Council for Science and Technology (KSCST) and Centre for Sustainable Technology (CST), Indian Institute of Science, Bangalore. Bharatiya Agro Industries Foundation (BAIF) Development Research Foundation are our field partners. Project details and progress are available at our website https://publicnutrition.aurosociety.org/

This is a unique, holistic, multi-sectoral, development project covering Horticulture, Women’s Empowerment, Nutrition and Education. Our project began in 2022 with a Base Line Survey of the two poorest quintile households of the District, and was accompanied by a multi-layered communication strategy for behavior change at community level.[3]

I am placing below an extract which tells us just how poor and worrisome the human development indicators of Yadgir District are.

  • 20% of mothers of children below 3 years (all migrant labourers) said that their infants did not consume any complementary food until they were about 2 years. The mothers said that whenever the infants were given something from the family food, mostly roti, dal, idli (a soft steamed cake made from rice and lentils) or ganji (soft boiled rice), they were not able to digest it and became ill. All the mothers were migrant workers and did not access any benefits from ICDS (Integrated Child Development Services).
  • Among children aged 6-35 years, about 64.5% are either stunted, or wasted or underweight. The proportion of children (both boys and girls) under 3 years who are not stunted, not wasted or not underweight decreases as the age increases, implying that their nutritional status/health deteriorates as they grow older.
  • Among children aged 3-5 years about 72.79% are either stunted or wasted or underweight. The proportion of children (both boys and girls) who are not stunted, not wasted and not underweight decreases as age increases, implying that the nutritional status/health of the children is deteriorating as they grow older.
  • About 17.5% of adolescent girls and 7.2% of the adolescent boys (between 11-18 years) are illiterate. None of the girls have studied up to class 10, and about 20% of boys are in class 10. Overall, about 47.39% adolescent girls and 52.9% adolescent boys are severely underweight and 27.96% girls and 30.77% boys are moderately underweight. About 57% of mothers of children under 3 years and 63.5% mothers of children between 3-5 years are illiterate. Consumption of fruits, vegetables, dairy products constitute a very small part of the daily diet.
The Table below shows some Baseline Survey Indicators compared with NFHS 5[4] Indicators for Karnataka State and Yadgir District
BLS Yadgir District NFHS 5-Yadgir District NFHS 5-Karnataka State
Percentage children under five years % (N) %(N) %(N)
Stunted* 47.9 (698) 57.6(215) 35.4 (6785)
Wasted* 32.5 (695) 17.7 (209) 19.5 (6563)
Underweight* 53.5 (703) 45.2 (219) 32.9 (6991)
Adolescent BMI (% BMI < 18.5 – total thin)$ (11-18 years) (15-19 years)
Boys 83.3 (221) 47.1 (576)
Girls 75.4 (211) 42.4 (3993)

*Statistically Significant differences at 95% CI and p < 0.05

 

I have always maintained that one of the root causes for persistent undernutrition, anemia and calorie-protein-micronutrient deficiency among large sections of India’s population, especially the poorest 30-40 percent, is a complete vacuum in the market for low cost, fortified nutritious foods, which I call the market deficit.

The daily diets of the poorest families are meagre, subsistence diets and do not provide the balanced nutrition required for healthy growth of children and adolescents during rapid growth periods, for women during pregnancy and lactation, for all age groups of both genders during or after illness, and complementary food for infants after 6 months of age. Even though the per capita income has more than quadrupled in the last decade, the vast dietary deficit in terms of protein, calorie and micronutrients remains among around 50% of our population of both sexes and all age groups.[5]

A Feasibility Study conducted through KPMG in 2018 under the World Bank funded Karnataka Multi-sectoral Nutrition Pilot Projects[6] implemented by the Karnataka Comprehensive Nutrition Mission, gives a firm finding that there is a direct correlation between high incidence of low weight, stunting and wasting among children, low body mass index and stunting among adolescents, and lack of affordable fortified energy food in the market.  The study calculates a market demand of 42 million tons of low-cost energy food per year.

Data regarding severe child malnutrition and wasting on a real time basis in the Karnataka Multi-sectoral Nutrition Pilot Projects, led by the author, confirmed that all cases of severely malnourished/wasted children were from households where both parents were engaged in construction or agricultural labour. The infants were left under the care of elder siblings or grandparents, and apart from some roti (flat bread), rice and pulses, which the infants could not eat, there was no other food in the house. And there was no affordable, nutritive children’s food available in the market.

Availability of affordable, nutritious food in the market assumed even greater importance during the COVID 19 pandemic – lockdown and post lockdown. Reports from the field categorically informed that poor rural families were on a survival diet of rice and wheat given under PDS (Public Distribution System), and sometimes some dal. In many villages, even after the pandemic, there continued to be no milk or any other food for children. A study done by Azim Premji University confirmed this[7].

On the other hand, India, one of the largest fruit and vegetable producers in the world loses a large percentage of production due to spoilage and post-harvest losses because of lack of primary processing facilities, fuel-efficient post-harvest technology and hygienic storage facilities. Horticultural loss estimates vary from 15% to 40%.[8] [9] In the absence of primary processing facilities for preservation or processing, it is to be expected that the wastage of horticulture produce will continue unless simpler methods using alternative source of energy and more decentralized operations at the grassroots for processing and preserving horticulture produce are introduced.

Our project therefore included that a Production Unit would be set up for producing fortified nutritious multi-grain food, VitaPoshan, for children, adolescents, adults and family, also using locally available horticulture produce with short shelf life, primarily tomatoes and bananas, through simple energy friendly rural technology.  Women SHGs would be trained for running the production unit with hand-holding support from us and for marketing VitaPoshan within the District. This would fill the huge technology gap that exists in Yadgir District, provide the poorest sections of the community access to affordable nutritious food, and prevent wastage of horticultural produce.

I am informed that our production unit will be the first medium scale production unit being set up in Yadgir District, though there are some small industrial units for cleaning pulses and cotton, the main agricultural crops of Yadgir District. In fact, I often describe Yadgir District as a “pre-industrial pocket of India”!

In short, the Project Objectives are: 

  • Provide livelihoods to SHGs/FPOs through Innovative Farm Based Enterprises, Value Chains and Market Linkages.
  • Address malnutrition, reduce anaemia and improve the health status of the community and provide fortified nutritious food to the rural poor – to children, adolescents, adults and family.
  • Prevent wastage of fruits and vegetables, reduce losses during glut season, arrest distress sales and reduce market risks.
  • Provide cash income to the SHGs/FPOs and contribute to their economic empowerment.
  • Build capacity of FPOs/SHGs, improve the quality of life of women through value added income generation and marketing of nutritive horticultural products preserved/dehydrated/processed through fuel efficient, green energy. 

Project Interventions, Completed and Ongoing:

  • Baseline Survey and Socio-Economic survey have been completed (2022). [10] The indicators are extremely worrisome and need urgent interventions. (Summary above)
  • SHG mobilization and Information Education Communication (IEC) Campaign for Behaviour Change is ongoing. Advocacy material is being given to the SHGs with personal counselling regarding proper child, adolescent and maternal care, and proper dietary practices within family budgets.
  • Product Development, Nutrition Analysis and Shelf Life Tests have been completed for all the four VitaPoshan products.
  • A green, environment friendly, Production Unit is being set up by KSCST and CST, for producing fortified nutritious food, VitaPoshan, for children, adolescents, adults and a special nutritious family food, which is a fortified blend of pulses and tomato powder. Trial Production is expected to start by end of June 2024 and regular production is expected to start in July 2024.
  • Marketing of products produced by the SHG women, will be done through a hybrid Marketing Strategy involving marketing by SHGs, traditional retail and wholesale distribution networks, on-line sales. Marketing training of women SHGs is going on.

We eagerly await VitaPoshan to start reaching the community, and hope to see an improvement in the human development indicators of the poorest households of the community.

A valuable Lesson Learnt

A valuable lesson that we have learnt so far in our journey for bringing about the much required behaviour change and belief systems change in the community and family is that children are the most aspirational and influential agents to create that change. We saw for ourselves how they actually created aspirations in this Aspirational District.

Initially, we had started the behaviour change programme with tried and tested methods of engaging with the women SHG members and village influencers.  Awareness generation activities were organized in villages focusing on basic child, adolescent and maternal care, and proper nutritional practices within family budgets. However, we realized that we were not creating any impact. We debated amongst ourselves – perhaps this indifference was on account of lack of trust which the community seemed to show for any kind of behaviour change messaging; perhaps their cynicism within the culture of poverty was too strong to allow them to believe the messages. After all, they had lived in this subsistence state for generations and had come to accept it with a sense of fatalism.

After much discussion and brain storming with our field partners, we finally concluded that the most influential agents of change in this generational subsistence society were the children, as they held a very special place in the family. The boys are treated as assets to take care of their parents once they are old and unable to work, and the girls are considered as temporary inmates who would move away to their marital homes after some years.  We learnt that parents here generally are very indulgent towards their children.

We therefore took a decision that we would start the behaviour change programmes through students in the senior schools. Relevant themes that were urgently required to be disseminated were selected and age appropriate IEC material in the form of posters and films were developed.

The themes covered were:

  1. Importance of balanced diet and consumption of locally available fruits and vegetables
  2. Not coming to school on an empty stomach
  3. Avoiding junk food
  4. Importance of clean drinking water and sanitation
  5. Causes of anemia and how to prevent it
  6. Intergeneration lifecycle of Malnutrition

IEC programmes were conducted in 40 senior schools across the district from November, 2022 onwards. The programmes were made more interesting through films[11], quizzes and games so that children could enjoy them and take home the messages to their parents. We deliberately selected schools in the most backward and remote villages of the district, many of which did not even have motorable roads.

Impact of Our Programme

An Impact Assessment was conducted in April 2023, across 40 schools in 37 villages, that covered formal interviews with students, parents and teachers.[12] The observations were extremely encouraging.

  • There were positive behaviour changes in around 60% families
  • Many students started eating sprouts and local fruits daily
  • All children started eating a meal before coming to school
  • Children started asking their parents for a variety of fruits and vegetables
  • Students realised the risks of junk food and chose healthier options like chikki (peanut and jiggery toffee) and banana as a snack
  • Students were not wasting vegetables served as part of their school mid-day meal
  • Teachers reported that the health of students who followed the messages has improved
  • Students were more active; they participated in games and had better concentration in the classroom

We were extremely happy that our experiment of starting behavior change and creating aspirations in the family through children worked. I hope this important learning will be useful for other development agencies, NGOs, and field workers operating in the poorest regions of the world.

 

References

[1] https://www.niti.gov.in/aspirational-districts-programme

[2] SHG- Self Help Group; FPO-Farmer Producer Organization

[3] https://publicnutrition.aurosociety.org/wp-content/uploads/2023/03/Baseline-and-Social-Survey-Yadgir.pdf

[4] National Family Health Survey 5, 2019-2020

[5] NFHS 5, 2019-20; Comprehensive National Nutrition Survey 2016-18; NNMB 3rd Repeat Survey (2012; NNMB Report 27, 2017

[6]http://karnutmission.org.in/documents/New_Feasibility_Study.pdf

[7]https://cse.azimpremjiuniversity.edu.in/wp-content/uploads/2020/06/Compilation-of-findings-APU-COVID-19-Livelihoods-Survey_Final.pdf

[8]https://www.researchgate.net/publication/374116896_Post_harvest_losses_of_fruits_and_vegetables_in_India

[9] https://www.nationalheraldindia.com/national/40-vegetables-fruits-get-wasted-in-india-iari-director#google_vignette

[10] https://publicnutrition.aurosociety.org/wp-content/uploads/2023/03/Baseline-and-Social-Survey-Yadgir.pdf

[11] The films can be viewed @ https://publicnutrition .aurosociety.org/gallery/

[12] : https://publicnutrition.aurosociety.org/wp-content/uploads/2023/04/27-4-Impact-Assessment.pdf

 

By the same Author on PEAH

Karnataka Multisectoral Nutrition Pilot Project (2014-2018): Some Significant New Evidence Based Findings and Need for Further Research

Multisectoral Nutrition Interventions: Impact and Transitions in Undernutrition, Stunting and Wasting in Children – An Open Experiment in Two Remote Blocks of Karnataka

Nourishing India – What Needs to Be Done