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’


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


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


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

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


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


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

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


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

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’.
...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.
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