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Credit: Albert González Farran, UNAMID

By Mark J. Wood
WASHINGTON DC, Jul 27 2023 (IPS)

When war broke out in Khartoum, the capital of Sudan, in April 2023, those of us who know the region well feared what would happen to the west, in Darfur. In 2003, former Sudanese President Omar al-Bashir called on the Janjaweed Arab militia to quell an uprising in Darfur.

The systematic raping, pillaging, looting, and scorched-earth tactics of the Janjaweed led to the deaths of more than 300,000 people in what has been recognized as a genocide.

The paramilitary Rapid Support Forces (RSF) of today, which is battling the Sudanese Armed Forces for control of the country, traces its origins to the Janjaweed of 20 years ago. The rise of ethnically targeted violence in the region now threatens a recurrence of that dark chapter.

Experts and organizations from the U.S. Holocaust Memorial Museum to the UN’s Special Adviser on the Prevention of Genocide are once again warning of genocide.

Yet the world’s response remains muted and lacks a clear strategy for Sudan. The United States has placed sanctions on Sudanese leaders, worked with Saudi Arabia to broker short-lived ceasefires, and seems set to belatedly appoint a Special Envoy.

But there is another measure taken in response to the violence of 20 years ago that is yet to be seriously considered— military intervention. This can take the form of a United Nations Peacekeeping force, or a hybrid force in partnership with the African Union, which seeks to enforce the Responsibility to Protect (R2P).

While geo-political barriers to such a step are formidable, the pace and brutality of today’s violence demand it be considered.

Following the struggles to respond swiftly and prevent war crimes and crimes against humanity in the 1990s, the Responsibility to Protect, a “political commitment to end the worst forms of violence and persecution,” came into being by an act of the United Nations General Assembly in 2005. R2P stands on three pillars:

1) Every state has the responsibility to protect its populations from mass atrocities; 2) The international community has a responsibility to assist states to meet their obligations; 3) If a state is failing to protect its population, the international community must take appropriate action in line with the UN Charter.

It is clear based on the situation in Sudan and Darfur that the authorities in Sudan are failing in their obligation to protect civilians. Pillars two and three need to be enforced. Invoking R2P will lay the foundation for what will be needed when this violence subsides—a stabilization peacekeeping force.

The UN, which was founded on the principle “to save succeeding generations from the scourge of war” must endeavor to use the tools at its disposal to save the people of Sudan.

At the beginning of the Millennium, peacekeeping was still viewed as a powerful and effective tool to protect civilians. To be sure, peacekeepers were limited by ambiguous and unrealistic mandates and a lack of resources to effectively carry out missions. But they saw some success, notably in Sierra Leone, Cote d’Ivoire and Liberia.

However, today in a divided Security Council, a tepid approach is taken towards peacekeeping. China and Russia continue to speak in echo chambers and maintain a hardline view of sovereignty to avoid any precedent for intervention in their own countries. This limits constructive dialogue and effective utilization of a key tool in the UN Security Council’s tool kit.

Peacekeepers in Sudan are not infeasible. There is precedent for peacekeepers in Darfur, and it is worth considering. In June 2021, the African Union–United Nations Mission Hybrid Operation in Darfur (UNAMID) completed its withdrawal following 13 years trying to stabilize the region.

The operation brought relative stability and a semblance of normality, highlighting the effectiveness of peacekeeping operations. It is abundantly clear three months into the war that no one among Sudanese authorities is fostering a substantial effort to ensure civilians are protected, particularly those in Darfur.

Under chapters VI, VII, and VIII of the UN Charter, the Security Council is instructed to take the appropriate action to settle disputes; act when peace is being breached; and utilize regional arrangements to bring about peace. There is a precedent of having regional provisions, through diplomatic, operational, and joint operational support, under Chapter VIII.

For example, in the former Yugoslavia, NATO provided air support for UN troops on the ground. And the Organization of American States, in conjunction with the UN, launched MICAH, a civilian mission in Haiti in 1993.

The role of the East African bloc IGAD, and its call to send a standby force to protect civilians and create a humanitarian corridor, is a welcomed step. With a regional bloc providing military support, the UN secretariat can use its good offices to provide humanitarian assistance and facilitate a road map toward nation building. Diplomacy must continue until cessation of hostilities is in place, and an observer mission is deployed.

The conflict in Darfur—once again on the lines of ethnicity, tribal allegiances, and coveted minerals—has the potential to catapult the region into a new dimension. The international community should not be surprised at the repeated tragedies unfolding in Darfur and the country at large.

Decades of impunity emboldened the protagonists of today’s conflict. The instruments to protect civilians are there. The UN Security Council has its mandate. Lives can be saved if swift action is taken. We cannot afford to fail the people of Sudan who never asked for this—and certainly do not deserve it.

Mark J Wood is the program associate for Refugees International. He has extensive research and advocacy experience on peace and security efforts in Africa and the Middle East, focusing on the root causes of violence. Prior to joining Refugees International, he worked for CARITAS Internationalis at their UN office as an Advocacy Assistant and with the International Peace Institute as a Research Assistant – where we focused on UN Peacekeeping challenges and mandate renewals.

Source: Global Dispatches: a newsletter read by over 9,300 members of the international affairs community, including senior leadership at the United Nations, government, the NGO community and media.

IPS UN Bureau

 

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Lack of accessible information in sign language has made online platforms, education, healthcare inaccessible for the Deaf due to non-provision of information in sign language formats. Credit: Shutterstock.

By Egwelu Timothy
KAMPALA, Jul 27 2023 (IPS)

Every July, the disability community honors its history, accomplishments, and experiences during Disability Pride Month. One such group is the deaf community in Uganda, which makes up 3.4% of the population.

Members of the Deaf community celebrate the positive aspects of deaf culture, activism, and the pride of being Deaf, and feel value. But, we also recognize our oppression and know that we deserve better than the prevalent discrimination, exclusions and inaccessibility we regularly face.

While the inclusion of Deaf persons in organisations such as Uganda National Association of the Deaf (UNAD) , Deaf Youth Advocacy Network, and National Union of Persons with Disabilities enables us to help with some development of policies and best practices, merely having representation in consultations is not enough.

It is critical for a truly inclusive and accessible society that Deaf persons are involved in the decision-making processes. However, it is only feasible if policies can be understood, deaf people can actually attend meetings, and their voices are heard and taken seriously

All mainstream laws, policies and services also must be accessible to Deaf persons in sign language beforehand so we can contribute and guide language and outcomes.

Too often, however, Deaf persons are excluded. For instance, in the wake of the COVID-19 pandemic, there was an unfortunate digital gap for over 20,000 Deaf persons who use assistive devices like smart phones to access information.

Today, generally, lack of accessible information in sign language has made online platforms, education, healthcare inaccessible for the Deaf due to non-provision of information in sign language formats.

Furthermore, the lack of adequate support services such as access to interpretation, Sexual Reproductive Health, mental health services and social protection are concerning. In policy consultations, there is no meaningful participation as 60% of deaf participants cannot comprehend the written law.

The Constitution of Uganda is the second in the world to recognize the right to sign language both within the body and under the Cultural Objective Principle XXIV (iii) of the National Directives of State Policy. Article 21(1) on equality before the law, under the law and all spheres of life is equally instrumental.

These are further operationalised under the Persons with Disability Act of 2020. Most notably under Section 6, 7, 9 and 12 on non-discrimination under provision of education and general commercial services, health and employment. Despite this plethora of legal backing, the provision of information in sign language is still lacking.

The Constitution and other relevant laws such as the Penal code Act chapter 120 laws of Uganda are similarly inaccessible in sign language therefore ignorance of law is guaranteed for deaf persons despite it being no exception to criminal liability.

There is widespread agreement around the world that governments and institutions must take proactive measures to ensure that deaf persons have equal access to mainstream policies, systems, and services.

This includes providing accessible communication, transportation, education, healthcare, employment opportunities, and other essential services. However, the law and appropriate implementation are two different things.

Furthermore, regardless of the sector, policymakers must ensure that sign language accessibility is considered from the outset of policy development and implementation. They must engage Deaf persons and their representative organizations in meaningful consultation to understand their needs, preferences, and priorities.

Policymakers must also ensure that the Deaf have equal protection under the law to engage in the policy formulation process, voice their opinions, and influence decision-making. This includes providing accessible venues, information, formats, and technologies to facilitate their participation. In the recent consultations on development of the policy guidelines for television access, I applaud Uganda Communication Commission for inviting stakeholders from the various organisations to partipate in the consultancies and ensuring accesibility to sign language.

To sum up, it is critical for a truly inclusive and accessible society that Deaf persons are involved in the decision-making processes. However, it is only feasible if policies can be understood, deaf people can actually attend meetings, and their voices are heard and taken seriously. In this Disability Pride month, let’s level the playing field and ensure that everyone can participate in meaningful ways to make a truly inclusive society.

Egwelu Timothy is a lawyer and a disability policy & inclusion consultant

South Africa's pioneering coach Desiree Ellis on the growth of women's football and leading her nation at a second World Cup.

Pioneering coach Desiree Ellis on the growth of women’s football and leading her nation at a second World Cup.

Forty African head of states are expected to attend the second Russia-Africa in St Petersburg.

Secretary-General António Guterres (centre) visits residential neighborhoods of Irpin, in Ukraine's Kyiv Oblast February 2023 . Credit: UN Photo/Eskinder Debebe

By Thalif Deen
UNITED NATIONS, Jul 27 2023 (IPS)

The Secretary-General of the United Nations is the creature of—and subservient to — the 193 member states who largely reign supreme in the world body.

But, in reality, Antonio Guterres has been defiant and openly challenged one of the five permanent members of the Security Council lambasting Russia for its 17-month-old invasion of Ukraine.

Mercifully, and hopefully, he has no plans to run for a third term and face a Russian veto— as did former Secretary-General Boutros Boutros-Ghali, who defied the US, and was defeated in his bid for a second term (when 14 members of the Security Council voted for him while the US exercised its veto).

Guterres, a former Prime Minister of Portugal, has been consistent in his attacks on Russia pointing out that Moscow’s invasion of Ukraine is a violation of the United Nations Charter and international law.

In his most recent a statement released July 23, Guterres “strongly condemned the Russian missile attack on Odesa that resulted in civilian causalities and damaged the UNESCO-protected Transfiguration Cathedral and other historical buildings in the Historic Centre of Odesa, a World Heritage site.”

“In addition to the appalling toll the war is taking on civilian lives, this is yet another attack in an area protected under the World Heritage Convention in violation of the 1954 Hague Convention for the Protection of Cultural Property in the Event of Armed Conflict.”

Guterres said he was concerned about the threat that this war increasingly poses to Ukrainian culture and heritage. Since 24 February 2022, UNESCO has verified damage to 270 cultural sites in Ukraine, including 116 religious sites.

Still, is Guterres — and the international community– fighting a losing battle against Russian President Vladimir Putin? Are there any other alternatives in sight?

James Paul, a former Executive Director of the New York-based Global Policy Forum (GPF), told IPS the Secretary-General should really be able to help with negotiations– or even lead them.

“Thus, he cannot be too partial. But the Secretary-General (SG) is always partial to the US and any criticism is dealt with very severely as when Kofi Annan said the US had broken international law in Iraq,” said Paul, author of the 2017 book titled “Of Foxes and Chickens: Oligarchy and Global Power in the UN Security Council”.

“All his staff were stripped away, and he was humiliated in The New York Times,” he pointed out. “I think the SG should try to stay in a position that enables him to act as an intermediary”

“Did the then SG criticize the damage to heritage sites in Iraq by US forces? No. The P-5 are not equal”, said Paul, who was a prominent figure in the NGO advocacy community at the United Nations and a well-known speaker and writer on the UN and global policy issues.

Martin S. Edwards, Professor, School of Diplomacy and International Relations, Seton Hall University in New Jersey, told IPS the SG is playing this correctly, working to delegitimize Russia, and rightly so. There’s not much else that can be done to make Russia into a pariah state.

“The SGs voice on this in recent days (not only in criticizing this missile strike but also the end of the grain deal) has been both steadfast and needed,” he said.

“The main problem, sadly, is that this needs to be resolved on the battlefield”.

“ The more that Putin realizes he will not achieve any of his objectives, and the more that he realizes his regime is in danger, the more he would be willing to listen to overtures for peace. This war remains a huge tragedy for all involved,” declared Edwards.

Andreas Bummel, Executive Director, Democracy Without Borders, told IPS it is part of the UN Secretary-General’s duties to protect the rules and values of the UN Charter.

The Russian war of aggression against Ukraine, aimed at annexing territory and erasing Ukraine’s existence as an independent state, is the most blatant violation of the Charter’s fundamental rules and of international law, he pointed out.

“The Secretary General has no choice but to condemn Russia for its criminal actions even if this means that Russia does not accept him as a mediator. As the UN General Assembly has said, there is no solution to this war except for Russia to withdraw its troops and to cease all attacks,” declared Bummel.

Meanwhile, the United Nations has described the deaths and destruction in the nine-year-old civil war in Yemen as “the world’s worst humanitarian disaster”.

The killings, mostly civilians, have been estimated at over 100,000, with accusations of war crimes against a coalition led by Saudi Arabia and the United Arab Emirates (UAE) battling Yemen, described as one of the world’s poorest nations in the UN’s list of least developing countries (LDCs).

But the weapons used in these killings originated in the US which has remained the primary arms supplier to both countries. But neither the UN nor successive SGs have at least hinted or accused the US of being implicitly responsible for the civilian killings,

The New York Times said in 2017 that some US lawmakers worry that American weapons were being used to commit war crimes in Yemen—including the intentional or unintentional bombings of funerals, weddings, factories and other civilian infrastructure—triggering condemnation from the United Nations and human rights groups who also accuse the Houthis of violating humanitarian laws of war and peace.

https://www.globalissues.org/news/2019/04/26/25240

Going back to 2003, then Secretary-General Kofi Annan challenged the United States, and surprisingly, lived to tell the tale—but paid an unfairly heavy price after being hounded by the US administration..

When the US invaded Iraq in March 2003, he described the invasion as “illegal” because it did not have the blessings of the 15-member UN Security Council, the only institution in the world body with the power to declare war and peace.

But the administration of President George W. Bush went after Annan for challenging its decision to unilaterally declare war against Iraq: an attack by a member state against another for no legally-justifiable reason.

The weapons of mass destruction (WMDs), reportedly in Iraq’s military arsenal, which was one of the primary reasons for the invasion, were never found.

Subsequently, Annan came under heavy fire for misperceived lapses in the implementation of the “Oil-for-Food” program which was aimed at alleviating the sufferings of millions of Iraqis weighed down by UN sanctions

Meanwhile, in his 368-page 1999 book titled “Unvanquished: A US-UN Saga,” Boutros-Ghali provided an insider’s view of how the United Nations and its chief administrative officer (CAO) were manipulated by the Organization’s most powerful member: the United States.

Although he was accused by Washington of being “too independent” of the US, he eventually did everything in his power to please the Americans. But still the US was the only country to say “no” to a second five-year term for Boutros-Ghali.

In his book, Boutros-Ghali recalls a meeting in which he tells the then Secretary of State Warren Christopher that many Americans had been appointed to UN jobs “at Washington’s request over the objections of other UN member states.”

“I had done so, I said, because I wanted American support to succeed in my job (as Secretary-General”), Boutros-Ghali says. But Christopher refused to respond.

When he was elected Secretary-General in January 1992, Boutros-Ghali noted that 50 percent of the staff assigned to the UN’s administration and management were Americans, although Washington paid only 25 percent of the UN’s regular budget.

When the Clinton administration took office in Washington in January 1993, Boutros-Ghali was signaled that two of the highest-ranking UN staffers appointed on the recommendation of the outgoing Bush administration– Under-Secretary-General Richard Thornburgh and Under-Secretary-General Joseph Verner Reed — were to be dismissed despite the fact that they were theoretically “international civil servants” answerable only to the world body.

They were both replaced by two other Americans who had the blessings of the Clinton Administration.

Just before his election in November 1991, Boutros-Ghali remembers someone telling him that John Bolton, the US Assistant Secretary of State for International Organizations, was “at odds” with the earlier Secretary-General Javier Perez de Cuellar because he had “been insufficiently attentive to American interests.”

“I assured Bolton of my own serious regard for US policy.” “Without American support” Boutros-Ghali told Bolton, “the United Nations would be paralyzed.”

IPS UN Bureau Report

 

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By Jomo Kwame Sundaram
KUALA LUMPUR, Malaysia, Jul 26 2023 (IPS)

Currency values and foreign exchange rates change for many reasons, largely following market perceptions, regardless of fundamentals. Market speculation has worsened volatility, instability and fragility in most economies, especially of small, open, developing countries.

US Fed pushing up interest rates
For no analytical rhyme or reason, US Federal Reserve Bank (Fed) chairman Jerome Powell insists on raising interest rates until inflation is brought under 2% yearly. Obliged to follow the US Fed, most central banks have raised interest rates, especially since early 2022.

Jomo Kwame Sundaram

The US dollar or greenback’s strengthening has been largely due to aggressive Fed interest rate hikes. Undoubtedly, inflation has been rising, especially since last year. But there are different types of inflation, with different implications, which should be differentiated by nature and cause.

Typically, inflationary episodes are due to either demand pull or supply push. With rentier behaviour better recognized, there is now more attention to asset price and profit-driven inflation, e.g., ‘sellers inflation’ due to price-fixing in monopolistic and oligopolistic conditions.

Recent international price increases are widely seen as due to new Cold War measures since Obama, Trump presidency initiatives, COVID-19 pandemic responses, as well as Ukraine War economic sanctions.

These are all supply-side constraints, rather than demand-side or other causes of inflation.

The Fed chair’s pretext for raising interest rates is to get inflation down to 2%. But bringing inflation under 2% – the fetishized, but nonetheless arbitrary Fed and almost universal central bank inflation target – only reduces demand, without addressing supply-side inflation.

But there is no analytical – theoretical or empirical – justification for this completely arbitrary 2% inflation limit fetish. Thus, raising interest rates to address supply-side inflation is akin to prescribing and taking the wrong medicine for an ailment.

Fed driving world to stagnation
Thus, raising interest rates to suppress demand cannot be expected to address such supply-side driven inflation. Instead, tighter credit is likely to further depress economic growth and employment, worsening living conditions.

Increasing interest rates is expected to reduce expenditure for consumption or investment. Thus, raising the costs of funds is supposed to reduce demand as well as ensuing price increases.

Earlier research – e.g., by then World Bank chief economist Michael Bruno, with William Easterly, and by Stan Fischer and Rudiger Dornbusch of the Massachusetts Institute of Technology – found even low double-digit inflation to be growth-enhancing.

The Milton Friedman-inspired notion of a ‘non-accelerating inflation rate of unemployment’ (NAIRU) also implies Fed interest rate hikes inappropriate and unnecessarily contractionary when inflation is not accelerating. US consumer price increases have decelerated since mid-2022, meaning inflation has not been accelerating for over a year.

At least two conservative monetary economists with Nobel laureates have reminded the world how such Fed interventions triggered US contractions, abruptly ending economic recoveries. Although not discussed by them, the same Fed interventions also triggered international recessions.

Friedman showed how the Fed ended the US recovery from 1937 at the start of Franklin Delano Roosevelt’s second presidential term. Recent US Fed chair Ben Bernanke and his colleagues also showed how similar Fed policies caused stagflation after the 1970s’ oil price hikes.

De-dollarization?
However, the US dollar has not been strengthening much in recent months. The greenback has been slipping since mid-2023 despite continuing Fed interest rate hikes a full year after consumer price increases stopped accelerating in mid-2022.

Many blame recent greenback depreciation on ‘de-dollarization’, ironically accelerated by US sanctions against its rivals. Such illegal sanctions have disrupted financial payments, investment flows, dispute settlement mechanisms and other longstanding economic processes and arrangements authorized by the World Trade Organization, International Monetary Fund and UN charters.

Even the ‘rule of law’ – long favouring the US, other rich countries and transnational corporate interests – has been ‘suspended’ for ‘reasons of state’ due to economic warfare which continues to escalate. Unilateral asset and technology expropriation has been justified as necessary to ‘de-risk’ for ‘national security’ and other such considerations.

Horns of currency dilemma
For many monetary authorities, the choice is between a weak currency and higher interest rates. With growing financialization over recent decades, big finance has become much more influential, typically demanding higher interest income and stronger currencies.

Central bank independence – from the political executive and legislative processes – has enabled financial lobbies to influence policymaking even more. For example, Malaysia’s household debt share of national output rose from 47% in 2000 to over four-fifths before the COVID-19 pandemic, and 81% in 2022.

There is little reason to believe recent exchange rates have been due to ‘economic fundamentals’. Currencies of countries with persistent trade and current account deficits have strengthened, while others with sustained surpluses have declined. Instead, relative interest rate changes recently appear to explain more.

Thus, both the Japanese yen and Chinese renminbi depreciated by at least six per cent against the US dollar, at least before its recent tumble. By contrast, British pound sterling has appreciated against the greenback despite the dismal state of its real economy.

IPS UN Bureau

 

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The progress made in HIV prevention is nothing short of a global success story. It is time that TB caught up to HIV. Medicine is simply too advanced for us to tolerate how one disease can be beaten back yet another continues to flourish. Credit: Jeffrey Moyo/IPS.

By Violet Chihota
JOHANNESBURG, Jul 26 2023 (IPS)

Before COVID-19 came along, the two most lethal infectious diseases were HIV and tuberculosis (TB). Even though HIV still lingers, with 1.5 million people contracting the infection every year, epidemiologists point to the availability of many HIV prevention options as a primary reason for the decreasing caseload.

According to the World Health Organization (WHO), over the past two decades, new HIV infections decreased by 49%, HIV-related deaths decreased by 61% and an estimated 18.6 million lives were saved because of new treatments that minimise the infection and prevent its spread.

We have so many options for HIV prevention at our disposal, including the dapivirine vaginal ring, oral Pre-Exposure Prophylaxis (PrEP), harm reduction for people who use drugs, condoms for both men and women, voluntary medical male circumcision and the recently approved long-acting cabotegravir, with other options in development.

We have a suite of prevention tools because everyone is different, and people need to be able to choose their methods according to the way they live their lives. We observe a similar abundance of choice within family planning with oral pills, a variety of injectables, intra-uterine devices and condoms—we share this prevention method with HIV programs.

The urgency of the need is clear: an estimated 1.6 million people lost their lives to the disease in 2021, the second consecutive year the death toll went up after 14 years of progress. In Africa, an estimated 2.5 million people contracted the disease in 2021, one million of which were never diagnosed and treated

We do not have this many options for TB prevention, but the world needs to adapt to embrace choice if we are to meet the globally agreed-upon goal of reducing TB deaths by 90% by 2030—referred to as the “End TB targets.”

The urgency of the need is clear: an estimated 1.6 million people lost their lives to the disease in 2021, the second consecutive year the death toll went up after 14 years of progress. In Africa, an estimated 2.5 million people contracted the disease in 2021, one million of which were never diagnosed and treated.

Yet there are glimmers of good news. Despite the COVID-19 pandemic, estimates of TB incidence have slowly declined over the past few years in Angola, Ethiopia, Gabon, the Republic of Congo, Sierra Leone, South Africa, Tanzania and Zambia—all countries with high burdens of TB.

Of these countries, Zambia has also had success in finding and diagnosing an increasing number of these infections; the pandemic impacted the surveillance efforts of the other governments.

As for HIV, there is no effective vaccine to prevent TB in adults: the BCG vaccine only prevents severe TB in children. However, there are ways to prevent TB when someone is potentially exposed to an infected person. In the workplace or when a family member at home becomes sick, for example, prevention starts with masking, which was traditionally used in clinical care settings. The other ways work through prophylactic regimens. For TB, we initially only had isoniazid that could be taken for six, nine, 12 or 36 months depending on country guidelines, but now we have shorter regimens that allow for patient choice.

These options include regimens lasting one (1HP) and three months (3HP), with different combinations of the antibiotic drugs rifapentine and isoniazid, all with vitamin B6 supplements to help counter some of the side effects of treatment. There is also a three-month regimen of rifampicin and isoniazid (often given to children and adolescents) and a four-month regimen of rifampicin alone. Longer courses of isoniazid taken for 6–36 months also remain options, though most people are eligible to take a shorter rifapentine- or rifampicin-based regimen and should be given the choice to do so.

We need to do a better job of making sure that people at risk of TB have access to the full range of prevention options. A recent peer-reviewed study underlines this point, estimating that tracing the personal contacts of people diagnosed with TB and providing them with prevention treatment would save the lives of 700,000 children under the age of 15 and 150,000 adults by 2035.

Even the financial benefits of the prevention program, in terms of increased economic productivity, would outweigh the costs. Nobody questions the need to have options for HIV prevention or family planning, but questions arise when trying to roll out a one-month TB prevention regimen when there’s already a three-month regimen available. We need them all. We also need to collect more data to differentiate which prevention regimens are best for each patient type to ensure success.

The WHO guidelines for preventive TB treatment create the possibility of choice among TB preventive treatments by not ranking the regimens by preference or effectiveness. But health care facilities and outreach programs need to embrace that range of options and make sure that a choice exists in practice. Supply chains may limit choice initially, but if there is no demand for more options from providers, there is no impetus to expand the supply chains.

The progress made in HIV prevention is nothing short of a global success story. It took a combination of scientific ingenuity and innovation, combined with an intensive dedication of resources that made a range of preventive options available around the world.

It is time that TB caught up to HIV. Medicine is simply too advanced for us to tolerate how one disease can be beaten back yet another continues to flourish.

Violet Chihota is an Adjunct Associate Professor and Chief Specialist Scientist at the Aurum Institute. She has been a researcher in global health for over 10 years, designing and managing the conduct of clinical research studies in South Africa, Zimbabwe, Botswana, Cameroon, Georgia, India and Malaysia.