Africa

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

By Joyce Chimbi
NAIROBI, Mar 13 2023 (IPS)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

IPS UN Bureau Report

 

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Delegates at the Arab and Asian Parliamentarians’ Meeting to Follow-Up on ICPD25 Commitments: Addressing Youth Empowerment and Gender-Based Violence, held in Jakarta, Indonesia held in Jakarta, Indonesia. Credit: APDA

By Cecilia Russell
JOHANNESBURG, Mar 13 2023 (IPS)

Child marriage, gender-based violence (GBV), sexuality education, religion, and tradition came under the spotlight during a conference, Arab and Asian Parliamentarians’ Meeting to Follow-Up on ICPD25 Commitments: Addressing Youth Empowerment and Gender-Based Violence, held in Jakarta, Indonesia.

Professor Keizo Takemi, MP Japan, Chair of the Asian Forum of Parliamentarians on Population and Development (AFPPD), reminded delegates that GBV is on the rise in conflict situations, during disasters, and during the prolonged COVID-19 pandemic.

“Furthermore, children in some countries are at higher risk of child marriage due to economic pressures and school closures caused by the pandemic. Globally, about one in five (21 percent) girls are married before the age of 18. Child marriage not only deprives girls of educational opportunities, but early pregnancy and childbearing also come with a higher risk of complications and death.

Pierre Bou Assi, MP Lebanon, President of the Forum of Arab Parliamentarians on Population and Development (FAPPD), told the delegates it was necessary to acknowledge and confront the issues of GBV in the region. It was clear from a series of case studies from the Arab and Asia Pacific region that while there has been some success, there was plenty of work to do.

Dr Dede Yusuf Macan Effendi, MP for Indonesia and Chair of the Indonesian Forum of Parliamentarians on Population and Development (IFPPD), said the country had had some successes – for example, the incidence of GBV dropped from 33 percent in 2016 to 26 percent in 2021. However, many incidents were unreported, and this was considered “the tip of the iceberg.”

Effendi noted the region’s issues – like the high proportion of child marriage and exposure to HIV/Aids.

Dr Hasto Wardoyo, the chairperson of BKKBN, said parliamentarians played a critical role, with various “studies suggesting that the government should take steps such as increasing care capacity and access to services such as health services, social services, developing children’s abilities, opening and equalizing access, strengthening family and social bonds.”

A professor from UIN Jakarta, Dr Nur Rofiah, gave a perspective from Islam and said the religion had a  concept of maslahah or goodness. This recognizes women’s bodily experiences are different from men’s, and it would be important to consider actions that “cause painful experiences for women’s bodies, including gender-based injustice.”

Rofiah emphasized the adverse effects of child marriage for women saying that child brides lost out on their childhood, dropped out of school, experienced domestic violence, often were adversely impacted by divorce, were stigmatized by being widowed, lacked competitiveness in the work environment, very often experienced single parenthood and were susceptible to child marriage.

COVID-19 had impacted the ICPD25 programme of action, especially on health care, with malaria and tuberculosis neglected, as was gender equality, said  Nadimul Haque, an MP in India. The Regional Sexual and Reproductive Health Adviser, UNFPA ASRO Professor Hala Youssef, developed this theme, saying policymakers need to change strategy during this decade of action to 2030 – without which it would be difficult to achieve the goals. She called on delegates to move from the idea of “funding” ICPD goals to “financing” them. Funding was reliant on the government, but financing involved the wider society.

Delegates took a deep look at the pressing issues of child marriage, sexuality education, religion and gender-based violence during the Arab and Asian Parliamentarians’ Meeting to Follow-Up on ICPD25 Commitments: Addressing Youth Empowerment and Gender-Based Violence meeting held in Jakarta, Indonesia. Credit: APDA

Youssef called on parliamentarians to concentrate on the needs of young people, people with disabilities, universal health coverage, budgetary and financial allocations, social determinants of health, maternal deaths among adolescent girls, strengthening health workforce numbers, and capacity building.

The case study presented by Professor Ashraf Hatem, an MP from Egypt, showed that his country’s Universal Health Insurance (UHI) would soon remove the issue of what he called “catastrophic health expenditure” of the poor. The scheme rolled out in phases, would decrease out-of-pocket expenditure from 62 percent to 32 percent in 2032.

The government was subsidizing about 35 percent of the population. He gave an example of open heart surgery done in a UHI facility that would cost a patient 300 Egyptian pounds or about USD 10.

A grim picture of the social, psychological, economic, and medical burdens resulting from unintended pregnancies in her country was painted by Soukaina Lahmouch, an MP from Morocco. While there had been an improvement in the legal arsenal regarding abortion, marriage, and access to quality health services, much was still to be done. She explained that in Morocco, about 153 newborns are born out of wedlock each day, of which 24 children are abandoned at birth.

About 11,4 percent of pregnant women still received no prenatal care; however, in rural areas, about one-fifth of mothers received no prenatal care, and 13.4 percent gave birth without the assistance of qualified personnel.

“More than half of the women affected by poverty do not seek follow-up during pregnancies,” Lahmouch said, adding that education was a determinant, with almost all women with secondary school education giving birth in a health facility, but those without education more likely to give birth at home.

About 12 percent of women were married under 18, and a recent survey showed that 62.8 percent of women aged between 18 and 64 experienced violence during the year before the survey.

Dr Suhail  Alouini, a former MP of Tunisia, quoted a World Bank study, saying 18 percent of women were married before 18 in the Middle East/North Africa (MENA) region. While in many countries, the legal minimum age for marriage is set at 18, there were exceptions for the marriage of underage individuals due to court decisions.

Alouini said conflict and displacement increased the risk of GBV, including sexual violence and forced marriages.

“In some conflict-affected areas in the Arab region, the rates of child marriage have increased, and the COVID-19 pandemic has led to a surge in reports of GBV in the Arab region and around the world. The pandemic also disrupted efforts to prevent child marriage as school closures and economic hardships made girls more vulnerable to early marriage.”

He noted that GBV and child marriage requires a comprehensive and multi-sectorial approach focusing on prevention response and political leadership, and ICPD25 recommendations provide a road map for action emphasizing the importance of investing in data and research and engaging a wide range of stakeholders and political leadership. The role of parliamentarians is critical in addressing GBV and child marriage.

Laissa Alamia, MP of Bangsamoro Transition Authority, Philippines, spoke about the situation in the self-governing region and the Philippines.

“One in four Filipino women aged 15 to 49 experienced physical, emotional, and sexual violence by their partner or husband. One in six Filipino girls finds herself married before hitting the age of 18.”

This is the case even though the Philippines is known for its “most vibrant woman’s rights movement and the most comprehensive anti-GBV legal frameworks and mechanisms in the world.”

Bangsamoro region is disproportionately poor, and 62 percent of the women belonged to poor communities; the approximate number of child brides was 88,600 out of a population of 2.46 million women.

He said ethnic minority Muslim women continue to face different forms of discrimination, and the code of Muslim personal laws in the country gives a prescribed age for marriage of 15 for men and 15 or at puberty for females.

Alamia said the Philippines law, which prohibits child marriages, is not universally accepted by all communities and brings up religious freedom debates.

Dr Jetn Sirathranont, MP Thailand, noted in his closing remarks that there was still a long way to go to achieve the ICPD25 programme of action, but he hoped this conference would give an impetus to finding solutions.

Tomoko Fukuda, Regional Director of IPPF ESEAOR, encouraged parliamentarians to continue their work on the ICPD programme of action, despite conflicting priorities.

“So we as the older generation have to be committed to ensuring that the world is a better place for the young people and the children born into this world,” she said.

Anjali Sen, UNFPA Representative in Indonesia, shared a study by Schneider and Hirsch in 2020 that showed that “comprehensive sexuality education meets the characteristics of an effective GBV prevention … comprehensive sexuality education is based on human rights and gender equality.”

She called for it to be implemented, stating that it needed support and involvement from teachers, parents, healthcare providers, young people, and the government. Parliamentarians had a role in ensuring that policy and financial support were available.

Note:. This conference was organized by APDA and FAPPD, hosted by IFPPD and supported by UNFPA and Japan Trust Fund (JTF).

IPS UN Bureau Report

 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Way Forward

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

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

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

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

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

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

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

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

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

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

IPS UN Bureau

 

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Salvadoran President Nayib Bukele (C) tours the facilities of the Terrorism Confinement Center (Cecot) in January, when through a video he showed for the first time the interior of the new mega-prison, built to hold 40,000 gang members. Some 65,000 people accused of belonging to the gangs or maras have been arrested since the state of emergency was declared in March 2022. CREDIT: Presidency of El Salvador

By Edgardo Ayala
SAN SALVADOR, Mar 13 2023 (IPS)

Despite serious allegations by the US justice system that two officials of the government of Nayib Bukele reached a secret agreement with the MS-13 gang to keep the homicide rate low, the Salvadoran president seems to have escaped unscathed for now, without political costs.

The MS-13 gang members reached the agreement, according to investigations, in exchange for benefits offered by the Bukele administration after the president took office in February 2019.

One of the benefits was apparently not to extradite to the United States leaders of the gangs who are in prison in El Salvador, according to the criminal indictment filed by the Attorney General’s Office of the Eastern District of New York.

The legal action was filed in September 2022, but it was made public on Feb. 23, and it targets 13 leaders of the fearsome MS-13 gang, who are held responsible for murders and other crimes committed in the United States, Mexico and El Salvador.“I do not believe the legal action in New York will damage Bukele’s reelection prospects.” -- Jorge Villacorta

“The accusation (in New York) merely confirms something we already knew,” analyst Jorge Villacorta told IPS.

Villacorta was referring to investigative journalistic reports by the newspaper El Faro, which since 2021 revealed the secret negotiations that the Bukele administration held with the gangs, which the president has consistently denied.

But it is one thing for a newspaper to report this and quite another for it to come from an accusation from the United States Attorney’s Office, in an investigation in which the Federal Bureau of Investigation (FBI) participated.

“Because in this case we are talking about legal action” by the U.S. justice system, which could affect the two officials implicated, Mario Vega, an evangelical pastor who studies the phenomenon of gang violence in El Salvador, told IPS.

Since 2012, the United States has considered MS-13 a transnational criminal organization.

A grand jury has reportedly already heard the evidence presented by the prosecution and has endorsed a trial, at an unspecified date.

Three gang members and others who could be captured later could at some point in the trial testify against the two Bukele officials, “and we are going to find out about all the secrecy that has surrounded the negotiations,” Vega added.

The two officials are the director of the General Directorate of Penitentiaries, Osiris Luna, and the head of the Directorate for the Reconstruction of the Social Fabric, Carlos Marroquín.

Neither of them are mentioned by name in the legal action, but they are clearly identifiable by their government positions.

Nor is it mentioned that they reportedly reached an agreement with gang members under the auspices of the Salvadoran president, but that is obvious because given the president’s authoritarian style, no one moves a finger without his consent.

Bukele, a millennial neo-populist who governs with increasing authoritarianism, has been waging a frontal war against gangs since Mar. 27, 2022, which has led him to imprison more than 65,000 members, with the help of a state of emergency in place since then.

However, the war apparently broke out once the pact with the gangs broke down. In the course of the trial in New York it may be verified that the secret negotiations took place since 2019 and were suspended in March 2022.

So far, the crackdown on the gangs, known here as maras, has drawn the applause of the majority of the population in this Central American country of 6.7 million people, according to the opinion polls.

But the president has also come under fire for abuses by soldiers and police, who have arrested people with no ties to the maras.

 

Immune ahead of the elections

And what could spell a major blow to their credibility for any president and would perhaps shake the foundations of a government would not make a big dent in Bukele’s popularity, said analysts interviewed by IPS.

With regard to the news about the case in New York, “people see it as suppositions or simply do not believe it; I do not see it as generating significant political costs for Bukele,” added Villacorta, a former leftist member of Congress.

It will apparently not affect the president even as he is getting ready to seek reelection in the Feb. 4, 2024 elections. He has already announced that he will run again, but his candidacy has not yet been made official.

Although his campaign has not been launched, Bukele and his Nuevas Ideas party are already mobilizing their publicity machine, in the face of an opposition that is keeping its head down.

Most lawyers agree that the Salvadoran constitution prohibits immediate reelection.

In May 2021, a new Legislative Assembly, controlled by Nuevas Ideas, dismissed the five judges of the Constitutional Chamber of the Supreme Court without the proper procedures and appointed five of their allies, who endorsed the right to reelection.

“I do not believe the legal action in New York will damage Bukele’s reelection prospects,” said Villacorta, a critic of the president.

This is due to the high levels of popularity that the president has among the public and the widespread acceptance of the state of emergency, which suspends some constitutional guarantees and has made it possible to capture 65,000 gang members.

Some 2,000 imprisoned gang members were transferred at the end of February to the Terrorism Confinement Center, a mega-prison that the government built on the outskirts of the municipality of Tecoluca in central El Salvador to hold some 40,000 prisoners.

Villacorta added: “What is perceived in the country and abroad is that Bukele, like some kind of superhero, in a few months has squashed the gangs.”

However, despite abundant evidence of abuses and arbitrary arrests, ordinary Salvadorans are overlooking this because their main problem, gang violence, has been successfully reduced.

“People will tend to forgive his past deeds, due to the fact that now they (gang members) are all imprisoned. This narrative is the one that moves people, and these are the emotions that count when it comes to voting,” commented Pastor Vega, also an opponent of Bukele.

Of the 65,000 incarcerated gang members, 58,000 have had an initial hearing before a judge, Justice and Public Security Minister Gustavo Villatoro said on Mar. 8 in a television interview.

The case brought in New York does not affect Bukele; “on the contrary, it makes Salvadorans mad, because they say ‘do they want us to keep suffering (from the gangs)?’. They are not going to say, ‘Ok they’re right, (the government) has brainwashed us’,” criminologist Misael Rivas told IPS.

 

Negotiations today and always

But Bukele’s war against the “maras” is now more in doubt than ever, with the investigation and accusation initiated by the US justice system against the 13 leaders of the MS-13.

In the criminal indictment, the US Attorney’s Office states that since 2012 the gangs, including Barrio 18, the other major mara, engaged in secret negotiations with the government and political parties.

In that year, the country was governed by the Farabundo Martí National Liberation Front (FMLN), the guerrilla group that became a political party in 1992, after the end of the 12-year Salvadoran civil war.

The pact or “truce” fell apart in 2015.

Negotiations with the gangs continued in 2019 “in connection with the 2019 elections,” the document continues. That year, in February, Nayib Bukele won the presidency with a large majority of votes.

It adds that several leaders of the MS-13 secretly met “numerous times” with the two officials – Luna and Marroquín, although it does not mention their names, only their posts.

These meetings took place in the Zacatecoluca and Izalco prisons, in the center and west of the country, it adds, which had already been reported by El Faro.

 

Batman in trouble?

Even when the alleged pact with the Bukele administration fell apart in March 2022, in one of the voice recordings published two months later by the newspaper, Marroquín is heard saying that “Batman” (a pseudonym for the president) was fully aware of the situation.

The MS-13 also agreed to support Nuevas Ideas in the 2021 parliamentary elections, which that party won by a large majority

Of the 13 indicted MS-13 leaders, three were arrested on Feb. 22 in Mexico “by the authorities of that country and extradited to the United States,” the Attorney General’s Office for the Eastern District of New York said a day later, in an official statement.

Those captured are: Vladimir Antonio Arévalo Chávez (nicknamed “Vampiro de Monserrat Criminales”), Walter Yovani Hernández Rivera (“Baxter from Park View”) and Marlon Antonio Menjívar Portillo (“Red from Park View”).

Criminologist Rivas said the outcome of the trial, once it begins, is far from certain.

If prosecutors press for the details of the negotiations with the Bukele government, defense attorneys would have to work hard to undermine the gang members’ credibility when it came to implicating the two Salvadoran officials, he said.

“Thinking as a defense attorney, suppose they gave me the case, I would insist on why they are bringing the case up now, when there is a frontal attack against the gangs and the Salvadoran people are finally happy?” said Rivas, who is also a lawyer and who supports the state of emergency.

Related Articles

• Salvadoran President’s Secrecy about New Mega-Prison – a Harbinger of Corruption
• Arbitrary Arrests in El Salvador Hit the LGBTI Community
• The Price of Bukele’s State of Emergency in El Salvador

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Delegates at the UN observance of International Women’s Day, under the theme “DigitALL: Innovation and technology for gender equality.” Credit: Naureen Hossain/IPS

By Naureen Hossain
UNITED NATIONS, Mar 10 2023 (IPS)

Promoting gender equality in technology and digital spaces is at the core of the UN’s observance of International Women’s Day (IWD) as UN senior officials call on the world to take concrete action against ingrained gender biases.

The United Nations and UN Women hosted their observance of IWD under the theme “DigitALL: Innovation and technology for gender equality,” with a special celebration of women and girls in the STEM fields. This year’s theme aligns with digital transformation and innovation for educating women and girls currently being discussed at the 67th Commission of the Status of Women (CSW).

The event was hosted by journalist and WABC-TV anchor Sabe Baderinwa, who remarked on the theme’s significance by reminding attendees that “access to and control over technology is crucial for women’s economic and social empowerment.”

The event touched on the significance of promoting gender equality in the digital space through the meaningful ways technology and innovation can empower women and girls when given the opportunity. It also notably dissected the barriers preventing complete gender parity in this sector. Put simply, women and girls have historically been underrepresented in the STEM fields and are prevented from unlocking the full potential of technology.

At present, nearly 37 percent of women do not have access to the internet, meaning that they neither have access to resources nor are able to acquire useful digital skills. Those women and girls who do use technology and occupy digital spaces are at greater risk of being subject to online harassment and violence, and misogynistic attitudes.

The gender disparity in online spaces is also evident in the ways that online harassment has targeted women and girls in these spaces and has even pushed them off these platforms. Within the tech industry, women make up less than a third of the workforce, with even fewer of them in leadership positions.

This was pointed out by several of the speakers present at the event, including President of the General Assembly Csaba Kőrösi in his opening remarks.

“As it stands, far too many women and girls still cannot access the opportunities offered by technology… Women are twenty-seven times more likely than men to face online harassment and hate speech. Only one in four reports [these incidents], and nearly nine in ten limit their online activity because of it, reinforcing the digital divide.”

Secretary-General Antonio Guterres said in a statement that technology can lift women and girls up in “a myriad of ways” through access to education and healthcare or entrepreneurship. But the full promise of technology can only be realized when the systematic barriers have been confronted. This starts with including more women in leadership roles in the tech sector.

“Without women’s leadership, the Silicon Valleys of this world don’t disrupt the patriarchy; they simply digitize sexism and perpetuate inequalities. And without women’s leadership, tomorrow’s products will have gender equality built into their code.”

In his own statement at the event, the Secretary-General’s Chef de Cabinet Earle Courtney Rattray brought attention to how the disparity in technology access is more prominent in developing countries, including the Least Developed Countries.

“Nowhere is this more evident than in LDCs,” he said. “According to the International Telecommunications Union, about two-thirds of the LDC population remains offline, and the gap between these countries and the rest of the world in the [sheer number] of people losing access to the internet has increased from 27% in 2011 to 30% last year.”

“The inclusion of women and girls as prominent key players in digital evolution for current and future generations gives the opportunity to address the most critical development and humanitarian challenges,” Chair of the 67th Commission on the Status of Women Mathu Joyini said in her statement.

UN-Women Executive Director Sima Bahous reminded those in attendance of the Sustainable Development Goals (SDG), particularly SDG5, which calls for gender equality and the empowerment of all women and girls. “It is no coincidence that today, as SDG5 is off-track, so are the SDGs as a whole. We live in a world of interconnected crises. At the heart of every crisis, we see inequality multiplied. We now have a new form of poverty. Digital poverty is growing and intensely gendered.”

In her statement, Secretary-General of the International Telecommunications Union (ITU) Doreen Bogdan-Martin shared stories of young women and girls who used technology to improve the quality of life in their communities through their own innovations, remarking on how their examples “reminds us that technology is not a luxury, but a necessity.”

“We have the foundation because all countries agree on the need to achieve universal connectivity, and they agree on the need for sustainable digital transformation,” she said. “We also have the momentum, the Partner2Connect Digital Coalition led by the ITU, together with many UN partners, has mobilized in one year over $17 billion USD for digital gender equality. We also have the unique opportunity… all of us today together, to ensure that gender equality happens in our lifetime and not in 300 years.”

During a panel discussion moderated by Baderinwa, the current state of technology and innovation was further explored, with particular attention paid to the involvement that would be needed from multiple stakeholders to achieve gender parity.

As journalist and UN Women Goodwill Ambassador Marion Reimers remarked, when it comes to the safety of women and girls, attention should be given to the systems that perpetuate harassment online, including in the case of women journalists.

“We are so far behind because it feels like there is no help because this is a new landscape, and it has created so many new necessities that we need to catch up real quick,” she said. “When you take into account that 75% of women journalists are victims of online harassment, this is directly intertwined with how we speak about problems in the public sphere… with how the voices of women are taken into account.”

“If we want to succeed, we must have meaningful participation and involvement from civil society,” said Marie Bjerre, Minister for Digital Government and Gender Equality in Denmark. She also added that governments’ involvement should include introducing legislation that would place more protections online, citing Denmark’s own examples in passing laws that target online grooming and the distribution of intimate images.

Director of Strategic Initiatives at Pollicy, Dr Irene Mwendwa, spoke from the perspective of policymakers and researchers in the field and the transformative power that technology can have for local government women leaders in Africa. “Once they understand the power of technology and data, when they go into the council, when they go into cabinet and parliament, they will be able to debate better. When they debate better over the legal frameworks, the policies coming out of our countries into our communities will be inclusive to both women’s and men’s needs, pertaining to ICT.”

Finally, the perspective and contributions of young people as those most involved and present in online spaces must also be encouraged, especially young women. UNICEF Youth Advocate Gitanjali Rao remarked on the opportunity to “harness the ingenuity that youth bring to the plate.”

“Now is the time to maximize creativity. We should be taking these opportunities to look at the ways in which we can support girls, especially by digitizing content online and honestly supporting them in every way possible, whether that’s through the work they’re doing or making sure that they’re safe online as well,” she said.

The speakers and panelists called for multiple measures to be taken that could address the systemic gaps and inequalities that women and girls face with technology. These measures include broadening access to technology to reach more people, investing in digital skills-based learning for women and girls to effectively make use of technology and learning, and breaking down the gender biases and binaries that make digital spaces unsafe for certain groups, especially through gender-based violence facilitated through technology.

This also means promoting more women into leadership and decision-making roles in the tech sector and beyond, where there are able to directly influence policy and legislation. As technology continues to be ubiquitous in our daily lives, a gender-responsive approach will be crucial to future innovations.

“Without decisive action, the digital gender divide will become the new face of widening social and economic inequalities,” Deputy Secretary-General Amina Mohammed said in a video statement at the end of the event.
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By Sanjay Srivastava and Sudip Ranjan Basu
BANGKOK, Thailand, Mar 10 2023 (IPS)

Two destructive Category 4 tropical cyclones, Judy and Kevin, and an earthquake of 6.5 magnitude impacted over 80 per cent of the Vanuatu population from 1 to 3 March 2023. To address this emergency situation, the UN, along with Pacific member States have deployed personnel on the ground to coordinate humanitarian assistance and prepare post-disaster damage assessment.

Sitting in the Pacific “Ring of Fire,” Vanuatu experiences frequent volcanic and seismic activity. And along with the other Pacific small island developing States (SIDS), Vanuatu faces existential threats due to rising sea level, ocean acidification and the increased frequency and severity of natural disasters and is on the front line of climate crisis.

The twin cyclones and an earthquake in just 48 hours remind the world that seismic and climate risks are converging and intensifying – no community feels this stronger than those of the Blue Pacific Continent.

On macro-economic impact, in fact, Pacific SIDS face Average Annual Losses from multiple hazards totaling to US$ 1.1 billion in the current scenario. This figure is set to increase to US$ 1.3 billion under moderate and US$1.4 billion under worst-case climate warming scenarios. As a percentage of GDP, Vanuatu, Tonga and Palau are projected to face highest losses – Vanuatu is projected to lose a staggering 20 per cent GDP annually due to disasters.

Figure 1: Tropical cyclones Judy and Kevin track with wind speed zones (UNITAR-UNOSAT)


 

Intensifying and expanding climate crisis

In ESCAP’s recent report, the analysis shows that at 1.5 to 2.0 °C warming, there are likely intensifying annual wind speeds of tropical cyclones and that the risk of tropical cyclones is expected to expand and include newer areas beyond the historical tracks (Figure 2). Vanuatu in particular, will experience higher risk of tropical cyclone both in terms of the intensification as well as geographic expansion of the riskscape.

As cyclone hazards are intensifying and deviating from their traditional tracks, their greater complexity results in deeper uncertainties in the ability to predict. Our Blue Pacific Continent is not sufficiently prepared.

Figure 2: Intensifying and expanding cyclone risks under new climate change scenarios


 

Formulating transformative actions

As the climate changes, the riskscape is transforming. These disaster risks compound and cascade to amplify the great hardship experienced by the Pacific SIDS in terms of population and critical infrastructure exposure. The argument for transformative action to mitigate and adapt to intensifying and expanding disaster risks in the Blue Pacific Continent has never been more compelling.

First, early warning for all is an imperative, needs to capture compounding risks.

The UN Secretary-General highlighted that every person on the planet is to be covered by early warning systems by 2027. The Sendai Framework for Disaster Risk Reduction sets the increase in availability and access to of multi‑hazard early warning systems as a distinct target, Target G, to be achieved by 2030. As per the latest Sendai Framework reporting of Target G, large gaps remain for many countries in the Pacific SIDS (See Figure 3).

Relative to other countries in the subregion, Vanuatu’s Target G scores are high, reporting substantial to comprehensive coverage of multi-hazard early warning systems across all indicators. WMO’s Regional Specialized Meteorological Centre in Nadi, Fiji was providing early warnings in the face of power outages and surmounting uncertainties – as a result, there have been no reported fatalities.

Figure 3: Sendai Framework for DRR Target G scores for countries in the Pacific region


 

Second, transformative adaptation solutions are needed.

To minimize and prevent systemic and cascading risk, we need to make new infrastructure and water resource management more resilient. Improving dryland crop production and using nature-based solutions such as increasing mangroves protection are also priority adaptation solutions.

1.5 per cent of GDP for adaptation investment is estimated to be needed in Pacific SIDS – three times less than the average losses projected. These adaptation investments must be risk-informed and strategically directed towards policy actions that yield high cost-benefits. Where there are multi-hazard risk hotspots across the region, risk-informed policy and transformative actions should capitalize on inter-sectoral synergies and co-benefits.

Third, the 2050 Strategy for the Blue Pacific Continent provides a clear pathway

With the adoption of the 2050 Strategy for the Blue Pacific Continent in July 2022, Pacific SIDS have developed a clear pathway to synergize regional priorities with accelerated implementation of the 2030 Agenda for Sustainable Development, the Sendai Framework for Disaster Risk Reduction and the SAMOA Pathway.

Next generation risk analytics, advances in climate science, geo-spatial modeling, Artificial Intelligence and machine learning must be at the heart of people-centered and evidence-based decision-making. And, the Framework for Resilient Development in the Pacific is an ideal platform to take forward some of the policy decisions.

Strengthening subregional and regional cooperation platform

Tropical cyclones, often transboundary in nature, require an architecture of regional co-operation mechanisms to effectively manage the shared risks. In this instance, local capacities and regional support mechanisms should be commended. To further strengthen this work, the lesson from Vanuatu’s back-to-back cyclones and earthquake is to have effective, impact-based and risk informed early warning systems that can capture the complexity and dynamisms of a compounding risk.

The Asia-Pacific Risk and Resilience Portal was developed by ESCAP with the goal of creating a user-friendly one stop platform for policymakers to access a vast array of scientific information and decision support tools to promote risk informed policy decisions.

Furthermore, the Vanuatu incidents underscores the need for conducting a rapid post-disaster needs assessment that can support formulation of a long-term recovery strategy and plan for its reconstruction by applying a standardized approach with innovative methodology and framework.

The overlapping and transboundary nature of risks experienced by countries of the Blue Pacific Continent cannot be addressed without solidarity and collective action towards strengthening regional cooperation platform.

Sanjay Srivastava is Chief, Disaster Risk Reduction, United Nations Economic and Social Commission for Asia and the Pacific (ESCAP);
Sudip Ranjan Basu is Deputy Head, ESCAP Subregional Office for the Pacific

IPS UN Bureau

 

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The 67th session of the Commission on the Status of Women (6-17 March) gets underway at UN headquarters in New York . Credit: UN Photo/Manuel Elías

By Dana Abed
BEIRUT, Mar 10 2023 (IPS)

This month, government and civil society organization representatives gathered in New York for the United Nations’ 67th session of the Commission on the Status of Women (CSW) to discuss technology as a tool to facilitate access to education for women and girls.

But what should have been discussed were the basic issues of gender equality in education. As more than 85% of the world is living under austerity, and with 70% of countries cutting funding to education services, access to education for women and girls is being devastated by the lack of public funding.

The gap between boys and girls when it comes to school enrolment continues to be major, and quite concerning. Data consistently shows – particularly in low- and middle- income countries – that girls from poor families are the children most likely to be, and remain, out of school.

And the cost of education is one of the main barriers for access – which raises the question of affordability when it comes to technological integration.

While technological innovation has the potential to support instruction and education governance, we cannot turn a blind eye to the reality of digital inequality, the possibility of increased fees, and the privatization of education.

That is on top of the existing risks that are associated with the use of technology, including online violence and abuse and the lack of digital protection for girls, further locking girls out of their rights to education.

Austerity measures, public funding cuts, and privatization severely limit the goal of universal education. In a report published last November, Oxfam found that austerity is a form of gender-based violence.

And during CSW67, we emphasized that access to public and quality education is fundamental to gender equality and the realization of the rights of women and girls.

Oxfam does not claim that austerity measures are designed to hurt women and girls, but as policy makers design those policies, they tend to ignore the specific needs of women and girls and turn a blind eye to the disproportionate impact that those policies have on our communities.

We’ve reached this conclusion by gathering evidence from around the world, which showed that governments do not prioritize the needs to women and girls. For instance, more than 54% of the countries planning to cut their social protection budget in 2023 have minimal or no maternity and child support.

In their misguided attempts to balance their books against a looming global economic crisis, governments are treating women and girls as expendable. Women, particularly those from marginalized racial, ethnic, caste, and age groups, are inherently discriminated against when it comes to economic and social opportunities and accessing available public resources. Additional cuts to inequality-combatting public services mean these groups are the hardest hit.

Cuts to both the public wage bill and public health and social protection services – measures that women and their families rely on for survival – mean that women and girls bear the brunt of this austerity because health, education, feeding the family, paying the bills, caring for children and elderly all fall most heavily onto them.

For example, cutting wages in the public work force – especially in sectors like health where women represent 90% of the workforce or education where they represent 64% of the workforce – will directly impact job security.

We must resist austerity and should instead be taxing the wealthiest corporations and people properly. A progressive tax on the world’s millionaires and billionaires could raise $1.1 trillion more than the savings that governments are currently planning to make through their austerity cuts.

With such funding, governments could adopt feminist budgeting across all sectors that put women and girls in all their diversity at the heart of policy making, including ensuring access to quality, and public education.

Feminist movements have for years pushed for bold alternatives to our neo-liberal, capital-oriented economies, and Oxfam raises its voice with them. The integration of technology in education must be looked at from an intersectional lens, taking into consideration barriers to access for girls and low- and middle-income countries, and should not come with an additional cost to the education bill.

We need to stand in solidarity with the women’s rights and feminist movements in demanding that our leaders stop peddling the gender-based violence of austerity as the solution and support more feminist progressive representation beyond identity politics.

We must resist creating societies that prioritize the needs of the most privileged at the expense of everyone else – and instead work to create communities and policies that reflect our diverse backgrounds and identities.

IPS UN Bureau

 

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Excerpt:

The writer is Global Campaigns Strategist for Gender Rights and Justice at Oxfam International.

Uganda used public health measures like screening, testing of temperatures, and isolation of suspected cases to contain the Ebola outbreak. While those measures were successful, scientists warn that another outbreak could occur. Credit: Wambi Michael/IPS

By Wambi Michael
KAMPALA & MUBENDE, Mar 10 2023 (IPS)

It is two months since the World Health Organization declared Uganda free of the most recent Sudan ebolavirus, which killed 55 people.

Uganda employed public health measures to end the outbreak. In the absence of vaccines and therapeutics, the threat of the next outbreak looms.

Scientists are yet to find answers to questions like who was the first person to be affected? Or the index case, what viral host reservoir did that patient get in contact with?

“We don’t have answers to those questions. And honestly, we are hoping that Uganda will provide us and the world with those answers,” says Emmy Bore, program director for the CDC’s Division of Global Health Protection in Uganda.

“In every Ebola outbreak we have responded to, in West Africa, in DRC, there have been attempts to trace the roots back to the very first person who got infected. When you figure out where that person went and what they ate, you can figure out how they managed to get the virus. In most outbreaks, we don’t,” she said.

With those questions answered, Lt Colonel Dr Kyobe Henry Bossa, who has been at the front lines against Ebola outbreaks and COVID-19, told IPS that it is urgent they track precisely the viral host reservoir before the next outbreak.

“We know that the reservoir lives in the jungle innocently. We suspect that the viral host reservoir is a bat circulating in the area, and the virus is maintained in nature,” said Kyobe.

Bats have long been the prime suspects for what scientists have termed as the “spillover” of novel pathogens to humans. They are believed to harbor diverse viruses more lethal to humans than any other mammals.

Ugandan Veterinarian and Epidemiologist Dr Monica Musenero Masanza is no stranger to fighting viruses like Ebola and Marburg in Uganda and West Africa. Musenero came to be commonly known as Dr Kornya—loosely translated as a female warrior for her fight against Ebola in Port Loko in northern Sierra Leone. She told IPS that Ebola is categorized among emerging or re-emerging diseases.

“And those diseases show up with a lot of drama. Ebola, when it shows up, there is a lot of drama. Now those emerging and re-emerging diseases are attracting a lot of attention. Unfortunately, because we don’t know much about them, there is usually little we can do about them in the immediate except control,” said Musenero.

According to Musenero, now that Uganda successfully ended the Sudan ebolavirus, efforts should be geared towards finding pathogen X otherwise, another outbreak is guaranteed. “It’s not a matter of if, but when. That is why we should get to the jungles to find the host reservoir,” she said.

On September 20, 2022, Uganda declared an Ebola disease outbreak caused by the Sudan ebolavirus species in the Mubende district.

It was the country’s first Sudan ebolavirus outbreak in a decade and its fifth of this kind of Ebola. There were 164 cases (142 confirmed and 22 probable), 55 confirmed deaths, and 87 recovered patients.

The outbreaks have over the years occurred in a very similar region, with the suspected viral host reservoir suspected to be a bat.

Dr Trevor Shoemaker, an epidemiologist in the Division of High-Consequence Pathogens and Pathology at the National Center for Emerging and Zoonotic Diseases at the Center for Disease Control (CDC), suspects that bats carrying the virus are circulating in that area.

“It is not unexpected that there would be an outbreak where we have seen previous outbreaks in the central region of Uganda,” said Shoemaker.

According to Shoemaker, during the course of testing for ebolavirus cases in the just-ended outbreak, three of the samples were negative for ebolavirus but tested positive for another viral hemorrhagic fever called Crimean Congo hemorrhagic fever.

“There are pathogens that we know about, and there are those we know. So we need to trace them before they spill over to humans,” said Shoemaker.

Scientists from the University of Bonn have in the past confirmed the presence of Crimean Congo viruses in African bats and therefore suggesting that bats could play a role in spreading the virus.

Others studies have linked Crimean Congo viruses to ticks. While bats have been suspected as reservoirs of the Sudan ebolavirus, no conclusive evidence exists.

The district of Mubende and Kasanda forested with indigenous trees. Some private plantation forests are also thriving. Late in the evening, different species of bats fly into the darkening sky.

Fortytwo-year-old Bright Ndawula is an Ebola survivor. He tells IPS that there are as more as ten types of bats that he knows of “Some are tiny, they live under the rooftops, some are big, and they live in trees. Health workers told us that bats carry Ebola, but we don’t know one,” said Ndawula who lost his wife and three family members to the virus.

So far, scientists have been able to identify only one species of African fruit bat (R. aegyptiacus) positive for Marburg virus infection. No evidence of the Marburg virus was identified in the other species of insect-eating or fruit bats tested.

A few kilometers out of Mubende town, IPS comes across farmers and loggers living on the edge of the forest, risking some of the infectious diseases that may spill over from bats to humans.

Dr Charles Drago Kato leads a surveillance team with USAID funded project named Strategies to Prevent Spillover, or STOP Spillover. It targets viral zoonotic diseases—infections that originate in animals before they “spill over” into humans. His teams have been to Districts like Mubende, Kibale, and parts of the Rwenzori Mountains, specifically researching bats and humans.

He told IPS that under the project, they are trying to trace pathogens in bats that may be dangerous when they cross over to humans.

IPS UN Bureau Report

 

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