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More than 120 lawmakers from over 40 countries lend their support to civil society campaign for a more democratic and inclusive UN. -- It is time for a more inclusive and democratic UN Parliamentarians from around the globe call for more participation. Credit: We The Peoples

By Frank Habineza, Susanne Menge, Nik Nazmi Nik Ahmad and Angela Brown Burke
KIGALI/ BERLIN/ KUALA LUMPUR/ KINGSTON, Feb 7 2022 (IPS)

The global challenges we face are too complex for governance as usual. It is high time to strengthen the United Nations’ (UN) democratic and participatory character.

The Covid-19 pandemic has exposed deep fissures and inequalities across the world, both between and within countries. At the same time, so much more has to be done to address existential issues such as climate change, poverty, hunger, violence and exclusion. This can be accomplished via governance that puts power in the hands of the people and ensures that no one is left without access to public goods, regardless of their background.

As the premier global body, the UN has a key role to play. Over the past 75 years, the UN has done incredibly valuable work to keep the peace and advance the wellbeing of millions around the globe. However, change is urgently needed for the UN to better meet the challenges we face. No institution should shy away from processes of renewal and reform if it wishes to remain relevant.

This is why we were happy to see that the UN Secretary-General’s recent report “Our Common Agenda” highlights the need for greater participation and inclusion of people, civil society, parliamentarians and other stakeholders in the work of the UN. However, ad hoc consultations and existing mechanisms are nowhere near sufficient to satisfy this need. We need sustainable and permanent democratic infrastructure also on the global level.

In a joint statement with over 120 colleagues, parliamentarians from more than 40 countries on six continents, and in support of a global coalition of over 200 civil society organizations we are proposing three specific measures: a UN World Citizens’ Initiative which enables people to put forward proposals on key issues of global concern; a UN Parliamentary Assembly which includes elected representatives; and a high-level UN Civil Society Envoy to enable greater participation of civil society representatives.

Credit: We The Peoples

We strongly believe that the spirit and proposals embodied in these instruments will provide a way forward for the UN to emerge stronger and to allow it to continue to fulfill its invaluable work in the world.

Allowing citizens to help shape the agenda of multilateral institutions through a UN World Citizens Initiative will make our institutions more inclusive of global diversity. This will allow people all over the globe to help set the priorities for global governance.

Giving people more of a say over who represents them at the UN through a UN Parliamentary Assembly, will ensure more accountability and transparency even on the global level.

The involvement of civil society representatives would help to strengthen cooperation in partnership against power-political interests and increase social and ecological competence in our world. At the moment, it is primarily more privileged voices of civil society that find access to the discussions in New York and Geneva.

Approaching civil societies globally through a high-level UN Civil Society Envoy would engage people on the ground, take them seriously, and recognize their diversity. Against the background of shrinking spaces of civil society worldwide, the stronger involvement of civil society in the United Nations would be a strong signal to the committed people on the ground.

Our planet and the 7.8 billion people who live upon it face grave challenges. We urgently require less talk and more decisive action. The 2023 UN “Summit of the Future” proposed by the UN Secretary-General presents a unique chance to reshape global governance and to rethink the UN as the truly inclusive and democratic forum it always had the potential to be.

It is of the utmost importance that the lead up to the Summit is an inclusive and transparent process that allows all stakeholders to deliberate on these and other relevant proposals. Only by working together and allowing all affected at the table, humanity has a chance to meet the challenges of the century ahead.

Frank Habineza is Member of Parliament, Republic of Rwanda; Susanne Menge is Member of the Bundestag, Federal Republic of Germany; Nik Nazmi Nik Ahmad is Member of Parliament of Malaysia and Dr. Angela Brown Burke is Member of Parliament, Jamaica.

In the We The Peoples statement, published on 26 January 2022, over 120 sitting parliamentarians from more than 40 countries and six continents called on the United Nations and its member governments to strengthen the world organization’s “democratic and participatory character.”

“We The Peoples” campaign is supported by an alliance of 200 civil society organizations, led by Democracy Without Borders, Democracy International, and CIVICUS: World Alliance for Citizen Participation.

https://www.wethepeoples.org/mpstatement/

 

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Without proper planning, organization and health and safety support the impact of teleworking on the physical and mental health and social wellbeing of workers can be significant, warns new report. Credit: Martin/ILO

By Baher Kamal
MADRID, Feb 4 2022 (IPS)

Now it comes to teleworking, the double-edged, relatively recent phenomenon imposed by COVID-19 lockdowns. On the one hand, it improves work-life balance, opportunities for flexible working hours and physical activity, reduced traffic and commuting time, and a decrease in air pollution. So far so good, but…

… But, on the other hand, teleworking has also heavy negative impacts: it can lead to isolation, burnout, depression, domestic violence, musculoskeletal and other injuries, eye strain, an increase in smoking and alcohol consumption, prolonged sitting and screen time and unhealthy weight gain.

A new technical brief on healthy and safe teleworking, jointly released on 2 February 2022, by the World Health Organization (WHO), and the International Labour Organization (ILO) adds on this regard the changes needed to accommodate the shift towards different forms of remote work arrangements brought on by the COVID-19 pandemic and the digital transformation of work.

Among the benefits, the report says, teleworking can also lead to higher productivity and lower operational costs for many companies.

However, the report warns that without proper planning, organisation and health and safety support the impact of teleworking on the physical and mental health and social wellbeing of workers can be significant.

"In the nearly two years since the start of the pandemic, it’s become very clear that teleworking can easily bring health benefits and it can also have a dire impact"

Dr Maria Neira, Director, Department of Environment, Climate Change and Health, WHO

The WHO/ILO joint report outlines the roles that governments, employers, workers and workplace health services should play in promoting and protecting health and safety while teleworking.

“The pandemic has led to a surge of teleworking, effectively changing the nature of work practically overnight for many workers”, said Dr Maria Neira, Director, Department of Environment, Climate Change and Health, WHO.

 

Pros and cons

In the nearly two years since the start of the pandemic, it’s become very clear that teleworking can easily bring health benefits and it can also have a dire impact, she said.

“Which way the pendulum swings depends entirely on whether governments, employers and workers work together and whether there are agile and inventive occupational health services to put in place policies and practices that benefit both workers and the work.”

For her part, Vera Paquete-Perdigão, Director of the ILO’s Governance and Tripartism Department, said that teleworking and particularly hybrid working are here to stay and are likely to increase after the pandemic, as both companies and individuals have experienced its feasibility and benefits.

 

What to do?

“As we move away from this ‘holding pattern’ to settle into a new normal, we have the opportunity to embed new supportive policies, practices and norms to ensure that millions of teleworkers have healthy, happy, productive and decent work.”

Measures that should be put in place by employers include ensuring that workers receive adequate equipment to complete the tasks of the job; providing relevant information, guidelines and training to reduce the psychosocial and mental health impact of teleworking; training managers in effective risk management, distance leadership and workplace health promotion; and establishing the “right to disconnect” and sufficient rest days.

According to the joint report, occupational health services should be enabled to provide “ergonomic, mental health and psychosocial support to teleworkers using digital telehealth technologies, the report says and offers practical recommendations for the organisation of telework to meet the needs of both workers and organisations.”

These include discussing and developing individual teleworking work plans and clarifying priorities; being clear about timelines and expected results; agreeing on a common system to signal availability for work; and ensuring that managers and colleagues respect the system, explains the WHO/ILO study.

“Enterprises with teleworkers should develop special programmes for teleworking, combining measures for the management of work and performance with information and communication technologies and adequate equipment, and occupational health services for general health, ergonomic and psychosocial support.”

 

Key findings

Already in September 2021, the Organisation for Economic Co-operation and Development (OECD) released the following key findings regarding teleworking:

• In Australia, France and the United Kingdom, 47% of employees teleworked during lockdowns in 2020. In Japan, which did not institute a nationwide lockdown, the teleworking rate increased from 10% to 28% between December 2019 and May 2020.
• Highly digitalised industries, including information and communication services, professional, scientific and technical services as well as financial services, achieved the highest rates of teleworking during the pandemic – over 50% of employees, on average.
• Teleworking rates during the pandemic were higher among workers in large firms than in small ones, reflecting lower digital uptake among small firms and their specialisation in activities less amenable to remote working.
• Workers with a higher level of qualifications were more likely to telework during the pandemic. In the United States, for instance, teleworking rates for individuals holding a Master’s degree or a PhD were fifteen times higher than for the least qualified employees.
• In most countries for which data are available, teleworking rates during the pandemic were much higher for women than for men, although the gap was narrower in Denmark, Sweden and the United Kingdom.
• Perceived productivity at home appears strongly associated with the desire to work at home. However, while most businesses and individuals now expect a greater use of teleworking than before the pandemic, relatively few employees are likely to telework full time in the future.

In view of all the above, teleworking is a two-faced coin and, anyway, should be accompanied by the needed measures aiming at protecting the remote working environment, which is here to stay.

 

Medical staff pose in a new maternal care ward at the Melamchi Municipality Hospital, Nepal, in November 2021. Credit: Marty Logan/IPS

By Marty Logan
KATHMANDU, Feb 4 2022 (IPS)

As the omicron wave of Covid-19 rose ominously in Nepal recently, to entice more people to get tested the government reduced the cost of PCR tests from 1,000 rupees ($8.37) to 800 rupees ($6.70) in government facilities and about double that in private ones.

“People with limited incomes can’t afford to get the test, and imagine if four members of a family have symptoms, the PCR tests alone will make a hole in their income,” Dr Baburam Marasini, former director at the Government of Nepal Epidemiology and Disease Control Division, told the Kathmandu Post.

Income per capita in Nepal in 2020 was $1,190, according to the World Bank.

“High quality health care was not universally accessible in Nepal, but was generally enjoyed by only a relatively small and elite portion of the population, and generally, access to health care in the country is unequal and the health system faces perennial shortages of resources, essential drugs and necessary medical infrastructure”

Noting that free treatment of conditions like tuberculosis, malnutrition and malaria had saved many lives in the country, Marasini argued that “the government should make PCR tests free across the country for those who have symptoms.”

While the government has not taken that step, in recent years it has provided free treatment for a growing number of chronic conditions to members of groups in need, such as the elderly, young children and the poorest in society. Yet equality in health care remains a paper promise.

In a briefing paper on the right to health in Nepal during Covid-19, the International Commission of Journalists argued that the government must “ensure that health services, facilities and goods are available to all without discrimination” and “ensure access to at very least the ‘minimum essential level’ of health services, facilities, and goods.”

Originally released in November 2020 and updated in September 2021, the ICJ paper notes that a plan was made to distribute COVID-19 vaccines to members of vulnerable groups first, but “According to various media reports, for example, some of the vaccines allocated for older persons were instead used to inoculate political party leaders, local level representatives, army personnel, their family and friends, administrators, businessmen’s families and their relatives.”

Article 35 of the Constitution of Nepal guarantees “the right to health care,” and its third provision states: “Each person shall have equal access to health care. ” The constitution’s Directive Principles, Policies and Obligations of the State also require that Nepal “keep on enhancing investment necessary in the public health sector by the State in order to make the citizens healthy” and “ensure easy, convenient and equal access of all to quality health services.”

Yet as ICJ points out, research done prior to Covid-19 found that “high quality health care was not universally accessible in Nepal, but was generally enjoyed by only a relatively small and elite portion of the population, and generally, access to health care in the country is unequal and the health system faces perennial shortages of resources, essential drugs and necessary medical infrastructure.”

Senior cardiologist Dr Prakash Raj Regmi says he sees the impact of inequality in health care daily. “In the process of investigation, in the process of treatment, even middle-class people face some difficulty.”

In an online interview the doctor notes that most of his patients are burdened by multiple non-communicable diseases (NCDs), such as cardiovascular diseases, diabetes and kidney and heart issues, whose diagnosis requires extensive testing. Afterwards, these patients often need multiple treatments. “Patients need to undergo several investigations: laboratory tests, x-rays, ultrasound, echo-cardiography. People may need coronary angiography or a CT scan or MRI—all these investigations are expensive.”

While the quality of available drugs is improving, they are also getting more expensive, so some patients discontinue their use prematurely, says Dr Regmi. “For example, a patient is given a follow-up time of three months, but they come only after six months. in that time they have stopped using two out of four drugs, so they develop complications.”

While he can provide financial support, both at his private clinic and at the non-profit community clinic where he also serves, Dr Regmi isn’t sure how many other doctors do the same. “I call myself a social worker… in my private clinic also, people who come for treatment, if they can’t afford their tests and treatment I find some way out; I support those patients.” Some tests can be done for free and for others he says he can direct patients to government labs; samples of medication can be provided at no charge and cheaper versions of drugs prescribed.

Despite the need for these informal mechanisms, Dr Regmi says that fewer patients require financial support today than in previous years, and that those who can afford it usually opt to visit less crowded private facilities.

Various developments have helped improve services in the government system: a new national health insurance scheme, devolution of some health care responsibilities to provinces and municipalities following Nepal’s transition to federalism in 2017, and free treatment of some chronic illnesses for the poorest of the poor, children and the elderly.

“A huge amount of money is being invested in this… This is very good for patients who cannot afford treatment: most of the patients are poor and these NCDs require lifelong treatment.” But the doctor says one thing is missing: “The government should focus on prevention in parallel with providing treatment, but it is not investing in prevention,” he argues.

Inequality is also obvious in maternal health services. For example, Sindhupalchowk is a mostly rural district three hours’ drive from the capital Kathmandu. Despite it having 79 health facilities, families who can afford to do so travel to the capital to have their children delivered or to larger facilities in neighbouring districts. In fact, in 2020 more than 70 percent of pregnant women left Sindhupalchowk to have their babies outside the district.

About one-half of Nepal’s hospitals, including centres for specialised care, such as the national maternity centre, are located in the Kathmandu Valley.

A recent report analysing data from 2001 to 2016 found a growing “remarkable improvement” in maternal health progress nationally, in all wealth groups. But drilling down into the statistics revealed that the poorest of Nepal’s seven provinces “have made minimal to zero progress.”

“Special investment to address barriers to access and utilization in provinces that are lagging to make progress in reducing inequality is urgent. Further studies are needed to understand the strategies required to address the gaps in these provinces and bring about fair improvement,” added the study.