How One Man With COPD Suffered Through COVID-19 29/11/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Jaime Barba Jaime Barba, from Mexico, developed Chronic Obstructive Pulmonary Disease (COPD) after smoking for 32 years. When COVID-19 struck, the country converted the hospital at which Barba received treatment into a COVID facility, leaving him no place to be treated if his COPD worsened. Eventually, he and his wife both tested positive for the virus. “Although our symptoms were mild and my respiratory system did not affect me, I had other affectations, mainly kidneys and prostate that are still under treatment,” Barba wrote in his NCD Diary. “When we were positively diagnosed, it was distressing not to have guaranteed care in case it became complicated and hospitalization was necessary.” But the hardest part was the mental battle, he explained. “Since the COVID-19 pandemic began, we have been on the razor’s edge between remaining confined and trying to generate resources to survive,” wrote Barba. “I have suffered insomnia, sometimes even panic attacks with chest pain and shortness of breath, and gastritis and colitis are normal.” People with lung diseases are among the most likely to develop serious cases of COVID-19. Some of Barba’s ex-smoker friends or people with other NCDs died during the pandemic, some of them from COVID-19 and others due to lack of care and medicines for their chronic diseases. While the fear was high, he said the pandemic also brought him closer to other people with NCDs. They shared video calls and chats and served as a support network – emotionally and sometimes physically. “Someone needed an oxygen tank and another had an unused one, so lent it to them,” Barba gave as an example. “The need of some and the disposition of others leads us to get what is necessary and optimize the use of the available equipment and drugs that have risen in price or are out of stock. WhatsApp groups are the main channel for exchanging inputs and information quickly. We do video conferences and promote participation in some that seem relevant, we see each other there, we talk. Many times, they serve as therapy since we need to keep in touch and seeing each other through virtual channels is comforting.” He said there is one message that he still feels the need to get across, even as the pandemic has become less bold: “As people with non‑communicable diseases, we must say loudly: ENOUGH! No more! We want sufficient health care for all!” Read Jaime Barba’s full NCD Diary. Read previous Image Credits: Courtesy of NCD Alliance. How Palliative Care Made One Woman ‘Whole Again’ 29/11/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Ashla Rani Joining Pallium India in 2014 gave Ashla Rani back her life. Rani fell off a moving train and suffered a spinal cord injury that left her bed-bound and dependent on others for almost everything. She became depressed, asking herself, ‘Why bother to live’? Finally, friends suggested Pallium India, an NGO through which palliative care is provided and advocated for. “I was accepted into the fold, and moved to their headquarters in Thiruvananthapuram in 2014,” wrote Rani. “The impact my healthcare provider has had on my NCD journey is unbelievable; and nothing short of a fairy tale. I feel whole again, doing meaningful work, having a life purpose.” Pallium India became Rani’s home. She said the team listened and treated her and her mother with empathy and care. They also focused not only on treatment but on wellbeing and quality of life. “My medical needs were addressed on time, preventing secondary complications,” Rani wrote. She eventually took up a role in the facility. In her NCD Diary, Rani highlights other cases where Pallium India was able to help, such as a mother with type 1 diabetes who had a diabetic foot and was nearly blind. When she came to Pallium India, her sugar levels were out of control and she and her son were on the verge of starvation. “We got her a diabetologist, who adjusted her medicines to maintain her sugar levels, which saved her limb from amputation,” Rani recalled. “She’s now able to walk with special footwear. We brought her to an eye hospital to receive surgery that allowed her to see her son after four years. With community support, she’s rented a house, where she lives with her son. He receives education support from Pallium India.” Diverse challenges Rani said that people living with noncommunicable diseases face diverse challenges and often do not receive adequate care. It is especially challenging in India, where rehabilitation facilities can be expensive or far away, so many people end up lying in their beds at home and dying of secondary complications. “When there’s a person with some disability in a family, it’s not just that person who is suffering,” Rani added. “The family members around that person also suffer in different ways.” She shared her calls to action: Meaningfully involve people with disabilities in the NCD response in India and globally, ensuring equal representation in discussions and decisions. Create interdisciplinary teams at the community healthcare level to prevent and manage NCDs, including trained staff to counsel and encourage people living with NCDs to live their lives to the fullest and not hide in private spaces. Create support groups for each NCD as despite many shared priorities, different types have specific needs and issues to be addressed. Establish rehab centers and home-based care for NCDs. This should include home-based palliative care for mobility-challenged people living with NCDs. Read Ashla Rani full story. Read previous post. Image Credits: Courtesy of NCD Alliance. From Monkeypox to Mpox 29/11/2022 Kerry Cullinan Colorized transmission electron micrograph of monkeypox particles (purple) found within an infected cell (brown), cultured in the laboratory. Image captured and color-enhanced at the NIAID Integrated Research Facility (IRF) in Fort Detrick, Maryland. The term monkeypox will be replaced by mpox within the next year, according to the World Health Organization (WHO). This follows “racist and stigmatizing language” being used in relation to the large outbreak of mpox for the first time in Europe and the US. The WHO said it had been approached by a number of individuals and countries that had asked the WHO to propose a way forward to change the name. “Assigning names to new and, very exceptionally, to existing diseases is the responsibility of WHO under the International Classification of Diseases and the WHO Family of International Health Related Classifications through a consultative process which includes WHO member states,” the WHO said in a statement on Monday. After consultations to gather views from a range of experts, countries and the general public, who were invited to submit suggestions for new names, the WHO has recommended the name change. Considerations for the recommendations included rationale, scientific appropriateness, extent of current usage, pronounceability, usability in different languages, absence of geographical or zoological references, and the ease of retrieval of historical scientific information. Human monkeypox was given its name in 1970 after the virus that causes the disease was discovered in captive monkeys in 1958. This was way before the publication of WHO best practices in naming diseases, in 2015, which recommended that new disease names should minimize the unnecessary negative impact of names on trade, travel, tourism or animal welfare, and avoid causing offence to any cultural, social, national, regional, professional or ethnic groups. Image Credits: NIAID/Flickr. ‘Zero-COVID’ Protestors Win Concessions But Expert Urges China to Increase ‘Hybrid Immunity’ Before Abandoning Policy 28/11/2022 Kerry Cullinan University professors stand between protestors and police at Fudan University in China. Almost three years of harsh lockdowns, enforced quarantines in state facilities and daily testing have tried the patience of many Chinese people, who since Friday have taken to the streets from Shanghai and Nanjing in the east, to central Chengdu and Wuhan and Urumqi and Korla in the north and west. While scores of people have been arrested, protestors have also won some concessions. In Urumqi, where four million people have been in lockdown for over 100 days, officials announced on Monday that it would allow people to travel on buses to do errands and parcel deliveries would resume. Meanwhile, Beijing officials also announced on Sunday that lockdowns of residential areas would not be enforced for longer than 24 hours. These are small indications that Chinese leader Xi Jinping’s “zero-COVID” policy is becoming increasingly impossible to enforce in the face of people’s growing anger and desperation. Two weeks ago, China’s State Council cut compulsory quarantine in a state facility for international visitors and the close contacts of people with COVID from seven to five days, with a further three days at home. It also did away with restrictions on secondary contacts. But a surge in COVID cases in Beijing was followed swiftly by lockdowns, school and restaurant closures, dampening hopes that the country was quietly abandoning the zero-COVID approach. Journalist arrested, assaulted China is trying to both quell and downplay the protests. On Monday, there was increased military and police deployment at sites of weekend protests, and BBC reporter Ed Lawrence was arrested and reportedly assaulted in police custody in Shanghai while reporting on the protests. BBC Statement on Ed Lawrence pic.twitter.com/wedDetCtpF — BBC News Press Team (@BBCNewsPR) November 27, 2022 The weekend protests were sparked by the deaths of 10 people in a fire in an apartment building in Urumqi, the capital of Xinjiang, on Thursday. The screams of people trapped in the burning building last Thursday were captured on social media amid reports that apartment doors had been closed from the outside to enforce the city’s lockdown. Firefighters took more than three hours to stop the fire as cars blocked their path – many with flat batteries after months of not being driven. @renzhiqiang2 ♬ 原聲 – renzhiqiang2 Sealing the doors of COVID-19 contacts is reported to be a common occurrence in China as part of the country’s enforced lockdowns. 用木棍封门,显然还不够。建议官方用钢筋焊死,同时把门上通电,并请官方派两名军人在门外架上机枪。 生我九州者,虽远必封! pic.twitter.com/ajHSk7Jk7Z — 领导干部 (@808Penny) August 30, 2022 Outrage at the deaths in Urumqi led to vigils and protests being arranged in Shanghai, Xi’an, Chongqing and Nanjing, as well as various university campuses, and people turned up in their thousands at some of the protests. Amid chants of ‘Lift lockdown’, ‘No PCR test’ and “We want freedom’, anti-Xi and anti-Communist Party chanting could also be heard. Many people carried blank sheets of white paper to symbolise government censorship, but reports on the protests on Weibo, the Chinese social media platform, were short-lived. Chinese protestors hold blank papers to signify censorship. Back in May, WHO Secretary-General Dr Tedros Adhanom Ghebreyesus told a media briefing that China’s strategy was no longer sustainable in the face of the more infectious but less lethal Omicron. “When we talk about the zero-COVID strategy, we don’t think that it’s sustainable, considering the behaviour of the virus now and what we anticipate in the future,” said Tedros, prompting a rebuke from Chinese officials Aside from its zero-COVID policy, China’s vaccines, Sinopharm and Coronavac, are only about 60% effective against severe infection in comparison to over 90% protection offered by mRNA vaccines. China still to reckon with COVID infections However, it is possible that China will still have its reckoning with COVID as its weary citizens resist further controls and the highly infectious virus spreads through a population with little immunity. Global data analysis group Airfinity estimates that 1.3 and 2.1 million lives could be at risk if China lifts its zero-COVID policy “given low vaccination and booster rates as well as a lack of hybrid immunity”. It based its risk analysis on the cumulative peak cases and deaths from Hong Kong’s BA.1 wave as a proxy for mainland China. “Mainland China has very low levels of immunity across its population. Its citizens were vaccinated with domestically produced jabs Sinovac and Sinopharm which have been proven to have significantly lower efficacy and provide less protection against infection and death,” Airfinity said in a statement on Monday. “This vaccine-induced immunity has waned over time and with low booster uptake and no natural infections, the population is more susceptible to severe disease. China’s current booster uptake is 40%, whilst Hong Kong’s primary series uptake was 34% back in February 2022 when it saw a large spike in cases due to the BA.1 omicron variant,” said Airfinity. Dr Louise Blair, Airfinity’s head of vaccines and epidemiology, called on China to “ramp up vaccinations to raise immunity in order to lift its zero-COVID policy, especially given how large its elderly population is”. Blair said that China needs “hybrid immunity” from both vaccinations and infections to ensure “much less impactful and deadly COVID-19 waves”. Localised protests Prior to the national weekend protests, there have been intense local protests, particularly at the Foxconn facility in Zhengzhou, which makes 70% of the Apple’s iPhones. Workers work long shifts and usually stay in massive factory dormitories that can house up to 300,000 people. But after a small COVID outbreak in the city in October, Foxconn closed the dining halls and introduced “closed loop” production to cut workers’ contact with the outside world to meet production demands for the launch of the iPhone14. Tesla and other factories have used this approach during lockdowns in Shanghai in March. But Foxconn workers started to panic in fear of being forcibly quarantined there, and have clashed a number of times with police. Numerous reports of poor treatment and neglect at state quarantine facilities have also leaked out in public, alongside videos of small children removed from COVID-exposed parents being forced to fend for themselves in such facilities. 上海儿童集中营。 pic.twitter.com/BNTbOPXBLD — 方舟子 (@fangshimin) April 2, 2022 Image Credits: Twitter. Uganda Extends Lockdowns in Bid to End Ebola Outbreak 28/11/2022 Stefan Anderson 68 days and 52 deaths into Uganda’s Ebola outbreak, authorities are hopeful the spread of the virus has been contained. Uganda’s President Yoweri Museveni has extended quarantine measures in the two districts at the epicentre of the country’s Ebola epidemic for another 21 days, citing the need to protect gains in the fight against the virus. This marks the third renewal of lockdowns in Kassanda and Mubende, and authorities are hopeful it will be the last. Movement in and out of the districts was first restricted on 15 October, and renewed for another 21 days on 5 November. The measures include a curfew and the closure of social spaces like churches, bars and markets. “It may be too early to celebrate success, but overall, I have been briefed that the picture is good,” Museveni said in a televised address delivered by vice-president Jessica Alupo. While the situation is “still fragile”, Museveni said Ugandan health authorities are “very optimistic” that the outbreak will end “in the coming month.” The government’s optimism is buoyed by Uganda’s continued progress in stamping out the outbreak. Three districts have completed over 42 days since the last case of Ebola was detected, while six districts – including the epicentres of Kassanda and Mubende as well as the capital, Kampala – remain in “follow-up” protocols. The virus has so far claimed 56 lives, while another 22 probable Ebola deaths were registered before the government issued its official declaration of the outbreak on 20 September. “If we open now and a case appears, we will have destroyed all the gains we have made in this war,” Museveni said. “Our healthcare workers will continue to do all it takes to save lives and bring the epidemic to an end.” Full reopening if the 21-day mark is reached With numbers dropping, bed occupancy rates within the past 24 hours stood at just 27.9% in Mubende isolation units. The government’s decision to extend lockdowns by 21 days is based on the incubation period of Ebola. The three-week mark is a key indicator of whether transmission has been stopped. Mid-way through November, Mubende appeared to be in the clear. The district had gone 13 days without reporting a new case. But on day 14, a 23-year-old medical student with links to previous cases was diagnosed with the virus. “Without completing 21 days, as we saw with Mubende, a case can pop up anywhere,” the President said. “It is important that we complete the entire cycle.” Kassanda has now reached 15 days since reporting a new case, while Mubende has not registered a confirmed case for 14 days. If both districts hold on for another week, Uganda’s fifth deadly encounter with the Sudan strain of Ebola may come to a swift end. “We are relying on you to cooperate and bring this epidemic to an end,” the President told residents of Kassanda and Mubende, noting their commitment and sacrifice thus far. “If there is no case by the end of the 21-day period, we will re-open fully.” Threat of urban transmission avoided Ebola’s invasion of Uganda’s Gulu municipality and its slum-like camps for internally displaced persons in 2000 was the cause of the deadliest Ebola epidemic in the country’s history. When six school children were diagnosed with Ebola in Kampala in late October, fears of the virus embedding itself in the capital spiked. On paper, Ebola’s mortality rate of up to 90% makes the virus easy to contain. Museveni also noted that as a virus transferred through contact and bodily fluids, Ebola, despite its “devastating nature”, is far easier to control than airborne threats like COVID-19. But if allowed to embed itself in densely populated areas, things can quickly spiral out of control. “If we had allowed the escalation of the outbreak into Kampala, the consequences would have been bad, including possible exportation to our African brothers in neighbouring countries,” Museveni said. Despite calls from doctors and health advocates to lockdown the capital earlier this month, Museveni and Health Minister Jane Ruth Aceng elected not to bow to the pressure. So far, their decision appears to be validated. “The opportunity for immediate quarantine of contacts was lost for Mubende and Kassanda,” Museveni said, noting the first suspected cases were registered on 6 September, two weeks before authorities declared the outbreak. This was not the case for Kampala. Knowledge of the threat allowed health authorities to be on reactive footing, and respond quickly to isolate infected people and their contacts. Today, over 300 contacts remain under institutional quarantine overseen by the Ministry of Health. Vaccine Trials Are Underway WHO Africa Director Dr Matshidiso Moeti visited Kassanda and Mubende earlier this month to coordinate with Ugandan health authorities and other international partners in responding to the outbreak. There is currently no known vaccine for the Sudan strain of Ebola responsible for the Ugandan outbreak. But the outbreak presents a unique opportunity to bridge this treatment gap, and a series of trials have been set in motion with the aim of minimizing hospitalisations and deaths. A coalition of organizations including CEPI, Gavi, the World Health Organization and Ugandan health authorities are deploying three vaccine candidates to about 3,000 people who have been in contact with Ebola patients. “As we speak, the government of Uganda is finalizing the regulatory approvals,” Africa CDC Director Dr Ahmed Ogwell told CNN. If any of the candidates can succeed, authorities are hopeful this will be the last outbreak Uganda faces without medical defenses. “By embedding research at the heart of the outbreak response, we can achieve two goals,” the WHO said in a statement. “Evaluate potentially efficacious candidate vaccines, potentially contribute to end this outbreak, and protect populations at risk in the future.” Image Credits: WHO, WHO, WHO. Parliamentarians Seek to Address Post-COVID ‘Tsunami’ of Health System Problems 28/11/2022 Maayan Hoffman UNITE president Ricardo Leite (fourth from right) and MPs at the World Health Summit. “There is this tsunami that is happening after the earthquake that was COVID-19 that is now coming to shore and hitting health systems across the world,” said Ricardo Baptista Leite, president and founder of UNITE, a global network of parliamentarians committed to addressing global health challenges. “The pandemic also led to a huge economic crisis and even poor countries in the global South, who might have been less affected by the pandemic, are going to pay a very severe price due to economic consequences that will lead to challenges in responding to the health needs of those countries,” he said. A week before his organization brings together hundreds of parliamentarians from around the world to discuss the most pressing issues in public health at a global summit, the Portuguese MP, who collaborates closely with the World Health Organization (WHO), warned Health Policy Watch of the need to take swift and collective action before the next pandemic. “This is the moment when international institutions and governments need to step up their game and tackle the global health crisis,” Leite said. “We must double up our efforts to make sure we are better equipped in the future and can respond to health needs.” Leite is a long-time global health advocate. He is also a trained medical doctor in infectious diseases and heads the Public Health department at Católica University of Portugal. False sense of security He told Health Policy Watch that whenever the world has felt “capable of controlling infectious disease, we create a false sense of security that we can lower our guard. Whenever we lower our guard, infectious diseases come back with a vengeance.” This can be seen throughout history with multiple pandemics over the centuries, but also in this century with the emergence of antibiotics and the belief that with penicillin we could control infections – a belief now being called into question with the development of antibiotic-resistant bacteria. Antibiotic-resistant bacteria are responsible for the deaths of some 700,000 people each year – with scientists predicting that these infections could kill more people than cancer by 2050. The pandemic has set back the fight against many diseases by years. Take HIV/AIDS. In December 2020, UNAIDS released its 95-95-95 targets, calling for 95% of all people living with HIV to know their HIV status, 95% of all people with diagnosed HIV infection to receive sustained antiretroviral therapy and 95% of all people receiving antiretroviral therapy to have viral suppression by 2025. But during COVID-19, in many countries, measurement of these goals ceased altogether. Where tracking continued, in some cases, diagnoses were slower. “HIV is an interesting proxy for all infectious and communicable diseases out there,” Leite said. In addition, COVID-19 led to a rise in people being diagnosed with late-stage cancer, an increase in cases related to chronic diseases due to people being kept away from health systems, and a spike in mental illness globally. “Pandemics are a strong demonstration of the case that infectious diseases can undermine our efforts toward prosperity for all,” Leite said. He added that during his time as a medical volunteer in Ukraine he saw a huge rise in multi-resistant and extremely resistant tuberculosis in the region. Leite predicted that as the war continues, it will be almost impossible not to see the TB spillover into neighboring countries and then across the world. “There has to be a clear understanding from the world that dealing with infectious diseases is not only something recommended but is a prerequisite for economic and social development worldwide,” he said. The role of parliamentarians WHO parliamentarian session during the World Health Summit (UNITE) Part of the solution is getting parliamentarians around the table, according to Leite. In 2017, the United Nations passed a resolution on the nexus of global health and foreign policy, encouraging a multi-stakeholder approach to achieve universal health coverage. “The voice of parliamentarians was not part of the discussion,” Leite said. “One cannot expect to build a global health architecture or move forward science-based policy making if we do not keep those who write policy in the loop. We cannot make sure money gets where it needs to if we do not include those that make and approve budgets in parliaments.” While he admitted that UNITE is not a “silver bullet,” he said it is a valuable tool for bringing parliamentarians from more than 90 countries together to share experiences and learn how they can best bring their own country toward a more sustainable future. “The first step was to get the conversation going. The second was to develop regional leadership. We now have 10 regional chapters, each led by an MP or former MP. Then we developed policy hubs, specialized teams that focus on specific policy areas, so they can drill down on concrete policymaking in key areas,” Leite explained. “We empower policymakers to be leaders for change in their own countries.” UNITE’s three priorities At its founding, UNITE was focused solely on issues of infectious diseases, but COVID-19 led it to change its mandate over the summer of 2022 and the organization is now focused more generally on global health matters. “The pandemic has demonstrated that global health issues and infectious diseases go hand in hand,” Leite told Health Policy Watch. “We cannot solve many challenges related to infectious disease, which were the basis of our work in the first years, without addressing all the other global health challenges out there.” UNITE is now taking a three-priority approach, focusing on pandemic prevention preparedness and response; the future of health systems; and health as a human right. The group signed a memorandum of understanding recently with WHO to work together on these pillars and supply parliamentary feedback and insight to support WHO’s related efforts. Next week: UNITE Global Summit From 5-7 December, UNITE will host its global summit in Lisbon, bringing together its parliamentarians and leaders from the global health community to expand and forge new partnerships. Members of the lawmaking, civil society, medical and academic communities will meet to talk about what they feel are the most pressing issues on the global health agenda. Another priority that UNITE is bringing to the forefront of the parliamentarian agenda is the use of digital health to promote universal health coverage. “In the last few months with the creation of the digital health hub, parliamentarians were able to discuss with other stakeholders how to build the right frameworks and increase budgets to implement digital health transformation that can promote access to millions,” Leite said. Finally, Leite added that with its new direction in mind, UNITE members would try to answer three questions during the event: What progress have we made so far during the UN’s Sustainable Development Goals period? What have we learned to help us make even more progress by 2030? What is the role of parliamentarians in helping drive that progress? MPs and the pandemic treaty Session on the pandemic treaty at the World Health Summit. In the past, parliamentary involvement has helped achieve public health goals. In Portugal, Leite cited an example from 22 years ago when the parliament decided to decriminalize the use of drugs. “This was not making drug use legal, but now no one goes to jail for using drugs,” he explained. “We stopped looking at people who use drugs as criminals but instead as people who potentially had a health challenge that needed to be dealt with.” Instead of jail time, drug abusers receive harm reduction and other social and health services. When the legislation was passed, around 1% of the Portuguese population used heroin. Since then, Leite said, the numbers have dropped dramatically. Drug-related crime is down, and new HIV cases tied to drug use have fallen from as high as 60% to only 2%. “The fact that we provided harm reduction services and shifted from a criminal perspective to a health perspective was transformative in achieving better health outcomes and partially solving the drug problem in Portugal,” Leite said. A more recent example was the decision by the African Union to set up the African Medicines Agency, which will become a regulatory body for access to health technologies in the continent and creates a common standard of rules based on science to ensure the safety of citizens in the region. Leite equated the AMA to the European Medicines Agency. UNITE founder Ricardo Baptista Leite and Dr Tedros at signing of an MOU between the two organizations. Moving forward, UNITE Parliamentarians will play a key role in finalizing WHO’s pandemic treaty, aimed at guiding the global response to pandemics. “The regulations that were in place when COVID-19 hit were not sufficient or were not properly enforced,” Leite said. He added that “there is a lack of acknowledgement and awareness among most citizens and many parliamentarians around the world that these negotiations are taking place. We need parliamentarians involved early on. If governments agree on a document, parliaments must ratify it.” In an era of “polarized politics and fake news,” he said that if parliamentarians are not part of the process there is a risk that such a treaty would not be ratified, and the world would be left exactly where it was in December 2019. “Everyone is committed to finding a balanced approach to what we hope will create a toolkit from a policy perspective that can help the world be better prepared to detect outbreaks early and lock them down before they transform into pandemics,” Leite said. “It is not acceptable that 100 years after the Spanish flu we saw so many countries react to COVID-19 the same way as they did 100 years before,” he continued. “We have an obligation to be better prepared to constrain any risk, to keep as many people as possible safe. This is a prerequisite for economic and social development. “We need to keep peace and prosperity as our main goal,” Leite concluded. Image Credits: UNITE. There are a Wide Range of Treatments for Obesity, but Many People Cannot Afford Care 28/11/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Amber Huett-Garcia at her high and low weight from 2008 to 2021. Amber Huett-Garcia is trying to drive global change for affordable treatment, care and support for individuals suffering from obesity. A resident of the United States and born into a family suffering from generational obesity, she weighed 101 pounds by the time she was in kindergarten. As an adult, she lost 245 pounds and reduced her BMI from 69 to 24. She did it through a combination of treatments, including bariatric surgery, medication and mental health care. While Huett-Garcia is lucky to have a comprehensive employer-based healthcare plan, she recognizes that many people in the United States do not. And for those who are obese, the cost of care can be enormous. The cost of obesity Obesity costs the US healthcare system nearly $173 billion a year, according to the latest report by the Centers for Disease Control and Prevention. Personal medical costs for people living with obesity are close to $1,500 more per year than those who do not suffer from the condition. For people living with obesity and who are on Medicare, few treatments are covered. For example, Medicare has zero anti-obesity medication coverage. Moreover, roughly 40% of the US population lacks coverage for bariatric surgery for obesity, which has been proven most effective. “Affordable healthcare is a human right,” Huett-Garcia said. Amber Huett-Garcia taking part in the “Stop Weight Bias” campaign. She has called for action to ensure that insurance plans pay for the treatment of a wider range of conditions, including obesity, by covering comprehensive science-based interventions. She has also asked that decision-makers within healthcare systems listen and amplify the voices of people with NCDs. “The lives of people living with NCDs depend on it,” she concluded. Read Amber Huett-Garcia’s full NCD Diary. Read previous post. Image Credits: Courtesy of NCD Alliance. In Vietnam, Nguyen Ha Linh Calls on Government to Give Economic Support to People Living with NCDs 28/11/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Nguyen Ha Linh A young woman living in Vietnam has called on organizations and communities locally and globally to step up support for people living with noncommunicable diseases (NCDs) – especially multiple sclerosis (MS). “I call on the Vietnamese government to give economic support packages to people living with NCDs, especially people with disabilities, because many are paralyzed, unable to support themselves and earn a living,” said Nguyen Ha Linh. Ha Linh lives with MS. Since the age of 23 she has been rapidly deteriorating. While at first she worked as a graphic designer, gradually her arms and legs weakened until she became paralyzed. She developed atrophy of the nerve in her eyes. Today, all of her activities depend on the care of her relatives. Nguyen Ha Linh Access to care But her greatest challenges have been access to care and finances. “Multiple sclerosis is not covered by insurance in Vietnam, so I must pay for my care out of pocket, with financial support from my relatives,” Ha Linh explained. “Multiple sclerosis is considered a rare disease in Vietnam. People living with this condition find it very difficult to access diagnosis and care, and not all major hospitals have the resources for treatment. For those that manage to access care for multiple sclerosis, this is very expensive.” Government must take action She said that people living with MS often focus on getting funding from philanthropists who care about people living with disabilities. However, she believes that the government should be the one to take action first. “Many challenges related to treatment, care and support for people living with NCDs remain largely unaddressed,” Ha Linh said. “In particular, the components of care and support are weak, which therefore means that relatives play an important role for those who have a good support system at home. This is not always the case. “People living with NCDs would like to call on the government to change the regulations around health insurance to allow access to affordable diagnostics and care to help us have a better life,” she concluded. Read Nguyen Ha Linh’s full NCD Diary. Read next post. Image Credits: Courtesy of the NCD Alliance. More Than Five Women Killed Every Hour by Intimate Partners or Family: UN Women, UNODC report 25/11/2022 Megha Kaveri Women and girls are more at risk of getting killed at home by intimate partners or family. A new report by UN Women and the UN Office on Drugs and Crimes (UNODC) said that more than five women or girls are killed every hour across the world by their partners or families. The report, released ahead of the UN’s International Day for the Elimination of Violence Against Women on Friday, said that while men are subjected to higher rates of homicides across the world, women and girls are disproportionately affected by higher rates of homicides in private spaces. In 2021, 81,000 women and girls were killed intentionally, of which around 45,000 – some 55% – were killed by their own intimate partners or family members. By comparison, 11% of the total male homicides happened in private spaces. Covid-19 huge push to fatal violence against women The report found mixed trends on femicide across the world. Between 2010 and 2021, the total number of female homicides by intimate partners or families fell by 19% in Europe. But that number rose by 6% in the Americas overall even as South America reported a decrease. COVID-19 and the subsequent confinement to homes seems to have led to an increase in gender-related killings of women and girls in North America, Western and Southern Europe in 2020, according to the report. “Other sub-regions in Europe and the Americas recorded negligible changes or decreases in the number of killings between 2019 and the end of 2020, which suggests that the onset of the COVID-19 pandemic had heterogeneous impacts,” it said. “The decreases in some sub-regions may reflect delays in recording due to COVID-19 rather than reductions in the number of killings.” The report did not mention similar trends in Asia, Africa or Oceania, due to a lack of data. A World Health Organization-led report last year found almost one in three women experience physical and/or sexual violence across the course of their lifetimes, and in the previous 12 months, more than one in ten women suffered from physical and/or sexual intimate partner violence. More data key to policy formulation Women and girls in all regions are affected by gender-based killings. While Asia isthe region with the largest absolute number of killings, Africa is the region with thehighest level of violence relative to the size of its female population. Highlighting the lack of sufficient and comprehensive data on global femicides, the new report from UN Women and UNODC said more data will enable policy makers to gain a better understanding of the issue and to push for changes. “Additional data beyond identification purposes, such as age of perpetrators and victims, including information surrounding the event of the killing should be collected for analytical purposes,” the report said, adding that will help policy makers detect failures in responses and protection, develop better preventive measures and improve access to justice. Solutions include survivor-centric approaches The report also called for more survivor-centred responses to address gender-based violence in the world, saying it’s an approach that’s “fundamental to preventing and eliminating gender-based violence against women and girls and ensuring it does not escalate to femicide/gender-related killings.” Providing victims with a positive experience when they first report gender-based violence can increase trust and potentially save lives, and encourage other victims to report and disclose crimes. Another measure called for in the report is stronger civil society organisations that work in the women’s rights sector, the report said, because they serve “an important role in preventing gender-based violence against women and girls, by advocating for and securing normative and policy change, providing psycho-social support services and holding governments to account.” Image Credits: Artem Maltzev, UN Women. Fossil Fuels Cast Dark Shadow Over Tanzania’s Green Future 25/11/2022 Kizito Makoye Issa Abdul’s single solar panel powers his barber shop. DAR ES SALAAM, Tanzania – Issa Abdul’s desperate urge for solar power began when he realised a smoke-spewing generator at his barber shop was costing him too much. “Solar power is very cheap. I regret spending my money on this fuel-guzzling machine,” he told Health Policy Watch. The 32-year-old barber in Tanzania’s port city spent roughly Tanzanian shillings 150,000 ($65) to purchase a small solar system and this now powers his hair cutting business. “I am very happy to have my own solar system. It is very useful,” he said. On a humid Sunday morning, Abdul adeptly digs a buzzing clipper through the hair of the client sitting on a leather chair before him. “I was spending a lot of money every month buying fuel, that is history now,” he said. Perched on a rusty roof, Abdul’s lone solar panel produces enough electricity to run two clippers, three bright lights and a cell phone charger. “There’s plenty of sunshine, I don’t disappoint my customers,” he said. Drought cripples hydropower facilities However, like other east African countries such as Kenya and Uganda, solar power still remains a small part of the country’s energy mix. While Tanzania’s electric grid has been primarily powered by hydroelectric power, another renewable source, for some time, hydro’s dominance is slipping now. Climate-related spells of drought have crippled the country’s hydropower facilities and the ageing distribution infrastructure, and the country is experiencing an electricity crisis affecting various sectors of the economy. Hydropower, which can potentially generate 4.7 GW of electricity according to government estimates, is only producing 12% of its power potential, and is prone to weather variability. And as drought tightens its grip, Tanzania, which has 57 trillion cubic feet of natural gas reserves, is now poised to tap this chunk of fossil fuels to cover the electricity deficit Natural gas, oil and coal will almost certainly remain dominant in the country’s energy mix in the near future, according to experts. A motorcyclist riding outside TPTL plant in Dar es Salaam that uses heavy furnace oil to produce electricity. Addressing climate change impact with fossil fuels Tanzania’s experience is just one example of an emerging paradox of addressing climate change impacts with more climate-changing fossil fuel. Tanzania, Kenya and Uganda have been dependent on hydropower, but as all three countries grapple with climate-related drought, they may also find it easier to tap their fossil fuel reserves with the help of multinational investors standing by than develop greener alternatives. This is even as technologies exist for large-scale grid-quality solar power that is ultimately cheaper, industry observers say. While nations worldwide are shifting to renewable energy to reduce the global carbon footprint and ease the toll that fossil fuels take on people’s health, economy and climate, the majority of Tanzanians, like those in large parts of Africa, still use dirty energy sources that pollute the air, causing some 1.1 million deaths annually on the continent, according to a recent study. Air pollution is the second risk factor for death in Africa after malnutrition, concluded the study by the Boston-based Health Effects Institute. Tanzania’s electricity generation comes mostly from natural gas (48%), followed by hydropower (31%), petrol/diesel (18%), solar (1%), and biofuels (1%). In Kenya and Uganda, hydropower and geothermal power are the dominant portions of the electricity generation mix, with solar power making up a very minor proportion of the mix. As demand for energy continues to grow, it is unclear how to ensure that renewables become more attractive than fossil fuel. Investments in fossil fuels far outweigh that of renewables in most parts of Africa, and oil and gas exploration and exploitation continues apace in Kenya, Uganda and Tanzania. Dirty diesel At Kariakoo, a business hub in Dar es Salaam dotted with shopping centres, a toxic haze of diesel hangs in the air as generators roar so loudly that they drown out people’s conversations. Like the lone solar panel precariously hanging on Abdul’s salon, smoke-spewing generators are widely used when grid electricity goes off. They power everything from ceiling fans to television sets, air conditioners and freezers – the latter two items pulling too much power to make a rooftop solar system reliable. Among the available choices, portable diesel generators are among the dirtiest, spewing particulate-laden emissions into the air directly into spaces where people live and work. But they remain the go-to solution in much of Tanzania and Africa more broadly. “To me, a diesel generator provides the necessary power,” said Aloycia Mosha who runs a cold fish store. Soaked with sweat, Mosha repeatedly pulls a string to rev the engine of her generator. “If I don’t switch it on now, all my fish stock will get spoilt,” said Mosha. The 45-year-old entrepreneur has often found a trail of blood oozing on her shop’s tiled floor, a clear sign that the fish defrosted overnight. Vendor stand near a standby diesel generator in Dar es Salaam Power cuts are part of daily life Power cuts are part of daily life in Dar es Salaam, a busy city that is home to 5.8 million people, and accounts for 40% of the country’s GDP. While a few city dwellers have installed solar power on their roof tops to save spiralling energy costs, analysts say the lack of clear financing mechanism to cover initial installation costs, coupled with an unreliable distribution network, have made solar systems a distant luxury to many families. Asteria Mchomvu, a resident of Upanga, a middle-class neighborhood in Dar es Salaam, began to dream of installing solar panels on her roof a decade ago. At first, Mchomvu, who works as a teacher, was excited to learn that solar technology could help her save money and protect the environment. But a home solar system was too expensive for her t the time. A modest 8-kilowat system would roughly cost Tanzanian shillings 10, million ($4347) in 2012, according to Tanzania’s Rural Energy Agency. Prices for solar systems in Tanzania have since fallen by more than 60% and companies are aggressively jostling to pitch their sales. Yet still, the numbers didn’t work for Mchomvu, who teaches geography and science Then early in November, at the Dar es Salaam International Trade Fair, Mchomvu caught up with Richard Tairo, a salesman from Arti energy, a solar company focusing on mid and low -income customers. Tairo understood Mchomvu’s passion for solar and her financial dilemma and he introduced her to Mali Kauli, a program that finances residential solar systems and offers borrowers, below-market rates. Mchomvu accepted the offer after the company assured her that the system could lower her energy bills and spare her the agony of power cuts. “I wanted to be 100% sure it is worth investing,” she told the Health Policy Watch. Skewed regulatory framework disadvantages solar Despite the growing public awareness, renewable energy penetration in Tanzania is still facing major hurdles due to a skewed regulatory framework and limited market. Samuel Wangwe, a research associate with Research on Poverty Alleviation (REPOA) said solar power market has seen sluggish growth due to fragmented financing plans, uneven service after equipment sale and technical weaknesses in batteries and solar lamps, which are often cheap items imported from China with warranties that cannot be honoured. “The most obvious barrier to renewable energy, notably solar is cost. The upfront expenses that people pay to get solar panels installed at their homes are still too high,” Wangwe said. Many investors are discouraged to take on renewable energy projects because of high capital costs and a long net payback period, he added. Wangwe says that the industry is also dogged by a lack of training institutes, which has prevented renewable energy technologies from scaling up. “We must encourage our children to take renewable energy courses and hone their technical skills,” he said. A shop for solar equipment at Kariakoo business centre in Dar es Salaam Bigger subsidies for fossil fuels Although some subsidies are offered for rooftop solar, the subsidies the government provides to fossil fuel sources are much higher, Wangwe said. In fact, in July, the Tanzanian government introduced a new fuel subsidy of a whopping Tanzanian shillings 100 billion ($43 million) monthly to stabilise the domestic price of fuel, Wangwe said. While solar panel and wind turbines are exempt from VAT and are not charged import duties, accessories including the batteries essential to operating a household solar package are charged up to 35% import duty, said Wangwe. “This is the reason why solar technology is not scaling up as fast as possible” he said. Coal, oil and gas are by far the largest contributors to climate change, experts say. In addition, some 65% of deaths from air pollution are generated by fossil fuel combustion, including the noisy and smokey generators that are omnipresent in households and big African cities like Dar es Salaam. While global leaders have endorsed the scientific consensus to limit global warming to 1.5°C above pre-industrial level, as spelled out in the Paris Agreement, there is a growing rush for oil and gas exploration in the global south. This is what COP27 civil society participants called the “dash for gas” reminiscent of the colonial scramble for Africa. More fossil fuel exploration Tanzania has enough gas reserves to put the country on a path of economic prosperity, and may unlock as much as $30 billion in liquified natural gas (LNG) investments. At the same time, if the historic pattern long followed in east and west Africa remains the same, many of the new LNG is likely to be sold to Europe and other countries to generate foreign currency, rather than used at home. “Our political leaders are caught up in a dilemma. Such investments are worthwhile economically but bad for the environment,” said Wangwe. While many have argued that off-grid solar solutions hold the key to Tanzania’s urban and rural electrification, fossil fuels subsidies have reduced its competitiveness. Yusto Mugisha, professor of renewable energy at the school of engineering and technology a Sokoine University of Agriculture, said in order to build a sustainable future, Tanzania needs to invest in clean, accessible and affordable energy sources. “Renewable energy sources are available and their potential is not fully harnessed,” said Mugisha. Although upfront costs for renewable projects can be daunting, Mugisha said efficient and more reliable renewable technologies can create a system that is less prone to market shocks and improve energy security. Unlike fossil fuels, which need to be extracted and transported to large power plants and require a grid network extending to remote areas, renewable sources like solar and wind can be developed in various flexible arrays. They can be just a few panels on a household installation, part of a community mini-grid, or as a solar power plant feeding into the large grid. That, according to the International Energy Agency and countless other assessments means that solar could leap-frog over grid-dependent fossil fuel technologies much like portable phones leap-frogged over fixed phone lines in Africa, providing better service much faster. But renewable energy versus fossil fuels has seemingly placed Tanzania politicians in the moral dilemma. While fossil fuel provides badly needed energy, it leaves behind a carbon footprint that’s proving catastrophic to humans and the planet. Yet, in the short term, policymakers strongly support fuel subsidies to stabilise the prices of other commodities. Meanwhile, renewable energy subsidies, notably on solar, are indirectly offered mostly through the Rural Energy Agency, and are clustered depending on the scale of the project. Despite its small market share local experts say renewable energy has the potential to respond to present and future challenges by enhancing energy security, generating income, and providing employment. Rural dependence on kerosene William Kahise, a student at Itetemia primary school, persuaded hus mother to buy a solar lamp as the kerosene one made him cough. In the dusty western town of Tabora, 12-year-old William Kahise and his sister Juliana routinely huddled around the faint glow of kerosene lamp when the darkness sets in, struggling to get their homework done before their mother blows off the lamp to save the fuel cost. “I must finish my work, otherwise my teacher will be very angry,” Kahise told Health Policy Watch. The paraffin lamp, made from a discarded cooking oil tin, emitted choking smoke and casts scary shadows on the walls. Kerosene is one of the household fuels that WHO has recommended not be used at all, because of its health harmful effects, including impaired lung function, asthma and cancer. The Itetemia primary school pupil may not know about the WHO recommendation, but he knew the smoke made him cough and convinced his mother to ditch the kerosene lantern, for a cheap solar version. Kerosene is used by millions of rural households i to meet basic lighting needs and subsidies have long been used to make the fuel more affordable. Kerosene subsidies have been at the centre of energy policy debate, with renewable energy activists arguing that, for health, safety and environmental reasons, a switch to solar power is better. “The subsidized kerosene is extremely costly and wasteful, the government is spending a lot of money every month to keep the price low,” said Mugisha. But for Abdul, who enjoys solar power, the challenge arises when his Chinese-made panel starts to age and needs to be replaced as Africa produces virtually no panels of its own. –First of two parts on the barriers to clean, renewable energy in Africa. -Research and reporting for this story was supported by the Rosa Luxembourg Foundation. Image Credits: Peter Mgongo. Posts navigation Older postsNewer posts
How Palliative Care Made One Woman ‘Whole Again’ 29/11/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Ashla Rani Joining Pallium India in 2014 gave Ashla Rani back her life. Rani fell off a moving train and suffered a spinal cord injury that left her bed-bound and dependent on others for almost everything. She became depressed, asking herself, ‘Why bother to live’? Finally, friends suggested Pallium India, an NGO through which palliative care is provided and advocated for. “I was accepted into the fold, and moved to their headquarters in Thiruvananthapuram in 2014,” wrote Rani. “The impact my healthcare provider has had on my NCD journey is unbelievable; and nothing short of a fairy tale. I feel whole again, doing meaningful work, having a life purpose.” Pallium India became Rani’s home. She said the team listened and treated her and her mother with empathy and care. They also focused not only on treatment but on wellbeing and quality of life. “My medical needs were addressed on time, preventing secondary complications,” Rani wrote. She eventually took up a role in the facility. In her NCD Diary, Rani highlights other cases where Pallium India was able to help, such as a mother with type 1 diabetes who had a diabetic foot and was nearly blind. When she came to Pallium India, her sugar levels were out of control and she and her son were on the verge of starvation. “We got her a diabetologist, who adjusted her medicines to maintain her sugar levels, which saved her limb from amputation,” Rani recalled. “She’s now able to walk with special footwear. We brought her to an eye hospital to receive surgery that allowed her to see her son after four years. With community support, she’s rented a house, where she lives with her son. He receives education support from Pallium India.” Diverse challenges Rani said that people living with noncommunicable diseases face diverse challenges and often do not receive adequate care. It is especially challenging in India, where rehabilitation facilities can be expensive or far away, so many people end up lying in their beds at home and dying of secondary complications. “When there’s a person with some disability in a family, it’s not just that person who is suffering,” Rani added. “The family members around that person also suffer in different ways.” She shared her calls to action: Meaningfully involve people with disabilities in the NCD response in India and globally, ensuring equal representation in discussions and decisions. Create interdisciplinary teams at the community healthcare level to prevent and manage NCDs, including trained staff to counsel and encourage people living with NCDs to live their lives to the fullest and not hide in private spaces. Create support groups for each NCD as despite many shared priorities, different types have specific needs and issues to be addressed. Establish rehab centers and home-based care for NCDs. This should include home-based palliative care for mobility-challenged people living with NCDs. Read Ashla Rani full story. Read previous post. Image Credits: Courtesy of NCD Alliance. From Monkeypox to Mpox 29/11/2022 Kerry Cullinan Colorized transmission electron micrograph of monkeypox particles (purple) found within an infected cell (brown), cultured in the laboratory. Image captured and color-enhanced at the NIAID Integrated Research Facility (IRF) in Fort Detrick, Maryland. The term monkeypox will be replaced by mpox within the next year, according to the World Health Organization (WHO). This follows “racist and stigmatizing language” being used in relation to the large outbreak of mpox for the first time in Europe and the US. The WHO said it had been approached by a number of individuals and countries that had asked the WHO to propose a way forward to change the name. “Assigning names to new and, very exceptionally, to existing diseases is the responsibility of WHO under the International Classification of Diseases and the WHO Family of International Health Related Classifications through a consultative process which includes WHO member states,” the WHO said in a statement on Monday. After consultations to gather views from a range of experts, countries and the general public, who were invited to submit suggestions for new names, the WHO has recommended the name change. Considerations for the recommendations included rationale, scientific appropriateness, extent of current usage, pronounceability, usability in different languages, absence of geographical or zoological references, and the ease of retrieval of historical scientific information. Human monkeypox was given its name in 1970 after the virus that causes the disease was discovered in captive monkeys in 1958. This was way before the publication of WHO best practices in naming diseases, in 2015, which recommended that new disease names should minimize the unnecessary negative impact of names on trade, travel, tourism or animal welfare, and avoid causing offence to any cultural, social, national, regional, professional or ethnic groups. Image Credits: NIAID/Flickr. ‘Zero-COVID’ Protestors Win Concessions But Expert Urges China to Increase ‘Hybrid Immunity’ Before Abandoning Policy 28/11/2022 Kerry Cullinan University professors stand between protestors and police at Fudan University in China. Almost three years of harsh lockdowns, enforced quarantines in state facilities and daily testing have tried the patience of many Chinese people, who since Friday have taken to the streets from Shanghai and Nanjing in the east, to central Chengdu and Wuhan and Urumqi and Korla in the north and west. While scores of people have been arrested, protestors have also won some concessions. In Urumqi, where four million people have been in lockdown for over 100 days, officials announced on Monday that it would allow people to travel on buses to do errands and parcel deliveries would resume. Meanwhile, Beijing officials also announced on Sunday that lockdowns of residential areas would not be enforced for longer than 24 hours. These are small indications that Chinese leader Xi Jinping’s “zero-COVID” policy is becoming increasingly impossible to enforce in the face of people’s growing anger and desperation. Two weeks ago, China’s State Council cut compulsory quarantine in a state facility for international visitors and the close contacts of people with COVID from seven to five days, with a further three days at home. It also did away with restrictions on secondary contacts. But a surge in COVID cases in Beijing was followed swiftly by lockdowns, school and restaurant closures, dampening hopes that the country was quietly abandoning the zero-COVID approach. Journalist arrested, assaulted China is trying to both quell and downplay the protests. On Monday, there was increased military and police deployment at sites of weekend protests, and BBC reporter Ed Lawrence was arrested and reportedly assaulted in police custody in Shanghai while reporting on the protests. BBC Statement on Ed Lawrence pic.twitter.com/wedDetCtpF — BBC News Press Team (@BBCNewsPR) November 27, 2022 The weekend protests were sparked by the deaths of 10 people in a fire in an apartment building in Urumqi, the capital of Xinjiang, on Thursday. The screams of people trapped in the burning building last Thursday were captured on social media amid reports that apartment doors had been closed from the outside to enforce the city’s lockdown. Firefighters took more than three hours to stop the fire as cars blocked their path – many with flat batteries after months of not being driven. @renzhiqiang2 ♬ 原聲 – renzhiqiang2 Sealing the doors of COVID-19 contacts is reported to be a common occurrence in China as part of the country’s enforced lockdowns. 用木棍封门,显然还不够。建议官方用钢筋焊死,同时把门上通电,并请官方派两名军人在门外架上机枪。 生我九州者,虽远必封! pic.twitter.com/ajHSk7Jk7Z — 领导干部 (@808Penny) August 30, 2022 Outrage at the deaths in Urumqi led to vigils and protests being arranged in Shanghai, Xi’an, Chongqing and Nanjing, as well as various university campuses, and people turned up in their thousands at some of the protests. Amid chants of ‘Lift lockdown’, ‘No PCR test’ and “We want freedom’, anti-Xi and anti-Communist Party chanting could also be heard. Many people carried blank sheets of white paper to symbolise government censorship, but reports on the protests on Weibo, the Chinese social media platform, were short-lived. Chinese protestors hold blank papers to signify censorship. Back in May, WHO Secretary-General Dr Tedros Adhanom Ghebreyesus told a media briefing that China’s strategy was no longer sustainable in the face of the more infectious but less lethal Omicron. “When we talk about the zero-COVID strategy, we don’t think that it’s sustainable, considering the behaviour of the virus now and what we anticipate in the future,” said Tedros, prompting a rebuke from Chinese officials Aside from its zero-COVID policy, China’s vaccines, Sinopharm and Coronavac, are only about 60% effective against severe infection in comparison to over 90% protection offered by mRNA vaccines. China still to reckon with COVID infections However, it is possible that China will still have its reckoning with COVID as its weary citizens resist further controls and the highly infectious virus spreads through a population with little immunity. Global data analysis group Airfinity estimates that 1.3 and 2.1 million lives could be at risk if China lifts its zero-COVID policy “given low vaccination and booster rates as well as a lack of hybrid immunity”. It based its risk analysis on the cumulative peak cases and deaths from Hong Kong’s BA.1 wave as a proxy for mainland China. “Mainland China has very low levels of immunity across its population. Its citizens were vaccinated with domestically produced jabs Sinovac and Sinopharm which have been proven to have significantly lower efficacy and provide less protection against infection and death,” Airfinity said in a statement on Monday. “This vaccine-induced immunity has waned over time and with low booster uptake and no natural infections, the population is more susceptible to severe disease. China’s current booster uptake is 40%, whilst Hong Kong’s primary series uptake was 34% back in February 2022 when it saw a large spike in cases due to the BA.1 omicron variant,” said Airfinity. Dr Louise Blair, Airfinity’s head of vaccines and epidemiology, called on China to “ramp up vaccinations to raise immunity in order to lift its zero-COVID policy, especially given how large its elderly population is”. Blair said that China needs “hybrid immunity” from both vaccinations and infections to ensure “much less impactful and deadly COVID-19 waves”. Localised protests Prior to the national weekend protests, there have been intense local protests, particularly at the Foxconn facility in Zhengzhou, which makes 70% of the Apple’s iPhones. Workers work long shifts and usually stay in massive factory dormitories that can house up to 300,000 people. But after a small COVID outbreak in the city in October, Foxconn closed the dining halls and introduced “closed loop” production to cut workers’ contact with the outside world to meet production demands for the launch of the iPhone14. Tesla and other factories have used this approach during lockdowns in Shanghai in March. But Foxconn workers started to panic in fear of being forcibly quarantined there, and have clashed a number of times with police. Numerous reports of poor treatment and neglect at state quarantine facilities have also leaked out in public, alongside videos of small children removed from COVID-exposed parents being forced to fend for themselves in such facilities. 上海儿童集中营。 pic.twitter.com/BNTbOPXBLD — 方舟子 (@fangshimin) April 2, 2022 Image Credits: Twitter. Uganda Extends Lockdowns in Bid to End Ebola Outbreak 28/11/2022 Stefan Anderson 68 days and 52 deaths into Uganda’s Ebola outbreak, authorities are hopeful the spread of the virus has been contained. Uganda’s President Yoweri Museveni has extended quarantine measures in the two districts at the epicentre of the country’s Ebola epidemic for another 21 days, citing the need to protect gains in the fight against the virus. This marks the third renewal of lockdowns in Kassanda and Mubende, and authorities are hopeful it will be the last. Movement in and out of the districts was first restricted on 15 October, and renewed for another 21 days on 5 November. The measures include a curfew and the closure of social spaces like churches, bars and markets. “It may be too early to celebrate success, but overall, I have been briefed that the picture is good,” Museveni said in a televised address delivered by vice-president Jessica Alupo. While the situation is “still fragile”, Museveni said Ugandan health authorities are “very optimistic” that the outbreak will end “in the coming month.” The government’s optimism is buoyed by Uganda’s continued progress in stamping out the outbreak. Three districts have completed over 42 days since the last case of Ebola was detected, while six districts – including the epicentres of Kassanda and Mubende as well as the capital, Kampala – remain in “follow-up” protocols. The virus has so far claimed 56 lives, while another 22 probable Ebola deaths were registered before the government issued its official declaration of the outbreak on 20 September. “If we open now and a case appears, we will have destroyed all the gains we have made in this war,” Museveni said. “Our healthcare workers will continue to do all it takes to save lives and bring the epidemic to an end.” Full reopening if the 21-day mark is reached With numbers dropping, bed occupancy rates within the past 24 hours stood at just 27.9% in Mubende isolation units. The government’s decision to extend lockdowns by 21 days is based on the incubation period of Ebola. The three-week mark is a key indicator of whether transmission has been stopped. Mid-way through November, Mubende appeared to be in the clear. The district had gone 13 days without reporting a new case. But on day 14, a 23-year-old medical student with links to previous cases was diagnosed with the virus. “Without completing 21 days, as we saw with Mubende, a case can pop up anywhere,” the President said. “It is important that we complete the entire cycle.” Kassanda has now reached 15 days since reporting a new case, while Mubende has not registered a confirmed case for 14 days. If both districts hold on for another week, Uganda’s fifth deadly encounter with the Sudan strain of Ebola may come to a swift end. “We are relying on you to cooperate and bring this epidemic to an end,” the President told residents of Kassanda and Mubende, noting their commitment and sacrifice thus far. “If there is no case by the end of the 21-day period, we will re-open fully.” Threat of urban transmission avoided Ebola’s invasion of Uganda’s Gulu municipality and its slum-like camps for internally displaced persons in 2000 was the cause of the deadliest Ebola epidemic in the country’s history. When six school children were diagnosed with Ebola in Kampala in late October, fears of the virus embedding itself in the capital spiked. On paper, Ebola’s mortality rate of up to 90% makes the virus easy to contain. Museveni also noted that as a virus transferred through contact and bodily fluids, Ebola, despite its “devastating nature”, is far easier to control than airborne threats like COVID-19. But if allowed to embed itself in densely populated areas, things can quickly spiral out of control. “If we had allowed the escalation of the outbreak into Kampala, the consequences would have been bad, including possible exportation to our African brothers in neighbouring countries,” Museveni said. Despite calls from doctors and health advocates to lockdown the capital earlier this month, Museveni and Health Minister Jane Ruth Aceng elected not to bow to the pressure. So far, their decision appears to be validated. “The opportunity for immediate quarantine of contacts was lost for Mubende and Kassanda,” Museveni said, noting the first suspected cases were registered on 6 September, two weeks before authorities declared the outbreak. This was not the case for Kampala. Knowledge of the threat allowed health authorities to be on reactive footing, and respond quickly to isolate infected people and their contacts. Today, over 300 contacts remain under institutional quarantine overseen by the Ministry of Health. Vaccine Trials Are Underway WHO Africa Director Dr Matshidiso Moeti visited Kassanda and Mubende earlier this month to coordinate with Ugandan health authorities and other international partners in responding to the outbreak. There is currently no known vaccine for the Sudan strain of Ebola responsible for the Ugandan outbreak. But the outbreak presents a unique opportunity to bridge this treatment gap, and a series of trials have been set in motion with the aim of minimizing hospitalisations and deaths. A coalition of organizations including CEPI, Gavi, the World Health Organization and Ugandan health authorities are deploying three vaccine candidates to about 3,000 people who have been in contact with Ebola patients. “As we speak, the government of Uganda is finalizing the regulatory approvals,” Africa CDC Director Dr Ahmed Ogwell told CNN. If any of the candidates can succeed, authorities are hopeful this will be the last outbreak Uganda faces without medical defenses. “By embedding research at the heart of the outbreak response, we can achieve two goals,” the WHO said in a statement. “Evaluate potentially efficacious candidate vaccines, potentially contribute to end this outbreak, and protect populations at risk in the future.” Image Credits: WHO, WHO, WHO. Parliamentarians Seek to Address Post-COVID ‘Tsunami’ of Health System Problems 28/11/2022 Maayan Hoffman UNITE president Ricardo Leite (fourth from right) and MPs at the World Health Summit. “There is this tsunami that is happening after the earthquake that was COVID-19 that is now coming to shore and hitting health systems across the world,” said Ricardo Baptista Leite, president and founder of UNITE, a global network of parliamentarians committed to addressing global health challenges. “The pandemic also led to a huge economic crisis and even poor countries in the global South, who might have been less affected by the pandemic, are going to pay a very severe price due to economic consequences that will lead to challenges in responding to the health needs of those countries,” he said. A week before his organization brings together hundreds of parliamentarians from around the world to discuss the most pressing issues in public health at a global summit, the Portuguese MP, who collaborates closely with the World Health Organization (WHO), warned Health Policy Watch of the need to take swift and collective action before the next pandemic. “This is the moment when international institutions and governments need to step up their game and tackle the global health crisis,” Leite said. “We must double up our efforts to make sure we are better equipped in the future and can respond to health needs.” Leite is a long-time global health advocate. He is also a trained medical doctor in infectious diseases and heads the Public Health department at Católica University of Portugal. False sense of security He told Health Policy Watch that whenever the world has felt “capable of controlling infectious disease, we create a false sense of security that we can lower our guard. Whenever we lower our guard, infectious diseases come back with a vengeance.” This can be seen throughout history with multiple pandemics over the centuries, but also in this century with the emergence of antibiotics and the belief that with penicillin we could control infections – a belief now being called into question with the development of antibiotic-resistant bacteria. Antibiotic-resistant bacteria are responsible for the deaths of some 700,000 people each year – with scientists predicting that these infections could kill more people than cancer by 2050. The pandemic has set back the fight against many diseases by years. Take HIV/AIDS. In December 2020, UNAIDS released its 95-95-95 targets, calling for 95% of all people living with HIV to know their HIV status, 95% of all people with diagnosed HIV infection to receive sustained antiretroviral therapy and 95% of all people receiving antiretroviral therapy to have viral suppression by 2025. But during COVID-19, in many countries, measurement of these goals ceased altogether. Where tracking continued, in some cases, diagnoses were slower. “HIV is an interesting proxy for all infectious and communicable diseases out there,” Leite said. In addition, COVID-19 led to a rise in people being diagnosed with late-stage cancer, an increase in cases related to chronic diseases due to people being kept away from health systems, and a spike in mental illness globally. “Pandemics are a strong demonstration of the case that infectious diseases can undermine our efforts toward prosperity for all,” Leite said. He added that during his time as a medical volunteer in Ukraine he saw a huge rise in multi-resistant and extremely resistant tuberculosis in the region. Leite predicted that as the war continues, it will be almost impossible not to see the TB spillover into neighboring countries and then across the world. “There has to be a clear understanding from the world that dealing with infectious diseases is not only something recommended but is a prerequisite for economic and social development worldwide,” he said. The role of parliamentarians WHO parliamentarian session during the World Health Summit (UNITE) Part of the solution is getting parliamentarians around the table, according to Leite. In 2017, the United Nations passed a resolution on the nexus of global health and foreign policy, encouraging a multi-stakeholder approach to achieve universal health coverage. “The voice of parliamentarians was not part of the discussion,” Leite said. “One cannot expect to build a global health architecture or move forward science-based policy making if we do not keep those who write policy in the loop. We cannot make sure money gets where it needs to if we do not include those that make and approve budgets in parliaments.” While he admitted that UNITE is not a “silver bullet,” he said it is a valuable tool for bringing parliamentarians from more than 90 countries together to share experiences and learn how they can best bring their own country toward a more sustainable future. “The first step was to get the conversation going. The second was to develop regional leadership. We now have 10 regional chapters, each led by an MP or former MP. Then we developed policy hubs, specialized teams that focus on specific policy areas, so they can drill down on concrete policymaking in key areas,” Leite explained. “We empower policymakers to be leaders for change in their own countries.” UNITE’s three priorities At its founding, UNITE was focused solely on issues of infectious diseases, but COVID-19 led it to change its mandate over the summer of 2022 and the organization is now focused more generally on global health matters. “The pandemic has demonstrated that global health issues and infectious diseases go hand in hand,” Leite told Health Policy Watch. “We cannot solve many challenges related to infectious disease, which were the basis of our work in the first years, without addressing all the other global health challenges out there.” UNITE is now taking a three-priority approach, focusing on pandemic prevention preparedness and response; the future of health systems; and health as a human right. The group signed a memorandum of understanding recently with WHO to work together on these pillars and supply parliamentary feedback and insight to support WHO’s related efforts. Next week: UNITE Global Summit From 5-7 December, UNITE will host its global summit in Lisbon, bringing together its parliamentarians and leaders from the global health community to expand and forge new partnerships. Members of the lawmaking, civil society, medical and academic communities will meet to talk about what they feel are the most pressing issues on the global health agenda. Another priority that UNITE is bringing to the forefront of the parliamentarian agenda is the use of digital health to promote universal health coverage. “In the last few months with the creation of the digital health hub, parliamentarians were able to discuss with other stakeholders how to build the right frameworks and increase budgets to implement digital health transformation that can promote access to millions,” Leite said. Finally, Leite added that with its new direction in mind, UNITE members would try to answer three questions during the event: What progress have we made so far during the UN’s Sustainable Development Goals period? What have we learned to help us make even more progress by 2030? What is the role of parliamentarians in helping drive that progress? MPs and the pandemic treaty Session on the pandemic treaty at the World Health Summit. In the past, parliamentary involvement has helped achieve public health goals. In Portugal, Leite cited an example from 22 years ago when the parliament decided to decriminalize the use of drugs. “This was not making drug use legal, but now no one goes to jail for using drugs,” he explained. “We stopped looking at people who use drugs as criminals but instead as people who potentially had a health challenge that needed to be dealt with.” Instead of jail time, drug abusers receive harm reduction and other social and health services. When the legislation was passed, around 1% of the Portuguese population used heroin. Since then, Leite said, the numbers have dropped dramatically. Drug-related crime is down, and new HIV cases tied to drug use have fallen from as high as 60% to only 2%. “The fact that we provided harm reduction services and shifted from a criminal perspective to a health perspective was transformative in achieving better health outcomes and partially solving the drug problem in Portugal,” Leite said. A more recent example was the decision by the African Union to set up the African Medicines Agency, which will become a regulatory body for access to health technologies in the continent and creates a common standard of rules based on science to ensure the safety of citizens in the region. Leite equated the AMA to the European Medicines Agency. UNITE founder Ricardo Baptista Leite and Dr Tedros at signing of an MOU between the two organizations. Moving forward, UNITE Parliamentarians will play a key role in finalizing WHO’s pandemic treaty, aimed at guiding the global response to pandemics. “The regulations that were in place when COVID-19 hit were not sufficient or were not properly enforced,” Leite said. He added that “there is a lack of acknowledgement and awareness among most citizens and many parliamentarians around the world that these negotiations are taking place. We need parliamentarians involved early on. If governments agree on a document, parliaments must ratify it.” In an era of “polarized politics and fake news,” he said that if parliamentarians are not part of the process there is a risk that such a treaty would not be ratified, and the world would be left exactly where it was in December 2019. “Everyone is committed to finding a balanced approach to what we hope will create a toolkit from a policy perspective that can help the world be better prepared to detect outbreaks early and lock them down before they transform into pandemics,” Leite said. “It is not acceptable that 100 years after the Spanish flu we saw so many countries react to COVID-19 the same way as they did 100 years before,” he continued. “We have an obligation to be better prepared to constrain any risk, to keep as many people as possible safe. This is a prerequisite for economic and social development. “We need to keep peace and prosperity as our main goal,” Leite concluded. Image Credits: UNITE. There are a Wide Range of Treatments for Obesity, but Many People Cannot Afford Care 28/11/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Amber Huett-Garcia at her high and low weight from 2008 to 2021. Amber Huett-Garcia is trying to drive global change for affordable treatment, care and support for individuals suffering from obesity. A resident of the United States and born into a family suffering from generational obesity, she weighed 101 pounds by the time she was in kindergarten. As an adult, she lost 245 pounds and reduced her BMI from 69 to 24. She did it through a combination of treatments, including bariatric surgery, medication and mental health care. While Huett-Garcia is lucky to have a comprehensive employer-based healthcare plan, she recognizes that many people in the United States do not. And for those who are obese, the cost of care can be enormous. The cost of obesity Obesity costs the US healthcare system nearly $173 billion a year, according to the latest report by the Centers for Disease Control and Prevention. Personal medical costs for people living with obesity are close to $1,500 more per year than those who do not suffer from the condition. For people living with obesity and who are on Medicare, few treatments are covered. For example, Medicare has zero anti-obesity medication coverage. Moreover, roughly 40% of the US population lacks coverage for bariatric surgery for obesity, which has been proven most effective. “Affordable healthcare is a human right,” Huett-Garcia said. Amber Huett-Garcia taking part in the “Stop Weight Bias” campaign. She has called for action to ensure that insurance plans pay for the treatment of a wider range of conditions, including obesity, by covering comprehensive science-based interventions. She has also asked that decision-makers within healthcare systems listen and amplify the voices of people with NCDs. “The lives of people living with NCDs depend on it,” she concluded. Read Amber Huett-Garcia’s full NCD Diary. Read previous post. Image Credits: Courtesy of NCD Alliance. In Vietnam, Nguyen Ha Linh Calls on Government to Give Economic Support to People Living with NCDs 28/11/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Nguyen Ha Linh A young woman living in Vietnam has called on organizations and communities locally and globally to step up support for people living with noncommunicable diseases (NCDs) – especially multiple sclerosis (MS). “I call on the Vietnamese government to give economic support packages to people living with NCDs, especially people with disabilities, because many are paralyzed, unable to support themselves and earn a living,” said Nguyen Ha Linh. Ha Linh lives with MS. Since the age of 23 she has been rapidly deteriorating. While at first she worked as a graphic designer, gradually her arms and legs weakened until she became paralyzed. She developed atrophy of the nerve in her eyes. Today, all of her activities depend on the care of her relatives. Nguyen Ha Linh Access to care But her greatest challenges have been access to care and finances. “Multiple sclerosis is not covered by insurance in Vietnam, so I must pay for my care out of pocket, with financial support from my relatives,” Ha Linh explained. “Multiple sclerosis is considered a rare disease in Vietnam. People living with this condition find it very difficult to access diagnosis and care, and not all major hospitals have the resources for treatment. For those that manage to access care for multiple sclerosis, this is very expensive.” Government must take action She said that people living with MS often focus on getting funding from philanthropists who care about people living with disabilities. However, she believes that the government should be the one to take action first. “Many challenges related to treatment, care and support for people living with NCDs remain largely unaddressed,” Ha Linh said. “In particular, the components of care and support are weak, which therefore means that relatives play an important role for those who have a good support system at home. This is not always the case. “People living with NCDs would like to call on the government to change the regulations around health insurance to allow access to affordable diagnostics and care to help us have a better life,” she concluded. Read Nguyen Ha Linh’s full NCD Diary. Read next post. Image Credits: Courtesy of the NCD Alliance. More Than Five Women Killed Every Hour by Intimate Partners or Family: UN Women, UNODC report 25/11/2022 Megha Kaveri Women and girls are more at risk of getting killed at home by intimate partners or family. A new report by UN Women and the UN Office on Drugs and Crimes (UNODC) said that more than five women or girls are killed every hour across the world by their partners or families. The report, released ahead of the UN’s International Day for the Elimination of Violence Against Women on Friday, said that while men are subjected to higher rates of homicides across the world, women and girls are disproportionately affected by higher rates of homicides in private spaces. In 2021, 81,000 women and girls were killed intentionally, of which around 45,000 – some 55% – were killed by their own intimate partners or family members. By comparison, 11% of the total male homicides happened in private spaces. Covid-19 huge push to fatal violence against women The report found mixed trends on femicide across the world. Between 2010 and 2021, the total number of female homicides by intimate partners or families fell by 19% in Europe. But that number rose by 6% in the Americas overall even as South America reported a decrease. COVID-19 and the subsequent confinement to homes seems to have led to an increase in gender-related killings of women and girls in North America, Western and Southern Europe in 2020, according to the report. “Other sub-regions in Europe and the Americas recorded negligible changes or decreases in the number of killings between 2019 and the end of 2020, which suggests that the onset of the COVID-19 pandemic had heterogeneous impacts,” it said. “The decreases in some sub-regions may reflect delays in recording due to COVID-19 rather than reductions in the number of killings.” The report did not mention similar trends in Asia, Africa or Oceania, due to a lack of data. A World Health Organization-led report last year found almost one in three women experience physical and/or sexual violence across the course of their lifetimes, and in the previous 12 months, more than one in ten women suffered from physical and/or sexual intimate partner violence. More data key to policy formulation Women and girls in all regions are affected by gender-based killings. While Asia isthe region with the largest absolute number of killings, Africa is the region with thehighest level of violence relative to the size of its female population. Highlighting the lack of sufficient and comprehensive data on global femicides, the new report from UN Women and UNODC said more data will enable policy makers to gain a better understanding of the issue and to push for changes. “Additional data beyond identification purposes, such as age of perpetrators and victims, including information surrounding the event of the killing should be collected for analytical purposes,” the report said, adding that will help policy makers detect failures in responses and protection, develop better preventive measures and improve access to justice. Solutions include survivor-centric approaches The report also called for more survivor-centred responses to address gender-based violence in the world, saying it’s an approach that’s “fundamental to preventing and eliminating gender-based violence against women and girls and ensuring it does not escalate to femicide/gender-related killings.” Providing victims with a positive experience when they first report gender-based violence can increase trust and potentially save lives, and encourage other victims to report and disclose crimes. Another measure called for in the report is stronger civil society organisations that work in the women’s rights sector, the report said, because they serve “an important role in preventing gender-based violence against women and girls, by advocating for and securing normative and policy change, providing psycho-social support services and holding governments to account.” Image Credits: Artem Maltzev, UN Women. Fossil Fuels Cast Dark Shadow Over Tanzania’s Green Future 25/11/2022 Kizito Makoye Issa Abdul’s single solar panel powers his barber shop. DAR ES SALAAM, Tanzania – Issa Abdul’s desperate urge for solar power began when he realised a smoke-spewing generator at his barber shop was costing him too much. “Solar power is very cheap. I regret spending my money on this fuel-guzzling machine,” he told Health Policy Watch. The 32-year-old barber in Tanzania’s port city spent roughly Tanzanian shillings 150,000 ($65) to purchase a small solar system and this now powers his hair cutting business. “I am very happy to have my own solar system. It is very useful,” he said. On a humid Sunday morning, Abdul adeptly digs a buzzing clipper through the hair of the client sitting on a leather chair before him. “I was spending a lot of money every month buying fuel, that is history now,” he said. Perched on a rusty roof, Abdul’s lone solar panel produces enough electricity to run two clippers, three bright lights and a cell phone charger. “There’s plenty of sunshine, I don’t disappoint my customers,” he said. Drought cripples hydropower facilities However, like other east African countries such as Kenya and Uganda, solar power still remains a small part of the country’s energy mix. While Tanzania’s electric grid has been primarily powered by hydroelectric power, another renewable source, for some time, hydro’s dominance is slipping now. Climate-related spells of drought have crippled the country’s hydropower facilities and the ageing distribution infrastructure, and the country is experiencing an electricity crisis affecting various sectors of the economy. Hydropower, which can potentially generate 4.7 GW of electricity according to government estimates, is only producing 12% of its power potential, and is prone to weather variability. And as drought tightens its grip, Tanzania, which has 57 trillion cubic feet of natural gas reserves, is now poised to tap this chunk of fossil fuels to cover the electricity deficit Natural gas, oil and coal will almost certainly remain dominant in the country’s energy mix in the near future, according to experts. A motorcyclist riding outside TPTL plant in Dar es Salaam that uses heavy furnace oil to produce electricity. Addressing climate change impact with fossil fuels Tanzania’s experience is just one example of an emerging paradox of addressing climate change impacts with more climate-changing fossil fuel. Tanzania, Kenya and Uganda have been dependent on hydropower, but as all three countries grapple with climate-related drought, they may also find it easier to tap their fossil fuel reserves with the help of multinational investors standing by than develop greener alternatives. This is even as technologies exist for large-scale grid-quality solar power that is ultimately cheaper, industry observers say. While nations worldwide are shifting to renewable energy to reduce the global carbon footprint and ease the toll that fossil fuels take on people’s health, economy and climate, the majority of Tanzanians, like those in large parts of Africa, still use dirty energy sources that pollute the air, causing some 1.1 million deaths annually on the continent, according to a recent study. Air pollution is the second risk factor for death in Africa after malnutrition, concluded the study by the Boston-based Health Effects Institute. Tanzania’s electricity generation comes mostly from natural gas (48%), followed by hydropower (31%), petrol/diesel (18%), solar (1%), and biofuels (1%). In Kenya and Uganda, hydropower and geothermal power are the dominant portions of the electricity generation mix, with solar power making up a very minor proportion of the mix. As demand for energy continues to grow, it is unclear how to ensure that renewables become more attractive than fossil fuel. Investments in fossil fuels far outweigh that of renewables in most parts of Africa, and oil and gas exploration and exploitation continues apace in Kenya, Uganda and Tanzania. Dirty diesel At Kariakoo, a business hub in Dar es Salaam dotted with shopping centres, a toxic haze of diesel hangs in the air as generators roar so loudly that they drown out people’s conversations. Like the lone solar panel precariously hanging on Abdul’s salon, smoke-spewing generators are widely used when grid electricity goes off. They power everything from ceiling fans to television sets, air conditioners and freezers – the latter two items pulling too much power to make a rooftop solar system reliable. Among the available choices, portable diesel generators are among the dirtiest, spewing particulate-laden emissions into the air directly into spaces where people live and work. But they remain the go-to solution in much of Tanzania and Africa more broadly. “To me, a diesel generator provides the necessary power,” said Aloycia Mosha who runs a cold fish store. Soaked with sweat, Mosha repeatedly pulls a string to rev the engine of her generator. “If I don’t switch it on now, all my fish stock will get spoilt,” said Mosha. The 45-year-old entrepreneur has often found a trail of blood oozing on her shop’s tiled floor, a clear sign that the fish defrosted overnight. Vendor stand near a standby diesel generator in Dar es Salaam Power cuts are part of daily life Power cuts are part of daily life in Dar es Salaam, a busy city that is home to 5.8 million people, and accounts for 40% of the country’s GDP. While a few city dwellers have installed solar power on their roof tops to save spiralling energy costs, analysts say the lack of clear financing mechanism to cover initial installation costs, coupled with an unreliable distribution network, have made solar systems a distant luxury to many families. Asteria Mchomvu, a resident of Upanga, a middle-class neighborhood in Dar es Salaam, began to dream of installing solar panels on her roof a decade ago. At first, Mchomvu, who works as a teacher, was excited to learn that solar technology could help her save money and protect the environment. But a home solar system was too expensive for her t the time. A modest 8-kilowat system would roughly cost Tanzanian shillings 10, million ($4347) in 2012, according to Tanzania’s Rural Energy Agency. Prices for solar systems in Tanzania have since fallen by more than 60% and companies are aggressively jostling to pitch their sales. Yet still, the numbers didn’t work for Mchomvu, who teaches geography and science Then early in November, at the Dar es Salaam International Trade Fair, Mchomvu caught up with Richard Tairo, a salesman from Arti energy, a solar company focusing on mid and low -income customers. Tairo understood Mchomvu’s passion for solar and her financial dilemma and he introduced her to Mali Kauli, a program that finances residential solar systems and offers borrowers, below-market rates. Mchomvu accepted the offer after the company assured her that the system could lower her energy bills and spare her the agony of power cuts. “I wanted to be 100% sure it is worth investing,” she told the Health Policy Watch. Skewed regulatory framework disadvantages solar Despite the growing public awareness, renewable energy penetration in Tanzania is still facing major hurdles due to a skewed regulatory framework and limited market. Samuel Wangwe, a research associate with Research on Poverty Alleviation (REPOA) said solar power market has seen sluggish growth due to fragmented financing plans, uneven service after equipment sale and technical weaknesses in batteries and solar lamps, which are often cheap items imported from China with warranties that cannot be honoured. “The most obvious barrier to renewable energy, notably solar is cost. The upfront expenses that people pay to get solar panels installed at their homes are still too high,” Wangwe said. Many investors are discouraged to take on renewable energy projects because of high capital costs and a long net payback period, he added. Wangwe says that the industry is also dogged by a lack of training institutes, which has prevented renewable energy technologies from scaling up. “We must encourage our children to take renewable energy courses and hone their technical skills,” he said. A shop for solar equipment at Kariakoo business centre in Dar es Salaam Bigger subsidies for fossil fuels Although some subsidies are offered for rooftop solar, the subsidies the government provides to fossil fuel sources are much higher, Wangwe said. In fact, in July, the Tanzanian government introduced a new fuel subsidy of a whopping Tanzanian shillings 100 billion ($43 million) monthly to stabilise the domestic price of fuel, Wangwe said. While solar panel and wind turbines are exempt from VAT and are not charged import duties, accessories including the batteries essential to operating a household solar package are charged up to 35% import duty, said Wangwe. “This is the reason why solar technology is not scaling up as fast as possible” he said. Coal, oil and gas are by far the largest contributors to climate change, experts say. In addition, some 65% of deaths from air pollution are generated by fossil fuel combustion, including the noisy and smokey generators that are omnipresent in households and big African cities like Dar es Salaam. While global leaders have endorsed the scientific consensus to limit global warming to 1.5°C above pre-industrial level, as spelled out in the Paris Agreement, there is a growing rush for oil and gas exploration in the global south. This is what COP27 civil society participants called the “dash for gas” reminiscent of the colonial scramble for Africa. More fossil fuel exploration Tanzania has enough gas reserves to put the country on a path of economic prosperity, and may unlock as much as $30 billion in liquified natural gas (LNG) investments. At the same time, if the historic pattern long followed in east and west Africa remains the same, many of the new LNG is likely to be sold to Europe and other countries to generate foreign currency, rather than used at home. “Our political leaders are caught up in a dilemma. Such investments are worthwhile economically but bad for the environment,” said Wangwe. While many have argued that off-grid solar solutions hold the key to Tanzania’s urban and rural electrification, fossil fuels subsidies have reduced its competitiveness. Yusto Mugisha, professor of renewable energy at the school of engineering and technology a Sokoine University of Agriculture, said in order to build a sustainable future, Tanzania needs to invest in clean, accessible and affordable energy sources. “Renewable energy sources are available and their potential is not fully harnessed,” said Mugisha. Although upfront costs for renewable projects can be daunting, Mugisha said efficient and more reliable renewable technologies can create a system that is less prone to market shocks and improve energy security. Unlike fossil fuels, which need to be extracted and transported to large power plants and require a grid network extending to remote areas, renewable sources like solar and wind can be developed in various flexible arrays. They can be just a few panels on a household installation, part of a community mini-grid, or as a solar power plant feeding into the large grid. That, according to the International Energy Agency and countless other assessments means that solar could leap-frog over grid-dependent fossil fuel technologies much like portable phones leap-frogged over fixed phone lines in Africa, providing better service much faster. But renewable energy versus fossil fuels has seemingly placed Tanzania politicians in the moral dilemma. While fossil fuel provides badly needed energy, it leaves behind a carbon footprint that’s proving catastrophic to humans and the planet. Yet, in the short term, policymakers strongly support fuel subsidies to stabilise the prices of other commodities. Meanwhile, renewable energy subsidies, notably on solar, are indirectly offered mostly through the Rural Energy Agency, and are clustered depending on the scale of the project. Despite its small market share local experts say renewable energy has the potential to respond to present and future challenges by enhancing energy security, generating income, and providing employment. Rural dependence on kerosene William Kahise, a student at Itetemia primary school, persuaded hus mother to buy a solar lamp as the kerosene one made him cough. In the dusty western town of Tabora, 12-year-old William Kahise and his sister Juliana routinely huddled around the faint glow of kerosene lamp when the darkness sets in, struggling to get their homework done before their mother blows off the lamp to save the fuel cost. “I must finish my work, otherwise my teacher will be very angry,” Kahise told Health Policy Watch. The paraffin lamp, made from a discarded cooking oil tin, emitted choking smoke and casts scary shadows on the walls. Kerosene is one of the household fuels that WHO has recommended not be used at all, because of its health harmful effects, including impaired lung function, asthma and cancer. The Itetemia primary school pupil may not know about the WHO recommendation, but he knew the smoke made him cough and convinced his mother to ditch the kerosene lantern, for a cheap solar version. Kerosene is used by millions of rural households i to meet basic lighting needs and subsidies have long been used to make the fuel more affordable. Kerosene subsidies have been at the centre of energy policy debate, with renewable energy activists arguing that, for health, safety and environmental reasons, a switch to solar power is better. “The subsidized kerosene is extremely costly and wasteful, the government is spending a lot of money every month to keep the price low,” said Mugisha. But for Abdul, who enjoys solar power, the challenge arises when his Chinese-made panel starts to age and needs to be replaced as Africa produces virtually no panels of its own. –First of two parts on the barriers to clean, renewable energy in Africa. -Research and reporting for this story was supported by the Rosa Luxembourg Foundation. Image Credits: Peter Mgongo. Posts navigation Older postsNewer posts
From Monkeypox to Mpox 29/11/2022 Kerry Cullinan Colorized transmission electron micrograph of monkeypox particles (purple) found within an infected cell (brown), cultured in the laboratory. Image captured and color-enhanced at the NIAID Integrated Research Facility (IRF) in Fort Detrick, Maryland. The term monkeypox will be replaced by mpox within the next year, according to the World Health Organization (WHO). This follows “racist and stigmatizing language” being used in relation to the large outbreak of mpox for the first time in Europe and the US. The WHO said it had been approached by a number of individuals and countries that had asked the WHO to propose a way forward to change the name. “Assigning names to new and, very exceptionally, to existing diseases is the responsibility of WHO under the International Classification of Diseases and the WHO Family of International Health Related Classifications through a consultative process which includes WHO member states,” the WHO said in a statement on Monday. After consultations to gather views from a range of experts, countries and the general public, who were invited to submit suggestions for new names, the WHO has recommended the name change. Considerations for the recommendations included rationale, scientific appropriateness, extent of current usage, pronounceability, usability in different languages, absence of geographical or zoological references, and the ease of retrieval of historical scientific information. Human monkeypox was given its name in 1970 after the virus that causes the disease was discovered in captive monkeys in 1958. This was way before the publication of WHO best practices in naming diseases, in 2015, which recommended that new disease names should minimize the unnecessary negative impact of names on trade, travel, tourism or animal welfare, and avoid causing offence to any cultural, social, national, regional, professional or ethnic groups. Image Credits: NIAID/Flickr. ‘Zero-COVID’ Protestors Win Concessions But Expert Urges China to Increase ‘Hybrid Immunity’ Before Abandoning Policy 28/11/2022 Kerry Cullinan University professors stand between protestors and police at Fudan University in China. Almost three years of harsh lockdowns, enforced quarantines in state facilities and daily testing have tried the patience of many Chinese people, who since Friday have taken to the streets from Shanghai and Nanjing in the east, to central Chengdu and Wuhan and Urumqi and Korla in the north and west. While scores of people have been arrested, protestors have also won some concessions. In Urumqi, where four million people have been in lockdown for over 100 days, officials announced on Monday that it would allow people to travel on buses to do errands and parcel deliveries would resume. Meanwhile, Beijing officials also announced on Sunday that lockdowns of residential areas would not be enforced for longer than 24 hours. These are small indications that Chinese leader Xi Jinping’s “zero-COVID” policy is becoming increasingly impossible to enforce in the face of people’s growing anger and desperation. Two weeks ago, China’s State Council cut compulsory quarantine in a state facility for international visitors and the close contacts of people with COVID from seven to five days, with a further three days at home. It also did away with restrictions on secondary contacts. But a surge in COVID cases in Beijing was followed swiftly by lockdowns, school and restaurant closures, dampening hopes that the country was quietly abandoning the zero-COVID approach. Journalist arrested, assaulted China is trying to both quell and downplay the protests. On Monday, there was increased military and police deployment at sites of weekend protests, and BBC reporter Ed Lawrence was arrested and reportedly assaulted in police custody in Shanghai while reporting on the protests. BBC Statement on Ed Lawrence pic.twitter.com/wedDetCtpF — BBC News Press Team (@BBCNewsPR) November 27, 2022 The weekend protests were sparked by the deaths of 10 people in a fire in an apartment building in Urumqi, the capital of Xinjiang, on Thursday. The screams of people trapped in the burning building last Thursday were captured on social media amid reports that apartment doors had been closed from the outside to enforce the city’s lockdown. Firefighters took more than three hours to stop the fire as cars blocked their path – many with flat batteries after months of not being driven. @renzhiqiang2 ♬ 原聲 – renzhiqiang2 Sealing the doors of COVID-19 contacts is reported to be a common occurrence in China as part of the country’s enforced lockdowns. 用木棍封门,显然还不够。建议官方用钢筋焊死,同时把门上通电,并请官方派两名军人在门外架上机枪。 生我九州者,虽远必封! pic.twitter.com/ajHSk7Jk7Z — 领导干部 (@808Penny) August 30, 2022 Outrage at the deaths in Urumqi led to vigils and protests being arranged in Shanghai, Xi’an, Chongqing and Nanjing, as well as various university campuses, and people turned up in their thousands at some of the protests. Amid chants of ‘Lift lockdown’, ‘No PCR test’ and “We want freedom’, anti-Xi and anti-Communist Party chanting could also be heard. Many people carried blank sheets of white paper to symbolise government censorship, but reports on the protests on Weibo, the Chinese social media platform, were short-lived. Chinese protestors hold blank papers to signify censorship. Back in May, WHO Secretary-General Dr Tedros Adhanom Ghebreyesus told a media briefing that China’s strategy was no longer sustainable in the face of the more infectious but less lethal Omicron. “When we talk about the zero-COVID strategy, we don’t think that it’s sustainable, considering the behaviour of the virus now and what we anticipate in the future,” said Tedros, prompting a rebuke from Chinese officials Aside from its zero-COVID policy, China’s vaccines, Sinopharm and Coronavac, are only about 60% effective against severe infection in comparison to over 90% protection offered by mRNA vaccines. China still to reckon with COVID infections However, it is possible that China will still have its reckoning with COVID as its weary citizens resist further controls and the highly infectious virus spreads through a population with little immunity. Global data analysis group Airfinity estimates that 1.3 and 2.1 million lives could be at risk if China lifts its zero-COVID policy “given low vaccination and booster rates as well as a lack of hybrid immunity”. It based its risk analysis on the cumulative peak cases and deaths from Hong Kong’s BA.1 wave as a proxy for mainland China. “Mainland China has very low levels of immunity across its population. Its citizens were vaccinated with domestically produced jabs Sinovac and Sinopharm which have been proven to have significantly lower efficacy and provide less protection against infection and death,” Airfinity said in a statement on Monday. “This vaccine-induced immunity has waned over time and with low booster uptake and no natural infections, the population is more susceptible to severe disease. China’s current booster uptake is 40%, whilst Hong Kong’s primary series uptake was 34% back in February 2022 when it saw a large spike in cases due to the BA.1 omicron variant,” said Airfinity. Dr Louise Blair, Airfinity’s head of vaccines and epidemiology, called on China to “ramp up vaccinations to raise immunity in order to lift its zero-COVID policy, especially given how large its elderly population is”. Blair said that China needs “hybrid immunity” from both vaccinations and infections to ensure “much less impactful and deadly COVID-19 waves”. Localised protests Prior to the national weekend protests, there have been intense local protests, particularly at the Foxconn facility in Zhengzhou, which makes 70% of the Apple’s iPhones. Workers work long shifts and usually stay in massive factory dormitories that can house up to 300,000 people. But after a small COVID outbreak in the city in October, Foxconn closed the dining halls and introduced “closed loop” production to cut workers’ contact with the outside world to meet production demands for the launch of the iPhone14. Tesla and other factories have used this approach during lockdowns in Shanghai in March. But Foxconn workers started to panic in fear of being forcibly quarantined there, and have clashed a number of times with police. Numerous reports of poor treatment and neglect at state quarantine facilities have also leaked out in public, alongside videos of small children removed from COVID-exposed parents being forced to fend for themselves in such facilities. 上海儿童集中营。 pic.twitter.com/BNTbOPXBLD — 方舟子 (@fangshimin) April 2, 2022 Image Credits: Twitter. Uganda Extends Lockdowns in Bid to End Ebola Outbreak 28/11/2022 Stefan Anderson 68 days and 52 deaths into Uganda’s Ebola outbreak, authorities are hopeful the spread of the virus has been contained. Uganda’s President Yoweri Museveni has extended quarantine measures in the two districts at the epicentre of the country’s Ebola epidemic for another 21 days, citing the need to protect gains in the fight against the virus. This marks the third renewal of lockdowns in Kassanda and Mubende, and authorities are hopeful it will be the last. Movement in and out of the districts was first restricted on 15 October, and renewed for another 21 days on 5 November. The measures include a curfew and the closure of social spaces like churches, bars and markets. “It may be too early to celebrate success, but overall, I have been briefed that the picture is good,” Museveni said in a televised address delivered by vice-president Jessica Alupo. While the situation is “still fragile”, Museveni said Ugandan health authorities are “very optimistic” that the outbreak will end “in the coming month.” The government’s optimism is buoyed by Uganda’s continued progress in stamping out the outbreak. Three districts have completed over 42 days since the last case of Ebola was detected, while six districts – including the epicentres of Kassanda and Mubende as well as the capital, Kampala – remain in “follow-up” protocols. The virus has so far claimed 56 lives, while another 22 probable Ebola deaths were registered before the government issued its official declaration of the outbreak on 20 September. “If we open now and a case appears, we will have destroyed all the gains we have made in this war,” Museveni said. “Our healthcare workers will continue to do all it takes to save lives and bring the epidemic to an end.” Full reopening if the 21-day mark is reached With numbers dropping, bed occupancy rates within the past 24 hours stood at just 27.9% in Mubende isolation units. The government’s decision to extend lockdowns by 21 days is based on the incubation period of Ebola. The three-week mark is a key indicator of whether transmission has been stopped. Mid-way through November, Mubende appeared to be in the clear. The district had gone 13 days without reporting a new case. But on day 14, a 23-year-old medical student with links to previous cases was diagnosed with the virus. “Without completing 21 days, as we saw with Mubende, a case can pop up anywhere,” the President said. “It is important that we complete the entire cycle.” Kassanda has now reached 15 days since reporting a new case, while Mubende has not registered a confirmed case for 14 days. If both districts hold on for another week, Uganda’s fifth deadly encounter with the Sudan strain of Ebola may come to a swift end. “We are relying on you to cooperate and bring this epidemic to an end,” the President told residents of Kassanda and Mubende, noting their commitment and sacrifice thus far. “If there is no case by the end of the 21-day period, we will re-open fully.” Threat of urban transmission avoided Ebola’s invasion of Uganda’s Gulu municipality and its slum-like camps for internally displaced persons in 2000 was the cause of the deadliest Ebola epidemic in the country’s history. When six school children were diagnosed with Ebola in Kampala in late October, fears of the virus embedding itself in the capital spiked. On paper, Ebola’s mortality rate of up to 90% makes the virus easy to contain. Museveni also noted that as a virus transferred through contact and bodily fluids, Ebola, despite its “devastating nature”, is far easier to control than airborne threats like COVID-19. But if allowed to embed itself in densely populated areas, things can quickly spiral out of control. “If we had allowed the escalation of the outbreak into Kampala, the consequences would have been bad, including possible exportation to our African brothers in neighbouring countries,” Museveni said. Despite calls from doctors and health advocates to lockdown the capital earlier this month, Museveni and Health Minister Jane Ruth Aceng elected not to bow to the pressure. So far, their decision appears to be validated. “The opportunity for immediate quarantine of contacts was lost for Mubende and Kassanda,” Museveni said, noting the first suspected cases were registered on 6 September, two weeks before authorities declared the outbreak. This was not the case for Kampala. Knowledge of the threat allowed health authorities to be on reactive footing, and respond quickly to isolate infected people and their contacts. Today, over 300 contacts remain under institutional quarantine overseen by the Ministry of Health. Vaccine Trials Are Underway WHO Africa Director Dr Matshidiso Moeti visited Kassanda and Mubende earlier this month to coordinate with Ugandan health authorities and other international partners in responding to the outbreak. There is currently no known vaccine for the Sudan strain of Ebola responsible for the Ugandan outbreak. But the outbreak presents a unique opportunity to bridge this treatment gap, and a series of trials have been set in motion with the aim of minimizing hospitalisations and deaths. A coalition of organizations including CEPI, Gavi, the World Health Organization and Ugandan health authorities are deploying three vaccine candidates to about 3,000 people who have been in contact with Ebola patients. “As we speak, the government of Uganda is finalizing the regulatory approvals,” Africa CDC Director Dr Ahmed Ogwell told CNN. If any of the candidates can succeed, authorities are hopeful this will be the last outbreak Uganda faces without medical defenses. “By embedding research at the heart of the outbreak response, we can achieve two goals,” the WHO said in a statement. “Evaluate potentially efficacious candidate vaccines, potentially contribute to end this outbreak, and protect populations at risk in the future.” Image Credits: WHO, WHO, WHO. Parliamentarians Seek to Address Post-COVID ‘Tsunami’ of Health System Problems 28/11/2022 Maayan Hoffman UNITE president Ricardo Leite (fourth from right) and MPs at the World Health Summit. “There is this tsunami that is happening after the earthquake that was COVID-19 that is now coming to shore and hitting health systems across the world,” said Ricardo Baptista Leite, president and founder of UNITE, a global network of parliamentarians committed to addressing global health challenges. “The pandemic also led to a huge economic crisis and even poor countries in the global South, who might have been less affected by the pandemic, are going to pay a very severe price due to economic consequences that will lead to challenges in responding to the health needs of those countries,” he said. A week before his organization brings together hundreds of parliamentarians from around the world to discuss the most pressing issues in public health at a global summit, the Portuguese MP, who collaborates closely with the World Health Organization (WHO), warned Health Policy Watch of the need to take swift and collective action before the next pandemic. “This is the moment when international institutions and governments need to step up their game and tackle the global health crisis,” Leite said. “We must double up our efforts to make sure we are better equipped in the future and can respond to health needs.” Leite is a long-time global health advocate. He is also a trained medical doctor in infectious diseases and heads the Public Health department at Católica University of Portugal. False sense of security He told Health Policy Watch that whenever the world has felt “capable of controlling infectious disease, we create a false sense of security that we can lower our guard. Whenever we lower our guard, infectious diseases come back with a vengeance.” This can be seen throughout history with multiple pandemics over the centuries, but also in this century with the emergence of antibiotics and the belief that with penicillin we could control infections – a belief now being called into question with the development of antibiotic-resistant bacteria. Antibiotic-resistant bacteria are responsible for the deaths of some 700,000 people each year – with scientists predicting that these infections could kill more people than cancer by 2050. The pandemic has set back the fight against many diseases by years. Take HIV/AIDS. In December 2020, UNAIDS released its 95-95-95 targets, calling for 95% of all people living with HIV to know their HIV status, 95% of all people with diagnosed HIV infection to receive sustained antiretroviral therapy and 95% of all people receiving antiretroviral therapy to have viral suppression by 2025. But during COVID-19, in many countries, measurement of these goals ceased altogether. Where tracking continued, in some cases, diagnoses were slower. “HIV is an interesting proxy for all infectious and communicable diseases out there,” Leite said. In addition, COVID-19 led to a rise in people being diagnosed with late-stage cancer, an increase in cases related to chronic diseases due to people being kept away from health systems, and a spike in mental illness globally. “Pandemics are a strong demonstration of the case that infectious diseases can undermine our efforts toward prosperity for all,” Leite said. He added that during his time as a medical volunteer in Ukraine he saw a huge rise in multi-resistant and extremely resistant tuberculosis in the region. Leite predicted that as the war continues, it will be almost impossible not to see the TB spillover into neighboring countries and then across the world. “There has to be a clear understanding from the world that dealing with infectious diseases is not only something recommended but is a prerequisite for economic and social development worldwide,” he said. The role of parliamentarians WHO parliamentarian session during the World Health Summit (UNITE) Part of the solution is getting parliamentarians around the table, according to Leite. In 2017, the United Nations passed a resolution on the nexus of global health and foreign policy, encouraging a multi-stakeholder approach to achieve universal health coverage. “The voice of parliamentarians was not part of the discussion,” Leite said. “One cannot expect to build a global health architecture or move forward science-based policy making if we do not keep those who write policy in the loop. We cannot make sure money gets where it needs to if we do not include those that make and approve budgets in parliaments.” While he admitted that UNITE is not a “silver bullet,” he said it is a valuable tool for bringing parliamentarians from more than 90 countries together to share experiences and learn how they can best bring their own country toward a more sustainable future. “The first step was to get the conversation going. The second was to develop regional leadership. We now have 10 regional chapters, each led by an MP or former MP. Then we developed policy hubs, specialized teams that focus on specific policy areas, so they can drill down on concrete policymaking in key areas,” Leite explained. “We empower policymakers to be leaders for change in their own countries.” UNITE’s three priorities At its founding, UNITE was focused solely on issues of infectious diseases, but COVID-19 led it to change its mandate over the summer of 2022 and the organization is now focused more generally on global health matters. “The pandemic has demonstrated that global health issues and infectious diseases go hand in hand,” Leite told Health Policy Watch. “We cannot solve many challenges related to infectious disease, which were the basis of our work in the first years, without addressing all the other global health challenges out there.” UNITE is now taking a three-priority approach, focusing on pandemic prevention preparedness and response; the future of health systems; and health as a human right. The group signed a memorandum of understanding recently with WHO to work together on these pillars and supply parliamentary feedback and insight to support WHO’s related efforts. Next week: UNITE Global Summit From 5-7 December, UNITE will host its global summit in Lisbon, bringing together its parliamentarians and leaders from the global health community to expand and forge new partnerships. Members of the lawmaking, civil society, medical and academic communities will meet to talk about what they feel are the most pressing issues on the global health agenda. Another priority that UNITE is bringing to the forefront of the parliamentarian agenda is the use of digital health to promote universal health coverage. “In the last few months with the creation of the digital health hub, parliamentarians were able to discuss with other stakeholders how to build the right frameworks and increase budgets to implement digital health transformation that can promote access to millions,” Leite said. Finally, Leite added that with its new direction in mind, UNITE members would try to answer three questions during the event: What progress have we made so far during the UN’s Sustainable Development Goals period? What have we learned to help us make even more progress by 2030? What is the role of parliamentarians in helping drive that progress? MPs and the pandemic treaty Session on the pandemic treaty at the World Health Summit. In the past, parliamentary involvement has helped achieve public health goals. In Portugal, Leite cited an example from 22 years ago when the parliament decided to decriminalize the use of drugs. “This was not making drug use legal, but now no one goes to jail for using drugs,” he explained. “We stopped looking at people who use drugs as criminals but instead as people who potentially had a health challenge that needed to be dealt with.” Instead of jail time, drug abusers receive harm reduction and other social and health services. When the legislation was passed, around 1% of the Portuguese population used heroin. Since then, Leite said, the numbers have dropped dramatically. Drug-related crime is down, and new HIV cases tied to drug use have fallen from as high as 60% to only 2%. “The fact that we provided harm reduction services and shifted from a criminal perspective to a health perspective was transformative in achieving better health outcomes and partially solving the drug problem in Portugal,” Leite said. A more recent example was the decision by the African Union to set up the African Medicines Agency, which will become a regulatory body for access to health technologies in the continent and creates a common standard of rules based on science to ensure the safety of citizens in the region. Leite equated the AMA to the European Medicines Agency. UNITE founder Ricardo Baptista Leite and Dr Tedros at signing of an MOU between the two organizations. Moving forward, UNITE Parliamentarians will play a key role in finalizing WHO’s pandemic treaty, aimed at guiding the global response to pandemics. “The regulations that were in place when COVID-19 hit were not sufficient or were not properly enforced,” Leite said. He added that “there is a lack of acknowledgement and awareness among most citizens and many parliamentarians around the world that these negotiations are taking place. We need parliamentarians involved early on. If governments agree on a document, parliaments must ratify it.” In an era of “polarized politics and fake news,” he said that if parliamentarians are not part of the process there is a risk that such a treaty would not be ratified, and the world would be left exactly where it was in December 2019. “Everyone is committed to finding a balanced approach to what we hope will create a toolkit from a policy perspective that can help the world be better prepared to detect outbreaks early and lock them down before they transform into pandemics,” Leite said. “It is not acceptable that 100 years after the Spanish flu we saw so many countries react to COVID-19 the same way as they did 100 years before,” he continued. “We have an obligation to be better prepared to constrain any risk, to keep as many people as possible safe. This is a prerequisite for economic and social development. “We need to keep peace and prosperity as our main goal,” Leite concluded. Image Credits: UNITE. There are a Wide Range of Treatments for Obesity, but Many People Cannot Afford Care 28/11/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Amber Huett-Garcia at her high and low weight from 2008 to 2021. Amber Huett-Garcia is trying to drive global change for affordable treatment, care and support for individuals suffering from obesity. A resident of the United States and born into a family suffering from generational obesity, she weighed 101 pounds by the time she was in kindergarten. As an adult, she lost 245 pounds and reduced her BMI from 69 to 24. She did it through a combination of treatments, including bariatric surgery, medication and mental health care. While Huett-Garcia is lucky to have a comprehensive employer-based healthcare plan, she recognizes that many people in the United States do not. And for those who are obese, the cost of care can be enormous. The cost of obesity Obesity costs the US healthcare system nearly $173 billion a year, according to the latest report by the Centers for Disease Control and Prevention. Personal medical costs for people living with obesity are close to $1,500 more per year than those who do not suffer from the condition. For people living with obesity and who are on Medicare, few treatments are covered. For example, Medicare has zero anti-obesity medication coverage. Moreover, roughly 40% of the US population lacks coverage for bariatric surgery for obesity, which has been proven most effective. “Affordable healthcare is a human right,” Huett-Garcia said. Amber Huett-Garcia taking part in the “Stop Weight Bias” campaign. She has called for action to ensure that insurance plans pay for the treatment of a wider range of conditions, including obesity, by covering comprehensive science-based interventions. She has also asked that decision-makers within healthcare systems listen and amplify the voices of people with NCDs. “The lives of people living with NCDs depend on it,” she concluded. Read Amber Huett-Garcia’s full NCD Diary. Read previous post. Image Credits: Courtesy of NCD Alliance. In Vietnam, Nguyen Ha Linh Calls on Government to Give Economic Support to People Living with NCDs 28/11/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Nguyen Ha Linh A young woman living in Vietnam has called on organizations and communities locally and globally to step up support for people living with noncommunicable diseases (NCDs) – especially multiple sclerosis (MS). “I call on the Vietnamese government to give economic support packages to people living with NCDs, especially people with disabilities, because many are paralyzed, unable to support themselves and earn a living,” said Nguyen Ha Linh. Ha Linh lives with MS. Since the age of 23 she has been rapidly deteriorating. While at first she worked as a graphic designer, gradually her arms and legs weakened until she became paralyzed. She developed atrophy of the nerve in her eyes. Today, all of her activities depend on the care of her relatives. Nguyen Ha Linh Access to care But her greatest challenges have been access to care and finances. “Multiple sclerosis is not covered by insurance in Vietnam, so I must pay for my care out of pocket, with financial support from my relatives,” Ha Linh explained. “Multiple sclerosis is considered a rare disease in Vietnam. People living with this condition find it very difficult to access diagnosis and care, and not all major hospitals have the resources for treatment. For those that manage to access care for multiple sclerosis, this is very expensive.” Government must take action She said that people living with MS often focus on getting funding from philanthropists who care about people living with disabilities. However, she believes that the government should be the one to take action first. “Many challenges related to treatment, care and support for people living with NCDs remain largely unaddressed,” Ha Linh said. “In particular, the components of care and support are weak, which therefore means that relatives play an important role for those who have a good support system at home. This is not always the case. “People living with NCDs would like to call on the government to change the regulations around health insurance to allow access to affordable diagnostics and care to help us have a better life,” she concluded. Read Nguyen Ha Linh’s full NCD Diary. Read next post. Image Credits: Courtesy of the NCD Alliance. More Than Five Women Killed Every Hour by Intimate Partners or Family: UN Women, UNODC report 25/11/2022 Megha Kaveri Women and girls are more at risk of getting killed at home by intimate partners or family. A new report by UN Women and the UN Office on Drugs and Crimes (UNODC) said that more than five women or girls are killed every hour across the world by their partners or families. The report, released ahead of the UN’s International Day for the Elimination of Violence Against Women on Friday, said that while men are subjected to higher rates of homicides across the world, women and girls are disproportionately affected by higher rates of homicides in private spaces. In 2021, 81,000 women and girls were killed intentionally, of which around 45,000 – some 55% – were killed by their own intimate partners or family members. By comparison, 11% of the total male homicides happened in private spaces. Covid-19 huge push to fatal violence against women The report found mixed trends on femicide across the world. Between 2010 and 2021, the total number of female homicides by intimate partners or families fell by 19% in Europe. But that number rose by 6% in the Americas overall even as South America reported a decrease. COVID-19 and the subsequent confinement to homes seems to have led to an increase in gender-related killings of women and girls in North America, Western and Southern Europe in 2020, according to the report. “Other sub-regions in Europe and the Americas recorded negligible changes or decreases in the number of killings between 2019 and the end of 2020, which suggests that the onset of the COVID-19 pandemic had heterogeneous impacts,” it said. “The decreases in some sub-regions may reflect delays in recording due to COVID-19 rather than reductions in the number of killings.” The report did not mention similar trends in Asia, Africa or Oceania, due to a lack of data. A World Health Organization-led report last year found almost one in three women experience physical and/or sexual violence across the course of their lifetimes, and in the previous 12 months, more than one in ten women suffered from physical and/or sexual intimate partner violence. More data key to policy formulation Women and girls in all regions are affected by gender-based killings. While Asia isthe region with the largest absolute number of killings, Africa is the region with thehighest level of violence relative to the size of its female population. Highlighting the lack of sufficient and comprehensive data on global femicides, the new report from UN Women and UNODC said more data will enable policy makers to gain a better understanding of the issue and to push for changes. “Additional data beyond identification purposes, such as age of perpetrators and victims, including information surrounding the event of the killing should be collected for analytical purposes,” the report said, adding that will help policy makers detect failures in responses and protection, develop better preventive measures and improve access to justice. Solutions include survivor-centric approaches The report also called for more survivor-centred responses to address gender-based violence in the world, saying it’s an approach that’s “fundamental to preventing and eliminating gender-based violence against women and girls and ensuring it does not escalate to femicide/gender-related killings.” Providing victims with a positive experience when they first report gender-based violence can increase trust and potentially save lives, and encourage other victims to report and disclose crimes. Another measure called for in the report is stronger civil society organisations that work in the women’s rights sector, the report said, because they serve “an important role in preventing gender-based violence against women and girls, by advocating for and securing normative and policy change, providing psycho-social support services and holding governments to account.” Image Credits: Artem Maltzev, UN Women. Fossil Fuels Cast Dark Shadow Over Tanzania’s Green Future 25/11/2022 Kizito Makoye Issa Abdul’s single solar panel powers his barber shop. DAR ES SALAAM, Tanzania – Issa Abdul’s desperate urge for solar power began when he realised a smoke-spewing generator at his barber shop was costing him too much. “Solar power is very cheap. I regret spending my money on this fuel-guzzling machine,” he told Health Policy Watch. The 32-year-old barber in Tanzania’s port city spent roughly Tanzanian shillings 150,000 ($65) to purchase a small solar system and this now powers his hair cutting business. “I am very happy to have my own solar system. It is very useful,” he said. On a humid Sunday morning, Abdul adeptly digs a buzzing clipper through the hair of the client sitting on a leather chair before him. “I was spending a lot of money every month buying fuel, that is history now,” he said. Perched on a rusty roof, Abdul’s lone solar panel produces enough electricity to run two clippers, three bright lights and a cell phone charger. “There’s plenty of sunshine, I don’t disappoint my customers,” he said. Drought cripples hydropower facilities However, like other east African countries such as Kenya and Uganda, solar power still remains a small part of the country’s energy mix. While Tanzania’s electric grid has been primarily powered by hydroelectric power, another renewable source, for some time, hydro’s dominance is slipping now. Climate-related spells of drought have crippled the country’s hydropower facilities and the ageing distribution infrastructure, and the country is experiencing an electricity crisis affecting various sectors of the economy. Hydropower, which can potentially generate 4.7 GW of electricity according to government estimates, is only producing 12% of its power potential, and is prone to weather variability. And as drought tightens its grip, Tanzania, which has 57 trillion cubic feet of natural gas reserves, is now poised to tap this chunk of fossil fuels to cover the electricity deficit Natural gas, oil and coal will almost certainly remain dominant in the country’s energy mix in the near future, according to experts. A motorcyclist riding outside TPTL plant in Dar es Salaam that uses heavy furnace oil to produce electricity. Addressing climate change impact with fossil fuels Tanzania’s experience is just one example of an emerging paradox of addressing climate change impacts with more climate-changing fossil fuel. Tanzania, Kenya and Uganda have been dependent on hydropower, but as all three countries grapple with climate-related drought, they may also find it easier to tap their fossil fuel reserves with the help of multinational investors standing by than develop greener alternatives. This is even as technologies exist for large-scale grid-quality solar power that is ultimately cheaper, industry observers say. While nations worldwide are shifting to renewable energy to reduce the global carbon footprint and ease the toll that fossil fuels take on people’s health, economy and climate, the majority of Tanzanians, like those in large parts of Africa, still use dirty energy sources that pollute the air, causing some 1.1 million deaths annually on the continent, according to a recent study. Air pollution is the second risk factor for death in Africa after malnutrition, concluded the study by the Boston-based Health Effects Institute. Tanzania’s electricity generation comes mostly from natural gas (48%), followed by hydropower (31%), petrol/diesel (18%), solar (1%), and biofuels (1%). In Kenya and Uganda, hydropower and geothermal power are the dominant portions of the electricity generation mix, with solar power making up a very minor proportion of the mix. As demand for energy continues to grow, it is unclear how to ensure that renewables become more attractive than fossil fuel. Investments in fossil fuels far outweigh that of renewables in most parts of Africa, and oil and gas exploration and exploitation continues apace in Kenya, Uganda and Tanzania. Dirty diesel At Kariakoo, a business hub in Dar es Salaam dotted with shopping centres, a toxic haze of diesel hangs in the air as generators roar so loudly that they drown out people’s conversations. Like the lone solar panel precariously hanging on Abdul’s salon, smoke-spewing generators are widely used when grid electricity goes off. They power everything from ceiling fans to television sets, air conditioners and freezers – the latter two items pulling too much power to make a rooftop solar system reliable. Among the available choices, portable diesel generators are among the dirtiest, spewing particulate-laden emissions into the air directly into spaces where people live and work. But they remain the go-to solution in much of Tanzania and Africa more broadly. “To me, a diesel generator provides the necessary power,” said Aloycia Mosha who runs a cold fish store. Soaked with sweat, Mosha repeatedly pulls a string to rev the engine of her generator. “If I don’t switch it on now, all my fish stock will get spoilt,” said Mosha. The 45-year-old entrepreneur has often found a trail of blood oozing on her shop’s tiled floor, a clear sign that the fish defrosted overnight. Vendor stand near a standby diesel generator in Dar es Salaam Power cuts are part of daily life Power cuts are part of daily life in Dar es Salaam, a busy city that is home to 5.8 million people, and accounts for 40% of the country’s GDP. While a few city dwellers have installed solar power on their roof tops to save spiralling energy costs, analysts say the lack of clear financing mechanism to cover initial installation costs, coupled with an unreliable distribution network, have made solar systems a distant luxury to many families. Asteria Mchomvu, a resident of Upanga, a middle-class neighborhood in Dar es Salaam, began to dream of installing solar panels on her roof a decade ago. At first, Mchomvu, who works as a teacher, was excited to learn that solar technology could help her save money and protect the environment. But a home solar system was too expensive for her t the time. A modest 8-kilowat system would roughly cost Tanzanian shillings 10, million ($4347) in 2012, according to Tanzania’s Rural Energy Agency. Prices for solar systems in Tanzania have since fallen by more than 60% and companies are aggressively jostling to pitch their sales. Yet still, the numbers didn’t work for Mchomvu, who teaches geography and science Then early in November, at the Dar es Salaam International Trade Fair, Mchomvu caught up with Richard Tairo, a salesman from Arti energy, a solar company focusing on mid and low -income customers. Tairo understood Mchomvu’s passion for solar and her financial dilemma and he introduced her to Mali Kauli, a program that finances residential solar systems and offers borrowers, below-market rates. Mchomvu accepted the offer after the company assured her that the system could lower her energy bills and spare her the agony of power cuts. “I wanted to be 100% sure it is worth investing,” she told the Health Policy Watch. Skewed regulatory framework disadvantages solar Despite the growing public awareness, renewable energy penetration in Tanzania is still facing major hurdles due to a skewed regulatory framework and limited market. Samuel Wangwe, a research associate with Research on Poverty Alleviation (REPOA) said solar power market has seen sluggish growth due to fragmented financing plans, uneven service after equipment sale and technical weaknesses in batteries and solar lamps, which are often cheap items imported from China with warranties that cannot be honoured. “The most obvious barrier to renewable energy, notably solar is cost. The upfront expenses that people pay to get solar panels installed at their homes are still too high,” Wangwe said. Many investors are discouraged to take on renewable energy projects because of high capital costs and a long net payback period, he added. Wangwe says that the industry is also dogged by a lack of training institutes, which has prevented renewable energy technologies from scaling up. “We must encourage our children to take renewable energy courses and hone their technical skills,” he said. A shop for solar equipment at Kariakoo business centre in Dar es Salaam Bigger subsidies for fossil fuels Although some subsidies are offered for rooftop solar, the subsidies the government provides to fossil fuel sources are much higher, Wangwe said. In fact, in July, the Tanzanian government introduced a new fuel subsidy of a whopping Tanzanian shillings 100 billion ($43 million) monthly to stabilise the domestic price of fuel, Wangwe said. While solar panel and wind turbines are exempt from VAT and are not charged import duties, accessories including the batteries essential to operating a household solar package are charged up to 35% import duty, said Wangwe. “This is the reason why solar technology is not scaling up as fast as possible” he said. Coal, oil and gas are by far the largest contributors to climate change, experts say. In addition, some 65% of deaths from air pollution are generated by fossil fuel combustion, including the noisy and smokey generators that are omnipresent in households and big African cities like Dar es Salaam. While global leaders have endorsed the scientific consensus to limit global warming to 1.5°C above pre-industrial level, as spelled out in the Paris Agreement, there is a growing rush for oil and gas exploration in the global south. This is what COP27 civil society participants called the “dash for gas” reminiscent of the colonial scramble for Africa. More fossil fuel exploration Tanzania has enough gas reserves to put the country on a path of economic prosperity, and may unlock as much as $30 billion in liquified natural gas (LNG) investments. At the same time, if the historic pattern long followed in east and west Africa remains the same, many of the new LNG is likely to be sold to Europe and other countries to generate foreign currency, rather than used at home. “Our political leaders are caught up in a dilemma. Such investments are worthwhile economically but bad for the environment,” said Wangwe. While many have argued that off-grid solar solutions hold the key to Tanzania’s urban and rural electrification, fossil fuels subsidies have reduced its competitiveness. Yusto Mugisha, professor of renewable energy at the school of engineering and technology a Sokoine University of Agriculture, said in order to build a sustainable future, Tanzania needs to invest in clean, accessible and affordable energy sources. “Renewable energy sources are available and their potential is not fully harnessed,” said Mugisha. Although upfront costs for renewable projects can be daunting, Mugisha said efficient and more reliable renewable technologies can create a system that is less prone to market shocks and improve energy security. Unlike fossil fuels, which need to be extracted and transported to large power plants and require a grid network extending to remote areas, renewable sources like solar and wind can be developed in various flexible arrays. They can be just a few panels on a household installation, part of a community mini-grid, or as a solar power plant feeding into the large grid. That, according to the International Energy Agency and countless other assessments means that solar could leap-frog over grid-dependent fossil fuel technologies much like portable phones leap-frogged over fixed phone lines in Africa, providing better service much faster. But renewable energy versus fossil fuels has seemingly placed Tanzania politicians in the moral dilemma. While fossil fuel provides badly needed energy, it leaves behind a carbon footprint that’s proving catastrophic to humans and the planet. Yet, in the short term, policymakers strongly support fuel subsidies to stabilise the prices of other commodities. Meanwhile, renewable energy subsidies, notably on solar, are indirectly offered mostly through the Rural Energy Agency, and are clustered depending on the scale of the project. Despite its small market share local experts say renewable energy has the potential to respond to present and future challenges by enhancing energy security, generating income, and providing employment. Rural dependence on kerosene William Kahise, a student at Itetemia primary school, persuaded hus mother to buy a solar lamp as the kerosene one made him cough. In the dusty western town of Tabora, 12-year-old William Kahise and his sister Juliana routinely huddled around the faint glow of kerosene lamp when the darkness sets in, struggling to get their homework done before their mother blows off the lamp to save the fuel cost. “I must finish my work, otherwise my teacher will be very angry,” Kahise told Health Policy Watch. The paraffin lamp, made from a discarded cooking oil tin, emitted choking smoke and casts scary shadows on the walls. Kerosene is one of the household fuels that WHO has recommended not be used at all, because of its health harmful effects, including impaired lung function, asthma and cancer. The Itetemia primary school pupil may not know about the WHO recommendation, but he knew the smoke made him cough and convinced his mother to ditch the kerosene lantern, for a cheap solar version. Kerosene is used by millions of rural households i to meet basic lighting needs and subsidies have long been used to make the fuel more affordable. Kerosene subsidies have been at the centre of energy policy debate, with renewable energy activists arguing that, for health, safety and environmental reasons, a switch to solar power is better. “The subsidized kerosene is extremely costly and wasteful, the government is spending a lot of money every month to keep the price low,” said Mugisha. But for Abdul, who enjoys solar power, the challenge arises when his Chinese-made panel starts to age and needs to be replaced as Africa produces virtually no panels of its own. –First of two parts on the barriers to clean, renewable energy in Africa. -Research and reporting for this story was supported by the Rosa Luxembourg Foundation. Image Credits: Peter Mgongo. Posts navigation Older postsNewer posts
‘Zero-COVID’ Protestors Win Concessions But Expert Urges China to Increase ‘Hybrid Immunity’ Before Abandoning Policy 28/11/2022 Kerry Cullinan University professors stand between protestors and police at Fudan University in China. Almost three years of harsh lockdowns, enforced quarantines in state facilities and daily testing have tried the patience of many Chinese people, who since Friday have taken to the streets from Shanghai and Nanjing in the east, to central Chengdu and Wuhan and Urumqi and Korla in the north and west. While scores of people have been arrested, protestors have also won some concessions. In Urumqi, where four million people have been in lockdown for over 100 days, officials announced on Monday that it would allow people to travel on buses to do errands and parcel deliveries would resume. Meanwhile, Beijing officials also announced on Sunday that lockdowns of residential areas would not be enforced for longer than 24 hours. These are small indications that Chinese leader Xi Jinping’s “zero-COVID” policy is becoming increasingly impossible to enforce in the face of people’s growing anger and desperation. Two weeks ago, China’s State Council cut compulsory quarantine in a state facility for international visitors and the close contacts of people with COVID from seven to five days, with a further three days at home. It also did away with restrictions on secondary contacts. But a surge in COVID cases in Beijing was followed swiftly by lockdowns, school and restaurant closures, dampening hopes that the country was quietly abandoning the zero-COVID approach. Journalist arrested, assaulted China is trying to both quell and downplay the protests. On Monday, there was increased military and police deployment at sites of weekend protests, and BBC reporter Ed Lawrence was arrested and reportedly assaulted in police custody in Shanghai while reporting on the protests. BBC Statement on Ed Lawrence pic.twitter.com/wedDetCtpF — BBC News Press Team (@BBCNewsPR) November 27, 2022 The weekend protests were sparked by the deaths of 10 people in a fire in an apartment building in Urumqi, the capital of Xinjiang, on Thursday. The screams of people trapped in the burning building last Thursday were captured on social media amid reports that apartment doors had been closed from the outside to enforce the city’s lockdown. Firefighters took more than three hours to stop the fire as cars blocked their path – many with flat batteries after months of not being driven. @renzhiqiang2 ♬ 原聲 – renzhiqiang2 Sealing the doors of COVID-19 contacts is reported to be a common occurrence in China as part of the country’s enforced lockdowns. 用木棍封门,显然还不够。建议官方用钢筋焊死,同时把门上通电,并请官方派两名军人在门外架上机枪。 生我九州者,虽远必封! pic.twitter.com/ajHSk7Jk7Z — 领导干部 (@808Penny) August 30, 2022 Outrage at the deaths in Urumqi led to vigils and protests being arranged in Shanghai, Xi’an, Chongqing and Nanjing, as well as various university campuses, and people turned up in their thousands at some of the protests. Amid chants of ‘Lift lockdown’, ‘No PCR test’ and “We want freedom’, anti-Xi and anti-Communist Party chanting could also be heard. Many people carried blank sheets of white paper to symbolise government censorship, but reports on the protests on Weibo, the Chinese social media platform, were short-lived. Chinese protestors hold blank papers to signify censorship. Back in May, WHO Secretary-General Dr Tedros Adhanom Ghebreyesus told a media briefing that China’s strategy was no longer sustainable in the face of the more infectious but less lethal Omicron. “When we talk about the zero-COVID strategy, we don’t think that it’s sustainable, considering the behaviour of the virus now and what we anticipate in the future,” said Tedros, prompting a rebuke from Chinese officials Aside from its zero-COVID policy, China’s vaccines, Sinopharm and Coronavac, are only about 60% effective against severe infection in comparison to over 90% protection offered by mRNA vaccines. China still to reckon with COVID infections However, it is possible that China will still have its reckoning with COVID as its weary citizens resist further controls and the highly infectious virus spreads through a population with little immunity. Global data analysis group Airfinity estimates that 1.3 and 2.1 million lives could be at risk if China lifts its zero-COVID policy “given low vaccination and booster rates as well as a lack of hybrid immunity”. It based its risk analysis on the cumulative peak cases and deaths from Hong Kong’s BA.1 wave as a proxy for mainland China. “Mainland China has very low levels of immunity across its population. Its citizens were vaccinated with domestically produced jabs Sinovac and Sinopharm which have been proven to have significantly lower efficacy and provide less protection against infection and death,” Airfinity said in a statement on Monday. “This vaccine-induced immunity has waned over time and with low booster uptake and no natural infections, the population is more susceptible to severe disease. China’s current booster uptake is 40%, whilst Hong Kong’s primary series uptake was 34% back in February 2022 when it saw a large spike in cases due to the BA.1 omicron variant,” said Airfinity. Dr Louise Blair, Airfinity’s head of vaccines and epidemiology, called on China to “ramp up vaccinations to raise immunity in order to lift its zero-COVID policy, especially given how large its elderly population is”. Blair said that China needs “hybrid immunity” from both vaccinations and infections to ensure “much less impactful and deadly COVID-19 waves”. Localised protests Prior to the national weekend protests, there have been intense local protests, particularly at the Foxconn facility in Zhengzhou, which makes 70% of the Apple’s iPhones. Workers work long shifts and usually stay in massive factory dormitories that can house up to 300,000 people. But after a small COVID outbreak in the city in October, Foxconn closed the dining halls and introduced “closed loop” production to cut workers’ contact with the outside world to meet production demands for the launch of the iPhone14. Tesla and other factories have used this approach during lockdowns in Shanghai in March. But Foxconn workers started to panic in fear of being forcibly quarantined there, and have clashed a number of times with police. Numerous reports of poor treatment and neglect at state quarantine facilities have also leaked out in public, alongside videos of small children removed from COVID-exposed parents being forced to fend for themselves in such facilities. 上海儿童集中营。 pic.twitter.com/BNTbOPXBLD — 方舟子 (@fangshimin) April 2, 2022 Image Credits: Twitter. Uganda Extends Lockdowns in Bid to End Ebola Outbreak 28/11/2022 Stefan Anderson 68 days and 52 deaths into Uganda’s Ebola outbreak, authorities are hopeful the spread of the virus has been contained. Uganda’s President Yoweri Museveni has extended quarantine measures in the two districts at the epicentre of the country’s Ebola epidemic for another 21 days, citing the need to protect gains in the fight against the virus. This marks the third renewal of lockdowns in Kassanda and Mubende, and authorities are hopeful it will be the last. Movement in and out of the districts was first restricted on 15 October, and renewed for another 21 days on 5 November. The measures include a curfew and the closure of social spaces like churches, bars and markets. “It may be too early to celebrate success, but overall, I have been briefed that the picture is good,” Museveni said in a televised address delivered by vice-president Jessica Alupo. While the situation is “still fragile”, Museveni said Ugandan health authorities are “very optimistic” that the outbreak will end “in the coming month.” The government’s optimism is buoyed by Uganda’s continued progress in stamping out the outbreak. Three districts have completed over 42 days since the last case of Ebola was detected, while six districts – including the epicentres of Kassanda and Mubende as well as the capital, Kampala – remain in “follow-up” protocols. The virus has so far claimed 56 lives, while another 22 probable Ebola deaths were registered before the government issued its official declaration of the outbreak on 20 September. “If we open now and a case appears, we will have destroyed all the gains we have made in this war,” Museveni said. “Our healthcare workers will continue to do all it takes to save lives and bring the epidemic to an end.” Full reopening if the 21-day mark is reached With numbers dropping, bed occupancy rates within the past 24 hours stood at just 27.9% in Mubende isolation units. The government’s decision to extend lockdowns by 21 days is based on the incubation period of Ebola. The three-week mark is a key indicator of whether transmission has been stopped. Mid-way through November, Mubende appeared to be in the clear. The district had gone 13 days without reporting a new case. But on day 14, a 23-year-old medical student with links to previous cases was diagnosed with the virus. “Without completing 21 days, as we saw with Mubende, a case can pop up anywhere,” the President said. “It is important that we complete the entire cycle.” Kassanda has now reached 15 days since reporting a new case, while Mubende has not registered a confirmed case for 14 days. If both districts hold on for another week, Uganda’s fifth deadly encounter with the Sudan strain of Ebola may come to a swift end. “We are relying on you to cooperate and bring this epidemic to an end,” the President told residents of Kassanda and Mubende, noting their commitment and sacrifice thus far. “If there is no case by the end of the 21-day period, we will re-open fully.” Threat of urban transmission avoided Ebola’s invasion of Uganda’s Gulu municipality and its slum-like camps for internally displaced persons in 2000 was the cause of the deadliest Ebola epidemic in the country’s history. When six school children were diagnosed with Ebola in Kampala in late October, fears of the virus embedding itself in the capital spiked. On paper, Ebola’s mortality rate of up to 90% makes the virus easy to contain. Museveni also noted that as a virus transferred through contact and bodily fluids, Ebola, despite its “devastating nature”, is far easier to control than airborne threats like COVID-19. But if allowed to embed itself in densely populated areas, things can quickly spiral out of control. “If we had allowed the escalation of the outbreak into Kampala, the consequences would have been bad, including possible exportation to our African brothers in neighbouring countries,” Museveni said. Despite calls from doctors and health advocates to lockdown the capital earlier this month, Museveni and Health Minister Jane Ruth Aceng elected not to bow to the pressure. So far, their decision appears to be validated. “The opportunity for immediate quarantine of contacts was lost for Mubende and Kassanda,” Museveni said, noting the first suspected cases were registered on 6 September, two weeks before authorities declared the outbreak. This was not the case for Kampala. Knowledge of the threat allowed health authorities to be on reactive footing, and respond quickly to isolate infected people and their contacts. Today, over 300 contacts remain under institutional quarantine overseen by the Ministry of Health. Vaccine Trials Are Underway WHO Africa Director Dr Matshidiso Moeti visited Kassanda and Mubende earlier this month to coordinate with Ugandan health authorities and other international partners in responding to the outbreak. There is currently no known vaccine for the Sudan strain of Ebola responsible for the Ugandan outbreak. But the outbreak presents a unique opportunity to bridge this treatment gap, and a series of trials have been set in motion with the aim of minimizing hospitalisations and deaths. A coalition of organizations including CEPI, Gavi, the World Health Organization and Ugandan health authorities are deploying three vaccine candidates to about 3,000 people who have been in contact with Ebola patients. “As we speak, the government of Uganda is finalizing the regulatory approvals,” Africa CDC Director Dr Ahmed Ogwell told CNN. If any of the candidates can succeed, authorities are hopeful this will be the last outbreak Uganda faces without medical defenses. “By embedding research at the heart of the outbreak response, we can achieve two goals,” the WHO said in a statement. “Evaluate potentially efficacious candidate vaccines, potentially contribute to end this outbreak, and protect populations at risk in the future.” Image Credits: WHO, WHO, WHO. Parliamentarians Seek to Address Post-COVID ‘Tsunami’ of Health System Problems 28/11/2022 Maayan Hoffman UNITE president Ricardo Leite (fourth from right) and MPs at the World Health Summit. “There is this tsunami that is happening after the earthquake that was COVID-19 that is now coming to shore and hitting health systems across the world,” said Ricardo Baptista Leite, president and founder of UNITE, a global network of parliamentarians committed to addressing global health challenges. “The pandemic also led to a huge economic crisis and even poor countries in the global South, who might have been less affected by the pandemic, are going to pay a very severe price due to economic consequences that will lead to challenges in responding to the health needs of those countries,” he said. A week before his organization brings together hundreds of parliamentarians from around the world to discuss the most pressing issues in public health at a global summit, the Portuguese MP, who collaborates closely with the World Health Organization (WHO), warned Health Policy Watch of the need to take swift and collective action before the next pandemic. “This is the moment when international institutions and governments need to step up their game and tackle the global health crisis,” Leite said. “We must double up our efforts to make sure we are better equipped in the future and can respond to health needs.” Leite is a long-time global health advocate. He is also a trained medical doctor in infectious diseases and heads the Public Health department at Católica University of Portugal. False sense of security He told Health Policy Watch that whenever the world has felt “capable of controlling infectious disease, we create a false sense of security that we can lower our guard. Whenever we lower our guard, infectious diseases come back with a vengeance.” This can be seen throughout history with multiple pandemics over the centuries, but also in this century with the emergence of antibiotics and the belief that with penicillin we could control infections – a belief now being called into question with the development of antibiotic-resistant bacteria. Antibiotic-resistant bacteria are responsible for the deaths of some 700,000 people each year – with scientists predicting that these infections could kill more people than cancer by 2050. The pandemic has set back the fight against many diseases by years. Take HIV/AIDS. In December 2020, UNAIDS released its 95-95-95 targets, calling for 95% of all people living with HIV to know their HIV status, 95% of all people with diagnosed HIV infection to receive sustained antiretroviral therapy and 95% of all people receiving antiretroviral therapy to have viral suppression by 2025. But during COVID-19, in many countries, measurement of these goals ceased altogether. Where tracking continued, in some cases, diagnoses were slower. “HIV is an interesting proxy for all infectious and communicable diseases out there,” Leite said. In addition, COVID-19 led to a rise in people being diagnosed with late-stage cancer, an increase in cases related to chronic diseases due to people being kept away from health systems, and a spike in mental illness globally. “Pandemics are a strong demonstration of the case that infectious diseases can undermine our efforts toward prosperity for all,” Leite said. He added that during his time as a medical volunteer in Ukraine he saw a huge rise in multi-resistant and extremely resistant tuberculosis in the region. Leite predicted that as the war continues, it will be almost impossible not to see the TB spillover into neighboring countries and then across the world. “There has to be a clear understanding from the world that dealing with infectious diseases is not only something recommended but is a prerequisite for economic and social development worldwide,” he said. The role of parliamentarians WHO parliamentarian session during the World Health Summit (UNITE) Part of the solution is getting parliamentarians around the table, according to Leite. In 2017, the United Nations passed a resolution on the nexus of global health and foreign policy, encouraging a multi-stakeholder approach to achieve universal health coverage. “The voice of parliamentarians was not part of the discussion,” Leite said. “One cannot expect to build a global health architecture or move forward science-based policy making if we do not keep those who write policy in the loop. We cannot make sure money gets where it needs to if we do not include those that make and approve budgets in parliaments.” While he admitted that UNITE is not a “silver bullet,” he said it is a valuable tool for bringing parliamentarians from more than 90 countries together to share experiences and learn how they can best bring their own country toward a more sustainable future. “The first step was to get the conversation going. The second was to develop regional leadership. We now have 10 regional chapters, each led by an MP or former MP. Then we developed policy hubs, specialized teams that focus on specific policy areas, so they can drill down on concrete policymaking in key areas,” Leite explained. “We empower policymakers to be leaders for change in their own countries.” UNITE’s three priorities At its founding, UNITE was focused solely on issues of infectious diseases, but COVID-19 led it to change its mandate over the summer of 2022 and the organization is now focused more generally on global health matters. “The pandemic has demonstrated that global health issues and infectious diseases go hand in hand,” Leite told Health Policy Watch. “We cannot solve many challenges related to infectious disease, which were the basis of our work in the first years, without addressing all the other global health challenges out there.” UNITE is now taking a three-priority approach, focusing on pandemic prevention preparedness and response; the future of health systems; and health as a human right. The group signed a memorandum of understanding recently with WHO to work together on these pillars and supply parliamentary feedback and insight to support WHO’s related efforts. Next week: UNITE Global Summit From 5-7 December, UNITE will host its global summit in Lisbon, bringing together its parliamentarians and leaders from the global health community to expand and forge new partnerships. Members of the lawmaking, civil society, medical and academic communities will meet to talk about what they feel are the most pressing issues on the global health agenda. Another priority that UNITE is bringing to the forefront of the parliamentarian agenda is the use of digital health to promote universal health coverage. “In the last few months with the creation of the digital health hub, parliamentarians were able to discuss with other stakeholders how to build the right frameworks and increase budgets to implement digital health transformation that can promote access to millions,” Leite said. Finally, Leite added that with its new direction in mind, UNITE members would try to answer three questions during the event: What progress have we made so far during the UN’s Sustainable Development Goals period? What have we learned to help us make even more progress by 2030? What is the role of parliamentarians in helping drive that progress? MPs and the pandemic treaty Session on the pandemic treaty at the World Health Summit. In the past, parliamentary involvement has helped achieve public health goals. In Portugal, Leite cited an example from 22 years ago when the parliament decided to decriminalize the use of drugs. “This was not making drug use legal, but now no one goes to jail for using drugs,” he explained. “We stopped looking at people who use drugs as criminals but instead as people who potentially had a health challenge that needed to be dealt with.” Instead of jail time, drug abusers receive harm reduction and other social and health services. When the legislation was passed, around 1% of the Portuguese population used heroin. Since then, Leite said, the numbers have dropped dramatically. Drug-related crime is down, and new HIV cases tied to drug use have fallen from as high as 60% to only 2%. “The fact that we provided harm reduction services and shifted from a criminal perspective to a health perspective was transformative in achieving better health outcomes and partially solving the drug problem in Portugal,” Leite said. A more recent example was the decision by the African Union to set up the African Medicines Agency, which will become a regulatory body for access to health technologies in the continent and creates a common standard of rules based on science to ensure the safety of citizens in the region. Leite equated the AMA to the European Medicines Agency. UNITE founder Ricardo Baptista Leite and Dr Tedros at signing of an MOU between the two organizations. Moving forward, UNITE Parliamentarians will play a key role in finalizing WHO’s pandemic treaty, aimed at guiding the global response to pandemics. “The regulations that were in place when COVID-19 hit were not sufficient or were not properly enforced,” Leite said. He added that “there is a lack of acknowledgement and awareness among most citizens and many parliamentarians around the world that these negotiations are taking place. We need parliamentarians involved early on. If governments agree on a document, parliaments must ratify it.” In an era of “polarized politics and fake news,” he said that if parliamentarians are not part of the process there is a risk that such a treaty would not be ratified, and the world would be left exactly where it was in December 2019. “Everyone is committed to finding a balanced approach to what we hope will create a toolkit from a policy perspective that can help the world be better prepared to detect outbreaks early and lock them down before they transform into pandemics,” Leite said. “It is not acceptable that 100 years after the Spanish flu we saw so many countries react to COVID-19 the same way as they did 100 years before,” he continued. “We have an obligation to be better prepared to constrain any risk, to keep as many people as possible safe. This is a prerequisite for economic and social development. “We need to keep peace and prosperity as our main goal,” Leite concluded. Image Credits: UNITE. There are a Wide Range of Treatments for Obesity, but Many People Cannot Afford Care 28/11/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Amber Huett-Garcia at her high and low weight from 2008 to 2021. Amber Huett-Garcia is trying to drive global change for affordable treatment, care and support for individuals suffering from obesity. A resident of the United States and born into a family suffering from generational obesity, she weighed 101 pounds by the time she was in kindergarten. As an adult, she lost 245 pounds and reduced her BMI from 69 to 24. She did it through a combination of treatments, including bariatric surgery, medication and mental health care. While Huett-Garcia is lucky to have a comprehensive employer-based healthcare plan, she recognizes that many people in the United States do not. And for those who are obese, the cost of care can be enormous. The cost of obesity Obesity costs the US healthcare system nearly $173 billion a year, according to the latest report by the Centers for Disease Control and Prevention. Personal medical costs for people living with obesity are close to $1,500 more per year than those who do not suffer from the condition. For people living with obesity and who are on Medicare, few treatments are covered. For example, Medicare has zero anti-obesity medication coverage. Moreover, roughly 40% of the US population lacks coverage for bariatric surgery for obesity, which has been proven most effective. “Affordable healthcare is a human right,” Huett-Garcia said. Amber Huett-Garcia taking part in the “Stop Weight Bias” campaign. She has called for action to ensure that insurance plans pay for the treatment of a wider range of conditions, including obesity, by covering comprehensive science-based interventions. She has also asked that decision-makers within healthcare systems listen and amplify the voices of people with NCDs. “The lives of people living with NCDs depend on it,” she concluded. Read Amber Huett-Garcia’s full NCD Diary. Read previous post. Image Credits: Courtesy of NCD Alliance. In Vietnam, Nguyen Ha Linh Calls on Government to Give Economic Support to People Living with NCDs 28/11/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Nguyen Ha Linh A young woman living in Vietnam has called on organizations and communities locally and globally to step up support for people living with noncommunicable diseases (NCDs) – especially multiple sclerosis (MS). “I call on the Vietnamese government to give economic support packages to people living with NCDs, especially people with disabilities, because many are paralyzed, unable to support themselves and earn a living,” said Nguyen Ha Linh. Ha Linh lives with MS. Since the age of 23 she has been rapidly deteriorating. While at first she worked as a graphic designer, gradually her arms and legs weakened until she became paralyzed. She developed atrophy of the nerve in her eyes. Today, all of her activities depend on the care of her relatives. Nguyen Ha Linh Access to care But her greatest challenges have been access to care and finances. “Multiple sclerosis is not covered by insurance in Vietnam, so I must pay for my care out of pocket, with financial support from my relatives,” Ha Linh explained. “Multiple sclerosis is considered a rare disease in Vietnam. People living with this condition find it very difficult to access diagnosis and care, and not all major hospitals have the resources for treatment. For those that manage to access care for multiple sclerosis, this is very expensive.” Government must take action She said that people living with MS often focus on getting funding from philanthropists who care about people living with disabilities. However, she believes that the government should be the one to take action first. “Many challenges related to treatment, care and support for people living with NCDs remain largely unaddressed,” Ha Linh said. “In particular, the components of care and support are weak, which therefore means that relatives play an important role for those who have a good support system at home. This is not always the case. “People living with NCDs would like to call on the government to change the regulations around health insurance to allow access to affordable diagnostics and care to help us have a better life,” she concluded. Read Nguyen Ha Linh’s full NCD Diary. Read next post. Image Credits: Courtesy of the NCD Alliance. More Than Five Women Killed Every Hour by Intimate Partners or Family: UN Women, UNODC report 25/11/2022 Megha Kaveri Women and girls are more at risk of getting killed at home by intimate partners or family. A new report by UN Women and the UN Office on Drugs and Crimes (UNODC) said that more than five women or girls are killed every hour across the world by their partners or families. The report, released ahead of the UN’s International Day for the Elimination of Violence Against Women on Friday, said that while men are subjected to higher rates of homicides across the world, women and girls are disproportionately affected by higher rates of homicides in private spaces. In 2021, 81,000 women and girls were killed intentionally, of which around 45,000 – some 55% – were killed by their own intimate partners or family members. By comparison, 11% of the total male homicides happened in private spaces. Covid-19 huge push to fatal violence against women The report found mixed trends on femicide across the world. Between 2010 and 2021, the total number of female homicides by intimate partners or families fell by 19% in Europe. But that number rose by 6% in the Americas overall even as South America reported a decrease. COVID-19 and the subsequent confinement to homes seems to have led to an increase in gender-related killings of women and girls in North America, Western and Southern Europe in 2020, according to the report. “Other sub-regions in Europe and the Americas recorded negligible changes or decreases in the number of killings between 2019 and the end of 2020, which suggests that the onset of the COVID-19 pandemic had heterogeneous impacts,” it said. “The decreases in some sub-regions may reflect delays in recording due to COVID-19 rather than reductions in the number of killings.” The report did not mention similar trends in Asia, Africa or Oceania, due to a lack of data. A World Health Organization-led report last year found almost one in three women experience physical and/or sexual violence across the course of their lifetimes, and in the previous 12 months, more than one in ten women suffered from physical and/or sexual intimate partner violence. More data key to policy formulation Women and girls in all regions are affected by gender-based killings. While Asia isthe region with the largest absolute number of killings, Africa is the region with thehighest level of violence relative to the size of its female population. Highlighting the lack of sufficient and comprehensive data on global femicides, the new report from UN Women and UNODC said more data will enable policy makers to gain a better understanding of the issue and to push for changes. “Additional data beyond identification purposes, such as age of perpetrators and victims, including information surrounding the event of the killing should be collected for analytical purposes,” the report said, adding that will help policy makers detect failures in responses and protection, develop better preventive measures and improve access to justice. Solutions include survivor-centric approaches The report also called for more survivor-centred responses to address gender-based violence in the world, saying it’s an approach that’s “fundamental to preventing and eliminating gender-based violence against women and girls and ensuring it does not escalate to femicide/gender-related killings.” Providing victims with a positive experience when they first report gender-based violence can increase trust and potentially save lives, and encourage other victims to report and disclose crimes. Another measure called for in the report is stronger civil society organisations that work in the women’s rights sector, the report said, because they serve “an important role in preventing gender-based violence against women and girls, by advocating for and securing normative and policy change, providing psycho-social support services and holding governments to account.” Image Credits: Artem Maltzev, UN Women. Fossil Fuels Cast Dark Shadow Over Tanzania’s Green Future 25/11/2022 Kizito Makoye Issa Abdul’s single solar panel powers his barber shop. DAR ES SALAAM, Tanzania – Issa Abdul’s desperate urge for solar power began when he realised a smoke-spewing generator at his barber shop was costing him too much. “Solar power is very cheap. I regret spending my money on this fuel-guzzling machine,” he told Health Policy Watch. The 32-year-old barber in Tanzania’s port city spent roughly Tanzanian shillings 150,000 ($65) to purchase a small solar system and this now powers his hair cutting business. “I am very happy to have my own solar system. It is very useful,” he said. On a humid Sunday morning, Abdul adeptly digs a buzzing clipper through the hair of the client sitting on a leather chair before him. “I was spending a lot of money every month buying fuel, that is history now,” he said. Perched on a rusty roof, Abdul’s lone solar panel produces enough electricity to run two clippers, three bright lights and a cell phone charger. “There’s plenty of sunshine, I don’t disappoint my customers,” he said. Drought cripples hydropower facilities However, like other east African countries such as Kenya and Uganda, solar power still remains a small part of the country’s energy mix. While Tanzania’s electric grid has been primarily powered by hydroelectric power, another renewable source, for some time, hydro’s dominance is slipping now. Climate-related spells of drought have crippled the country’s hydropower facilities and the ageing distribution infrastructure, and the country is experiencing an electricity crisis affecting various sectors of the economy. Hydropower, which can potentially generate 4.7 GW of electricity according to government estimates, is only producing 12% of its power potential, and is prone to weather variability. And as drought tightens its grip, Tanzania, which has 57 trillion cubic feet of natural gas reserves, is now poised to tap this chunk of fossil fuels to cover the electricity deficit Natural gas, oil and coal will almost certainly remain dominant in the country’s energy mix in the near future, according to experts. A motorcyclist riding outside TPTL plant in Dar es Salaam that uses heavy furnace oil to produce electricity. Addressing climate change impact with fossil fuels Tanzania’s experience is just one example of an emerging paradox of addressing climate change impacts with more climate-changing fossil fuel. Tanzania, Kenya and Uganda have been dependent on hydropower, but as all three countries grapple with climate-related drought, they may also find it easier to tap their fossil fuel reserves with the help of multinational investors standing by than develop greener alternatives. This is even as technologies exist for large-scale grid-quality solar power that is ultimately cheaper, industry observers say. While nations worldwide are shifting to renewable energy to reduce the global carbon footprint and ease the toll that fossil fuels take on people’s health, economy and climate, the majority of Tanzanians, like those in large parts of Africa, still use dirty energy sources that pollute the air, causing some 1.1 million deaths annually on the continent, according to a recent study. Air pollution is the second risk factor for death in Africa after malnutrition, concluded the study by the Boston-based Health Effects Institute. Tanzania’s electricity generation comes mostly from natural gas (48%), followed by hydropower (31%), petrol/diesel (18%), solar (1%), and biofuels (1%). In Kenya and Uganda, hydropower and geothermal power are the dominant portions of the electricity generation mix, with solar power making up a very minor proportion of the mix. As demand for energy continues to grow, it is unclear how to ensure that renewables become more attractive than fossil fuel. Investments in fossil fuels far outweigh that of renewables in most parts of Africa, and oil and gas exploration and exploitation continues apace in Kenya, Uganda and Tanzania. Dirty diesel At Kariakoo, a business hub in Dar es Salaam dotted with shopping centres, a toxic haze of diesel hangs in the air as generators roar so loudly that they drown out people’s conversations. Like the lone solar panel precariously hanging on Abdul’s salon, smoke-spewing generators are widely used when grid electricity goes off. They power everything from ceiling fans to television sets, air conditioners and freezers – the latter two items pulling too much power to make a rooftop solar system reliable. Among the available choices, portable diesel generators are among the dirtiest, spewing particulate-laden emissions into the air directly into spaces where people live and work. But they remain the go-to solution in much of Tanzania and Africa more broadly. “To me, a diesel generator provides the necessary power,” said Aloycia Mosha who runs a cold fish store. Soaked with sweat, Mosha repeatedly pulls a string to rev the engine of her generator. “If I don’t switch it on now, all my fish stock will get spoilt,” said Mosha. The 45-year-old entrepreneur has often found a trail of blood oozing on her shop’s tiled floor, a clear sign that the fish defrosted overnight. Vendor stand near a standby diesel generator in Dar es Salaam Power cuts are part of daily life Power cuts are part of daily life in Dar es Salaam, a busy city that is home to 5.8 million people, and accounts for 40% of the country’s GDP. While a few city dwellers have installed solar power on their roof tops to save spiralling energy costs, analysts say the lack of clear financing mechanism to cover initial installation costs, coupled with an unreliable distribution network, have made solar systems a distant luxury to many families. Asteria Mchomvu, a resident of Upanga, a middle-class neighborhood in Dar es Salaam, began to dream of installing solar panels on her roof a decade ago. At first, Mchomvu, who works as a teacher, was excited to learn that solar technology could help her save money and protect the environment. But a home solar system was too expensive for her t the time. A modest 8-kilowat system would roughly cost Tanzanian shillings 10, million ($4347) in 2012, according to Tanzania’s Rural Energy Agency. Prices for solar systems in Tanzania have since fallen by more than 60% and companies are aggressively jostling to pitch their sales. Yet still, the numbers didn’t work for Mchomvu, who teaches geography and science Then early in November, at the Dar es Salaam International Trade Fair, Mchomvu caught up with Richard Tairo, a salesman from Arti energy, a solar company focusing on mid and low -income customers. Tairo understood Mchomvu’s passion for solar and her financial dilemma and he introduced her to Mali Kauli, a program that finances residential solar systems and offers borrowers, below-market rates. Mchomvu accepted the offer after the company assured her that the system could lower her energy bills and spare her the agony of power cuts. “I wanted to be 100% sure it is worth investing,” she told the Health Policy Watch. Skewed regulatory framework disadvantages solar Despite the growing public awareness, renewable energy penetration in Tanzania is still facing major hurdles due to a skewed regulatory framework and limited market. Samuel Wangwe, a research associate with Research on Poverty Alleviation (REPOA) said solar power market has seen sluggish growth due to fragmented financing plans, uneven service after equipment sale and technical weaknesses in batteries and solar lamps, which are often cheap items imported from China with warranties that cannot be honoured. “The most obvious barrier to renewable energy, notably solar is cost. The upfront expenses that people pay to get solar panels installed at their homes are still too high,” Wangwe said. Many investors are discouraged to take on renewable energy projects because of high capital costs and a long net payback period, he added. Wangwe says that the industry is also dogged by a lack of training institutes, which has prevented renewable energy technologies from scaling up. “We must encourage our children to take renewable energy courses and hone their technical skills,” he said. A shop for solar equipment at Kariakoo business centre in Dar es Salaam Bigger subsidies for fossil fuels Although some subsidies are offered for rooftop solar, the subsidies the government provides to fossil fuel sources are much higher, Wangwe said. In fact, in July, the Tanzanian government introduced a new fuel subsidy of a whopping Tanzanian shillings 100 billion ($43 million) monthly to stabilise the domestic price of fuel, Wangwe said. While solar panel and wind turbines are exempt from VAT and are not charged import duties, accessories including the batteries essential to operating a household solar package are charged up to 35% import duty, said Wangwe. “This is the reason why solar technology is not scaling up as fast as possible” he said. Coal, oil and gas are by far the largest contributors to climate change, experts say. In addition, some 65% of deaths from air pollution are generated by fossil fuel combustion, including the noisy and smokey generators that are omnipresent in households and big African cities like Dar es Salaam. While global leaders have endorsed the scientific consensus to limit global warming to 1.5°C above pre-industrial level, as spelled out in the Paris Agreement, there is a growing rush for oil and gas exploration in the global south. This is what COP27 civil society participants called the “dash for gas” reminiscent of the colonial scramble for Africa. More fossil fuel exploration Tanzania has enough gas reserves to put the country on a path of economic prosperity, and may unlock as much as $30 billion in liquified natural gas (LNG) investments. At the same time, if the historic pattern long followed in east and west Africa remains the same, many of the new LNG is likely to be sold to Europe and other countries to generate foreign currency, rather than used at home. “Our political leaders are caught up in a dilemma. Such investments are worthwhile economically but bad for the environment,” said Wangwe. While many have argued that off-grid solar solutions hold the key to Tanzania’s urban and rural electrification, fossil fuels subsidies have reduced its competitiveness. Yusto Mugisha, professor of renewable energy at the school of engineering and technology a Sokoine University of Agriculture, said in order to build a sustainable future, Tanzania needs to invest in clean, accessible and affordable energy sources. “Renewable energy sources are available and their potential is not fully harnessed,” said Mugisha. Although upfront costs for renewable projects can be daunting, Mugisha said efficient and more reliable renewable technologies can create a system that is less prone to market shocks and improve energy security. Unlike fossil fuels, which need to be extracted and transported to large power plants and require a grid network extending to remote areas, renewable sources like solar and wind can be developed in various flexible arrays. They can be just a few panels on a household installation, part of a community mini-grid, or as a solar power plant feeding into the large grid. That, according to the International Energy Agency and countless other assessments means that solar could leap-frog over grid-dependent fossil fuel technologies much like portable phones leap-frogged over fixed phone lines in Africa, providing better service much faster. But renewable energy versus fossil fuels has seemingly placed Tanzania politicians in the moral dilemma. While fossil fuel provides badly needed energy, it leaves behind a carbon footprint that’s proving catastrophic to humans and the planet. Yet, in the short term, policymakers strongly support fuel subsidies to stabilise the prices of other commodities. Meanwhile, renewable energy subsidies, notably on solar, are indirectly offered mostly through the Rural Energy Agency, and are clustered depending on the scale of the project. Despite its small market share local experts say renewable energy has the potential to respond to present and future challenges by enhancing energy security, generating income, and providing employment. Rural dependence on kerosene William Kahise, a student at Itetemia primary school, persuaded hus mother to buy a solar lamp as the kerosene one made him cough. In the dusty western town of Tabora, 12-year-old William Kahise and his sister Juliana routinely huddled around the faint glow of kerosene lamp when the darkness sets in, struggling to get their homework done before their mother blows off the lamp to save the fuel cost. “I must finish my work, otherwise my teacher will be very angry,” Kahise told Health Policy Watch. The paraffin lamp, made from a discarded cooking oil tin, emitted choking smoke and casts scary shadows on the walls. Kerosene is one of the household fuels that WHO has recommended not be used at all, because of its health harmful effects, including impaired lung function, asthma and cancer. The Itetemia primary school pupil may not know about the WHO recommendation, but he knew the smoke made him cough and convinced his mother to ditch the kerosene lantern, for a cheap solar version. Kerosene is used by millions of rural households i to meet basic lighting needs and subsidies have long been used to make the fuel more affordable. Kerosene subsidies have been at the centre of energy policy debate, with renewable energy activists arguing that, for health, safety and environmental reasons, a switch to solar power is better. “The subsidized kerosene is extremely costly and wasteful, the government is spending a lot of money every month to keep the price low,” said Mugisha. But for Abdul, who enjoys solar power, the challenge arises when his Chinese-made panel starts to age and needs to be replaced as Africa produces virtually no panels of its own. –First of two parts on the barriers to clean, renewable energy in Africa. -Research and reporting for this story was supported by the Rosa Luxembourg Foundation. Image Credits: Peter Mgongo. Posts navigation Older postsNewer posts
Uganda Extends Lockdowns in Bid to End Ebola Outbreak 28/11/2022 Stefan Anderson 68 days and 52 deaths into Uganda’s Ebola outbreak, authorities are hopeful the spread of the virus has been contained. Uganda’s President Yoweri Museveni has extended quarantine measures in the two districts at the epicentre of the country’s Ebola epidemic for another 21 days, citing the need to protect gains in the fight against the virus. This marks the third renewal of lockdowns in Kassanda and Mubende, and authorities are hopeful it will be the last. Movement in and out of the districts was first restricted on 15 October, and renewed for another 21 days on 5 November. The measures include a curfew and the closure of social spaces like churches, bars and markets. “It may be too early to celebrate success, but overall, I have been briefed that the picture is good,” Museveni said in a televised address delivered by vice-president Jessica Alupo. While the situation is “still fragile”, Museveni said Ugandan health authorities are “very optimistic” that the outbreak will end “in the coming month.” The government’s optimism is buoyed by Uganda’s continued progress in stamping out the outbreak. Three districts have completed over 42 days since the last case of Ebola was detected, while six districts – including the epicentres of Kassanda and Mubende as well as the capital, Kampala – remain in “follow-up” protocols. The virus has so far claimed 56 lives, while another 22 probable Ebola deaths were registered before the government issued its official declaration of the outbreak on 20 September. “If we open now and a case appears, we will have destroyed all the gains we have made in this war,” Museveni said. “Our healthcare workers will continue to do all it takes to save lives and bring the epidemic to an end.” Full reopening if the 21-day mark is reached With numbers dropping, bed occupancy rates within the past 24 hours stood at just 27.9% in Mubende isolation units. The government’s decision to extend lockdowns by 21 days is based on the incubation period of Ebola. The three-week mark is a key indicator of whether transmission has been stopped. Mid-way through November, Mubende appeared to be in the clear. The district had gone 13 days without reporting a new case. But on day 14, a 23-year-old medical student with links to previous cases was diagnosed with the virus. “Without completing 21 days, as we saw with Mubende, a case can pop up anywhere,” the President said. “It is important that we complete the entire cycle.” Kassanda has now reached 15 days since reporting a new case, while Mubende has not registered a confirmed case for 14 days. If both districts hold on for another week, Uganda’s fifth deadly encounter with the Sudan strain of Ebola may come to a swift end. “We are relying on you to cooperate and bring this epidemic to an end,” the President told residents of Kassanda and Mubende, noting their commitment and sacrifice thus far. “If there is no case by the end of the 21-day period, we will re-open fully.” Threat of urban transmission avoided Ebola’s invasion of Uganda’s Gulu municipality and its slum-like camps for internally displaced persons in 2000 was the cause of the deadliest Ebola epidemic in the country’s history. When six school children were diagnosed with Ebola in Kampala in late October, fears of the virus embedding itself in the capital spiked. On paper, Ebola’s mortality rate of up to 90% makes the virus easy to contain. Museveni also noted that as a virus transferred through contact and bodily fluids, Ebola, despite its “devastating nature”, is far easier to control than airborne threats like COVID-19. But if allowed to embed itself in densely populated areas, things can quickly spiral out of control. “If we had allowed the escalation of the outbreak into Kampala, the consequences would have been bad, including possible exportation to our African brothers in neighbouring countries,” Museveni said. Despite calls from doctors and health advocates to lockdown the capital earlier this month, Museveni and Health Minister Jane Ruth Aceng elected not to bow to the pressure. So far, their decision appears to be validated. “The opportunity for immediate quarantine of contacts was lost for Mubende and Kassanda,” Museveni said, noting the first suspected cases were registered on 6 September, two weeks before authorities declared the outbreak. This was not the case for Kampala. Knowledge of the threat allowed health authorities to be on reactive footing, and respond quickly to isolate infected people and their contacts. Today, over 300 contacts remain under institutional quarantine overseen by the Ministry of Health. Vaccine Trials Are Underway WHO Africa Director Dr Matshidiso Moeti visited Kassanda and Mubende earlier this month to coordinate with Ugandan health authorities and other international partners in responding to the outbreak. There is currently no known vaccine for the Sudan strain of Ebola responsible for the Ugandan outbreak. But the outbreak presents a unique opportunity to bridge this treatment gap, and a series of trials have been set in motion with the aim of minimizing hospitalisations and deaths. A coalition of organizations including CEPI, Gavi, the World Health Organization and Ugandan health authorities are deploying three vaccine candidates to about 3,000 people who have been in contact with Ebola patients. “As we speak, the government of Uganda is finalizing the regulatory approvals,” Africa CDC Director Dr Ahmed Ogwell told CNN. If any of the candidates can succeed, authorities are hopeful this will be the last outbreak Uganda faces without medical defenses. “By embedding research at the heart of the outbreak response, we can achieve two goals,” the WHO said in a statement. “Evaluate potentially efficacious candidate vaccines, potentially contribute to end this outbreak, and protect populations at risk in the future.” Image Credits: WHO, WHO, WHO. Parliamentarians Seek to Address Post-COVID ‘Tsunami’ of Health System Problems 28/11/2022 Maayan Hoffman UNITE president Ricardo Leite (fourth from right) and MPs at the World Health Summit. “There is this tsunami that is happening after the earthquake that was COVID-19 that is now coming to shore and hitting health systems across the world,” said Ricardo Baptista Leite, president and founder of UNITE, a global network of parliamentarians committed to addressing global health challenges. “The pandemic also led to a huge economic crisis and even poor countries in the global South, who might have been less affected by the pandemic, are going to pay a very severe price due to economic consequences that will lead to challenges in responding to the health needs of those countries,” he said. A week before his organization brings together hundreds of parliamentarians from around the world to discuss the most pressing issues in public health at a global summit, the Portuguese MP, who collaborates closely with the World Health Organization (WHO), warned Health Policy Watch of the need to take swift and collective action before the next pandemic. “This is the moment when international institutions and governments need to step up their game and tackle the global health crisis,” Leite said. “We must double up our efforts to make sure we are better equipped in the future and can respond to health needs.” Leite is a long-time global health advocate. He is also a trained medical doctor in infectious diseases and heads the Public Health department at Católica University of Portugal. False sense of security He told Health Policy Watch that whenever the world has felt “capable of controlling infectious disease, we create a false sense of security that we can lower our guard. Whenever we lower our guard, infectious diseases come back with a vengeance.” This can be seen throughout history with multiple pandemics over the centuries, but also in this century with the emergence of antibiotics and the belief that with penicillin we could control infections – a belief now being called into question with the development of antibiotic-resistant bacteria. Antibiotic-resistant bacteria are responsible for the deaths of some 700,000 people each year – with scientists predicting that these infections could kill more people than cancer by 2050. The pandemic has set back the fight against many diseases by years. Take HIV/AIDS. In December 2020, UNAIDS released its 95-95-95 targets, calling for 95% of all people living with HIV to know their HIV status, 95% of all people with diagnosed HIV infection to receive sustained antiretroviral therapy and 95% of all people receiving antiretroviral therapy to have viral suppression by 2025. But during COVID-19, in many countries, measurement of these goals ceased altogether. Where tracking continued, in some cases, diagnoses were slower. “HIV is an interesting proxy for all infectious and communicable diseases out there,” Leite said. In addition, COVID-19 led to a rise in people being diagnosed with late-stage cancer, an increase in cases related to chronic diseases due to people being kept away from health systems, and a spike in mental illness globally. “Pandemics are a strong demonstration of the case that infectious diseases can undermine our efforts toward prosperity for all,” Leite said. He added that during his time as a medical volunteer in Ukraine he saw a huge rise in multi-resistant and extremely resistant tuberculosis in the region. Leite predicted that as the war continues, it will be almost impossible not to see the TB spillover into neighboring countries and then across the world. “There has to be a clear understanding from the world that dealing with infectious diseases is not only something recommended but is a prerequisite for economic and social development worldwide,” he said. The role of parliamentarians WHO parliamentarian session during the World Health Summit (UNITE) Part of the solution is getting parliamentarians around the table, according to Leite. In 2017, the United Nations passed a resolution on the nexus of global health and foreign policy, encouraging a multi-stakeholder approach to achieve universal health coverage. “The voice of parliamentarians was not part of the discussion,” Leite said. “One cannot expect to build a global health architecture or move forward science-based policy making if we do not keep those who write policy in the loop. We cannot make sure money gets where it needs to if we do not include those that make and approve budgets in parliaments.” While he admitted that UNITE is not a “silver bullet,” he said it is a valuable tool for bringing parliamentarians from more than 90 countries together to share experiences and learn how they can best bring their own country toward a more sustainable future. “The first step was to get the conversation going. The second was to develop regional leadership. We now have 10 regional chapters, each led by an MP or former MP. Then we developed policy hubs, specialized teams that focus on specific policy areas, so they can drill down on concrete policymaking in key areas,” Leite explained. “We empower policymakers to be leaders for change in their own countries.” UNITE’s three priorities At its founding, UNITE was focused solely on issues of infectious diseases, but COVID-19 led it to change its mandate over the summer of 2022 and the organization is now focused more generally on global health matters. “The pandemic has demonstrated that global health issues and infectious diseases go hand in hand,” Leite told Health Policy Watch. “We cannot solve many challenges related to infectious disease, which were the basis of our work in the first years, without addressing all the other global health challenges out there.” UNITE is now taking a three-priority approach, focusing on pandemic prevention preparedness and response; the future of health systems; and health as a human right. The group signed a memorandum of understanding recently with WHO to work together on these pillars and supply parliamentary feedback and insight to support WHO’s related efforts. Next week: UNITE Global Summit From 5-7 December, UNITE will host its global summit in Lisbon, bringing together its parliamentarians and leaders from the global health community to expand and forge new partnerships. Members of the lawmaking, civil society, medical and academic communities will meet to talk about what they feel are the most pressing issues on the global health agenda. Another priority that UNITE is bringing to the forefront of the parliamentarian agenda is the use of digital health to promote universal health coverage. “In the last few months with the creation of the digital health hub, parliamentarians were able to discuss with other stakeholders how to build the right frameworks and increase budgets to implement digital health transformation that can promote access to millions,” Leite said. Finally, Leite added that with its new direction in mind, UNITE members would try to answer three questions during the event: What progress have we made so far during the UN’s Sustainable Development Goals period? What have we learned to help us make even more progress by 2030? What is the role of parliamentarians in helping drive that progress? MPs and the pandemic treaty Session on the pandemic treaty at the World Health Summit. In the past, parliamentary involvement has helped achieve public health goals. In Portugal, Leite cited an example from 22 years ago when the parliament decided to decriminalize the use of drugs. “This was not making drug use legal, but now no one goes to jail for using drugs,” he explained. “We stopped looking at people who use drugs as criminals but instead as people who potentially had a health challenge that needed to be dealt with.” Instead of jail time, drug abusers receive harm reduction and other social and health services. When the legislation was passed, around 1% of the Portuguese population used heroin. Since then, Leite said, the numbers have dropped dramatically. Drug-related crime is down, and new HIV cases tied to drug use have fallen from as high as 60% to only 2%. “The fact that we provided harm reduction services and shifted from a criminal perspective to a health perspective was transformative in achieving better health outcomes and partially solving the drug problem in Portugal,” Leite said. A more recent example was the decision by the African Union to set up the African Medicines Agency, which will become a regulatory body for access to health technologies in the continent and creates a common standard of rules based on science to ensure the safety of citizens in the region. Leite equated the AMA to the European Medicines Agency. UNITE founder Ricardo Baptista Leite and Dr Tedros at signing of an MOU between the two organizations. Moving forward, UNITE Parliamentarians will play a key role in finalizing WHO’s pandemic treaty, aimed at guiding the global response to pandemics. “The regulations that were in place when COVID-19 hit were not sufficient or were not properly enforced,” Leite said. He added that “there is a lack of acknowledgement and awareness among most citizens and many parliamentarians around the world that these negotiations are taking place. We need parliamentarians involved early on. If governments agree on a document, parliaments must ratify it.” In an era of “polarized politics and fake news,” he said that if parliamentarians are not part of the process there is a risk that such a treaty would not be ratified, and the world would be left exactly where it was in December 2019. “Everyone is committed to finding a balanced approach to what we hope will create a toolkit from a policy perspective that can help the world be better prepared to detect outbreaks early and lock them down before they transform into pandemics,” Leite said. “It is not acceptable that 100 years after the Spanish flu we saw so many countries react to COVID-19 the same way as they did 100 years before,” he continued. “We have an obligation to be better prepared to constrain any risk, to keep as many people as possible safe. This is a prerequisite for economic and social development. “We need to keep peace and prosperity as our main goal,” Leite concluded. Image Credits: UNITE. There are a Wide Range of Treatments for Obesity, but Many People Cannot Afford Care 28/11/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Amber Huett-Garcia at her high and low weight from 2008 to 2021. Amber Huett-Garcia is trying to drive global change for affordable treatment, care and support for individuals suffering from obesity. A resident of the United States and born into a family suffering from generational obesity, she weighed 101 pounds by the time she was in kindergarten. As an adult, she lost 245 pounds and reduced her BMI from 69 to 24. She did it through a combination of treatments, including bariatric surgery, medication and mental health care. While Huett-Garcia is lucky to have a comprehensive employer-based healthcare plan, she recognizes that many people in the United States do not. And for those who are obese, the cost of care can be enormous. The cost of obesity Obesity costs the US healthcare system nearly $173 billion a year, according to the latest report by the Centers for Disease Control and Prevention. Personal medical costs for people living with obesity are close to $1,500 more per year than those who do not suffer from the condition. For people living with obesity and who are on Medicare, few treatments are covered. For example, Medicare has zero anti-obesity medication coverage. Moreover, roughly 40% of the US population lacks coverage for bariatric surgery for obesity, which has been proven most effective. “Affordable healthcare is a human right,” Huett-Garcia said. Amber Huett-Garcia taking part in the “Stop Weight Bias” campaign. She has called for action to ensure that insurance plans pay for the treatment of a wider range of conditions, including obesity, by covering comprehensive science-based interventions. She has also asked that decision-makers within healthcare systems listen and amplify the voices of people with NCDs. “The lives of people living with NCDs depend on it,” she concluded. Read Amber Huett-Garcia’s full NCD Diary. Read previous post. Image Credits: Courtesy of NCD Alliance. In Vietnam, Nguyen Ha Linh Calls on Government to Give Economic Support to People Living with NCDs 28/11/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Nguyen Ha Linh A young woman living in Vietnam has called on organizations and communities locally and globally to step up support for people living with noncommunicable diseases (NCDs) – especially multiple sclerosis (MS). “I call on the Vietnamese government to give economic support packages to people living with NCDs, especially people with disabilities, because many are paralyzed, unable to support themselves and earn a living,” said Nguyen Ha Linh. Ha Linh lives with MS. Since the age of 23 she has been rapidly deteriorating. While at first she worked as a graphic designer, gradually her arms and legs weakened until she became paralyzed. She developed atrophy of the nerve in her eyes. Today, all of her activities depend on the care of her relatives. Nguyen Ha Linh Access to care But her greatest challenges have been access to care and finances. “Multiple sclerosis is not covered by insurance in Vietnam, so I must pay for my care out of pocket, with financial support from my relatives,” Ha Linh explained. “Multiple sclerosis is considered a rare disease in Vietnam. People living with this condition find it very difficult to access diagnosis and care, and not all major hospitals have the resources for treatment. For those that manage to access care for multiple sclerosis, this is very expensive.” Government must take action She said that people living with MS often focus on getting funding from philanthropists who care about people living with disabilities. However, she believes that the government should be the one to take action first. “Many challenges related to treatment, care and support for people living with NCDs remain largely unaddressed,” Ha Linh said. “In particular, the components of care and support are weak, which therefore means that relatives play an important role for those who have a good support system at home. This is not always the case. “People living with NCDs would like to call on the government to change the regulations around health insurance to allow access to affordable diagnostics and care to help us have a better life,” she concluded. Read Nguyen Ha Linh’s full NCD Diary. Read next post. Image Credits: Courtesy of the NCD Alliance. More Than Five Women Killed Every Hour by Intimate Partners or Family: UN Women, UNODC report 25/11/2022 Megha Kaveri Women and girls are more at risk of getting killed at home by intimate partners or family. A new report by UN Women and the UN Office on Drugs and Crimes (UNODC) said that more than five women or girls are killed every hour across the world by their partners or families. The report, released ahead of the UN’s International Day for the Elimination of Violence Against Women on Friday, said that while men are subjected to higher rates of homicides across the world, women and girls are disproportionately affected by higher rates of homicides in private spaces. In 2021, 81,000 women and girls were killed intentionally, of which around 45,000 – some 55% – were killed by their own intimate partners or family members. By comparison, 11% of the total male homicides happened in private spaces. Covid-19 huge push to fatal violence against women The report found mixed trends on femicide across the world. Between 2010 and 2021, the total number of female homicides by intimate partners or families fell by 19% in Europe. But that number rose by 6% in the Americas overall even as South America reported a decrease. COVID-19 and the subsequent confinement to homes seems to have led to an increase in gender-related killings of women and girls in North America, Western and Southern Europe in 2020, according to the report. “Other sub-regions in Europe and the Americas recorded negligible changes or decreases in the number of killings between 2019 and the end of 2020, which suggests that the onset of the COVID-19 pandemic had heterogeneous impacts,” it said. “The decreases in some sub-regions may reflect delays in recording due to COVID-19 rather than reductions in the number of killings.” The report did not mention similar trends in Asia, Africa or Oceania, due to a lack of data. A World Health Organization-led report last year found almost one in three women experience physical and/or sexual violence across the course of their lifetimes, and in the previous 12 months, more than one in ten women suffered from physical and/or sexual intimate partner violence. More data key to policy formulation Women and girls in all regions are affected by gender-based killings. While Asia isthe region with the largest absolute number of killings, Africa is the region with thehighest level of violence relative to the size of its female population. Highlighting the lack of sufficient and comprehensive data on global femicides, the new report from UN Women and UNODC said more data will enable policy makers to gain a better understanding of the issue and to push for changes. “Additional data beyond identification purposes, such as age of perpetrators and victims, including information surrounding the event of the killing should be collected for analytical purposes,” the report said, adding that will help policy makers detect failures in responses and protection, develop better preventive measures and improve access to justice. Solutions include survivor-centric approaches The report also called for more survivor-centred responses to address gender-based violence in the world, saying it’s an approach that’s “fundamental to preventing and eliminating gender-based violence against women and girls and ensuring it does not escalate to femicide/gender-related killings.” Providing victims with a positive experience when they first report gender-based violence can increase trust and potentially save lives, and encourage other victims to report and disclose crimes. Another measure called for in the report is stronger civil society organisations that work in the women’s rights sector, the report said, because they serve “an important role in preventing gender-based violence against women and girls, by advocating for and securing normative and policy change, providing psycho-social support services and holding governments to account.” Image Credits: Artem Maltzev, UN Women. Fossil Fuels Cast Dark Shadow Over Tanzania’s Green Future 25/11/2022 Kizito Makoye Issa Abdul’s single solar panel powers his barber shop. DAR ES SALAAM, Tanzania – Issa Abdul’s desperate urge for solar power began when he realised a smoke-spewing generator at his barber shop was costing him too much. “Solar power is very cheap. I regret spending my money on this fuel-guzzling machine,” he told Health Policy Watch. The 32-year-old barber in Tanzania’s port city spent roughly Tanzanian shillings 150,000 ($65) to purchase a small solar system and this now powers his hair cutting business. “I am very happy to have my own solar system. It is very useful,” he said. On a humid Sunday morning, Abdul adeptly digs a buzzing clipper through the hair of the client sitting on a leather chair before him. “I was spending a lot of money every month buying fuel, that is history now,” he said. Perched on a rusty roof, Abdul’s lone solar panel produces enough electricity to run two clippers, three bright lights and a cell phone charger. “There’s plenty of sunshine, I don’t disappoint my customers,” he said. Drought cripples hydropower facilities However, like other east African countries such as Kenya and Uganda, solar power still remains a small part of the country’s energy mix. While Tanzania’s electric grid has been primarily powered by hydroelectric power, another renewable source, for some time, hydro’s dominance is slipping now. Climate-related spells of drought have crippled the country’s hydropower facilities and the ageing distribution infrastructure, and the country is experiencing an electricity crisis affecting various sectors of the economy. Hydropower, which can potentially generate 4.7 GW of electricity according to government estimates, is only producing 12% of its power potential, and is prone to weather variability. And as drought tightens its grip, Tanzania, which has 57 trillion cubic feet of natural gas reserves, is now poised to tap this chunk of fossil fuels to cover the electricity deficit Natural gas, oil and coal will almost certainly remain dominant in the country’s energy mix in the near future, according to experts. A motorcyclist riding outside TPTL plant in Dar es Salaam that uses heavy furnace oil to produce electricity. Addressing climate change impact with fossil fuels Tanzania’s experience is just one example of an emerging paradox of addressing climate change impacts with more climate-changing fossil fuel. Tanzania, Kenya and Uganda have been dependent on hydropower, but as all three countries grapple with climate-related drought, they may also find it easier to tap their fossil fuel reserves with the help of multinational investors standing by than develop greener alternatives. This is even as technologies exist for large-scale grid-quality solar power that is ultimately cheaper, industry observers say. While nations worldwide are shifting to renewable energy to reduce the global carbon footprint and ease the toll that fossil fuels take on people’s health, economy and climate, the majority of Tanzanians, like those in large parts of Africa, still use dirty energy sources that pollute the air, causing some 1.1 million deaths annually on the continent, according to a recent study. Air pollution is the second risk factor for death in Africa after malnutrition, concluded the study by the Boston-based Health Effects Institute. Tanzania’s electricity generation comes mostly from natural gas (48%), followed by hydropower (31%), petrol/diesel (18%), solar (1%), and biofuels (1%). In Kenya and Uganda, hydropower and geothermal power are the dominant portions of the electricity generation mix, with solar power making up a very minor proportion of the mix. As demand for energy continues to grow, it is unclear how to ensure that renewables become more attractive than fossil fuel. Investments in fossil fuels far outweigh that of renewables in most parts of Africa, and oil and gas exploration and exploitation continues apace in Kenya, Uganda and Tanzania. Dirty diesel At Kariakoo, a business hub in Dar es Salaam dotted with shopping centres, a toxic haze of diesel hangs in the air as generators roar so loudly that they drown out people’s conversations. Like the lone solar panel precariously hanging on Abdul’s salon, smoke-spewing generators are widely used when grid electricity goes off. They power everything from ceiling fans to television sets, air conditioners and freezers – the latter two items pulling too much power to make a rooftop solar system reliable. Among the available choices, portable diesel generators are among the dirtiest, spewing particulate-laden emissions into the air directly into spaces where people live and work. But they remain the go-to solution in much of Tanzania and Africa more broadly. “To me, a diesel generator provides the necessary power,” said Aloycia Mosha who runs a cold fish store. Soaked with sweat, Mosha repeatedly pulls a string to rev the engine of her generator. “If I don’t switch it on now, all my fish stock will get spoilt,” said Mosha. The 45-year-old entrepreneur has often found a trail of blood oozing on her shop’s tiled floor, a clear sign that the fish defrosted overnight. Vendor stand near a standby diesel generator in Dar es Salaam Power cuts are part of daily life Power cuts are part of daily life in Dar es Salaam, a busy city that is home to 5.8 million people, and accounts for 40% of the country’s GDP. While a few city dwellers have installed solar power on their roof tops to save spiralling energy costs, analysts say the lack of clear financing mechanism to cover initial installation costs, coupled with an unreliable distribution network, have made solar systems a distant luxury to many families. Asteria Mchomvu, a resident of Upanga, a middle-class neighborhood in Dar es Salaam, began to dream of installing solar panels on her roof a decade ago. At first, Mchomvu, who works as a teacher, was excited to learn that solar technology could help her save money and protect the environment. But a home solar system was too expensive for her t the time. A modest 8-kilowat system would roughly cost Tanzanian shillings 10, million ($4347) in 2012, according to Tanzania’s Rural Energy Agency. Prices for solar systems in Tanzania have since fallen by more than 60% and companies are aggressively jostling to pitch their sales. Yet still, the numbers didn’t work for Mchomvu, who teaches geography and science Then early in November, at the Dar es Salaam International Trade Fair, Mchomvu caught up with Richard Tairo, a salesman from Arti energy, a solar company focusing on mid and low -income customers. Tairo understood Mchomvu’s passion for solar and her financial dilemma and he introduced her to Mali Kauli, a program that finances residential solar systems and offers borrowers, below-market rates. Mchomvu accepted the offer after the company assured her that the system could lower her energy bills and spare her the agony of power cuts. “I wanted to be 100% sure it is worth investing,” she told the Health Policy Watch. Skewed regulatory framework disadvantages solar Despite the growing public awareness, renewable energy penetration in Tanzania is still facing major hurdles due to a skewed regulatory framework and limited market. Samuel Wangwe, a research associate with Research on Poverty Alleviation (REPOA) said solar power market has seen sluggish growth due to fragmented financing plans, uneven service after equipment sale and technical weaknesses in batteries and solar lamps, which are often cheap items imported from China with warranties that cannot be honoured. “The most obvious barrier to renewable energy, notably solar is cost. The upfront expenses that people pay to get solar panels installed at their homes are still too high,” Wangwe said. Many investors are discouraged to take on renewable energy projects because of high capital costs and a long net payback period, he added. Wangwe says that the industry is also dogged by a lack of training institutes, which has prevented renewable energy technologies from scaling up. “We must encourage our children to take renewable energy courses and hone their technical skills,” he said. A shop for solar equipment at Kariakoo business centre in Dar es Salaam Bigger subsidies for fossil fuels Although some subsidies are offered for rooftop solar, the subsidies the government provides to fossil fuel sources are much higher, Wangwe said. In fact, in July, the Tanzanian government introduced a new fuel subsidy of a whopping Tanzanian shillings 100 billion ($43 million) monthly to stabilise the domestic price of fuel, Wangwe said. While solar panel and wind turbines are exempt from VAT and are not charged import duties, accessories including the batteries essential to operating a household solar package are charged up to 35% import duty, said Wangwe. “This is the reason why solar technology is not scaling up as fast as possible” he said. Coal, oil and gas are by far the largest contributors to climate change, experts say. In addition, some 65% of deaths from air pollution are generated by fossil fuel combustion, including the noisy and smokey generators that are omnipresent in households and big African cities like Dar es Salaam. While global leaders have endorsed the scientific consensus to limit global warming to 1.5°C above pre-industrial level, as spelled out in the Paris Agreement, there is a growing rush for oil and gas exploration in the global south. This is what COP27 civil society participants called the “dash for gas” reminiscent of the colonial scramble for Africa. More fossil fuel exploration Tanzania has enough gas reserves to put the country on a path of economic prosperity, and may unlock as much as $30 billion in liquified natural gas (LNG) investments. At the same time, if the historic pattern long followed in east and west Africa remains the same, many of the new LNG is likely to be sold to Europe and other countries to generate foreign currency, rather than used at home. “Our political leaders are caught up in a dilemma. Such investments are worthwhile economically but bad for the environment,” said Wangwe. While many have argued that off-grid solar solutions hold the key to Tanzania’s urban and rural electrification, fossil fuels subsidies have reduced its competitiveness. Yusto Mugisha, professor of renewable energy at the school of engineering and technology a Sokoine University of Agriculture, said in order to build a sustainable future, Tanzania needs to invest in clean, accessible and affordable energy sources. “Renewable energy sources are available and their potential is not fully harnessed,” said Mugisha. Although upfront costs for renewable projects can be daunting, Mugisha said efficient and more reliable renewable technologies can create a system that is less prone to market shocks and improve energy security. Unlike fossil fuels, which need to be extracted and transported to large power plants and require a grid network extending to remote areas, renewable sources like solar and wind can be developed in various flexible arrays. They can be just a few panels on a household installation, part of a community mini-grid, or as a solar power plant feeding into the large grid. That, according to the International Energy Agency and countless other assessments means that solar could leap-frog over grid-dependent fossil fuel technologies much like portable phones leap-frogged over fixed phone lines in Africa, providing better service much faster. But renewable energy versus fossil fuels has seemingly placed Tanzania politicians in the moral dilemma. While fossil fuel provides badly needed energy, it leaves behind a carbon footprint that’s proving catastrophic to humans and the planet. Yet, in the short term, policymakers strongly support fuel subsidies to stabilise the prices of other commodities. Meanwhile, renewable energy subsidies, notably on solar, are indirectly offered mostly through the Rural Energy Agency, and are clustered depending on the scale of the project. Despite its small market share local experts say renewable energy has the potential to respond to present and future challenges by enhancing energy security, generating income, and providing employment. Rural dependence on kerosene William Kahise, a student at Itetemia primary school, persuaded hus mother to buy a solar lamp as the kerosene one made him cough. In the dusty western town of Tabora, 12-year-old William Kahise and his sister Juliana routinely huddled around the faint glow of kerosene lamp when the darkness sets in, struggling to get their homework done before their mother blows off the lamp to save the fuel cost. “I must finish my work, otherwise my teacher will be very angry,” Kahise told Health Policy Watch. The paraffin lamp, made from a discarded cooking oil tin, emitted choking smoke and casts scary shadows on the walls. Kerosene is one of the household fuels that WHO has recommended not be used at all, because of its health harmful effects, including impaired lung function, asthma and cancer. The Itetemia primary school pupil may not know about the WHO recommendation, but he knew the smoke made him cough and convinced his mother to ditch the kerosene lantern, for a cheap solar version. Kerosene is used by millions of rural households i to meet basic lighting needs and subsidies have long been used to make the fuel more affordable. Kerosene subsidies have been at the centre of energy policy debate, with renewable energy activists arguing that, for health, safety and environmental reasons, a switch to solar power is better. “The subsidized kerosene is extremely costly and wasteful, the government is spending a lot of money every month to keep the price low,” said Mugisha. But for Abdul, who enjoys solar power, the challenge arises when his Chinese-made panel starts to age and needs to be replaced as Africa produces virtually no panels of its own. –First of two parts on the barriers to clean, renewable energy in Africa. -Research and reporting for this story was supported by the Rosa Luxembourg Foundation. Image Credits: Peter Mgongo. Posts navigation Older postsNewer posts
Parliamentarians Seek to Address Post-COVID ‘Tsunami’ of Health System Problems 28/11/2022 Maayan Hoffman UNITE president Ricardo Leite (fourth from right) and MPs at the World Health Summit. “There is this tsunami that is happening after the earthquake that was COVID-19 that is now coming to shore and hitting health systems across the world,” said Ricardo Baptista Leite, president and founder of UNITE, a global network of parliamentarians committed to addressing global health challenges. “The pandemic also led to a huge economic crisis and even poor countries in the global South, who might have been less affected by the pandemic, are going to pay a very severe price due to economic consequences that will lead to challenges in responding to the health needs of those countries,” he said. A week before his organization brings together hundreds of parliamentarians from around the world to discuss the most pressing issues in public health at a global summit, the Portuguese MP, who collaborates closely with the World Health Organization (WHO), warned Health Policy Watch of the need to take swift and collective action before the next pandemic. “This is the moment when international institutions and governments need to step up their game and tackle the global health crisis,” Leite said. “We must double up our efforts to make sure we are better equipped in the future and can respond to health needs.” Leite is a long-time global health advocate. He is also a trained medical doctor in infectious diseases and heads the Public Health department at Católica University of Portugal. False sense of security He told Health Policy Watch that whenever the world has felt “capable of controlling infectious disease, we create a false sense of security that we can lower our guard. Whenever we lower our guard, infectious diseases come back with a vengeance.” This can be seen throughout history with multiple pandemics over the centuries, but also in this century with the emergence of antibiotics and the belief that with penicillin we could control infections – a belief now being called into question with the development of antibiotic-resistant bacteria. Antibiotic-resistant bacteria are responsible for the deaths of some 700,000 people each year – with scientists predicting that these infections could kill more people than cancer by 2050. The pandemic has set back the fight against many diseases by years. Take HIV/AIDS. In December 2020, UNAIDS released its 95-95-95 targets, calling for 95% of all people living with HIV to know their HIV status, 95% of all people with diagnosed HIV infection to receive sustained antiretroviral therapy and 95% of all people receiving antiretroviral therapy to have viral suppression by 2025. But during COVID-19, in many countries, measurement of these goals ceased altogether. Where tracking continued, in some cases, diagnoses were slower. “HIV is an interesting proxy for all infectious and communicable diseases out there,” Leite said. In addition, COVID-19 led to a rise in people being diagnosed with late-stage cancer, an increase in cases related to chronic diseases due to people being kept away from health systems, and a spike in mental illness globally. “Pandemics are a strong demonstration of the case that infectious diseases can undermine our efforts toward prosperity for all,” Leite said. He added that during his time as a medical volunteer in Ukraine he saw a huge rise in multi-resistant and extremely resistant tuberculosis in the region. Leite predicted that as the war continues, it will be almost impossible not to see the TB spillover into neighboring countries and then across the world. “There has to be a clear understanding from the world that dealing with infectious diseases is not only something recommended but is a prerequisite for economic and social development worldwide,” he said. The role of parliamentarians WHO parliamentarian session during the World Health Summit (UNITE) Part of the solution is getting parliamentarians around the table, according to Leite. In 2017, the United Nations passed a resolution on the nexus of global health and foreign policy, encouraging a multi-stakeholder approach to achieve universal health coverage. “The voice of parliamentarians was not part of the discussion,” Leite said. “One cannot expect to build a global health architecture or move forward science-based policy making if we do not keep those who write policy in the loop. We cannot make sure money gets where it needs to if we do not include those that make and approve budgets in parliaments.” While he admitted that UNITE is not a “silver bullet,” he said it is a valuable tool for bringing parliamentarians from more than 90 countries together to share experiences and learn how they can best bring their own country toward a more sustainable future. “The first step was to get the conversation going. The second was to develop regional leadership. We now have 10 regional chapters, each led by an MP or former MP. Then we developed policy hubs, specialized teams that focus on specific policy areas, so they can drill down on concrete policymaking in key areas,” Leite explained. “We empower policymakers to be leaders for change in their own countries.” UNITE’s three priorities At its founding, UNITE was focused solely on issues of infectious diseases, but COVID-19 led it to change its mandate over the summer of 2022 and the organization is now focused more generally on global health matters. “The pandemic has demonstrated that global health issues and infectious diseases go hand in hand,” Leite told Health Policy Watch. “We cannot solve many challenges related to infectious disease, which were the basis of our work in the first years, without addressing all the other global health challenges out there.” UNITE is now taking a three-priority approach, focusing on pandemic prevention preparedness and response; the future of health systems; and health as a human right. The group signed a memorandum of understanding recently with WHO to work together on these pillars and supply parliamentary feedback and insight to support WHO’s related efforts. Next week: UNITE Global Summit From 5-7 December, UNITE will host its global summit in Lisbon, bringing together its parliamentarians and leaders from the global health community to expand and forge new partnerships. Members of the lawmaking, civil society, medical and academic communities will meet to talk about what they feel are the most pressing issues on the global health agenda. Another priority that UNITE is bringing to the forefront of the parliamentarian agenda is the use of digital health to promote universal health coverage. “In the last few months with the creation of the digital health hub, parliamentarians were able to discuss with other stakeholders how to build the right frameworks and increase budgets to implement digital health transformation that can promote access to millions,” Leite said. Finally, Leite added that with its new direction in mind, UNITE members would try to answer three questions during the event: What progress have we made so far during the UN’s Sustainable Development Goals period? What have we learned to help us make even more progress by 2030? What is the role of parliamentarians in helping drive that progress? MPs and the pandemic treaty Session on the pandemic treaty at the World Health Summit. In the past, parliamentary involvement has helped achieve public health goals. In Portugal, Leite cited an example from 22 years ago when the parliament decided to decriminalize the use of drugs. “This was not making drug use legal, but now no one goes to jail for using drugs,” he explained. “We stopped looking at people who use drugs as criminals but instead as people who potentially had a health challenge that needed to be dealt with.” Instead of jail time, drug abusers receive harm reduction and other social and health services. When the legislation was passed, around 1% of the Portuguese population used heroin. Since then, Leite said, the numbers have dropped dramatically. Drug-related crime is down, and new HIV cases tied to drug use have fallen from as high as 60% to only 2%. “The fact that we provided harm reduction services and shifted from a criminal perspective to a health perspective was transformative in achieving better health outcomes and partially solving the drug problem in Portugal,” Leite said. A more recent example was the decision by the African Union to set up the African Medicines Agency, which will become a regulatory body for access to health technologies in the continent and creates a common standard of rules based on science to ensure the safety of citizens in the region. Leite equated the AMA to the European Medicines Agency. UNITE founder Ricardo Baptista Leite and Dr Tedros at signing of an MOU between the two organizations. Moving forward, UNITE Parliamentarians will play a key role in finalizing WHO’s pandemic treaty, aimed at guiding the global response to pandemics. “The regulations that were in place when COVID-19 hit were not sufficient or were not properly enforced,” Leite said. He added that “there is a lack of acknowledgement and awareness among most citizens and many parliamentarians around the world that these negotiations are taking place. We need parliamentarians involved early on. If governments agree on a document, parliaments must ratify it.” In an era of “polarized politics and fake news,” he said that if parliamentarians are not part of the process there is a risk that such a treaty would not be ratified, and the world would be left exactly where it was in December 2019. “Everyone is committed to finding a balanced approach to what we hope will create a toolkit from a policy perspective that can help the world be better prepared to detect outbreaks early and lock them down before they transform into pandemics,” Leite said. “It is not acceptable that 100 years after the Spanish flu we saw so many countries react to COVID-19 the same way as they did 100 years before,” he continued. “We have an obligation to be better prepared to constrain any risk, to keep as many people as possible safe. This is a prerequisite for economic and social development. “We need to keep peace and prosperity as our main goal,” Leite concluded. Image Credits: UNITE. There are a Wide Range of Treatments for Obesity, but Many People Cannot Afford Care 28/11/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Amber Huett-Garcia at her high and low weight from 2008 to 2021. Amber Huett-Garcia is trying to drive global change for affordable treatment, care and support for individuals suffering from obesity. A resident of the United States and born into a family suffering from generational obesity, she weighed 101 pounds by the time she was in kindergarten. As an adult, she lost 245 pounds and reduced her BMI from 69 to 24. She did it through a combination of treatments, including bariatric surgery, medication and mental health care. While Huett-Garcia is lucky to have a comprehensive employer-based healthcare plan, she recognizes that many people in the United States do not. And for those who are obese, the cost of care can be enormous. The cost of obesity Obesity costs the US healthcare system nearly $173 billion a year, according to the latest report by the Centers for Disease Control and Prevention. Personal medical costs for people living with obesity are close to $1,500 more per year than those who do not suffer from the condition. For people living with obesity and who are on Medicare, few treatments are covered. For example, Medicare has zero anti-obesity medication coverage. Moreover, roughly 40% of the US population lacks coverage for bariatric surgery for obesity, which has been proven most effective. “Affordable healthcare is a human right,” Huett-Garcia said. Amber Huett-Garcia taking part in the “Stop Weight Bias” campaign. She has called for action to ensure that insurance plans pay for the treatment of a wider range of conditions, including obesity, by covering comprehensive science-based interventions. She has also asked that decision-makers within healthcare systems listen and amplify the voices of people with NCDs. “The lives of people living with NCDs depend on it,” she concluded. Read Amber Huett-Garcia’s full NCD Diary. Read previous post. Image Credits: Courtesy of NCD Alliance. In Vietnam, Nguyen Ha Linh Calls on Government to Give Economic Support to People Living with NCDs 28/11/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Nguyen Ha Linh A young woman living in Vietnam has called on organizations and communities locally and globally to step up support for people living with noncommunicable diseases (NCDs) – especially multiple sclerosis (MS). “I call on the Vietnamese government to give economic support packages to people living with NCDs, especially people with disabilities, because many are paralyzed, unable to support themselves and earn a living,” said Nguyen Ha Linh. Ha Linh lives with MS. Since the age of 23 she has been rapidly deteriorating. While at first she worked as a graphic designer, gradually her arms and legs weakened until she became paralyzed. She developed atrophy of the nerve in her eyes. Today, all of her activities depend on the care of her relatives. Nguyen Ha Linh Access to care But her greatest challenges have been access to care and finances. “Multiple sclerosis is not covered by insurance in Vietnam, so I must pay for my care out of pocket, with financial support from my relatives,” Ha Linh explained. “Multiple sclerosis is considered a rare disease in Vietnam. People living with this condition find it very difficult to access diagnosis and care, and not all major hospitals have the resources for treatment. For those that manage to access care for multiple sclerosis, this is very expensive.” Government must take action She said that people living with MS often focus on getting funding from philanthropists who care about people living with disabilities. However, she believes that the government should be the one to take action first. “Many challenges related to treatment, care and support for people living with NCDs remain largely unaddressed,” Ha Linh said. “In particular, the components of care and support are weak, which therefore means that relatives play an important role for those who have a good support system at home. This is not always the case. “People living with NCDs would like to call on the government to change the regulations around health insurance to allow access to affordable diagnostics and care to help us have a better life,” she concluded. Read Nguyen Ha Linh’s full NCD Diary. Read next post. Image Credits: Courtesy of the NCD Alliance. More Than Five Women Killed Every Hour by Intimate Partners or Family: UN Women, UNODC report 25/11/2022 Megha Kaveri Women and girls are more at risk of getting killed at home by intimate partners or family. A new report by UN Women and the UN Office on Drugs and Crimes (UNODC) said that more than five women or girls are killed every hour across the world by their partners or families. The report, released ahead of the UN’s International Day for the Elimination of Violence Against Women on Friday, said that while men are subjected to higher rates of homicides across the world, women and girls are disproportionately affected by higher rates of homicides in private spaces. In 2021, 81,000 women and girls were killed intentionally, of which around 45,000 – some 55% – were killed by their own intimate partners or family members. By comparison, 11% of the total male homicides happened in private spaces. Covid-19 huge push to fatal violence against women The report found mixed trends on femicide across the world. Between 2010 and 2021, the total number of female homicides by intimate partners or families fell by 19% in Europe. But that number rose by 6% in the Americas overall even as South America reported a decrease. COVID-19 and the subsequent confinement to homes seems to have led to an increase in gender-related killings of women and girls in North America, Western and Southern Europe in 2020, according to the report. “Other sub-regions in Europe and the Americas recorded negligible changes or decreases in the number of killings between 2019 and the end of 2020, which suggests that the onset of the COVID-19 pandemic had heterogeneous impacts,” it said. “The decreases in some sub-regions may reflect delays in recording due to COVID-19 rather than reductions in the number of killings.” The report did not mention similar trends in Asia, Africa or Oceania, due to a lack of data. A World Health Organization-led report last year found almost one in three women experience physical and/or sexual violence across the course of their lifetimes, and in the previous 12 months, more than one in ten women suffered from physical and/or sexual intimate partner violence. More data key to policy formulation Women and girls in all regions are affected by gender-based killings. While Asia isthe region with the largest absolute number of killings, Africa is the region with thehighest level of violence relative to the size of its female population. Highlighting the lack of sufficient and comprehensive data on global femicides, the new report from UN Women and UNODC said more data will enable policy makers to gain a better understanding of the issue and to push for changes. “Additional data beyond identification purposes, such as age of perpetrators and victims, including information surrounding the event of the killing should be collected for analytical purposes,” the report said, adding that will help policy makers detect failures in responses and protection, develop better preventive measures and improve access to justice. Solutions include survivor-centric approaches The report also called for more survivor-centred responses to address gender-based violence in the world, saying it’s an approach that’s “fundamental to preventing and eliminating gender-based violence against women and girls and ensuring it does not escalate to femicide/gender-related killings.” Providing victims with a positive experience when they first report gender-based violence can increase trust and potentially save lives, and encourage other victims to report and disclose crimes. Another measure called for in the report is stronger civil society organisations that work in the women’s rights sector, the report said, because they serve “an important role in preventing gender-based violence against women and girls, by advocating for and securing normative and policy change, providing psycho-social support services and holding governments to account.” Image Credits: Artem Maltzev, UN Women. Fossil Fuels Cast Dark Shadow Over Tanzania’s Green Future 25/11/2022 Kizito Makoye Issa Abdul’s single solar panel powers his barber shop. DAR ES SALAAM, Tanzania – Issa Abdul’s desperate urge for solar power began when he realised a smoke-spewing generator at his barber shop was costing him too much. “Solar power is very cheap. I regret spending my money on this fuel-guzzling machine,” he told Health Policy Watch. The 32-year-old barber in Tanzania’s port city spent roughly Tanzanian shillings 150,000 ($65) to purchase a small solar system and this now powers his hair cutting business. “I am very happy to have my own solar system. It is very useful,” he said. On a humid Sunday morning, Abdul adeptly digs a buzzing clipper through the hair of the client sitting on a leather chair before him. “I was spending a lot of money every month buying fuel, that is history now,” he said. Perched on a rusty roof, Abdul’s lone solar panel produces enough electricity to run two clippers, three bright lights and a cell phone charger. “There’s plenty of sunshine, I don’t disappoint my customers,” he said. Drought cripples hydropower facilities However, like other east African countries such as Kenya and Uganda, solar power still remains a small part of the country’s energy mix. While Tanzania’s electric grid has been primarily powered by hydroelectric power, another renewable source, for some time, hydro’s dominance is slipping now. Climate-related spells of drought have crippled the country’s hydropower facilities and the ageing distribution infrastructure, and the country is experiencing an electricity crisis affecting various sectors of the economy. Hydropower, which can potentially generate 4.7 GW of electricity according to government estimates, is only producing 12% of its power potential, and is prone to weather variability. And as drought tightens its grip, Tanzania, which has 57 trillion cubic feet of natural gas reserves, is now poised to tap this chunk of fossil fuels to cover the electricity deficit Natural gas, oil and coal will almost certainly remain dominant in the country’s energy mix in the near future, according to experts. A motorcyclist riding outside TPTL plant in Dar es Salaam that uses heavy furnace oil to produce electricity. Addressing climate change impact with fossil fuels Tanzania’s experience is just one example of an emerging paradox of addressing climate change impacts with more climate-changing fossil fuel. Tanzania, Kenya and Uganda have been dependent on hydropower, but as all three countries grapple with climate-related drought, they may also find it easier to tap their fossil fuel reserves with the help of multinational investors standing by than develop greener alternatives. This is even as technologies exist for large-scale grid-quality solar power that is ultimately cheaper, industry observers say. While nations worldwide are shifting to renewable energy to reduce the global carbon footprint and ease the toll that fossil fuels take on people’s health, economy and climate, the majority of Tanzanians, like those in large parts of Africa, still use dirty energy sources that pollute the air, causing some 1.1 million deaths annually on the continent, according to a recent study. Air pollution is the second risk factor for death in Africa after malnutrition, concluded the study by the Boston-based Health Effects Institute. Tanzania’s electricity generation comes mostly from natural gas (48%), followed by hydropower (31%), petrol/diesel (18%), solar (1%), and biofuels (1%). In Kenya and Uganda, hydropower and geothermal power are the dominant portions of the electricity generation mix, with solar power making up a very minor proportion of the mix. As demand for energy continues to grow, it is unclear how to ensure that renewables become more attractive than fossil fuel. Investments in fossil fuels far outweigh that of renewables in most parts of Africa, and oil and gas exploration and exploitation continues apace in Kenya, Uganda and Tanzania. Dirty diesel At Kariakoo, a business hub in Dar es Salaam dotted with shopping centres, a toxic haze of diesel hangs in the air as generators roar so loudly that they drown out people’s conversations. Like the lone solar panel precariously hanging on Abdul’s salon, smoke-spewing generators are widely used when grid electricity goes off. They power everything from ceiling fans to television sets, air conditioners and freezers – the latter two items pulling too much power to make a rooftop solar system reliable. Among the available choices, portable diesel generators are among the dirtiest, spewing particulate-laden emissions into the air directly into spaces where people live and work. But they remain the go-to solution in much of Tanzania and Africa more broadly. “To me, a diesel generator provides the necessary power,” said Aloycia Mosha who runs a cold fish store. Soaked with sweat, Mosha repeatedly pulls a string to rev the engine of her generator. “If I don’t switch it on now, all my fish stock will get spoilt,” said Mosha. The 45-year-old entrepreneur has often found a trail of blood oozing on her shop’s tiled floor, a clear sign that the fish defrosted overnight. Vendor stand near a standby diesel generator in Dar es Salaam Power cuts are part of daily life Power cuts are part of daily life in Dar es Salaam, a busy city that is home to 5.8 million people, and accounts for 40% of the country’s GDP. While a few city dwellers have installed solar power on their roof tops to save spiralling energy costs, analysts say the lack of clear financing mechanism to cover initial installation costs, coupled with an unreliable distribution network, have made solar systems a distant luxury to many families. Asteria Mchomvu, a resident of Upanga, a middle-class neighborhood in Dar es Salaam, began to dream of installing solar panels on her roof a decade ago. At first, Mchomvu, who works as a teacher, was excited to learn that solar technology could help her save money and protect the environment. But a home solar system was too expensive for her t the time. A modest 8-kilowat system would roughly cost Tanzanian shillings 10, million ($4347) in 2012, according to Tanzania’s Rural Energy Agency. Prices for solar systems in Tanzania have since fallen by more than 60% and companies are aggressively jostling to pitch their sales. Yet still, the numbers didn’t work for Mchomvu, who teaches geography and science Then early in November, at the Dar es Salaam International Trade Fair, Mchomvu caught up with Richard Tairo, a salesman from Arti energy, a solar company focusing on mid and low -income customers. Tairo understood Mchomvu’s passion for solar and her financial dilemma and he introduced her to Mali Kauli, a program that finances residential solar systems and offers borrowers, below-market rates. Mchomvu accepted the offer after the company assured her that the system could lower her energy bills and spare her the agony of power cuts. “I wanted to be 100% sure it is worth investing,” she told the Health Policy Watch. Skewed regulatory framework disadvantages solar Despite the growing public awareness, renewable energy penetration in Tanzania is still facing major hurdles due to a skewed regulatory framework and limited market. Samuel Wangwe, a research associate with Research on Poverty Alleviation (REPOA) said solar power market has seen sluggish growth due to fragmented financing plans, uneven service after equipment sale and technical weaknesses in batteries and solar lamps, which are often cheap items imported from China with warranties that cannot be honoured. “The most obvious barrier to renewable energy, notably solar is cost. The upfront expenses that people pay to get solar panels installed at their homes are still too high,” Wangwe said. Many investors are discouraged to take on renewable energy projects because of high capital costs and a long net payback period, he added. Wangwe says that the industry is also dogged by a lack of training institutes, which has prevented renewable energy technologies from scaling up. “We must encourage our children to take renewable energy courses and hone their technical skills,” he said. A shop for solar equipment at Kariakoo business centre in Dar es Salaam Bigger subsidies for fossil fuels Although some subsidies are offered for rooftop solar, the subsidies the government provides to fossil fuel sources are much higher, Wangwe said. In fact, in July, the Tanzanian government introduced a new fuel subsidy of a whopping Tanzanian shillings 100 billion ($43 million) monthly to stabilise the domestic price of fuel, Wangwe said. While solar panel and wind turbines are exempt from VAT and are not charged import duties, accessories including the batteries essential to operating a household solar package are charged up to 35% import duty, said Wangwe. “This is the reason why solar technology is not scaling up as fast as possible” he said. Coal, oil and gas are by far the largest contributors to climate change, experts say. In addition, some 65% of deaths from air pollution are generated by fossil fuel combustion, including the noisy and smokey generators that are omnipresent in households and big African cities like Dar es Salaam. While global leaders have endorsed the scientific consensus to limit global warming to 1.5°C above pre-industrial level, as spelled out in the Paris Agreement, there is a growing rush for oil and gas exploration in the global south. This is what COP27 civil society participants called the “dash for gas” reminiscent of the colonial scramble for Africa. More fossil fuel exploration Tanzania has enough gas reserves to put the country on a path of economic prosperity, and may unlock as much as $30 billion in liquified natural gas (LNG) investments. At the same time, if the historic pattern long followed in east and west Africa remains the same, many of the new LNG is likely to be sold to Europe and other countries to generate foreign currency, rather than used at home. “Our political leaders are caught up in a dilemma. Such investments are worthwhile economically but bad for the environment,” said Wangwe. While many have argued that off-grid solar solutions hold the key to Tanzania’s urban and rural electrification, fossil fuels subsidies have reduced its competitiveness. Yusto Mugisha, professor of renewable energy at the school of engineering and technology a Sokoine University of Agriculture, said in order to build a sustainable future, Tanzania needs to invest in clean, accessible and affordable energy sources. “Renewable energy sources are available and their potential is not fully harnessed,” said Mugisha. Although upfront costs for renewable projects can be daunting, Mugisha said efficient and more reliable renewable technologies can create a system that is less prone to market shocks and improve energy security. Unlike fossil fuels, which need to be extracted and transported to large power plants and require a grid network extending to remote areas, renewable sources like solar and wind can be developed in various flexible arrays. They can be just a few panels on a household installation, part of a community mini-grid, or as a solar power plant feeding into the large grid. That, according to the International Energy Agency and countless other assessments means that solar could leap-frog over grid-dependent fossil fuel technologies much like portable phones leap-frogged over fixed phone lines in Africa, providing better service much faster. But renewable energy versus fossil fuels has seemingly placed Tanzania politicians in the moral dilemma. While fossil fuel provides badly needed energy, it leaves behind a carbon footprint that’s proving catastrophic to humans and the planet. Yet, in the short term, policymakers strongly support fuel subsidies to stabilise the prices of other commodities. Meanwhile, renewable energy subsidies, notably on solar, are indirectly offered mostly through the Rural Energy Agency, and are clustered depending on the scale of the project. Despite its small market share local experts say renewable energy has the potential to respond to present and future challenges by enhancing energy security, generating income, and providing employment. Rural dependence on kerosene William Kahise, a student at Itetemia primary school, persuaded hus mother to buy a solar lamp as the kerosene one made him cough. In the dusty western town of Tabora, 12-year-old William Kahise and his sister Juliana routinely huddled around the faint glow of kerosene lamp when the darkness sets in, struggling to get their homework done before their mother blows off the lamp to save the fuel cost. “I must finish my work, otherwise my teacher will be very angry,” Kahise told Health Policy Watch. The paraffin lamp, made from a discarded cooking oil tin, emitted choking smoke and casts scary shadows on the walls. Kerosene is one of the household fuels that WHO has recommended not be used at all, because of its health harmful effects, including impaired lung function, asthma and cancer. The Itetemia primary school pupil may not know about the WHO recommendation, but he knew the smoke made him cough and convinced his mother to ditch the kerosene lantern, for a cheap solar version. Kerosene is used by millions of rural households i to meet basic lighting needs and subsidies have long been used to make the fuel more affordable. Kerosene subsidies have been at the centre of energy policy debate, with renewable energy activists arguing that, for health, safety and environmental reasons, a switch to solar power is better. “The subsidized kerosene is extremely costly and wasteful, the government is spending a lot of money every month to keep the price low,” said Mugisha. But for Abdul, who enjoys solar power, the challenge arises when his Chinese-made panel starts to age and needs to be replaced as Africa produces virtually no panels of its own. –First of two parts on the barriers to clean, renewable energy in Africa. -Research and reporting for this story was supported by the Rosa Luxembourg Foundation. Image Credits: Peter Mgongo. Posts navigation Older postsNewer posts
There are a Wide Range of Treatments for Obesity, but Many People Cannot Afford Care 28/11/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Amber Huett-Garcia at her high and low weight from 2008 to 2021. Amber Huett-Garcia is trying to drive global change for affordable treatment, care and support for individuals suffering from obesity. A resident of the United States and born into a family suffering from generational obesity, she weighed 101 pounds by the time she was in kindergarten. As an adult, she lost 245 pounds and reduced her BMI from 69 to 24. She did it through a combination of treatments, including bariatric surgery, medication and mental health care. While Huett-Garcia is lucky to have a comprehensive employer-based healthcare plan, she recognizes that many people in the United States do not. And for those who are obese, the cost of care can be enormous. The cost of obesity Obesity costs the US healthcare system nearly $173 billion a year, according to the latest report by the Centers for Disease Control and Prevention. Personal medical costs for people living with obesity are close to $1,500 more per year than those who do not suffer from the condition. For people living with obesity and who are on Medicare, few treatments are covered. For example, Medicare has zero anti-obesity medication coverage. Moreover, roughly 40% of the US population lacks coverage for bariatric surgery for obesity, which has been proven most effective. “Affordable healthcare is a human right,” Huett-Garcia said. Amber Huett-Garcia taking part in the “Stop Weight Bias” campaign. She has called for action to ensure that insurance plans pay for the treatment of a wider range of conditions, including obesity, by covering comprehensive science-based interventions. She has also asked that decision-makers within healthcare systems listen and amplify the voices of people with NCDs. “The lives of people living with NCDs depend on it,” she concluded. Read Amber Huett-Garcia’s full NCD Diary. Read previous post. Image Credits: Courtesy of NCD Alliance. In Vietnam, Nguyen Ha Linh Calls on Government to Give Economic Support to People Living with NCDs 28/11/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Nguyen Ha Linh A young woman living in Vietnam has called on organizations and communities locally and globally to step up support for people living with noncommunicable diseases (NCDs) – especially multiple sclerosis (MS). “I call on the Vietnamese government to give economic support packages to people living with NCDs, especially people with disabilities, because many are paralyzed, unable to support themselves and earn a living,” said Nguyen Ha Linh. Ha Linh lives with MS. Since the age of 23 she has been rapidly deteriorating. While at first she worked as a graphic designer, gradually her arms and legs weakened until she became paralyzed. She developed atrophy of the nerve in her eyes. Today, all of her activities depend on the care of her relatives. Nguyen Ha Linh Access to care But her greatest challenges have been access to care and finances. “Multiple sclerosis is not covered by insurance in Vietnam, so I must pay for my care out of pocket, with financial support from my relatives,” Ha Linh explained. “Multiple sclerosis is considered a rare disease in Vietnam. People living with this condition find it very difficult to access diagnosis and care, and not all major hospitals have the resources for treatment. For those that manage to access care for multiple sclerosis, this is very expensive.” Government must take action She said that people living with MS often focus on getting funding from philanthropists who care about people living with disabilities. However, she believes that the government should be the one to take action first. “Many challenges related to treatment, care and support for people living with NCDs remain largely unaddressed,” Ha Linh said. “In particular, the components of care and support are weak, which therefore means that relatives play an important role for those who have a good support system at home. This is not always the case. “People living with NCDs would like to call on the government to change the regulations around health insurance to allow access to affordable diagnostics and care to help us have a better life,” she concluded. Read Nguyen Ha Linh’s full NCD Diary. Read next post. Image Credits: Courtesy of the NCD Alliance. More Than Five Women Killed Every Hour by Intimate Partners or Family: UN Women, UNODC report 25/11/2022 Megha Kaveri Women and girls are more at risk of getting killed at home by intimate partners or family. A new report by UN Women and the UN Office on Drugs and Crimes (UNODC) said that more than five women or girls are killed every hour across the world by their partners or families. The report, released ahead of the UN’s International Day for the Elimination of Violence Against Women on Friday, said that while men are subjected to higher rates of homicides across the world, women and girls are disproportionately affected by higher rates of homicides in private spaces. In 2021, 81,000 women and girls were killed intentionally, of which around 45,000 – some 55% – were killed by their own intimate partners or family members. By comparison, 11% of the total male homicides happened in private spaces. Covid-19 huge push to fatal violence against women The report found mixed trends on femicide across the world. Between 2010 and 2021, the total number of female homicides by intimate partners or families fell by 19% in Europe. But that number rose by 6% in the Americas overall even as South America reported a decrease. COVID-19 and the subsequent confinement to homes seems to have led to an increase in gender-related killings of women and girls in North America, Western and Southern Europe in 2020, according to the report. “Other sub-regions in Europe and the Americas recorded negligible changes or decreases in the number of killings between 2019 and the end of 2020, which suggests that the onset of the COVID-19 pandemic had heterogeneous impacts,” it said. “The decreases in some sub-regions may reflect delays in recording due to COVID-19 rather than reductions in the number of killings.” The report did not mention similar trends in Asia, Africa or Oceania, due to a lack of data. A World Health Organization-led report last year found almost one in three women experience physical and/or sexual violence across the course of their lifetimes, and in the previous 12 months, more than one in ten women suffered from physical and/or sexual intimate partner violence. More data key to policy formulation Women and girls in all regions are affected by gender-based killings. While Asia isthe region with the largest absolute number of killings, Africa is the region with thehighest level of violence relative to the size of its female population. Highlighting the lack of sufficient and comprehensive data on global femicides, the new report from UN Women and UNODC said more data will enable policy makers to gain a better understanding of the issue and to push for changes. “Additional data beyond identification purposes, such as age of perpetrators and victims, including information surrounding the event of the killing should be collected for analytical purposes,” the report said, adding that will help policy makers detect failures in responses and protection, develop better preventive measures and improve access to justice. Solutions include survivor-centric approaches The report also called for more survivor-centred responses to address gender-based violence in the world, saying it’s an approach that’s “fundamental to preventing and eliminating gender-based violence against women and girls and ensuring it does not escalate to femicide/gender-related killings.” Providing victims with a positive experience when they first report gender-based violence can increase trust and potentially save lives, and encourage other victims to report and disclose crimes. Another measure called for in the report is stronger civil society organisations that work in the women’s rights sector, the report said, because they serve “an important role in preventing gender-based violence against women and girls, by advocating for and securing normative and policy change, providing psycho-social support services and holding governments to account.” Image Credits: Artem Maltzev, UN Women. Fossil Fuels Cast Dark Shadow Over Tanzania’s Green Future 25/11/2022 Kizito Makoye Issa Abdul’s single solar panel powers his barber shop. DAR ES SALAAM, Tanzania – Issa Abdul’s desperate urge for solar power began when he realised a smoke-spewing generator at his barber shop was costing him too much. “Solar power is very cheap. I regret spending my money on this fuel-guzzling machine,” he told Health Policy Watch. The 32-year-old barber in Tanzania’s port city spent roughly Tanzanian shillings 150,000 ($65) to purchase a small solar system and this now powers his hair cutting business. “I am very happy to have my own solar system. It is very useful,” he said. On a humid Sunday morning, Abdul adeptly digs a buzzing clipper through the hair of the client sitting on a leather chair before him. “I was spending a lot of money every month buying fuel, that is history now,” he said. Perched on a rusty roof, Abdul’s lone solar panel produces enough electricity to run two clippers, three bright lights and a cell phone charger. “There’s plenty of sunshine, I don’t disappoint my customers,” he said. Drought cripples hydropower facilities However, like other east African countries such as Kenya and Uganda, solar power still remains a small part of the country’s energy mix. While Tanzania’s electric grid has been primarily powered by hydroelectric power, another renewable source, for some time, hydro’s dominance is slipping now. Climate-related spells of drought have crippled the country’s hydropower facilities and the ageing distribution infrastructure, and the country is experiencing an electricity crisis affecting various sectors of the economy. Hydropower, which can potentially generate 4.7 GW of electricity according to government estimates, is only producing 12% of its power potential, and is prone to weather variability. And as drought tightens its grip, Tanzania, which has 57 trillion cubic feet of natural gas reserves, is now poised to tap this chunk of fossil fuels to cover the electricity deficit Natural gas, oil and coal will almost certainly remain dominant in the country’s energy mix in the near future, according to experts. A motorcyclist riding outside TPTL plant in Dar es Salaam that uses heavy furnace oil to produce electricity. Addressing climate change impact with fossil fuels Tanzania’s experience is just one example of an emerging paradox of addressing climate change impacts with more climate-changing fossil fuel. Tanzania, Kenya and Uganda have been dependent on hydropower, but as all three countries grapple with climate-related drought, they may also find it easier to tap their fossil fuel reserves with the help of multinational investors standing by than develop greener alternatives. This is even as technologies exist for large-scale grid-quality solar power that is ultimately cheaper, industry observers say. While nations worldwide are shifting to renewable energy to reduce the global carbon footprint and ease the toll that fossil fuels take on people’s health, economy and climate, the majority of Tanzanians, like those in large parts of Africa, still use dirty energy sources that pollute the air, causing some 1.1 million deaths annually on the continent, according to a recent study. Air pollution is the second risk factor for death in Africa after malnutrition, concluded the study by the Boston-based Health Effects Institute. Tanzania’s electricity generation comes mostly from natural gas (48%), followed by hydropower (31%), petrol/diesel (18%), solar (1%), and biofuels (1%). In Kenya and Uganda, hydropower and geothermal power are the dominant portions of the electricity generation mix, with solar power making up a very minor proportion of the mix. As demand for energy continues to grow, it is unclear how to ensure that renewables become more attractive than fossil fuel. Investments in fossil fuels far outweigh that of renewables in most parts of Africa, and oil and gas exploration and exploitation continues apace in Kenya, Uganda and Tanzania. Dirty diesel At Kariakoo, a business hub in Dar es Salaam dotted with shopping centres, a toxic haze of diesel hangs in the air as generators roar so loudly that they drown out people’s conversations. Like the lone solar panel precariously hanging on Abdul’s salon, smoke-spewing generators are widely used when grid electricity goes off. They power everything from ceiling fans to television sets, air conditioners and freezers – the latter two items pulling too much power to make a rooftop solar system reliable. Among the available choices, portable diesel generators are among the dirtiest, spewing particulate-laden emissions into the air directly into spaces where people live and work. But they remain the go-to solution in much of Tanzania and Africa more broadly. “To me, a diesel generator provides the necessary power,” said Aloycia Mosha who runs a cold fish store. Soaked with sweat, Mosha repeatedly pulls a string to rev the engine of her generator. “If I don’t switch it on now, all my fish stock will get spoilt,” said Mosha. The 45-year-old entrepreneur has often found a trail of blood oozing on her shop’s tiled floor, a clear sign that the fish defrosted overnight. Vendor stand near a standby diesel generator in Dar es Salaam Power cuts are part of daily life Power cuts are part of daily life in Dar es Salaam, a busy city that is home to 5.8 million people, and accounts for 40% of the country’s GDP. While a few city dwellers have installed solar power on their roof tops to save spiralling energy costs, analysts say the lack of clear financing mechanism to cover initial installation costs, coupled with an unreliable distribution network, have made solar systems a distant luxury to many families. Asteria Mchomvu, a resident of Upanga, a middle-class neighborhood in Dar es Salaam, began to dream of installing solar panels on her roof a decade ago. At first, Mchomvu, who works as a teacher, was excited to learn that solar technology could help her save money and protect the environment. But a home solar system was too expensive for her t the time. A modest 8-kilowat system would roughly cost Tanzanian shillings 10, million ($4347) in 2012, according to Tanzania’s Rural Energy Agency. Prices for solar systems in Tanzania have since fallen by more than 60% and companies are aggressively jostling to pitch their sales. Yet still, the numbers didn’t work for Mchomvu, who teaches geography and science Then early in November, at the Dar es Salaam International Trade Fair, Mchomvu caught up with Richard Tairo, a salesman from Arti energy, a solar company focusing on mid and low -income customers. Tairo understood Mchomvu’s passion for solar and her financial dilemma and he introduced her to Mali Kauli, a program that finances residential solar systems and offers borrowers, below-market rates. Mchomvu accepted the offer after the company assured her that the system could lower her energy bills and spare her the agony of power cuts. “I wanted to be 100% sure it is worth investing,” she told the Health Policy Watch. Skewed regulatory framework disadvantages solar Despite the growing public awareness, renewable energy penetration in Tanzania is still facing major hurdles due to a skewed regulatory framework and limited market. Samuel Wangwe, a research associate with Research on Poverty Alleviation (REPOA) said solar power market has seen sluggish growth due to fragmented financing plans, uneven service after equipment sale and technical weaknesses in batteries and solar lamps, which are often cheap items imported from China with warranties that cannot be honoured. “The most obvious barrier to renewable energy, notably solar is cost. The upfront expenses that people pay to get solar panels installed at their homes are still too high,” Wangwe said. Many investors are discouraged to take on renewable energy projects because of high capital costs and a long net payback period, he added. Wangwe says that the industry is also dogged by a lack of training institutes, which has prevented renewable energy technologies from scaling up. “We must encourage our children to take renewable energy courses and hone their technical skills,” he said. A shop for solar equipment at Kariakoo business centre in Dar es Salaam Bigger subsidies for fossil fuels Although some subsidies are offered for rooftop solar, the subsidies the government provides to fossil fuel sources are much higher, Wangwe said. In fact, in July, the Tanzanian government introduced a new fuel subsidy of a whopping Tanzanian shillings 100 billion ($43 million) monthly to stabilise the domestic price of fuel, Wangwe said. While solar panel and wind turbines are exempt from VAT and are not charged import duties, accessories including the batteries essential to operating a household solar package are charged up to 35% import duty, said Wangwe. “This is the reason why solar technology is not scaling up as fast as possible” he said. Coal, oil and gas are by far the largest contributors to climate change, experts say. In addition, some 65% of deaths from air pollution are generated by fossil fuel combustion, including the noisy and smokey generators that are omnipresent in households and big African cities like Dar es Salaam. While global leaders have endorsed the scientific consensus to limit global warming to 1.5°C above pre-industrial level, as spelled out in the Paris Agreement, there is a growing rush for oil and gas exploration in the global south. This is what COP27 civil society participants called the “dash for gas” reminiscent of the colonial scramble for Africa. More fossil fuel exploration Tanzania has enough gas reserves to put the country on a path of economic prosperity, and may unlock as much as $30 billion in liquified natural gas (LNG) investments. At the same time, if the historic pattern long followed in east and west Africa remains the same, many of the new LNG is likely to be sold to Europe and other countries to generate foreign currency, rather than used at home. “Our political leaders are caught up in a dilemma. Such investments are worthwhile economically but bad for the environment,” said Wangwe. While many have argued that off-grid solar solutions hold the key to Tanzania’s urban and rural electrification, fossil fuels subsidies have reduced its competitiveness. Yusto Mugisha, professor of renewable energy at the school of engineering and technology a Sokoine University of Agriculture, said in order to build a sustainable future, Tanzania needs to invest in clean, accessible and affordable energy sources. “Renewable energy sources are available and their potential is not fully harnessed,” said Mugisha. Although upfront costs for renewable projects can be daunting, Mugisha said efficient and more reliable renewable technologies can create a system that is less prone to market shocks and improve energy security. Unlike fossil fuels, which need to be extracted and transported to large power plants and require a grid network extending to remote areas, renewable sources like solar and wind can be developed in various flexible arrays. They can be just a few panels on a household installation, part of a community mini-grid, or as a solar power plant feeding into the large grid. That, according to the International Energy Agency and countless other assessments means that solar could leap-frog over grid-dependent fossil fuel technologies much like portable phones leap-frogged over fixed phone lines in Africa, providing better service much faster. But renewable energy versus fossil fuels has seemingly placed Tanzania politicians in the moral dilemma. While fossil fuel provides badly needed energy, it leaves behind a carbon footprint that’s proving catastrophic to humans and the planet. Yet, in the short term, policymakers strongly support fuel subsidies to stabilise the prices of other commodities. Meanwhile, renewable energy subsidies, notably on solar, are indirectly offered mostly through the Rural Energy Agency, and are clustered depending on the scale of the project. Despite its small market share local experts say renewable energy has the potential to respond to present and future challenges by enhancing energy security, generating income, and providing employment. Rural dependence on kerosene William Kahise, a student at Itetemia primary school, persuaded hus mother to buy a solar lamp as the kerosene one made him cough. In the dusty western town of Tabora, 12-year-old William Kahise and his sister Juliana routinely huddled around the faint glow of kerosene lamp when the darkness sets in, struggling to get their homework done before their mother blows off the lamp to save the fuel cost. “I must finish my work, otherwise my teacher will be very angry,” Kahise told Health Policy Watch. The paraffin lamp, made from a discarded cooking oil tin, emitted choking smoke and casts scary shadows on the walls. Kerosene is one of the household fuels that WHO has recommended not be used at all, because of its health harmful effects, including impaired lung function, asthma and cancer. The Itetemia primary school pupil may not know about the WHO recommendation, but he knew the smoke made him cough and convinced his mother to ditch the kerosene lantern, for a cheap solar version. Kerosene is used by millions of rural households i to meet basic lighting needs and subsidies have long been used to make the fuel more affordable. Kerosene subsidies have been at the centre of energy policy debate, with renewable energy activists arguing that, for health, safety and environmental reasons, a switch to solar power is better. “The subsidized kerosene is extremely costly and wasteful, the government is spending a lot of money every month to keep the price low,” said Mugisha. But for Abdul, who enjoys solar power, the challenge arises when his Chinese-made panel starts to age and needs to be replaced as Africa produces virtually no panels of its own. –First of two parts on the barriers to clean, renewable energy in Africa. -Research and reporting for this story was supported by the Rosa Luxembourg Foundation. Image Credits: Peter Mgongo. Posts navigation Older postsNewer posts
In Vietnam, Nguyen Ha Linh Calls on Government to Give Economic Support to People Living with NCDs 28/11/2022 Editorial team A special project celebrating the fifth anniversary of “Our Views, Our Voices” | Learn more Nguyen Ha Linh A young woman living in Vietnam has called on organizations and communities locally and globally to step up support for people living with noncommunicable diseases (NCDs) – especially multiple sclerosis (MS). “I call on the Vietnamese government to give economic support packages to people living with NCDs, especially people with disabilities, because many are paralyzed, unable to support themselves and earn a living,” said Nguyen Ha Linh. Ha Linh lives with MS. Since the age of 23 she has been rapidly deteriorating. While at first she worked as a graphic designer, gradually her arms and legs weakened until she became paralyzed. She developed atrophy of the nerve in her eyes. Today, all of her activities depend on the care of her relatives. Nguyen Ha Linh Access to care But her greatest challenges have been access to care and finances. “Multiple sclerosis is not covered by insurance in Vietnam, so I must pay for my care out of pocket, with financial support from my relatives,” Ha Linh explained. “Multiple sclerosis is considered a rare disease in Vietnam. People living with this condition find it very difficult to access diagnosis and care, and not all major hospitals have the resources for treatment. For those that manage to access care for multiple sclerosis, this is very expensive.” Government must take action She said that people living with MS often focus on getting funding from philanthropists who care about people living with disabilities. However, she believes that the government should be the one to take action first. “Many challenges related to treatment, care and support for people living with NCDs remain largely unaddressed,” Ha Linh said. “In particular, the components of care and support are weak, which therefore means that relatives play an important role for those who have a good support system at home. This is not always the case. “People living with NCDs would like to call on the government to change the regulations around health insurance to allow access to affordable diagnostics and care to help us have a better life,” she concluded. Read Nguyen Ha Linh’s full NCD Diary. Read next post. Image Credits: Courtesy of the NCD Alliance. More Than Five Women Killed Every Hour by Intimate Partners or Family: UN Women, UNODC report 25/11/2022 Megha Kaveri Women and girls are more at risk of getting killed at home by intimate partners or family. A new report by UN Women and the UN Office on Drugs and Crimes (UNODC) said that more than five women or girls are killed every hour across the world by their partners or families. The report, released ahead of the UN’s International Day for the Elimination of Violence Against Women on Friday, said that while men are subjected to higher rates of homicides across the world, women and girls are disproportionately affected by higher rates of homicides in private spaces. In 2021, 81,000 women and girls were killed intentionally, of which around 45,000 – some 55% – were killed by their own intimate partners or family members. By comparison, 11% of the total male homicides happened in private spaces. Covid-19 huge push to fatal violence against women The report found mixed trends on femicide across the world. Between 2010 and 2021, the total number of female homicides by intimate partners or families fell by 19% in Europe. But that number rose by 6% in the Americas overall even as South America reported a decrease. COVID-19 and the subsequent confinement to homes seems to have led to an increase in gender-related killings of women and girls in North America, Western and Southern Europe in 2020, according to the report. “Other sub-regions in Europe and the Americas recorded negligible changes or decreases in the number of killings between 2019 and the end of 2020, which suggests that the onset of the COVID-19 pandemic had heterogeneous impacts,” it said. “The decreases in some sub-regions may reflect delays in recording due to COVID-19 rather than reductions in the number of killings.” The report did not mention similar trends in Asia, Africa or Oceania, due to a lack of data. A World Health Organization-led report last year found almost one in three women experience physical and/or sexual violence across the course of their lifetimes, and in the previous 12 months, more than one in ten women suffered from physical and/or sexual intimate partner violence. More data key to policy formulation Women and girls in all regions are affected by gender-based killings. While Asia isthe region with the largest absolute number of killings, Africa is the region with thehighest level of violence relative to the size of its female population. Highlighting the lack of sufficient and comprehensive data on global femicides, the new report from UN Women and UNODC said more data will enable policy makers to gain a better understanding of the issue and to push for changes. “Additional data beyond identification purposes, such as age of perpetrators and victims, including information surrounding the event of the killing should be collected for analytical purposes,” the report said, adding that will help policy makers detect failures in responses and protection, develop better preventive measures and improve access to justice. Solutions include survivor-centric approaches The report also called for more survivor-centred responses to address gender-based violence in the world, saying it’s an approach that’s “fundamental to preventing and eliminating gender-based violence against women and girls and ensuring it does not escalate to femicide/gender-related killings.” Providing victims with a positive experience when they first report gender-based violence can increase trust and potentially save lives, and encourage other victims to report and disclose crimes. Another measure called for in the report is stronger civil society organisations that work in the women’s rights sector, the report said, because they serve “an important role in preventing gender-based violence against women and girls, by advocating for and securing normative and policy change, providing psycho-social support services and holding governments to account.” Image Credits: Artem Maltzev, UN Women. Fossil Fuels Cast Dark Shadow Over Tanzania’s Green Future 25/11/2022 Kizito Makoye Issa Abdul’s single solar panel powers his barber shop. DAR ES SALAAM, Tanzania – Issa Abdul’s desperate urge for solar power began when he realised a smoke-spewing generator at his barber shop was costing him too much. “Solar power is very cheap. I regret spending my money on this fuel-guzzling machine,” he told Health Policy Watch. The 32-year-old barber in Tanzania’s port city spent roughly Tanzanian shillings 150,000 ($65) to purchase a small solar system and this now powers his hair cutting business. “I am very happy to have my own solar system. It is very useful,” he said. On a humid Sunday morning, Abdul adeptly digs a buzzing clipper through the hair of the client sitting on a leather chair before him. “I was spending a lot of money every month buying fuel, that is history now,” he said. Perched on a rusty roof, Abdul’s lone solar panel produces enough electricity to run two clippers, three bright lights and a cell phone charger. “There’s plenty of sunshine, I don’t disappoint my customers,” he said. Drought cripples hydropower facilities However, like other east African countries such as Kenya and Uganda, solar power still remains a small part of the country’s energy mix. While Tanzania’s electric grid has been primarily powered by hydroelectric power, another renewable source, for some time, hydro’s dominance is slipping now. Climate-related spells of drought have crippled the country’s hydropower facilities and the ageing distribution infrastructure, and the country is experiencing an electricity crisis affecting various sectors of the economy. Hydropower, which can potentially generate 4.7 GW of electricity according to government estimates, is only producing 12% of its power potential, and is prone to weather variability. And as drought tightens its grip, Tanzania, which has 57 trillion cubic feet of natural gas reserves, is now poised to tap this chunk of fossil fuels to cover the electricity deficit Natural gas, oil and coal will almost certainly remain dominant in the country’s energy mix in the near future, according to experts. A motorcyclist riding outside TPTL plant in Dar es Salaam that uses heavy furnace oil to produce electricity. Addressing climate change impact with fossil fuels Tanzania’s experience is just one example of an emerging paradox of addressing climate change impacts with more climate-changing fossil fuel. Tanzania, Kenya and Uganda have been dependent on hydropower, but as all three countries grapple with climate-related drought, they may also find it easier to tap their fossil fuel reserves with the help of multinational investors standing by than develop greener alternatives. This is even as technologies exist for large-scale grid-quality solar power that is ultimately cheaper, industry observers say. While nations worldwide are shifting to renewable energy to reduce the global carbon footprint and ease the toll that fossil fuels take on people’s health, economy and climate, the majority of Tanzanians, like those in large parts of Africa, still use dirty energy sources that pollute the air, causing some 1.1 million deaths annually on the continent, according to a recent study. Air pollution is the second risk factor for death in Africa after malnutrition, concluded the study by the Boston-based Health Effects Institute. Tanzania’s electricity generation comes mostly from natural gas (48%), followed by hydropower (31%), petrol/diesel (18%), solar (1%), and biofuels (1%). In Kenya and Uganda, hydropower and geothermal power are the dominant portions of the electricity generation mix, with solar power making up a very minor proportion of the mix. As demand for energy continues to grow, it is unclear how to ensure that renewables become more attractive than fossil fuel. Investments in fossil fuels far outweigh that of renewables in most parts of Africa, and oil and gas exploration and exploitation continues apace in Kenya, Uganda and Tanzania. Dirty diesel At Kariakoo, a business hub in Dar es Salaam dotted with shopping centres, a toxic haze of diesel hangs in the air as generators roar so loudly that they drown out people’s conversations. Like the lone solar panel precariously hanging on Abdul’s salon, smoke-spewing generators are widely used when grid electricity goes off. They power everything from ceiling fans to television sets, air conditioners and freezers – the latter two items pulling too much power to make a rooftop solar system reliable. Among the available choices, portable diesel generators are among the dirtiest, spewing particulate-laden emissions into the air directly into spaces where people live and work. But they remain the go-to solution in much of Tanzania and Africa more broadly. “To me, a diesel generator provides the necessary power,” said Aloycia Mosha who runs a cold fish store. Soaked with sweat, Mosha repeatedly pulls a string to rev the engine of her generator. “If I don’t switch it on now, all my fish stock will get spoilt,” said Mosha. The 45-year-old entrepreneur has often found a trail of blood oozing on her shop’s tiled floor, a clear sign that the fish defrosted overnight. Vendor stand near a standby diesel generator in Dar es Salaam Power cuts are part of daily life Power cuts are part of daily life in Dar es Salaam, a busy city that is home to 5.8 million people, and accounts for 40% of the country’s GDP. While a few city dwellers have installed solar power on their roof tops to save spiralling energy costs, analysts say the lack of clear financing mechanism to cover initial installation costs, coupled with an unreliable distribution network, have made solar systems a distant luxury to many families. Asteria Mchomvu, a resident of Upanga, a middle-class neighborhood in Dar es Salaam, began to dream of installing solar panels on her roof a decade ago. At first, Mchomvu, who works as a teacher, was excited to learn that solar technology could help her save money and protect the environment. But a home solar system was too expensive for her t the time. A modest 8-kilowat system would roughly cost Tanzanian shillings 10, million ($4347) in 2012, according to Tanzania’s Rural Energy Agency. Prices for solar systems in Tanzania have since fallen by more than 60% and companies are aggressively jostling to pitch their sales. Yet still, the numbers didn’t work for Mchomvu, who teaches geography and science Then early in November, at the Dar es Salaam International Trade Fair, Mchomvu caught up with Richard Tairo, a salesman from Arti energy, a solar company focusing on mid and low -income customers. Tairo understood Mchomvu’s passion for solar and her financial dilemma and he introduced her to Mali Kauli, a program that finances residential solar systems and offers borrowers, below-market rates. Mchomvu accepted the offer after the company assured her that the system could lower her energy bills and spare her the agony of power cuts. “I wanted to be 100% sure it is worth investing,” she told the Health Policy Watch. Skewed regulatory framework disadvantages solar Despite the growing public awareness, renewable energy penetration in Tanzania is still facing major hurdles due to a skewed regulatory framework and limited market. Samuel Wangwe, a research associate with Research on Poverty Alleviation (REPOA) said solar power market has seen sluggish growth due to fragmented financing plans, uneven service after equipment sale and technical weaknesses in batteries and solar lamps, which are often cheap items imported from China with warranties that cannot be honoured. “The most obvious barrier to renewable energy, notably solar is cost. The upfront expenses that people pay to get solar panels installed at their homes are still too high,” Wangwe said. Many investors are discouraged to take on renewable energy projects because of high capital costs and a long net payback period, he added. Wangwe says that the industry is also dogged by a lack of training institutes, which has prevented renewable energy technologies from scaling up. “We must encourage our children to take renewable energy courses and hone their technical skills,” he said. A shop for solar equipment at Kariakoo business centre in Dar es Salaam Bigger subsidies for fossil fuels Although some subsidies are offered for rooftop solar, the subsidies the government provides to fossil fuel sources are much higher, Wangwe said. In fact, in July, the Tanzanian government introduced a new fuel subsidy of a whopping Tanzanian shillings 100 billion ($43 million) monthly to stabilise the domestic price of fuel, Wangwe said. While solar panel and wind turbines are exempt from VAT and are not charged import duties, accessories including the batteries essential to operating a household solar package are charged up to 35% import duty, said Wangwe. “This is the reason why solar technology is not scaling up as fast as possible” he said. Coal, oil and gas are by far the largest contributors to climate change, experts say. In addition, some 65% of deaths from air pollution are generated by fossil fuel combustion, including the noisy and smokey generators that are omnipresent in households and big African cities like Dar es Salaam. While global leaders have endorsed the scientific consensus to limit global warming to 1.5°C above pre-industrial level, as spelled out in the Paris Agreement, there is a growing rush for oil and gas exploration in the global south. This is what COP27 civil society participants called the “dash for gas” reminiscent of the colonial scramble for Africa. More fossil fuel exploration Tanzania has enough gas reserves to put the country on a path of economic prosperity, and may unlock as much as $30 billion in liquified natural gas (LNG) investments. At the same time, if the historic pattern long followed in east and west Africa remains the same, many of the new LNG is likely to be sold to Europe and other countries to generate foreign currency, rather than used at home. “Our political leaders are caught up in a dilemma. Such investments are worthwhile economically but bad for the environment,” said Wangwe. While many have argued that off-grid solar solutions hold the key to Tanzania’s urban and rural electrification, fossil fuels subsidies have reduced its competitiveness. Yusto Mugisha, professor of renewable energy at the school of engineering and technology a Sokoine University of Agriculture, said in order to build a sustainable future, Tanzania needs to invest in clean, accessible and affordable energy sources. “Renewable energy sources are available and their potential is not fully harnessed,” said Mugisha. Although upfront costs for renewable projects can be daunting, Mugisha said efficient and more reliable renewable technologies can create a system that is less prone to market shocks and improve energy security. Unlike fossil fuels, which need to be extracted and transported to large power plants and require a grid network extending to remote areas, renewable sources like solar and wind can be developed in various flexible arrays. They can be just a few panels on a household installation, part of a community mini-grid, or as a solar power plant feeding into the large grid. That, according to the International Energy Agency and countless other assessments means that solar could leap-frog over grid-dependent fossil fuel technologies much like portable phones leap-frogged over fixed phone lines in Africa, providing better service much faster. But renewable energy versus fossil fuels has seemingly placed Tanzania politicians in the moral dilemma. While fossil fuel provides badly needed energy, it leaves behind a carbon footprint that’s proving catastrophic to humans and the planet. Yet, in the short term, policymakers strongly support fuel subsidies to stabilise the prices of other commodities. Meanwhile, renewable energy subsidies, notably on solar, are indirectly offered mostly through the Rural Energy Agency, and are clustered depending on the scale of the project. Despite its small market share local experts say renewable energy has the potential to respond to present and future challenges by enhancing energy security, generating income, and providing employment. Rural dependence on kerosene William Kahise, a student at Itetemia primary school, persuaded hus mother to buy a solar lamp as the kerosene one made him cough. In the dusty western town of Tabora, 12-year-old William Kahise and his sister Juliana routinely huddled around the faint glow of kerosene lamp when the darkness sets in, struggling to get their homework done before their mother blows off the lamp to save the fuel cost. “I must finish my work, otherwise my teacher will be very angry,” Kahise told Health Policy Watch. The paraffin lamp, made from a discarded cooking oil tin, emitted choking smoke and casts scary shadows on the walls. Kerosene is one of the household fuels that WHO has recommended not be used at all, because of its health harmful effects, including impaired lung function, asthma and cancer. The Itetemia primary school pupil may not know about the WHO recommendation, but he knew the smoke made him cough and convinced his mother to ditch the kerosene lantern, for a cheap solar version. Kerosene is used by millions of rural households i to meet basic lighting needs and subsidies have long been used to make the fuel more affordable. Kerosene subsidies have been at the centre of energy policy debate, with renewable energy activists arguing that, for health, safety and environmental reasons, a switch to solar power is better. “The subsidized kerosene is extremely costly and wasteful, the government is spending a lot of money every month to keep the price low,” said Mugisha. But for Abdul, who enjoys solar power, the challenge arises when his Chinese-made panel starts to age and needs to be replaced as Africa produces virtually no panels of its own. –First of two parts on the barriers to clean, renewable energy in Africa. -Research and reporting for this story was supported by the Rosa Luxembourg Foundation. Image Credits: Peter Mgongo. Posts navigation Older postsNewer posts
More Than Five Women Killed Every Hour by Intimate Partners or Family: UN Women, UNODC report 25/11/2022 Megha Kaveri Women and girls are more at risk of getting killed at home by intimate partners or family. A new report by UN Women and the UN Office on Drugs and Crimes (UNODC) said that more than five women or girls are killed every hour across the world by their partners or families. The report, released ahead of the UN’s International Day for the Elimination of Violence Against Women on Friday, said that while men are subjected to higher rates of homicides across the world, women and girls are disproportionately affected by higher rates of homicides in private spaces. In 2021, 81,000 women and girls were killed intentionally, of which around 45,000 – some 55% – were killed by their own intimate partners or family members. By comparison, 11% of the total male homicides happened in private spaces. Covid-19 huge push to fatal violence against women The report found mixed trends on femicide across the world. Between 2010 and 2021, the total number of female homicides by intimate partners or families fell by 19% in Europe. But that number rose by 6% in the Americas overall even as South America reported a decrease. COVID-19 and the subsequent confinement to homes seems to have led to an increase in gender-related killings of women and girls in North America, Western and Southern Europe in 2020, according to the report. “Other sub-regions in Europe and the Americas recorded negligible changes or decreases in the number of killings between 2019 and the end of 2020, which suggests that the onset of the COVID-19 pandemic had heterogeneous impacts,” it said. “The decreases in some sub-regions may reflect delays in recording due to COVID-19 rather than reductions in the number of killings.” The report did not mention similar trends in Asia, Africa or Oceania, due to a lack of data. A World Health Organization-led report last year found almost one in three women experience physical and/or sexual violence across the course of their lifetimes, and in the previous 12 months, more than one in ten women suffered from physical and/or sexual intimate partner violence. More data key to policy formulation Women and girls in all regions are affected by gender-based killings. While Asia isthe region with the largest absolute number of killings, Africa is the region with thehighest level of violence relative to the size of its female population. Highlighting the lack of sufficient and comprehensive data on global femicides, the new report from UN Women and UNODC said more data will enable policy makers to gain a better understanding of the issue and to push for changes. “Additional data beyond identification purposes, such as age of perpetrators and victims, including information surrounding the event of the killing should be collected for analytical purposes,” the report said, adding that will help policy makers detect failures in responses and protection, develop better preventive measures and improve access to justice. Solutions include survivor-centric approaches The report also called for more survivor-centred responses to address gender-based violence in the world, saying it’s an approach that’s “fundamental to preventing and eliminating gender-based violence against women and girls and ensuring it does not escalate to femicide/gender-related killings.” Providing victims with a positive experience when they first report gender-based violence can increase trust and potentially save lives, and encourage other victims to report and disclose crimes. Another measure called for in the report is stronger civil society organisations that work in the women’s rights sector, the report said, because they serve “an important role in preventing gender-based violence against women and girls, by advocating for and securing normative and policy change, providing psycho-social support services and holding governments to account.” Image Credits: Artem Maltzev, UN Women. Fossil Fuels Cast Dark Shadow Over Tanzania’s Green Future 25/11/2022 Kizito Makoye Issa Abdul’s single solar panel powers his barber shop. DAR ES SALAAM, Tanzania – Issa Abdul’s desperate urge for solar power began when he realised a smoke-spewing generator at his barber shop was costing him too much. “Solar power is very cheap. I regret spending my money on this fuel-guzzling machine,” he told Health Policy Watch. The 32-year-old barber in Tanzania’s port city spent roughly Tanzanian shillings 150,000 ($65) to purchase a small solar system and this now powers his hair cutting business. “I am very happy to have my own solar system. It is very useful,” he said. On a humid Sunday morning, Abdul adeptly digs a buzzing clipper through the hair of the client sitting on a leather chair before him. “I was spending a lot of money every month buying fuel, that is history now,” he said. Perched on a rusty roof, Abdul’s lone solar panel produces enough electricity to run two clippers, three bright lights and a cell phone charger. “There’s plenty of sunshine, I don’t disappoint my customers,” he said. Drought cripples hydropower facilities However, like other east African countries such as Kenya and Uganda, solar power still remains a small part of the country’s energy mix. While Tanzania’s electric grid has been primarily powered by hydroelectric power, another renewable source, for some time, hydro’s dominance is slipping now. Climate-related spells of drought have crippled the country’s hydropower facilities and the ageing distribution infrastructure, and the country is experiencing an electricity crisis affecting various sectors of the economy. Hydropower, which can potentially generate 4.7 GW of electricity according to government estimates, is only producing 12% of its power potential, and is prone to weather variability. And as drought tightens its grip, Tanzania, which has 57 trillion cubic feet of natural gas reserves, is now poised to tap this chunk of fossil fuels to cover the electricity deficit Natural gas, oil and coal will almost certainly remain dominant in the country’s energy mix in the near future, according to experts. A motorcyclist riding outside TPTL plant in Dar es Salaam that uses heavy furnace oil to produce electricity. Addressing climate change impact with fossil fuels Tanzania’s experience is just one example of an emerging paradox of addressing climate change impacts with more climate-changing fossil fuel. Tanzania, Kenya and Uganda have been dependent on hydropower, but as all three countries grapple with climate-related drought, they may also find it easier to tap their fossil fuel reserves with the help of multinational investors standing by than develop greener alternatives. This is even as technologies exist for large-scale grid-quality solar power that is ultimately cheaper, industry observers say. While nations worldwide are shifting to renewable energy to reduce the global carbon footprint and ease the toll that fossil fuels take on people’s health, economy and climate, the majority of Tanzanians, like those in large parts of Africa, still use dirty energy sources that pollute the air, causing some 1.1 million deaths annually on the continent, according to a recent study. Air pollution is the second risk factor for death in Africa after malnutrition, concluded the study by the Boston-based Health Effects Institute. Tanzania’s electricity generation comes mostly from natural gas (48%), followed by hydropower (31%), petrol/diesel (18%), solar (1%), and biofuels (1%). In Kenya and Uganda, hydropower and geothermal power are the dominant portions of the electricity generation mix, with solar power making up a very minor proportion of the mix. As demand for energy continues to grow, it is unclear how to ensure that renewables become more attractive than fossil fuel. Investments in fossil fuels far outweigh that of renewables in most parts of Africa, and oil and gas exploration and exploitation continues apace in Kenya, Uganda and Tanzania. Dirty diesel At Kariakoo, a business hub in Dar es Salaam dotted with shopping centres, a toxic haze of diesel hangs in the air as generators roar so loudly that they drown out people’s conversations. Like the lone solar panel precariously hanging on Abdul’s salon, smoke-spewing generators are widely used when grid electricity goes off. They power everything from ceiling fans to television sets, air conditioners and freezers – the latter two items pulling too much power to make a rooftop solar system reliable. Among the available choices, portable diesel generators are among the dirtiest, spewing particulate-laden emissions into the air directly into spaces where people live and work. But they remain the go-to solution in much of Tanzania and Africa more broadly. “To me, a diesel generator provides the necessary power,” said Aloycia Mosha who runs a cold fish store. Soaked with sweat, Mosha repeatedly pulls a string to rev the engine of her generator. “If I don’t switch it on now, all my fish stock will get spoilt,” said Mosha. The 45-year-old entrepreneur has often found a trail of blood oozing on her shop’s tiled floor, a clear sign that the fish defrosted overnight. Vendor stand near a standby diesel generator in Dar es Salaam Power cuts are part of daily life Power cuts are part of daily life in Dar es Salaam, a busy city that is home to 5.8 million people, and accounts for 40% of the country’s GDP. While a few city dwellers have installed solar power on their roof tops to save spiralling energy costs, analysts say the lack of clear financing mechanism to cover initial installation costs, coupled with an unreliable distribution network, have made solar systems a distant luxury to many families. Asteria Mchomvu, a resident of Upanga, a middle-class neighborhood in Dar es Salaam, began to dream of installing solar panels on her roof a decade ago. At first, Mchomvu, who works as a teacher, was excited to learn that solar technology could help her save money and protect the environment. But a home solar system was too expensive for her t the time. A modest 8-kilowat system would roughly cost Tanzanian shillings 10, million ($4347) in 2012, according to Tanzania’s Rural Energy Agency. Prices for solar systems in Tanzania have since fallen by more than 60% and companies are aggressively jostling to pitch their sales. Yet still, the numbers didn’t work for Mchomvu, who teaches geography and science Then early in November, at the Dar es Salaam International Trade Fair, Mchomvu caught up with Richard Tairo, a salesman from Arti energy, a solar company focusing on mid and low -income customers. Tairo understood Mchomvu’s passion for solar and her financial dilemma and he introduced her to Mali Kauli, a program that finances residential solar systems and offers borrowers, below-market rates. Mchomvu accepted the offer after the company assured her that the system could lower her energy bills and spare her the agony of power cuts. “I wanted to be 100% sure it is worth investing,” she told the Health Policy Watch. Skewed regulatory framework disadvantages solar Despite the growing public awareness, renewable energy penetration in Tanzania is still facing major hurdles due to a skewed regulatory framework and limited market. Samuel Wangwe, a research associate with Research on Poverty Alleviation (REPOA) said solar power market has seen sluggish growth due to fragmented financing plans, uneven service after equipment sale and technical weaknesses in batteries and solar lamps, which are often cheap items imported from China with warranties that cannot be honoured. “The most obvious barrier to renewable energy, notably solar is cost. The upfront expenses that people pay to get solar panels installed at their homes are still too high,” Wangwe said. Many investors are discouraged to take on renewable energy projects because of high capital costs and a long net payback period, he added. Wangwe says that the industry is also dogged by a lack of training institutes, which has prevented renewable energy technologies from scaling up. “We must encourage our children to take renewable energy courses and hone their technical skills,” he said. A shop for solar equipment at Kariakoo business centre in Dar es Salaam Bigger subsidies for fossil fuels Although some subsidies are offered for rooftop solar, the subsidies the government provides to fossil fuel sources are much higher, Wangwe said. In fact, in July, the Tanzanian government introduced a new fuel subsidy of a whopping Tanzanian shillings 100 billion ($43 million) monthly to stabilise the domestic price of fuel, Wangwe said. While solar panel and wind turbines are exempt from VAT and are not charged import duties, accessories including the batteries essential to operating a household solar package are charged up to 35% import duty, said Wangwe. “This is the reason why solar technology is not scaling up as fast as possible” he said. Coal, oil and gas are by far the largest contributors to climate change, experts say. In addition, some 65% of deaths from air pollution are generated by fossil fuel combustion, including the noisy and smokey generators that are omnipresent in households and big African cities like Dar es Salaam. While global leaders have endorsed the scientific consensus to limit global warming to 1.5°C above pre-industrial level, as spelled out in the Paris Agreement, there is a growing rush for oil and gas exploration in the global south. This is what COP27 civil society participants called the “dash for gas” reminiscent of the colonial scramble for Africa. More fossil fuel exploration Tanzania has enough gas reserves to put the country on a path of economic prosperity, and may unlock as much as $30 billion in liquified natural gas (LNG) investments. At the same time, if the historic pattern long followed in east and west Africa remains the same, many of the new LNG is likely to be sold to Europe and other countries to generate foreign currency, rather than used at home. “Our political leaders are caught up in a dilemma. Such investments are worthwhile economically but bad for the environment,” said Wangwe. While many have argued that off-grid solar solutions hold the key to Tanzania’s urban and rural electrification, fossil fuels subsidies have reduced its competitiveness. Yusto Mugisha, professor of renewable energy at the school of engineering and technology a Sokoine University of Agriculture, said in order to build a sustainable future, Tanzania needs to invest in clean, accessible and affordable energy sources. “Renewable energy sources are available and their potential is not fully harnessed,” said Mugisha. Although upfront costs for renewable projects can be daunting, Mugisha said efficient and more reliable renewable technologies can create a system that is less prone to market shocks and improve energy security. Unlike fossil fuels, which need to be extracted and transported to large power plants and require a grid network extending to remote areas, renewable sources like solar and wind can be developed in various flexible arrays. They can be just a few panels on a household installation, part of a community mini-grid, or as a solar power plant feeding into the large grid. That, according to the International Energy Agency and countless other assessments means that solar could leap-frog over grid-dependent fossil fuel technologies much like portable phones leap-frogged over fixed phone lines in Africa, providing better service much faster. But renewable energy versus fossil fuels has seemingly placed Tanzania politicians in the moral dilemma. While fossil fuel provides badly needed energy, it leaves behind a carbon footprint that’s proving catastrophic to humans and the planet. Yet, in the short term, policymakers strongly support fuel subsidies to stabilise the prices of other commodities. Meanwhile, renewable energy subsidies, notably on solar, are indirectly offered mostly through the Rural Energy Agency, and are clustered depending on the scale of the project. Despite its small market share local experts say renewable energy has the potential to respond to present and future challenges by enhancing energy security, generating income, and providing employment. Rural dependence on kerosene William Kahise, a student at Itetemia primary school, persuaded hus mother to buy a solar lamp as the kerosene one made him cough. In the dusty western town of Tabora, 12-year-old William Kahise and his sister Juliana routinely huddled around the faint glow of kerosene lamp when the darkness sets in, struggling to get their homework done before their mother blows off the lamp to save the fuel cost. “I must finish my work, otherwise my teacher will be very angry,” Kahise told Health Policy Watch. The paraffin lamp, made from a discarded cooking oil tin, emitted choking smoke and casts scary shadows on the walls. Kerosene is one of the household fuels that WHO has recommended not be used at all, because of its health harmful effects, including impaired lung function, asthma and cancer. The Itetemia primary school pupil may not know about the WHO recommendation, but he knew the smoke made him cough and convinced his mother to ditch the kerosene lantern, for a cheap solar version. Kerosene is used by millions of rural households i to meet basic lighting needs and subsidies have long been used to make the fuel more affordable. Kerosene subsidies have been at the centre of energy policy debate, with renewable energy activists arguing that, for health, safety and environmental reasons, a switch to solar power is better. “The subsidized kerosene is extremely costly and wasteful, the government is spending a lot of money every month to keep the price low,” said Mugisha. But for Abdul, who enjoys solar power, the challenge arises when his Chinese-made panel starts to age and needs to be replaced as Africa produces virtually no panels of its own. –First of two parts on the barriers to clean, renewable energy in Africa. -Research and reporting for this story was supported by the Rosa Luxembourg Foundation. Image Credits: Peter Mgongo. Posts navigation Older postsNewer posts
Fossil Fuels Cast Dark Shadow Over Tanzania’s Green Future 25/11/2022 Kizito Makoye Issa Abdul’s single solar panel powers his barber shop. DAR ES SALAAM, Tanzania – Issa Abdul’s desperate urge for solar power began when he realised a smoke-spewing generator at his barber shop was costing him too much. “Solar power is very cheap. I regret spending my money on this fuel-guzzling machine,” he told Health Policy Watch. The 32-year-old barber in Tanzania’s port city spent roughly Tanzanian shillings 150,000 ($65) to purchase a small solar system and this now powers his hair cutting business. “I am very happy to have my own solar system. It is very useful,” he said. On a humid Sunday morning, Abdul adeptly digs a buzzing clipper through the hair of the client sitting on a leather chair before him. “I was spending a lot of money every month buying fuel, that is history now,” he said. Perched on a rusty roof, Abdul’s lone solar panel produces enough electricity to run two clippers, three bright lights and a cell phone charger. “There’s plenty of sunshine, I don’t disappoint my customers,” he said. Drought cripples hydropower facilities However, like other east African countries such as Kenya and Uganda, solar power still remains a small part of the country’s energy mix. While Tanzania’s electric grid has been primarily powered by hydroelectric power, another renewable source, for some time, hydro’s dominance is slipping now. Climate-related spells of drought have crippled the country’s hydropower facilities and the ageing distribution infrastructure, and the country is experiencing an electricity crisis affecting various sectors of the economy. Hydropower, which can potentially generate 4.7 GW of electricity according to government estimates, is only producing 12% of its power potential, and is prone to weather variability. And as drought tightens its grip, Tanzania, which has 57 trillion cubic feet of natural gas reserves, is now poised to tap this chunk of fossil fuels to cover the electricity deficit Natural gas, oil and coal will almost certainly remain dominant in the country’s energy mix in the near future, according to experts. A motorcyclist riding outside TPTL plant in Dar es Salaam that uses heavy furnace oil to produce electricity. Addressing climate change impact with fossil fuels Tanzania’s experience is just one example of an emerging paradox of addressing climate change impacts with more climate-changing fossil fuel. Tanzania, Kenya and Uganda have been dependent on hydropower, but as all three countries grapple with climate-related drought, they may also find it easier to tap their fossil fuel reserves with the help of multinational investors standing by than develop greener alternatives. This is even as technologies exist for large-scale grid-quality solar power that is ultimately cheaper, industry observers say. While nations worldwide are shifting to renewable energy to reduce the global carbon footprint and ease the toll that fossil fuels take on people’s health, economy and climate, the majority of Tanzanians, like those in large parts of Africa, still use dirty energy sources that pollute the air, causing some 1.1 million deaths annually on the continent, according to a recent study. Air pollution is the second risk factor for death in Africa after malnutrition, concluded the study by the Boston-based Health Effects Institute. Tanzania’s electricity generation comes mostly from natural gas (48%), followed by hydropower (31%), petrol/diesel (18%), solar (1%), and biofuels (1%). In Kenya and Uganda, hydropower and geothermal power are the dominant portions of the electricity generation mix, with solar power making up a very minor proportion of the mix. As demand for energy continues to grow, it is unclear how to ensure that renewables become more attractive than fossil fuel. Investments in fossil fuels far outweigh that of renewables in most parts of Africa, and oil and gas exploration and exploitation continues apace in Kenya, Uganda and Tanzania. Dirty diesel At Kariakoo, a business hub in Dar es Salaam dotted with shopping centres, a toxic haze of diesel hangs in the air as generators roar so loudly that they drown out people’s conversations. Like the lone solar panel precariously hanging on Abdul’s salon, smoke-spewing generators are widely used when grid electricity goes off. They power everything from ceiling fans to television sets, air conditioners and freezers – the latter two items pulling too much power to make a rooftop solar system reliable. Among the available choices, portable diesel generators are among the dirtiest, spewing particulate-laden emissions into the air directly into spaces where people live and work. But they remain the go-to solution in much of Tanzania and Africa more broadly. “To me, a diesel generator provides the necessary power,” said Aloycia Mosha who runs a cold fish store. Soaked with sweat, Mosha repeatedly pulls a string to rev the engine of her generator. “If I don’t switch it on now, all my fish stock will get spoilt,” said Mosha. The 45-year-old entrepreneur has often found a trail of blood oozing on her shop’s tiled floor, a clear sign that the fish defrosted overnight. Vendor stand near a standby diesel generator in Dar es Salaam Power cuts are part of daily life Power cuts are part of daily life in Dar es Salaam, a busy city that is home to 5.8 million people, and accounts for 40% of the country’s GDP. While a few city dwellers have installed solar power on their roof tops to save spiralling energy costs, analysts say the lack of clear financing mechanism to cover initial installation costs, coupled with an unreliable distribution network, have made solar systems a distant luxury to many families. Asteria Mchomvu, a resident of Upanga, a middle-class neighborhood in Dar es Salaam, began to dream of installing solar panels on her roof a decade ago. At first, Mchomvu, who works as a teacher, was excited to learn that solar technology could help her save money and protect the environment. But a home solar system was too expensive for her t the time. A modest 8-kilowat system would roughly cost Tanzanian shillings 10, million ($4347) in 2012, according to Tanzania’s Rural Energy Agency. Prices for solar systems in Tanzania have since fallen by more than 60% and companies are aggressively jostling to pitch their sales. Yet still, the numbers didn’t work for Mchomvu, who teaches geography and science Then early in November, at the Dar es Salaam International Trade Fair, Mchomvu caught up with Richard Tairo, a salesman from Arti energy, a solar company focusing on mid and low -income customers. Tairo understood Mchomvu’s passion for solar and her financial dilemma and he introduced her to Mali Kauli, a program that finances residential solar systems and offers borrowers, below-market rates. Mchomvu accepted the offer after the company assured her that the system could lower her energy bills and spare her the agony of power cuts. “I wanted to be 100% sure it is worth investing,” she told the Health Policy Watch. Skewed regulatory framework disadvantages solar Despite the growing public awareness, renewable energy penetration in Tanzania is still facing major hurdles due to a skewed regulatory framework and limited market. Samuel Wangwe, a research associate with Research on Poverty Alleviation (REPOA) said solar power market has seen sluggish growth due to fragmented financing plans, uneven service after equipment sale and technical weaknesses in batteries and solar lamps, which are often cheap items imported from China with warranties that cannot be honoured. “The most obvious barrier to renewable energy, notably solar is cost. The upfront expenses that people pay to get solar panels installed at their homes are still too high,” Wangwe said. Many investors are discouraged to take on renewable energy projects because of high capital costs and a long net payback period, he added. Wangwe says that the industry is also dogged by a lack of training institutes, which has prevented renewable energy technologies from scaling up. “We must encourage our children to take renewable energy courses and hone their technical skills,” he said. A shop for solar equipment at Kariakoo business centre in Dar es Salaam Bigger subsidies for fossil fuels Although some subsidies are offered for rooftop solar, the subsidies the government provides to fossil fuel sources are much higher, Wangwe said. In fact, in July, the Tanzanian government introduced a new fuel subsidy of a whopping Tanzanian shillings 100 billion ($43 million) monthly to stabilise the domestic price of fuel, Wangwe said. While solar panel and wind turbines are exempt from VAT and are not charged import duties, accessories including the batteries essential to operating a household solar package are charged up to 35% import duty, said Wangwe. “This is the reason why solar technology is not scaling up as fast as possible” he said. Coal, oil and gas are by far the largest contributors to climate change, experts say. In addition, some 65% of deaths from air pollution are generated by fossil fuel combustion, including the noisy and smokey generators that are omnipresent in households and big African cities like Dar es Salaam. While global leaders have endorsed the scientific consensus to limit global warming to 1.5°C above pre-industrial level, as spelled out in the Paris Agreement, there is a growing rush for oil and gas exploration in the global south. This is what COP27 civil society participants called the “dash for gas” reminiscent of the colonial scramble for Africa. More fossil fuel exploration Tanzania has enough gas reserves to put the country on a path of economic prosperity, and may unlock as much as $30 billion in liquified natural gas (LNG) investments. At the same time, if the historic pattern long followed in east and west Africa remains the same, many of the new LNG is likely to be sold to Europe and other countries to generate foreign currency, rather than used at home. “Our political leaders are caught up in a dilemma. Such investments are worthwhile economically but bad for the environment,” said Wangwe. While many have argued that off-grid solar solutions hold the key to Tanzania’s urban and rural electrification, fossil fuels subsidies have reduced its competitiveness. Yusto Mugisha, professor of renewable energy at the school of engineering and technology a Sokoine University of Agriculture, said in order to build a sustainable future, Tanzania needs to invest in clean, accessible and affordable energy sources. “Renewable energy sources are available and their potential is not fully harnessed,” said Mugisha. Although upfront costs for renewable projects can be daunting, Mugisha said efficient and more reliable renewable technologies can create a system that is less prone to market shocks and improve energy security. Unlike fossil fuels, which need to be extracted and transported to large power plants and require a grid network extending to remote areas, renewable sources like solar and wind can be developed in various flexible arrays. They can be just a few panels on a household installation, part of a community mini-grid, or as a solar power plant feeding into the large grid. That, according to the International Energy Agency and countless other assessments means that solar could leap-frog over grid-dependent fossil fuel technologies much like portable phones leap-frogged over fixed phone lines in Africa, providing better service much faster. But renewable energy versus fossil fuels has seemingly placed Tanzania politicians in the moral dilemma. While fossil fuel provides badly needed energy, it leaves behind a carbon footprint that’s proving catastrophic to humans and the planet. Yet, in the short term, policymakers strongly support fuel subsidies to stabilise the prices of other commodities. Meanwhile, renewable energy subsidies, notably on solar, are indirectly offered mostly through the Rural Energy Agency, and are clustered depending on the scale of the project. Despite its small market share local experts say renewable energy has the potential to respond to present and future challenges by enhancing energy security, generating income, and providing employment. Rural dependence on kerosene William Kahise, a student at Itetemia primary school, persuaded hus mother to buy a solar lamp as the kerosene one made him cough. In the dusty western town of Tabora, 12-year-old William Kahise and his sister Juliana routinely huddled around the faint glow of kerosene lamp when the darkness sets in, struggling to get their homework done before their mother blows off the lamp to save the fuel cost. “I must finish my work, otherwise my teacher will be very angry,” Kahise told Health Policy Watch. The paraffin lamp, made from a discarded cooking oil tin, emitted choking smoke and casts scary shadows on the walls. Kerosene is one of the household fuels that WHO has recommended not be used at all, because of its health harmful effects, including impaired lung function, asthma and cancer. The Itetemia primary school pupil may not know about the WHO recommendation, but he knew the smoke made him cough and convinced his mother to ditch the kerosene lantern, for a cheap solar version. Kerosene is used by millions of rural households i to meet basic lighting needs and subsidies have long been used to make the fuel more affordable. Kerosene subsidies have been at the centre of energy policy debate, with renewable energy activists arguing that, for health, safety and environmental reasons, a switch to solar power is better. “The subsidized kerosene is extremely costly and wasteful, the government is spending a lot of money every month to keep the price low,” said Mugisha. But for Abdul, who enjoys solar power, the challenge arises when his Chinese-made panel starts to age and needs to be replaced as Africa produces virtually no panels of its own. –First of two parts on the barriers to clean, renewable energy in Africa. -Research and reporting for this story was supported by the Rosa Luxembourg Foundation. Image Credits: Peter Mgongo. Posts navigation Older postsNewer posts