climate emissions
Fossil fuel combustion is a leading source of global warming and harmful air pollution.

Almost 50 organisations have written to the head of the upcoming United Nations climate change meeting, Conference of the Parties (COP) 28, calling for substantive progress against air pollution, which they describe as “the nexus of climate and health”.

With 100 days to go until COP28 in the United Arab Emirates, the groups organised by the Clean Air Fund, have written to president-designate Dr Ahmed Al Jaber, asking him to “put air pollution firmly on the agenda and to catalyse national commitments and international funding to improve air quality”.

“Air pollution is a pervasive public health crisis and an accelerator of climate change,” the letter notes.

The letter anticipates that the global stocktake process to evaluate progress towards meeting the goals of the Paris Climate Change Agreement, which concludes at COP28, “will be a devastating reality check, showing that countries are massively off track from their commitments”.

“Ninety-nine percent of the world’s population breathes air that fails to meet WHO guidelines. The main drivers of air pollution are also sources of greenhouse gases, the largest culprit being the combustion of fossil fuels. 

“This interconnectedness means that a full stop to burning fossil fuels is essential to unlock the enormous co-benefits of clean air. We emphasise that clean air cannot be solely achieved by carbon capture technologies, which do not address all toxic pollutants and particulates, such as black carbon which also accelerates warming. Only measures which result in better air quality will deliver the public health co-benefits of climate action.”

The letter reaffirms the Global Alliance on Health and Pollution’s most effective interventions to reduce fine particulate matter (PM2.5) and carbon dioxide emissions to improve heath involve replacing coal with renewable sources of energy for total power production; replacing diesel and gasoline-powered vehicles with electric vehicles; eliminating uncontrolled diesel emissions and preventing crop burning and forest fires.

It adds a further demand for “comprehensive air quality monitoring to demonstrate progress towards WHO Air Quality Guideline levels and campaigns to demonstrate the benefits of clean air to health, families, and communities to further build public support for climate action”.

“COP28 must deliver tangible progress to end all fossil fuel subsidies, as a way to unlock progress across the negotiations,” the signatories state.

A recent report from the World Health Organization noted that the global high emissions trajectory continues, nine million people per year will die annually from climate-related causes by the end of the century.

 

Image Credits: Ella Ivanescu/ Unsplash, Chris LeBoutillier.

WHO Traditional Medicine Summit 2023

PUNE, India – The World Health Organization’s (WHO) two-day summit on traditional medicine, held last week in the Indian city of Gandhinagar, was an attempt to start a dialogue about how to integrate evidence-based traditional medicine into modern medicine – but many were disconcerted about social media posts from the global health body that appeared to offer support for unproven treatments.

In addition, with India as summit co-host, Indian officials and programmes that have made controversial, unscientific claims were also given prominence.

At the start of the summit, WHO Director-General Dr Tedros Adhanom Ghebreyesus urged delegates to “use this meeting as the starting point for a global movement to unlock the power of traditional medicine through science and innovation”.

“I urge you all to identify specific, evidence-based and actionable recommendations that can inform the next WHO traditional medicine global strategy,” said Tedros, adding that countries should commit to examining the best way to include traditional, complementary and integrative medicine (TCIM) into their national health systems.

Dr Bruce Aylward, WHO’s Assistant Director-General, Universal Health Coverage, also highlighted the need for a “stronger evidence base” that could enable countries to “develop appropriate regulations and policies around traditional, complementary, and integrative medicine.”

Despite WHO officials’ stress on evidence-based treatment, some of its social media messaging appeared to endorse contentious medical systems such as homeopathy. One such Twitter post (see below) had over 5.3 million views, and provoked thousands of comments.

Many critics said the post appeared to be promoting untested treatments. Timothy Caulfield, a Canadian professor of health law and science policy, said that he found the WHO tweet “frustrating”, and asked how naturopathy, homeopathy and osteopathy  could be considered “traditional”., and warned against “legitimizing harmful pseudoscience” such as homeopathy.

“The WHO social media posts are, after all, an extension of the organisation and might be seen as an official position of the organisation,” Dr Anant Bhan, a global public health and bioethics researcher based in Bhopal, told Health Policy Watch. 

“You cannot detract from your core messaging which is around evidence-based medicine and the need to support it, including for public health policy. Once that starts happening, it will cause confusion,” said Bhan, adding that many people would not be able to discern the finer details of the WHO tweet.

The WHO late conceded that its tweet “could have been better articulated” but did not remove it.

 

Controversial Indian officials and programmes

The summit also allowed co-host India to promote controversial officials at press conferences – most notably, joint secretary of the Ministry of Health and Family Welfare (MoHFW) Lav Agarwal. During the COVID-19 pandemic, Agarwal repeatedly linked rising COVID-19 cases to a meeting held by a Muslim group, driving misinformation and stigmatization in an already charged religious environment in the country. 

Lav Agarwal (second from left), a senior health official in the Indian government who has been a prominent presence in the run-up to the traditional health summit was responsible for misinformation and stigmatization in the early weeks of the pandemic.

India’s Ministry of Ayurveda, Yoga, and Naturopathy, Unani, Siddha and Homoeopathy (AYUSH) also announced at the summit that it is in discussions with Malaysia about how to cooperate on traditional medicine and homeopathy. The official inclusion of homeopathy in the Ministry of AYUSH has long been a subject of controversy in India. 

Integration opportunities and challenges

While this is the first global summit on traditional medicine, the WHO has made attempts to include traditional medicine since 2014 when the first global 10-year strategy for traditional medicine was approved, and Tedros told delegates that the summit is likely to be a regular event.

There is clearly a demand for such summits. Preliminary findings from the WHO Global Survey on Traditional Medicine 2023, which were shared at the summit, indicate that around 100 countries have TCIM-related national policies and strategies.  

“In many WHO member states, TCIM treatments are part of the essential medicine lists, essential health service packages, and are covered by national health insurance schemes.  A large majority of people seek traditional, complementary and integrative medicine interventions for treatment, prevention and management of non-communicable diseases, palliative care and rehabilitation,” the WHO noted in a media release after the summit, which ended last Friday.

The WHO envisions a complementary role for traditional medicine, one in which it can be used alongside modern medicine in preventive healthcare as well as rehabilitation. 

For example, Professor Stefano Masiero, who chairs the rehabilitation unit at the Padua University-General Hospital in Italy, told the summit that the integration of traditional and complementary medicine could create a comprehensive rehabilitation experience. 

Meanwhile, Dr Hans Kluge, WHO Regional Director for Europe, told delegates at the close of the summit that they have “gently shaken up the status quo that has, for far too long, separated different approaches to medicine and health.” 

“By taking aim at silos, we are saying we will collaborate all the more to find optimal ways to bring traditional, complementary and integrative medicine well under the umbrella of primary health care and universal health coverage,” said Kluge, urging the need for “better evidence on the effectiveness, safety and quality of traditional and complementary medicine”.

But Dr Shyama Kuruvilla, lead for the WHO Traditional Medicine Global Centre, said “we have a long journey ahead in using science to further understand, develop and deliver the full potential of TCIM approaches to improve people’s health and well-being in harmony with the planet that sustains us.”

India currently holds the presidency of the G20 group of countries and the Traditional Medicine Global Summit coincided with the meeting of the health ministers of the G20 countries, who represent around two-thirds of the world’s population.

Image Credits: WHO, Ministry of AYUSH, India.

Two-thirds of US adults say either they or a family member have been addicted to alcohol or drugs – but the impact of alcohol still substantially out-paces that of drugs, despite the country’s massive opioid epidemic.

This is the finding from a survey of a representative sample of US adults conducted last month by KFF, which was released this week.

More than half of those (54%) polled said someone in their family had been addicted to alcohol, and 13% reported that they may have been addicted to alcohol.

Slightly over a quarter reported family members who were addicted to an illegal drug (27%) or prescription painkillers (24%) while 5% said they may have been addicted to prescription painkillers, and 4% reported a possible addiction to illegal drugs.

Opioid impact

US overdose deaths reached record levels in 2022, with almost 110,000 people dying – mostly as a result of fentanyl overdoses.

In the survey, 42% of people reported they or a family member have experienced opioid addiction in comparison to 30%  in suburban and 23% in urban areas. 

More Whites (33%) than Hispanics (28%) or Blacks (23%) report personal or familial experience with opioid addiction. 

Among those who say they or a family member experienced addiction to prescription painkillers, alcohol, or any illegal drug, less than half (46%) report they or their family member got treatment for the addiction. 

However, more Whites (51%), than Blacks (35%) or Hispanics (35%) received treatment. 

“Experiences with addiction and overdose are widespread, with large shares across income groups, education, race and ethnicity, age, and urbanicity all reporting some experience, though some groups report higher incidence than others,” notes KFF. 

“Overall, one in five adults (19%) say they have personally been addicted to drugs or alcohol, had a drug overdose requiring an ER visit or hospitalization, or experienced homelessness because of an addiction.

“The share increases to a quarter (25%) among adults with a household income of under $40,000 a year.”

This KFF Health Tracking Poll was designed and analyzed by public opinion researchers at KFF. The survey was conducted between 11-19  July online and by telephone among a nationally representative sample of 1,327 US. adults in English and Spanish.

Image Credits: Chuttersnap/ Unsplash.

A mural appeals for South Africans to get vaccinated against COVID-19.

The South African High Court has ordered the country’s health department to hand copies of all its COVID-19 vaccine procurement contracts, negotiations and agreements to a non-governmental organisation, Health Justice Initiative (HJI).

The Pretoria High Court ruling on Thursday comes in response to a court application by HJI for access to the contracts, arguing that the government had a constitutional requirement to be transparent and adding that it wanted to assess the legality and cost-effectiveness of the contracts.

The health department has 10 days to provide HJI with copies of all its COVID-19  vaccine procurement contracts, memoranda of understanding and agreements relating to a wide range of pharmaceutical companies and vaccine procurement groups.

These include Pfizer, Janssen/ Johnson & Johnson, Serum Institute of India, local generic company Aspen, China’s Sinovac, as well as the African Union Vaccine Access Task Team (AU AVATT) and COVAX.

Judge Anthony Millar said that the contracts were in the public interest as more than 30 million vaccines had been administered in South Africa with a budget of R10 billion (around $530 million) being allocated to cover this in 2021 alone, according to GroundUp.

Inflated prices, onerous terms

“This is a massive victory for transparency and accountability,” said HJI in a media release on Thursday.

“The contracts concern substantial public funds, and the contracting process has been marred by allegations that the government procured vaccines at differential, comparatively inflated prices and that the agreements may contain onerous and inequitable terms including broad indemnification clauses, export restrictions, and non-refundability clauses.”

In 2021, the South African health department itself complained about the onerous indemnity requirements that Pfizer had tried to extract in exchange for vaccines.

Then health minister Zweli Mkhize had told parliament that Pfizer had demanded that it be indemnified against civil claims from citizens with adverse vaccine effects and that the government put up sovereign assets as collateral to settle such cases, as reported by the Bureau of Investigative Journalism.

After a public outcry, Pfizer backed down on its demand for government assets as collateral but was still believed to have been indemnified against claims in many countries.

In fact, the global vaccine access platform, COVAX, established a No-Fault Compensation Program for Advance Market Commitment (AMC) Eligible Economies to ensure that people who experienced serious adverse effects from COVID-19 vaccines in poorer countries could receive compensation.

South Africa and other low- and middle-income countries were unable to procure vaccines for some months after they were available in Western countries as they had relied on COVAX. COVAX had ordered vaccines from the Serum Institute of India (SII). However, the Indian government banned SII from exporting its COVID-19 vaccines in April 2021 during the height of that country’s pandemic.

The collapse of the COVAX-SII deal forced South Africa to scramble to procure vaccines directly from pharmaceutical companies, paying a suspected premium for these.

Noting increasing reports of corruption within the healthcare sector, HJI added that “we cannot have a healthcare system shrouded in secrecy.  Procurement must be held in check, as it will involve powerful multinational companies, particularly from the pharmaceutical industry.”

During the pandemic, Health Minister Mkhize himself was forced to resign after it emerged that his family had benefitted from a COVID-19 communication contract the health department had awarded to a company run by a close friend.

Precedent for pandemic accord negotiations?

The HJI added that the judgement would assist in bolstering “provisions on transparency and accountability” in the current pandemic accord negotiations “where worrying attempts are being made to water down transparency”.

HJI had previously tried to get access to the contracts via the Promotion of Access to Information Act (PAIA), but the health department had refused to release the information, describing it as “confidential”.

Meanwhile, the judgement has been hailed by the People’s Vaccine Alliance.

“Pharmaceutical companies should never be allowed to operate without public scrutiny, particularly in a pandemic. But in South Africa and many other countries, governments were forced to sign up to strict secrecy clauses for their populations to access lifesaving vaccines and medicines,” said Mohga Kamal-Yanni, policy co-lead for the People’s Vaccine Alliance.

“This landmark decision shows that the public can take on powerful pharmaceutical companies and win. We hope to see more cases like this around the world.”

Noting that “transparency and equity must be at the heart of the world’s response to health crises”, Kamal-Yanni added that “people have a right to know how much pharmaceutical companies are charging them for lifesaving vaccines and medicines, and that right must be enshrined in the pandemic accord and the International Health Regulations.”

The South African Department of Health said that it “will study the judgement and respond in due course”.

Image Credits: Medecins sans Frontieres.

Dr Hans Kluge, WHO Regional Director for Europe.

Dr Hans Kluge, regional director of the World Health Organization (WHO) in Europe,  has warned member countries to maintain their COVID-19 infrastructure and genomic surveillance amid a “gradual increase in cases, including hospitalizations, in some European countries”. 

“COVID has not gone away. While its impact currently isn’t as severe as earlier, millions, especially the most vulnerable, remain unprotected in the WHO Europe Region. Worryingly, barely 11% of people across Europe & Central Asia have gotten their second booster shot,” Kluge noted in a media release.

Kluge cited infrastructure such as early warning systems, variant tracking and vaccine boosters for at-risk groups. 

“Key to reducing the risk of COVID-19 & other respiratory viruses is better ventilation in our buildings. That’s why WHO Europe is facilitating our region’s first-ever indoor air conference in Bern on 20 September 20, with the Geneva Health Forum,” said Kluge.

Globally, nearly 1.5 million new COVID-19 cases and over 2500 deaths were reported in the last 28 days (10 July to 6 August 2023), an increase of 80% and a decrease of 57%, respectively, compared to the previous 28 days, according to the WHO’s latest weekly COVID-19 report. 

While five WHO regions have reported decreases in the number of both cases and deaths, the Western Pacific Region has reported an increase in cases and a decrease in deaths. As of 6 August 2023, over 769 million confirmed cases and over 6.9 million deaths have been reported globally. 

 

Image Credits: WHO.

Pharmacy in Kenya; more consistent regulatory rules across the African continent can also expedite access to new medicines and formulations.

Three more countries, Kenya, Cape Verde and Democratic Republic of Congo, have ratified the African Medicines Agency (AMA) Treaty recently – and Kenya’s ratification now means that most major East African countries are on board with the treaty.

Twenty-six countries have now fully ratified the treaty, one of the steps required for the establishment of the specialised agency of the African Union (AU) dedicated to improving access to quality, safe and efficacious medical products in Africa.

Countries are required to both sign and officially ratify the AMA Treaty in their parliaments in order for it to become applicable in their country.

As of August 2023, 37 countries have formally supported the AMA treaty, including 26 ratifications, the latest by Kenya, Cape Verde and the Democratic Republic of Congo.

“Specifically, Kenya’s signing and ratification is a huge milestone in the journey to regulatory harmonisation being that this is one of the biggest economies in our region. AMA needs more support from the big economies,” Maureen Okoth, project coordinator for the Coalition for Health Research and Development (CHReaD), told Health Policy Watch.

In terms of what it takes to bring the “big countries” on board, Okoth said that one of the gaps experienced when engaging with different countries is the fact that AMA needs to be demystified over and over, “We need to demonstrate practically what and how the different countries will benefit from AMA.

Strengthening advocacy efforts

“This is exciting… We continue to strengthen our advocacy efforts so that we have more ratifications being done. We’re doing advocacy to ensure that we really talk to the member states that have ratified and those that haven’t,” said Chimwemwe Chamdimba, head of the Africa Medicines Regulation Harmonization (AMRH) programme, during a webinar on the next steps in operationalisation of AMA.

Chamdimba said that a lot of advocacy was underway with member states to encourage those that have not signed to do so, as well as to encourage those that have signed but not ratified the treaty to take that final step.

While the process of countries’ signing and ratification, which began in 2019, may seem prolonged, the AMA Treaty has received more support, faster, than almost any other treaty in AU history, Chamdimba noted. 

“It just tells you why everybody realised that we need this, especially after the COVID pandemic,” she added.

Chimwemwe Chamdimba, head of the Africa Medicines Regulation Harmonization (AMRH) programme

The approval process has been outpaced only by the treaty approving a continent-wide free trade area that was launched on 30 May 2019.

However, Okoth observed that details of AMA operationalization need to be shared more widely – including the cost implications to build confidence and enable countries to make informed choices. 

AMRH expects that the AMA will help Africa to access quality, safe products and leverage pharmaceutical markets.

Operationalising the AMA 

In a wide-ranging discussion, Chamdimba and other participants also discussed the next steps in AMA operationalisation, including the division of work between the AMA and national regulatory authorities, the appointment of AMA’s Executive Director and how to include patient voices.  

AMRH revealed that the Rwandan government has provided a fully furnished building with a space to expand for AMA. The Rwandan government won the bid to host AMA in 2022. Uganda, Algeria, Egypt, Morocco, Tanzania and Zimbabwe also submitted expressions of interest but did not succeed.

Administratively, the secretariat is setting up systems and structures and systems – including human resources, finances, procurement – that are required for the organisation to function. 

The AMA Treaty mandates the AU Commission to drive the operationalization of AMA. 

AMA will pick up from what the AMRH has been doing over the years, ensuring that it is now done within an organisation that is more sustainable and systematic for the continent.

Currently, Chamdimba says, there is an AU task team on AMA formed by the different entities of the AU, including the AU Commission to guide AMA’s operationalization.

“We also have the Conference of State Parties, which has been meeting in the last two years to provide leadership in setting up the structures of the AMA. The Conference of State Parties is composed of ministers of health from countries that are parties to the treaty,” Chamdimba said.

Appointment of AMA board and staff

Currently, AMRH is in the process of setting up the AMA Board. Nominations from the different regions have been received, and the board is expected to be functional in the next two months.

The board will take up the responsibility of recruiting AMA’s Director General (DG). The terms of reference have been finalised but are currently waiting for the Board to be set up so that it can provide oversight on the DG recruitment. The DG will then be responsible for the recruitment of the rest of the staff, dealing with AMA structural and administrative issues, according to AMRH.

Aside from its continental operations, AMA will also operate at the national level, where a member state’s national regulator will make decisions and at the regional level, where the regional economic communities will build their capacity to support and implement AMA decisions.

“AMA will not deal with 55 countries alone but depend on already available country capacities… So we look at these three levels being able to be interlinked, interrelated, sharing information and working together,” Chamdimba said.

AMA is also not expected to deal with all medical products, but “provide support where there’s limited capacity” – such as providing guidance on traditional medicine and responding to emergencies. 

But some products will be dealt with by member states and regional economic communities.

Patient involvement

During the webinar, International Alliance of Patient’s Organisations CEO Kawaldip Sehmi, asked how the AMA framework will provide for meaningful engagement with patients and academia in Africa.

Chamdimba assured Sehmi, who has passed away since the webinar, that patient groups and non-governmental organisations will be involved in AMA operationalisation.

“It would be a missed opportunity if we don’t even consult on the set-up terms. So when we have a draft ready, we would like to open for comments. We will ensure to reach out for input so that patients are effectively represented,” she said.

“[Patients’] lived condition can effectively contribute to setting the AMA systems. Whatever decisions made may directly impact on them.”

AMRH has been working on harmonised standards and regulations in the regional economic communities namely the East African community, Southern African Development Community (SADC), the Economic Community of West African States (ECOWAS), and the Economic Community of Central African States.

“We have tested harmonisation systems in the regional economic communities. They’re working. But we realise that there’s also a need for cross-leveraging and cross-harmonisation so that we look at Africa as a whole. Then move from the regional economic communities to one continent, especially when it comes to sharing of capacities across the regions,” said Chambimba.

To assist with the preparation of AMA, an Africa Regulatory Conference is being held from 12-15 September with the theme ‘Together for patients – Transforming the regulatory ecosystem in Africa’.

The AMA Treaty was adopted by the AU Assembly on 11 February 2019 and a minimum of 15 member states needed to ratify the AMA Treaty in their national parliaments for AMA to come into force.

Image Credits: Marco Verch/Flickr, Luigi Guarino .

 How history influences women’s health advocacy

How does the past tie into current health policy? At a time when women’s health and reproductive rights are being debated globally, it is important to examine how historic policies impact the world today.

In the latest episode of the Global Health Matters podcast, host Garry Aslanyan spoke with two sexual and reproductive health advocates.

Carmen Barroso, a lifetime advocate, researcher and implementer for sexual and reproductive health, talked about the importance of using history as a tool for current activists. “I think it’s crucial that current and future leaders look at history and learn the lessons, both from the mistakes and from what was achieved,” Barroso said. “What we’ve learned from sexual and reproductive health in the past is fundamental because it’s an area that always faced a lot of opposition.”

Now 78 years old, Barroso has worked with many campaigns and organizations throughout her life. In 1990, Barroso became Director of the Population and Reproductive Health Program of the MacArthur Foundation, where she provided support for women’s organizations in Latin America, Africa and Asia. Although retired now, she still participates in advocacy work.

Dakshitha Wickremarathne agreed on the great significance of past activists’ work, like Barroso, on the current public health climate. “When you look particularly at sexual and reproductive health and rights, there are a lot of old challenges historically coming up in our conversations which are also currently relevant,” Wickremarathne said.

Wickremarathne is a senior technical lead overseeing the implementation of FP2030’s Asia Pacific Hub at the UN Foundation, a global movement working to advance access to reproductive health services.

Aslanyan brought up the value of certain policies over the past few decades, specifically the Alma-Ata Declaration of 1978 and the 1994 Cairo Conference.

Both Barroso and Wickremarathne stressed the impact of the conferences on shaping the way sexual and reproductive health issues are framed — not just as a medical issue, but as a human rights issue.

“Women then became right-holders,” Barroso said. “They were no longer seen as just the uterus. They were human beings with multiple needs, responsibilities and rights. They had the right to decide.”

Policy is not the only influence on women’s health rights. Social factors change constantly, and it is important to look at surrounding issues in relation to sexual and reproductive health. “I think many other social movements and external factors, such as the racial justice movement, LGBTIQ rights movement, have also influenced the way we look at health,” Wickremarathne explained. “Not just from a very siloed approach, but from a very inclusive and intersectional approach.”

While some factors have remained prevalent throughout recent history, such as funding for sexual and reproductive health services, Wickremarathne also brought up facets unique to today which impact sexual and reproductive health policy, such as climate change, migration and refugee crises and technological and digital advances.

“So within this context, with all the old and new challenges, there is a lot for us to learn from the historical context and events and influences of global health,” Wickremarathne noted.

Although there is still a great deal of work to be done in women’s health rights, Barroso feels encouraged by how far the world has come in the past few decades. “If we only see the tremendous obstacles that are real and continue to exist, we lose perspective and we lose hope, and without hope, we don’t do anything.”

Read about and listen to more episodes on Health Policy Watch.

This article is part of our TDR Supported Series.

Image Credits: TDR.

DRC President Félix Tshisekedi (left) welcomed the appointment of the DRC’s Dr Jean Kaseya (right) as head of the Africa CDC.

Controversy continues to surround Dr Jean Kaseya, the new Director-General of the Africa Centres for Disease Control and Prevention (Africa CDC), although the organisation described the allegations as “unverified and baseless” over the weekend.

Last Friday, online platform Devex reported on a letter from a group of Africa CDC staff to the head of the African Union (AU) sent on 26 July accusing Kaseya of harassment, intimidation and “unlawful termination of staff contracts based on personal ego and interest”.

The anonymous group, calling itself the AU Leadership Focus Group, also alleged that Kaseya had requested irregular payments, was abusive to staff, failed to provide leadership and was trying to replace current staff with his “allies”.

Fall-out with former employer

This followed a report by Devex in June about Kaseya’s acrimonious fall-out with his former employer, the Clinton Health Access Initiative (CHAI) after it decided not to renew his contract as senior country director in the Democratic Republic of Congo (DRC). 

The Africa CDC’s 16-member senior management team issued its own letter last week in response to the staff allegations, describing them as “unsubstantiated”, calling on staff to use the centre’s grievance procedures and “institutional governance mechanism and control measures” to address their problems.

Over the weekend, the Africa CDC also issued a statement in which they described the allegations against Kaseya as “baseless” and questioned the motives of those making them.

“Unfortunately, over the past 100 days since the Director General took office, Africa CDC has noted a repetitive, deliberate and ill-intent smear campaign by a well-identified media house linked to anonymous entities, whose aim seems to destabilise the organisation by disseminating unverified and baseless allegations directed towards the leadership and staff of the organisation,” said the Africa CDC.

“The Africa CDC strongly condemns the smear campaigns and assures all staff, AU Member States, the AU family and our valued partners that the institution remains strong and focused on delivering on its mandate. Be assured, that the asserted crusades will never distract nor deter Africa CDC leadership and its staff from meeting its mandate in health security on the continent,” it added.

Controversial from the start

However, Kaseya’s four-year appointment has been dogged by controversy since he was appointed ahead of Dr Magda Robalo, the former health minister of Guinea-Bissau with extensive global health experience, who had been widely expected to succeed Dr John Nkengasong.

Kaseya was appointed by African Heads of State following an election that took place on the sidelines of the 36th session of the African Union, which was held in Addis Ababa, Ethiopia, 18-19 February. While a total of 180 candidates vied for the position, Kaseya and Robalo were the finalists for the position. 

In early March, Rwanda’s President Paul Kagame wrote a letter to the AU chairperson condemning the fact that, at the AU summit where Kaseya had been appointed, “no debate was allowed on the appointment of the Director General of Africa CDC, even though three member states had requested to speak”.

Writing in his capacity as leader of the AU institutional reform process, Kagame noted that this agenda item was the only one in which discussion was “forbidden”.

“Moreover, the report given by the legal counsel on the deliberations of the committee of the heads of state and government on the Africa CDC gave no indication for why the first ranked candidate, a woman, was not selected,” added Kagame, whose government has a tense relationship with the DRC.

“More troubling, besides yourself, no heads of state or government took part in the committee meeting, and delegated officials were mostly below ministerial level,” he added.

After Kaseya was appointed, a statement by DRC’s presidency described it as “an epilogue of a long, secret diplomatic battle waged for six months by President Félix Tshisekedi”.

DRC President Félix Tshisekedi congratulates the new Director General of the Africa CDC, DRC’s Dr Jean Kaseya.

Image Credits: DRC Presidency, Presidency, DRC.

The number of Sudanese facing hunger has doubled over the past year.

The number of people facing hunger in Sudan has doubled over the past year, with nearly over 42% of the country’s 46 million people facing high levels of food insecurity, a senior Food and Agriculture Organization (FAO) representative in the country said Friday.

“The food situation in the country is deeply alarming,” Adam Yao, FAO deputy representative in Sudan, told a press briefing in Geneva.

According to the latest IPC [Integrated food security report] the July-September 2023 projection is nearly double the number of food insecure people compared to the last analysis conducted in May 2022, said Yao, speaking remotely from Port Sudan after a tour of the affected regions.

“That means 20.3 million people in Sudan face a high level of acute food insecurity, making this one of the most food insecure countries on the planet.”

Some 14 million people, or 29% of the population, are at a food “crisis” level, he added, while more than 6.2 million people are a few steps away from famine.

In some south and western states, including parts of Darfur, more than half of the population is facing acute hunger, he said. “The situation is critical….  Families are facing unimaginable suffering and I’ve seen this with my own eyes.  They are destitute; they need help.”

Adam Yao, FAO deputy representative in Sudan, speaking to a Geneva UN press briefing from Port Sudan.

Emergency access ‘increasingly complex’ 

Since the conflict between rebel and government forces began in April, roughly 1.6 million people across Sudan have received World Food Programme assistance, with roughly 150,000 people on the outskirts of Khartoum currently receiving aid.

But access everywhere remains challenging. Getting emergency food supplies to people trapped in conflict-ridden rural regions is becoming “increasingly complex,” said Eddie Rowe, Country Director of the World Food Programme (WFP) for Sudan, also speaking from Port Sudan.

He described the situation around Darfur as “catastrophic” with women and children, abandoned by husbands and fathers who had been killed, injured or gone missing, too scared to flee to safer areas. Only last week, WFP reached West Darfur for the first time and assisted over 15,000 people, via a route from Chad, he said.

Supporting small farmers

On the brighter side, FAO had nearly completed its ambitious goal of distributing emergency crop seed to an estimated one million farmers. “With over 650,000 farmers reached, the 2023 November harvest is well positioned to meet the cereal needs of millions of people across Sudan,” Yao said. Beyond the current campaign, FAO aims to reach 1.3 million pastoralists with livestock services and inputs to strengthen the nutrition and food security of 6.5 million people.

The success of the campaign is a reminder of the importance of agriculture as a cost-efficient frontline humanitarian intervention to reduce vulnerability and strengthen food and nutrition security, Yao stressed. It also underscored the importance of localised solutions to hunger and food insecurity.

Image Credits: World Food Programme.

Preparation of herbal prescriptions at a traditional Chinese medicine clinic in Simao, Yunnan Province, China

PUNE, India – The first global summit to explore the role of traditional, complementary, and integrative medicine in addressing health challenges is being convened in India next week by the World Health Organization (WHO).

The WHO Traditional Medicine Global Summit will be co-hosted by the Indian government in Gandhinagar on 17 and 18 August.

“Advancing science in traditional medicine should be held to the same rigorous standards as in other fields of health,” said Dr John Reeder, WHO’s Research Director and Director of the Special Programme for Research and Training in Tropical Diseases, at a press briefing about the summit on Thursday.

“This may require new thinking on the methodologies to address these more holistic, contextual approaches and provide evidence that is sufficiently conclusive and robust to lead to policy recommendations,” added Reeder.

He said that there was already a lot of evidence of the efficacy of some traditional medicine: “This is the heart of it; we need to treat traditional interventions with the same respect we give to other more Western medical interventions and that means examining them closely and critically and scientifically in the same way.”

Around 40% of pharmaceutical products are drawn from nature and traditional knowledge, including landmark drugs such as aspirin, artemisinin, and childhood cancer treatments. The scientists behind them used traditional knowledge to achieve their breakthrough discoveries, WHO said in a press statement.

Dr Shyama Kuruvilla, WHO lead for the Global Traditional Medicine Centre

Demand from member states

“Bringing traditional medicine into the mainstream of health care – appropriately, effectively, and above all, safely based on the latest scientific evidence – can help bridge access gaps for millions of people around the world.  It would be an important step toward people-centred and holistic approaches to health and well-being,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus in a statement on Thursday.

Meanwhile, Dr Shyama Kuruvilla, WHO lead for the Global Traditional Medicine Centre, told the media briefing that the summit aimed to ” support member states to support populations who want to learn and use evidence-based safe, effective traditional medicine for their health and well-being”.

She added that the demand for the summit came from the member states, and 170 of WHO’s 194 member states have reported that their citizens use traditional treatments including herbal medicines, acupuncture, yoga and indigenous therapies.

In many places, traditional medicine represents a significant part of the health sector’s economy. For millions living in remote and rural areas, traditional medicine is often the only culturally acceptable, available and affordable care, and countries have taken steps to integrate the practices, products and practitioners into their national healthcare systems.

Complementary roles

Dr Kim Sungchol, head of the WHO’s Traditional, Complementary and Integrative Medicine Unit said that the summit will help WHO understand the needs of the member states and guide policy.

“Many systems of traditional medicine have a more holistic approach (than modern medicine). That’s why they are much more advanced in health promotion and disease prevention, particularly lifestyle-related non-communicable disease,” Sungchol said.

Reeder added that the WHO wanted to develop methodologies to examine traditional medicine and practices to “produce robust evidence” about what works and what doesn’t.

WHO has been working on traditional medicine since 1976, responding to requests from countries for evidence and data to inform policies and practices and to set global standards and regulations to ensure safety and quality.

Results from the WHO’s third global survey on traditional medicine will be released during the summit.

Heads of State and governments at the 2019 UN high-level meeting on universal health coverage acknowledged the need to include evidence-based traditional and complementary medicine services, particularly in primary health care.

Participants at next week’s summit will include WHO Director-General Dr Tedros Adhanom Ghebreyesus and regional directors, health ministers of the G20 countries; scientists, practitioners of traditional medicine, health workers and members of civil society organisations.

Image Credits: Simon Lim/ WHO-TDR.