CARE staff assist after the collapse of the wall of the Kakhovka Dam in Ukraine

Hours after the Kakhovka dam in Ukraine was destroyed, causing widespread floods, the World Health Organization (WHO) said that cholera and other waterborne diseases posed a risk, while the humanitarian agency CARE warned of landmine explosions.

The Kakhovka dam is located on river Dnipro in the city of Nova Kakhovka, in the Kherson region of Ukraine. Russian troops occupy the left bank of the river, while the right bank is under Ukrainian control. 

The wall of the dam collapsed early on Tuesday resulting in the flooding of tens of villages and parts of Kherson as well as the total destruction of the hydro-electric station providing electricity to the region. 

While the exact cause of the collapse is unknown, Russia and Ukraine have blamed each other for the destruction while some speculate that the dam could have been weakened in previous attacks. However, Norwegian seismic monitoring group Norsar registered seismic activity on the night of the collapse of the dam wall which indicates there was an explosion at the dam.

Since the dam collapse, thousands of people have been evacuated on both sides of the river and tens of thousands of hectares of agricultural land has been flooded. The authorities have not yet announced the official death toll following the dam collapse. 

“The impact of the region’s water supply, sanitation systems, and public health services cannot be underestimated,” Dr Tedros Adhanom Ghebreyesus, the WHO Director-General, said during a media briefing on Thursday.

“The exact information and the exact extent of the impact is yet to be seen because water continues to come downstream… figures at the moment show that initially 16,000 people were immediately at risk of flooding, on the river banks. Thousands have been evacuated,” Dr Teresa Zakaria, technical lead at WHO’s health emergencies program, told the briefing.

Ukraine
Dr Teresa Zakaria, WHO technical lead on health emergencies.

“The reservoir serves around 700,000 people downstream and there are over 30 settlements that are at a risk of flooding.” 

Zakaria added that while no cases of cholera have been reported in Ukraine since the war started in 2022, environmental samples show that the pathogens still exist in the region and  “that constitutes a risk”. 

Ukraine’s health ministry has also warned of water contamination caused by thousands of fish dying in the shallow water.

 

Landmines and oil

Meanwhile, Fabrice Martin, Country Director of humanitarian organisation CARE Ukraine, warned that “the area where the Kakhovka dam was, is full of landmines, which are now floating in the water and are posing a huge risk”. 

“We are very worried about the catastrophic consequences this explosion could have on the environment”, said Martin. “At least 150 tons of oil have been released into the Dnipro River with the risk of further leakage of more than 300 tons. This may lead to the Nyzhniodniprovskyi National Nature Park to disappear, which is more than 80 000 hectares of protected land.”

Ukraine’s president, Vladimir Zelensky, has accused Russian soldiers of firing on rescuers attempting to evacuate civilians affected by the flooding.

The dam also supplies cooling water to the Zaporizhzhia nuclear power plant around 160 kilometers away. The plant is currently under Russian control and the International Atomic Energy Agency (IAEA) has stated that there is no immediate danger to the plant and that it is monitoring the situation. 

The flooding has heightened the risk of water-borne diseases and food insecurity due to the destruction of agricultural lands. 

Ukraine’s agriculture ministry warned of a massive impact on farming, saying 94% of irrigation systems in the Kherson province, nearly 75% in Zaporizhzhia and about 30% in Dnipropetrovsk have been left without a water source. “Fields in the south of Ukraine next year can turn into deserts,” the ministry said, as reported in USA Today.

Support for Ukraine and Russia?

While emphasising that the WHO’s priority is to offer assistance and monitor health risks equally to all affected parties during a war, Dr Mike Ryan, WHO Executive Director of Health Emergencies, said that Ukrainians were in more need since Russia’s invasion. 

“Since the Russian invasion of Ukraine, we have focused on being able to support the people to whom we have the greatest access, and that has been people on the Ukrainian side of the conflict,” said Ryan.

“ We continue to engage with, coordinate with and receive information on a regular basis from the Russian authorities regarding the health situation of the people in occupied territories,” he added. 

The WHO does not have a permanent presence on the Russia-controlled bank of the river but that before the war, the agency had access to both sides of the river, Ryan added.

“We would be delighted to be able to access those areas and monitor health as we would in most situations. But again, it will be for the authorities of Ukraine and Russia to agree on how that could be achieved.”

“We have more presence at the moment and more visibility on needs [of the people] on the side of the river that is under Ukrainian control,” Zakaria added. 

“However, we are monitoring, especially through the leadership of our regional office in Europe, to make sure that all information coming from the other side of the river [controlled by Russia] is also monitored”. 

Marburg over in Equatorial Guinea

Forty two days since the last patient affected with Marburg Virus Disease (MVD) was discharged from treatment, Equatorial Guinea declared the outbreak as over, the WHO announced at the media briefing.

The announcement comes days after Tanzania announced that the MVD outbreak in the country was over. 

Equatorial Guinea reported its first three cases of MVD in February and subsequent cases in March. Seventeen people were confirmed to have contracted MVD, of which 12 died. In addition to this, 23 probable cases were reported and all of them died.  

United Nations Headquarters in New York.

Member states have been given nine days to comment on the ‘Zero draft of the Political Declaration on Pandemic Preparedness and Response, due to be adopted at the United Nations (UN) High-Level Meeting (HLM) on 20 September – with insiders describing the draft as “underwhelming”.

The HLM is essential for boosting waning political commitment to pandemic preparedness and response amid a myriad of urgent post-COVID recovery issues vying for politicians’ attention and financing.

The 14-page “zero-draft”, sent to member states on Monday with a comments deadline of 14 June, is deferential to the two ongoing negotiations on the pandemic accord and International Health Regulations (IHR)  amendments being conducted by the World Health Organization (WHO). These will only conclude in May 2024.

However, it also contains clauses that encapsulate the same red flags as in the two WHO pandemic negotiations – including how to ensure more accountability over public funds invested in the research and development (R&D) of vaccines, medicines and other tools; intellectual property constraints and technology transfer to low- and middle-income countries.

Alternative R&D funding mechanisms

While recognising the importance of the private sector in pandemics, the draft encourages the appropriate use of “alternative financing mechanisms” for R&D. This includes support for “voluntary initiatives and incentive mechanisms” that can separate R&D cost from “the price and volume of sales” and “facilitate equitable and affordable access to new tools” such as vaccines and therapeutics.

The draft encourages member states to investigate “innovative incentives and financing mechanisms” for public-health-driven R&D, such as stronger and transparent public-private partnerships and partnerships with academia.

However, the draft also asserts that “domestic public resources” are the “main source of financing for pandemic prevention preparedness and response”. To maximise these, member states are encouraged to pool resources, identify new revenue sources and improve public financial management.

“There should be language on the need to internationalise the rights to use government-funded inventions and know-how, either as global public good or to pool on a share and share alike basis,” said Jamie Love, director of Knowledge Ecology International (KEI),

He added that the inclusion of reference to TRIPS flexibilities was good “but suffer from the flaws of only reaffirming the right to use them, but not dealing with the many failures to do so”.

Seventeen equity clauses

There are 17 clauses devoted to equity, along with the acknowledgement of the need to “build trust” after COVID-19, when wealthy nations bought up and hoarded vaccines when supply was scarce – at the expense of low- and middle-income countries.

Support for the development of local and regional “manufacturing, regulation and procurement” also features, alongside a commitment to promote the transfer of technology to enable this.

However, Love said that reference to benefit sharing is limited to pathogens of pandemic potential, “which KEI sees as a weak basis for equity provisions, and we are disappointed there are no incentives to open source other inputs to countermeasures, such as data, inventions, know-how or cell lines, even though these are inadequately supplied”.

The draft also affirms the importance of universal health coverage based on primary healthcare, and the need to protect and train health workers – but steers clear of addressing the ongoing poaching of LMIC health workers by wealthier nations.

Role of WHO?

pandemic
Former Liberian President Ellen Johnson Sirleaf (left) and Former New Zealand Prime Minister Helen Clark (right), co-chairs of The Independent Panel.

The draft also affirms the centrality of WHO as the “directing and coordinating authority on international health work”  in relation to pandemic prevention, preparedness and response.

However, the Independent Panel for Pandemic Preparedness and Response has recommended the formation of a Global Health Threats Council by a UN General Assembly resolution that comprises the heads of state from each of the UN’s regional groupings and is independent of the WHO. 

“Pandemic readiness extends beyond health, and heads of state and government have no tradition of travelling to Geneva to report to the WHO Executive Board or World Health Assembly (WHA). An effective [Global Health Threats] council with adequate participation should not be solely under the mandate of the WHO; instead, it needs to operate with a strong General Assembly mandate and independence from the WHO,” Independent Panel leaders wrote in a recent article for Think GlobalHealth. 

The first reading of the zero draft for member states takes place on 12-13 June, with two other readings planned before a final draft is presented on 24-25 July.

Image Credits: John Samuel, UN Photo/Manuel Elias, @TheIndPanel.

Traditional cooking in India

The high cost of energy and negligible progress in rolling out electricity in sub-Saharan Africa since 2010 are some of the factors behind why 2.3 billion people are still reliant on cooking fuels like coal and firewood that harm their health.

Meanwhile, the transition to renewable energy has been too slow – and there has been a substantial drop in international finance available to help developing countries make this transition.

These are some of the findings of the 2023 edition of Tracking SDG 7: The Energy Progress Report  released on Tuesday, which warns that the world is far off track to meet Sustainable Development Goal (SDG) 7,  “ensuring access to affordable, reliable, sustainable and modern energy”.

The goal is broken down into access to electricity and clean cooking (7.1), a substantial increase in renewable energy (7.2) and doubling the global rate of improvement in energy efficiency by 2030 (7.3).

The report is published by the SDG 7 custodian agencies, the International Energy Agency (IEA), the International Renewable Energy Agency (IRENA), the United Nations Statistics Division (UNSD), the World Bank, and the World Health Organization (WHO).

“Attaining [SDG 7] will have a deep impact on people’s health and well-being, helping to protect them from environmental and social risks such as air pollution, and expanding access to primary health care and services,” according to the agencies in a media release.

Dirty fuel pollutes household air

According to WHO, 3.2 million people die each year from illnesses caused by the use of polluting fuels that increase household air pollution. Africa alone faces 1.1 million deaths from air pollution, second only to malnutrition.

“The use of traditional biomass also means households spend up to 40 hours a week gathering firewood and cooking, which prohibits women from pursuing employment or participating in local decision-making bodies and children from going to school,” according to the report, which adds that traditional fuel perpetuates “gender inequity, deforestation, and climate damage”.

While access to cleaner cooking fuels has improved since 2010 when 2.9 billion used dirty household energy, some 1.9 billion people would still be without access to clean cooking in 2030 – with 60% of these living in Sub-Saharan Africa – if current trends are followed. 

The economic impact of COVID-19 and soaring energy prices might also push 100 million people who recently transitioned to clean cooking to revert to using traditional biomass.

Eastern Asia, Latin America and the Caribbean were the only regions to sustain progress in access to clean cooking between 2019 and 2021. 

“Access to electricity and clean cooking still display great regional disparities and should be the focus of action to ensure that no one is left behind. Investment needs to reach the least-developed countries and sub-Saharan Africa to ensure more equitable progress toward Goal 7,” said Francesco La Camera, Director-General of IRENA.

Impressive electrification in South and Central Asia

Globally, 91% of the world’s population had access to electricity in 2021 in comparison to 84% in 2010 – an increase pf more than a billion people.

In Central and Southern Asia, 414 million people had no electricity in 2010 but this was slashed to 24 million by 2021, with Bangladesh and India singled out for their progress.

Eastern and South-eastern Asia cut those without electricity from 90 million to 35 million during the same period. 

But in Sub-Saharan Africa, over 80% of the 524 million people in rural areas are without access to electricity in 2021 – almost unchanged since 2010. Globally, around 675 million people don’t have access to electricity.

Swing to renewables is too slow but accelerating

Solar panels provide electricity to Mulalika Clinic in Zambia.

Global use of renewable electricity has grown from 26.3% in 2019 to 28.2% in 2020, the largest single-year increase since the start of tracking SDG 7 progress.

international public financial flows in support of clean energy in low- and middle-income countries have been decreasing since before the COVID-19 pandemic and funding is limited to a small number of countries.

Efforts to increase renewables’ share in heating and transport, which represent more than three-quarters of global energy consumption, remain off target to achieve 1.5oC climate objectives.

In addition, international public financial flows in support of clean energy in developing countries stand at $10.8 billion in 2021, 35% less than the 2010–2019 average. And this is financial flow is concentrated in 19 countries, which received 80% of the commitments.

The report will be presented to top decision-makers at a special launch event on 11 July at the High-Level Political Forum (HLPF) on Sustainable Development, ahead of the second SDG Summit in September 2023 in New York.

Image Credits: Nigel Bruce/WHO, Shruti Singh/ Unsplash, UNDP/Karin Schermbrucker for Slingshot .

The WHO aims to use the EU’s digital COVID-19 certificate to develop a global certificate network.

The World Health Organization (WHO) is establishing a global digital health certification network based on the European Union’s COVID-19 certificate to “facilitate global mobility and protect citizens across the world from ongoing and future health threats, including pandemics”, the body announced on Monday.

The EU’s digital COVID-19 certificate (DCC), which recorded vaccinations, tests and recovery, “facilitated safe travel for citizens, and it has also been key to support Europe’s hard-hit tourism industry”, according to the European Commission.

But when the DCC was first introduced in mid-2021, it was viewed with suspicion by non-EU members who feared it was a measure to exclude non-Europeans and in the early days a number of EU countries did not recognise vaccines used in other countries, such Covishield, India’s generic version of the AstraZeneca vaccine.

When a ​​vaccine was not centrally authorised by the EU, “each member state has the option to recognise it,” EU spokesperson Stefan de Keersmaecker told Health Policy Watch. 

However, the DCC open-source platform became widely used by non-EU countries to issue and validate certificates. But the DCC regulation is set to expire on 30 June and the WHO hopes to step into the gap with a global solution. 

“Building on the EU’s highly successful digital certification network, WHO aims to offer all WHO member states access to an open-source digital health tool, which is based on the principles of equity, innovation, transparency and data protection and privacy,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General, on Monday.

The WHO will work in partnership with the EC to develop the global digital health certificate, guided by the EU Global Health Strategy and WHO Global strategy on digital health.

Thierry Breton, European Commissioner for Internal Market, said: “With 80 countries and territories connected to the EU Digital COVID-19 Certificate, the EU has set a global standard. The EU certificate has not only been an important tool in our fight against the pandemic, but has also facilitated international travel and tourism. I am pleased that the WHO will build on the privacy-preserving principles and cutting-edge technology of the EU certificate to create a global tool against future pandemics.”

Image Credits: Lukas/ Unsplash.

Global Health Policy Lab launch event on 24 May, 2023 in Geneva
Global Health Policy Lab launch event on 24 May, 2023 in Geneva

A new collaboration called the “Global Health Policy Lab” (GHPL) aims to develop digital tools that strengthen the available global capacity to identify, benchmark, disseminate and assess the impact of relevant health laws and policies within the field of global health.

The lab, a partnership between the Harvard Health Systems Innovation Lab and the Charité Center for Global Health was announced on the sidelines of the World Health Assembly in Geneva last month. The partners will work to make science and evidence-based policy-making a “universal reality,” they said, with the end goal of improving access and quality of care across the globe.

“Policy design is painful, but policy implementation is even more painful,” said Dr. Rifat Atun, Director of the Harvard Health Systems Innovation Lab at Harvard School of Public Health. “We are therefore committed to innovate on how these challenges are addressed: with rigorous learning and collaboration, democratization and dissemination through machine learning and AI.”

Part of the collaboration will include building an accessible “Digital Repositorium” of health laws and policies, which will be disseminated through a yearly report that includes analysis of health policy trends, challenges, opportunities and threats.

Foundational to the lab is digitalization and use of new technologies to drive better care.

Digital Health Aim of WHO Since 2020

The World Health Organization set a Global Strategy on Digital Health in 2020 at the World Health Assembly. WHO’s vision is “for digital health to be supportive of equitable and universal access to quality health services,” the organization said.

The WHO program includes three critical objectives:

1 – Supporting the implementation of digital solution to inform medical decision making.

2 – To bring together experts around the world via digital communication to share best practices and knowledge.

3 – Linking countries with the specific health innovations that best meet their needs.

Similarly, according to Ricardo Baptista Leite, founding chair of the initiative, “We will harness the power of technology to foster innovation and knowledge that ultimately provides policy makers at all levels (multilateral, national, state, regional and local) with tools and competencies capable of accelerating the translation of science-based recommendations into concrete laws, policies, awareness campaigns and other political interventions that ultimately can contribute to a healthier population at a global scale.”

He said GHPL plans to play a “differentiating and disruptive role in how data and science
effectively translate into new approaches and solutions that lead to improved health
outcomes for all.”

AI: Challenges and Opportunities

On the other hand, some doctors and scientists have identified challenges to using AI in healthcare and health policy making. A paper published this year in the peer-reviewed journal Biomed Matter Devices highlighted the drawbacks of artificial intelligence and their potential solutions in the healthcare sector. Included in the list of obstacles is data collecting, technological development, clinical application and ethical and societal concerns.

The GHPL is supported by the Virchow Foundation for Global Health by providing the legal and collaborative framework for the initiative. The World Health Summit with its conference and activity platform is also a project partner.

“The gap in the translation between scientific knowledge, on one hand, and political action,
on the other hand, is still weak and leaves a lot to do,” said Dr. Axel Pries, President of the World Health Summit. “Science is inherently global, and governments on a national level have to work together much more to address these broad challenges. We believe this initiative will highly contribute to this goal.”

Image Credits: Courtesy Global Health Policy Lab.

There is growing evidence that using e-cigarettes doubles the chance of starting to smoke cigarettes later in life for never-smoker adolescents.

Electronic cigarettes are a trap to recruit children, not part of harm reduction, said Dr Tedros Adhanom Ghebreyesus, Director General of the World Health Organization (WHO) at the global body’s weekly media conference.

“When the tobacco industry introduced electronic cigarettes and vaping, one narrative they really tried to sell is that this is part of harm reduction. It’s not true. It actually is a trap, meaning kids are being recruited at the early age of 10,11,12 to do vaping and e-cigarettes,” said Tedros in one of the sharpest rebukes of the industry yet.

Children are attracted to e-cigarettes and vaping because think that it’s cool, and it comes in different colours and flavours, he added.

“Then they get hooked for life and most actually move into regular cigarette smoking,” said Tedros, who also stressed that e-cigarette and vaping were also harmful to health in themselves.

He appealed to WHO member states to regulate e-cigarettes and vaping to protect their citizens.

Earlier in the week, the WHO marked World No Tobacco Day by appealing to member states to assist local tobacco farmers in  to move to food crops by ending tobacco-growing subsidies.

Meanwhile, the US Food and Drug Administration issued warning letters to 30 retailers, for illegally selling unauthorized tobacco products. 

“The unauthorized products were various types of Puff and Hyde brand disposable e-cigarettes, which were two of the most commonly reported brands used by youth e-cigarette users in 2022,” according to the FDA.

“Protecting our nation’s youth from tobacco products – including disposable e-cigarettes – is a top priority for the FDA,” said FDA Commissioner Robert M. Califf, M.D. “We’re committed to holding all players in the supply chain – not just manufacturers but also retailers and distributors – accountable to the law.”

Bogus claims about pandemic treaty

Tedros also hailed the long list of resolutions adopted over the past 10 days by the World Health Assembly, the highest decision-making body of the WHO.

He described the decision to increase member states’ fees – assessed contributions – to cover 20% of the WHO’s budget and support for an investment drive as  “landmark agreements in our shared efforts towards a stronger, more effective and empowered WHO”.

However, he once again appealed for an end to disinformation that the pandemic accord and changes to the International Health Regulations currently being negotiated would threaten nations’ sovereignty.

Right-wing Swiss members of Freiheitstrychler protest against the WHO in Geneva

“This accord is a generational opportunity that we must seize. We are the generation that lived through the COVID-19 pandemic so we must be the generation that learns the lessons and makes the changes to keep future generations safer,” stressed Tedros.

“The two processes are being negotiated by member states for member states and will, if enacted, be implemented in member states in accordance with their own national laws,” said Tedros. 

“All member states will retain their own sovereignty to set their own domestic health policies. The idea that tthis accord or the amended international health regulations will cede sovereignty to WHO is simply bogus.”

Last Saturday, members of the right-wing Frieheitstrychler (“freedom bell-ringers”) held a protest outside the United Nations in Geneva in protest against the WHO and the pandemic treaty. Ringing cowbells, some of the protestors carried posters condemning the pandemic treaty and claiming that the WHO was trying to take power from member states.

Image Credits: WHO, Megha Kaveri.

Africa
Medical teams in Tanzania react to the country’s first-ever Marburg virus case.

Tanzania declared the end of its Marburg Virus Disease outbreak on Friday, two months after the outbreak was first detected in the north-western Kagera region. 

Nine cases (eight confirmed and one probable) and six deaths were recorded in the outbreak, which was declared on 21 March after laboratory analysis confirmed that the cause of deaths and illnesses that were reported earlier in the region was Marburg.

The last confirmed case tested negative for a second time on 19 April, setting off the 42-day waiting period before the end of the outbreak could be declared.

Marburg is from the same virus family as Ebola, and very virulent and causes haemorrhagic fever. Around 88% of cases dies.

Symptoms start almost immediately, with high fever, severe headache, and severe malaise. Many patients develop severe haemorrhagic symptoms within seven days.

The virus is transmitted to people from fruit bats and spreads between people through direct contact with the bodily fluids of infected people, surfaces and materials. 

There are no vaccines or antiviral treatments approved to treat the virus. However, supportive care – rehydration with oral or intravenous fluids – and treatment of specific symptoms, improve survival.

In Africa, previous outbreaks and sporadic cases have been reported in Angola, the Democratic Republic of the Congo, Ghana, Kenya, Equatorial Guinea, South Africa and Uganda.

The World Health Organization (WHO) assisted Tanzania to train responders, which had been slow to identify the disease because of a lack of laboratory facilities in the remote area where the first cases were found.

“With the investments being made to prepare for and tackle health emergencies in the region, we are responding even faster and more effectively to save lives, livelihoods and safeguard health,” said Dr Matshidiso Moeti, WHO Regional Director for Africa.

The WHO office in Tanzania also assisted the country’s efforts by deploying outbreak response experts to reinforce surveillance, testing, infection prevention and control, contact tracing, treatment and community engagement. 

Additionally, with partners, WHO shipped nearly three tons of supplies of personal protective equipment and is also working with the Ministry of Health to support survivors of the disease.

“Thanks to these efforts, Tanzania has been able to end this outbreak and limit the potentially devastating impacts of a highly infectious disease,” Dr Moeti said.

“The outbreak in Equatorial Guinea is also expected to be declared over next week if no further cases are detected,” WHO Director General Dr Tedros Adhanom Ghebreyesus told a media briefing on Friday.

Marburg was first identified in Marburg, Germany in 1967. Since then, there have been a limited number of outbreaks reported in Angola, the Democratic Republic of the Congo, Kenya, South Africa and Uganda.

In 2023, two separate Marburg outbreaks have been reported in two countries, Equatorial Guinea and the United Republic of Tanzania.

Image Credits: WHO, WHO.

A protest against the Anti-Homosexuality law in New York.

Two different court challenges of Uganda’s draconian Anti-Homosexuality Bill have been launched over the past week.

The first involves 10 Ugandans and a human rights organisation, which have petitioned the country’s Constitutional Court to prevent the Anti-Homosexuality Act signed into law on Monday from being implemented.

According to the petition, the law is unconstitutional as it violates a number of constitutional rights, including the rights of children as it allows for prison sentences for LGBTQ children, and it was introduced without public participation. According to the rules of the Ugandan Parliament,  every bill should be considered for at least 45 days at the committee level but this law was went through Parliament in about 30 days, without public engagement.

The Attorney General has 10 days to respond to the petition, which has been filed by a Member of Parliament, academics and activists alongside the Human Rights Awareness and Promotion Forum (HRAPF). 

MP Fox Odoi-Oywelowo, academics Professor Sylvia Tamale and Dr Busingye Kambymba and journalist Andrew Mwenda have joined forces with activists Frank Mugisha, Jacqueline Nabagesera, Richard Smith Lusimbo and Eris Ndawula to oppose the law.

The second petition filed with the Constitutional Court involves nine Ugandans, some of the same as in the first petition. It includes the only two MPs to vote against the bill in parliament, Fox Odoi-Oywelowo and Paul Kwizera Bucyana; Jane Nasiimbwa, who has a queer child, human rights activists Pepe Onziema and Frank Mugisha; feminist lawyer Linda Mutesi and feminist activist Jackline Kemigisa, diplomat Kintu Nyago, and journalist Andrew Mwenda.

 

Kemigisha, writing in openDemocracy this week, said she is “petitioning against this law simply because I am a Black African, and it is anti-Black to class queer Ugandans as non-humans deserving of life in prison or even death”.

“Queerness is well documented in our historical societies, including in the royal court of the Buganda kingdom, the nucleus around which colonialists cobbled present-day Uganda. To disown queer Ugandans is to disown both our past and our present,” she added.

The draconian law introduces the death penalty for “aggravated homosexuality”, prison terms for up to 20 years and fines for a wide range of people who provide services to LGBTQ people, including landlords.

Since Parliament passed the law earlier this month, there has been an increase in evictions as well as violence against people suspected of being LGBTQ.

Oxycontin

A US court’s decision to provide legal immunity to a family that made billions by marketing opioids as “non addictive painkillers” in exchange for a $6 billion settlement has evoked sharp criticism from politicians and health advocates. 

The US Court of Appeals ruled on Tuesday that the Sackler family will enjoy protection from current and future civil suits related to the role played by their company, Purdue Pharma, in the country’s opioid crisis. 

Purdue Pharma declared bankruptcy in 2019 and this order came as part of the court review in the bankruptcy process. The court added that the $6 billion paid as settlement will be used to address opioid addiction issues across the country. 

Democrat Senator Elizabeth Warren called for plugging the loophole in the existing bankruptcy laws that allows bad actors behind bankrupt companies to claim legal immunity even when they have not filed for personal bankruptcy.  

“Purdue and the Sackler family destroyed thousands of lives in their relentless pursuit of profit. They cravenly sought to hide behind our country’s broken bankruptcy code to escape justice and shield their blood money,” tweeted William Tong, the Attorney-General of Connecticut. 

“Since 2012, members of the Sackler family have donated over $10 million to the Federalist Society, the group rigging the courts in favor of extreme right-wing conservatives and corporate interests. It’s not a justice system if it’s also an auction,” tweeted Melanie D’Arrigo, the executive director of the New York for Health campaign. 

Settlement to address opioid crisis

The amount to be paid by the Sackler family as a settlement will be used to address the growing opioid crisis in the US, the court said. The money will be paid over a set period of time, and is expected to fund rehabilitation programmes run by the government. Around $750 million will be distributed amongst individual victims and families affected by the opioid crisis. 

As per the terms of the settlement, the family has also allowed their name to be taken off buildings, scholarships and fellowships. Several institutions including The Louvre have already dissociated themselves from the Sackler family in response to the company’s role in America’s opioid crisis. 

The Sackler family welcomed the decision in a statement and added that the decision will be instrumental in bringing relief to the people and the communities in need: “The Sackler families believe the long-awaited implementation of this resolution is critical to providing substantial resources for people and communities in need. We are pleased with the court’s decision to allow the agreement to move forward and look forward to it taking effect as soon as possible.”

While the latest order protects the families from civil suits, it does not provide immunity from criminal charges. 

Purdue Pharma and its role in the opioid crisis

Purdue Pharma was founded by the Sackler brothers, Mortimer, Richard and Raymond, and is blamed for fuelling the opioid crisis in the US. Since the 1990s, the company has produced OxyContin, a prescription-only extended-release painkiller.

The company is accused of funding research that severely understated the effects of opioid addiction and of misleading doctors. The Sackler family still holds controlling shares in the company. 

Almost immediately after the drug’s launch, its abuse began in remote pockets of the US, which then rapidly spread across the country. The drug’s warning label cautioned users from grinding it and snorting or mixing it in water and injecting it since doing so will bypass the “extended-release mechanism” and lead to rapid release and absorption of the drug; and this warning ended up as an instruction manual for vulnerable users.

Over time, several reports of OxyContin users dying after consuming the drug came to light and Purdue maintained that the usage of the drug was the responsibility of the individual. The company has previously pleaded guilty to charges related to opioid marketing, but the Sackler family has denied any wrongdoing in this regard. 

According to the US CDC, nearly 75% of the deaths caused by drug overdose in the US in 2020 involved an opioid. Between 1999 and 2020, more than 564,000 people were killed due to opioid overdose, including nearly 69,000 deaths in 2020. The first wave of the US opioid crisis began in the 1990s and overdose deaths involving prescription opioids have been on the rise since 1999.  

In 2019, after being bombarded with hundreds of lawsuits for their involvement in the opioid business, Purdue filed for bankruptcy. The Sackler family, however, did not file for personal bankruptcy. Their wealth is estimated to be around $11 billion, with a substantial amount stashed in offshore accounts. 

The company will now cease to exist and its assets will be transferred to a new company “Knoa”, which will be independently monitored. The new company will manufacture opioid reversal drugs and addiction treatments on a no-profit basis. It will continue to manufacture and sell OxyContin and use its profits to fund the settlement plan. 

Image Credits: US Drug Enforcement Administration.

Sprina Robu Chacha, a former tobacco farmer from Kenya

On World No Tobacco Day on Wednesday, the World Health Organization (WHO) appealed to governments to end tobacco growing subsidies and use the savings to support farmers to switch to “more sustainable crops that improve food security and nutrition”.

Over three million hectares of land in over 120 countries are being used to grow tobacco while over 300 million people globally are faced with acute food insecurity, according to the WHO.

“Tobacco is responsible for eight million deaths a year, yet governments across the world spend millions supporting tobacco farms,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “By choosing to grow food instead of tobacco, we prioritize health, preserve ecosystems, and strengthen food security for all.”

A new WHO report, “Grow food, not tobacco,” highlights the ills of tobacco growing and the benefits of switching to more sustainable food crops for farmers, communities, economies, the environment, and the world at large. 

The report also exposes the tobacco industry for trapping farmers in a vicious cycle of debt, propagating tobacco growing by exaggerating its economic benefits and lobbying through farming front groups.

Kenyan farmer Sprina Robi Chacha recalls how the WHO helped her to move from farming tobacco, as her parents had, to growing iron beans.

“Tobacco is a very delicate crop and it takes a lot of work,” said Chacha in a video produced by WHO. “It requires poisonous pesticide that the chemical companies supply in the form of a loan.”

Chacha said that her children had to stay out of school to assist to harvest the tobacco. In contrast, farming beans was not that labour-intensive, the beans replenished the soil and she was able to feed her family with the crop.

WHO, the Food and Agriculture Organization and the World Food Programme support the Tobacco Free Farms initiative that will provide help to more than 5000 farmers in Kenya and Zambia to grow sustainable food crops instead of tobacco

Harm to farmers

Tobacco farming causes diseases to the farmers themselves and more than one million child labourers are estimated to be working on tobacco farms, missing their opportunity for an education.

“Tobacco is not only a massive threat to food insecurity, but health overall, including the health of tobacco farmers. Farmers are exposed to chemical pesticides, tobacco smoke and as much nicotine as found in 50 cigarettes – leading to illnesses like chronic lung conditions and nicotine poisoning,” said Dr Ruediger Krech, Director of Health Promotion at WHO.

Tobacco growing is a global problem. While most of the tobacco farms are in Asia and South America, the latest data shows that, since 2005, there has been a nearly 20% increase in tobacco farming land across Africa.

FDA warns retailers

Meanwhile, the US Food and Drug Administration issued warning letters to 30 retailers, for illegally selling unauthorized tobacco products on Wednesday. 

“The unauthorized products were various types of Puff and Hyde brand disposable e-cigarettes, which were two of the most commonly reported brands used by youth e-cigarette users in 2022.,” according to the FDA.

“Protecting our nation’s youth from tobacco products – including disposable e-cigarettes – is a top priority for the FDA,” said FDA Commissioner Robert M. Califf, M.D. “We’re committed to holding all players in the supply chain – not just manufacturers but also retailers and distributors – accountable to the law.”