UNAIDS and WHO Africa Leaders Should Prioritize Women’s Health

Winnie Byanyima. Credit: Marianela Jarroud/IPS.

By Ifeanyi Nsofor
ABUJA, Sep 13 2019 – Two African women were recently appointed to top global health positions: Winnie Byanyima as the Executive Director of UNAIDS and Dr. Matshidiso Moeti reappointed as the World Health Organization (WHO) Regional Director for Africa.

Already, Ms. Byanyima is focusing on human rights as a way to end the AIDS epidemic, and Dr. Moeti’s priorities include ensuring more Africans have universal health coverage, preventing and managing disease outbreaks and promoting good health.

In these powerful roles, they should also prioritize addressing issues uniquely affecting women — from HIV to childbirth to infectious diseases — because when women are healthy, the society progresses.

Further, the health of women is a measure of a society’s level of development. As a father to two daughters, I am rooting for Ms. Byanyima and Dr. Moeti to succeed and leave the world healthier than they met it. This is what they can do.

 

HIV

Too many women still die while trying to give life. Globally, an estimated 830 women die due to pregnancy or birth related complications daily. The burden is more in developing than developed countries – a ratio of 239 versus 12 per 100,000 live births respectively

Thirty-eight million people were living with HIV and 23 million had access to antiretroviral therapy according to UNAIDS 2018 global data , women are disproportionately affected by HIV. For instance, in sub-Saharan Africa, 80% of new infections among adolescents aged 15–19 years are in girls.

Globally, young women aged 15–24 years are twice as likely to be living with HIV than men. An additional crisis is how of the 1.3 million pregnant women who were living with HIV, only 82% received drugs that would prevent mother to child transmission of HIV. Thus, the cycle of having above 180,000 new HIV infections in children aged 0-14 years continues.

Ms. Byanyima’s major focus around HIV infections should be to ensure that women of reproductive age have access to the right information to prevent new HIV infections and not give birth to a HIV-infected baby.

There is a solution already — Prevention of Mother to Child Transmission of HIV (PMTCT) reduces this risk from 45% to 5%, it just needs to be applied more broadly. Further, there are lessons UNAIDS can learn and share from Cuba and Malaysia, countries that have eliminated mother to child transmission of HIV.

 

Childbirth

Too many women still die while trying to give life. Globally, an estimated 830 women die due to pregnancy or birth related complications daily. The burden is more in developing than developed countries – a ratio of 239 versus 12 per 100,000 live births respectively.

The Maternal Health task Force at the Chan Harvard School of Public Health reports a 2013 reviewwhich showed that 5% of pregnancy-related deaths globally and 25% of pregnancy-related deaths in sub-Saharan Africa are attributable to HIV and AIDS.

Research shows that use of community drug keepers can prevent excessive bleeding after birth, which is the commonest cause of birth-related deaths, by up to 83%, even with low skilled attendance at birth.

Consequently, community health workers should be used to improve maternal health because they live and work in communities and are trusted by the people. They can accompany pregnant women to health facilities for antenatal services/birth and provide other supports that would reduce the stress of pregnancy.

Despite the strategic position of community health workers in improving health, most of them are unpaid. Therefore, Ms. Byanyima and Dr. Moeti should ensure that community health workers, who are mostly women are henceforth paid for their services.

The important work they do across communities globally should no longer be considered as mere volunteerism and if it is paid, more people could undertake the job and save more lives at childbirth.

 

Infectious Disease

It is inevitable that infectious disease outbreaks will happen and that they will spread quickly. An infection which begins in a remote location can get to major capitals within 36 hours.

Sadly, there is no African country that is fully ready for epidemics, based on scoring on preventepdemics.org. Women are usually the caregivers when family members are sick and bear the brunt of infectious disease outbreaks.

Dr. Moeti should use her influence as the Head of WHO Africa Office to advocate to African leaders to ensure all countries on the continent conduct a joint external evaluation to document their levels of preparedness for epidemics and engage with legislatures to appropriate more funds to national public health institutes for epidemic preparedness.

WHO should work with national and sub-national ministries of health to educate communities about epidemics and their roles in detecting, preparing and responding to disease outbreaks.

Partnership between UNAIDS and WHO AFRO is imperative. Therefore, Ms. Byanyima and Dr. Moeti should work together to achieve these objectives. The global health community will continue to hold both accountable and demand for improved services for women.

 

Translating Ambition to Action: High Hopes for United Nations Action Week

Cameron Diver is Deputy Director-General, the Pacific Community (SPC)

By Cameron Diver
New Caledonia, Sep 13 2019 – In less than 10 days, countries from around the planet will come together in New York for the United Nations Secretary General’s Climate Action Summit. I look forward to representing the Pacific Community (SPC) at this important event, and throughout “Action Week” during the upcoming UN General Assembly.

Cameron Diver

The interconnections and synergies between major issues of global concern and the key role multilateralism and international cooperation can play in helping tackle these challenges are illustrated by the agenda of the week from 23 to 27 September. Underpinned by the Sustainable Development Goals, each of the high-level summits will focus on commitments to accelerate action across climate change, enhance efforts to secure healthy, peaceful and prosperous lives for all, mobilise sufficient financing to realise the 2030 Agenda and address the specific issues and vulnerabilities of small island developing states.

The week of summits kicks off with a focus on climate action. And this is, in my mind, highly appropriate. The multiplier effect of climate change undermines our efforts to achieve the sustainable development goals, it increases the challenges of biodiversity conservation and sustainable use, it intensifies competition and the potential for conflict around natural resources and it poses the single greatest existential threat to the lives and livelihoods of millions of people around the globe. From where I stand, the science on climate change is clear. To take only these examples, the IPCC Special Reports on the impacts of global warming of 1.5° above pre-industrial levels and climate change, desertification, land degradation, sustainable land management, food security and greenhouse gas fluxes in terrestrial ecosystems provide us with the most robust, high quality evidence base to understand the significant negative impact climate change is already having on our natural environment, on the wellbeing of people, ecosystems, flora and fauna and the massive and potentially irreversible consequences of inaction. As regards our ocean, the upcoming Special Report on the Ocean and Cryosphere in a Changing Climate is likely to confirm what the islands of the Blue Pacific continent, and others whose cultures, traditions and livelihoods are deeply attached to the ocean, have already sensed: the climate crisis is a real and present threat to ocean and coastal ecosystems and the human communities that depend on them.

The stakes are high, but where there is a threat there is also an opportunity. If we act now, there is still have time effectively to tackle the climate crisis! To put it simply: ambition without action is insufficient and simply not an option. SPC is committed to working with our Member States, international and regional partners to translate climate ambition into tangible climate action, for both mitigation and adaptation. The benefits could be huge, with the Global Commission on Adaptation estimating that investing $1.8 trillion in climate adaptation globally in just five areas from 2020 to 2030 could generate $7.1 trillion in total net benefits. We are also convinced that we must collectively harness the synergies between, for example, climate and the ocean, biodiversity, health, security, economic development, food systems, land use, gender and many other development areas to fully exploit the potential of the SDGs and ensure that future pathways to sustainable development are integrated, inclusive, nature-friendly, climate-informed and resilient. SPC is already implementing this approach with its Members and partners. One illustration is our EU funded PROTEGE project, whose intended outcomes include a transition to sustainable integrated agriculture and sound forestry resource management; sustainable fisheries and aquaculture management that is integrated in and adapted to island economies; sustainable integrated water resource management; and invasive alien species control, all against a backdrop of climate-change hazards that require ecosystem and biodiversity protection, resilience and restoration.

As was recently remarked to me at the Green Climate Fund Global Programming Conference in Korea: “we already know what we must do. We need to stop talking and start doing”. It is my sincere hope that “Action Week” in New York will indeed be a turning point for “doing”; a catalyst for firm, measurable commitments to tangible actions that match the level of ambition already expressed to address the climate crisis and the multiple development challenges that remain as we approach the final decade of the 2030 Agenda. If we do not translate ambition into action, we will fail ourselves, we will fail future generations and we will fail our planet. If, however, we take up the challenge and take sustained, coordinated and integrated action, we can win the battle against climate change, create new and innovative opportunities for development, deliver on the promise of the Global Goals and trace a positive pathway to new era of resilient and sustainable development. High hopes indeed…