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.

 

Leaders Must Start Taking Science Seriously – U.N.

United Nations experts warned this week that world leaders attending this month’s United Nations General Assembly should listen harder to scientists if they want to tackle climate change and meet global anti-poverty targets. Pictured here is the 2017 damaged caused by Hurricane Irma on the British Virgin Islands. Credit: Kenton X. Chance/IPS

By James Reinl
UNITED NATIONS, Sep 13 2019 – World leaders attending this month’s United Nations General Assembly should listen harder to scientists if they want to tackle climate change and meet global anti-poverty targets, U.N. experts warned this week. 

Shantanu Mukherjee, from the U.N.’s Department of Economic and Social Affairs, said the presidents, prime ministers and princes coming to discuss development and global warming in New York must boost their efforts to avert global calamity.

Politicians must start “recognising the impact of science and policy and strengthening it among the people who are here so that it becomes a reliable basis for decision-making,” Mukherjee said in answer to a question from IPS.

“If there is a commitment among the leaders who come here, even some of them that they will take this seriously and use it to inform their policy, which we will support with scientific evidence, that would be great.”

Environmentalists have expressed fears of wavering commitments among leaders to limiting climate change, pointing to such skeptics as United States President Donald Trump and his Brazilian counterpart Jair Bolsonaro.

Mukherjee spoke with reporters in New York on Wednesday while releasing a report, called The Future is Now: Science for Achieving Sustainable Development, which warns of deepening inequalities and irreversible damage to ecosystems.  

The document says that mankind can still achieve the U.N.’s so-called Sustainable Development Goals (SDGs) towards ending poverty and other targets, but not without boosting efforts to reduce waste, pollution and inequality.

Between 2017 and 2060, the annual global consumption of material goods is expected to climb from 89 Gigatons to 167 Gigatons, leading to more greenhouse gas emissions, mining and other resource extraction, researchers said.

Meanwhile, the global population is expected to reach 8.5 billion people by 2030, meaning more mouths to feed and greater demand on power stations, most of which still pump carbon dioxide into the atmosphere. 

Endah Murniningtyas, a former Indonesian minister who helped write the report, said producing enough food while keeping the global rise in temperatures below a benchmark figure of 2 degrees Celsius could prove impossible.

“This is not inevitable. We have the knowledge and the means already to change and ensure that all our wellness [is maintained] even as we scale back the adverse impacts,” of climate change,” Murniningtyas told reporters.

“Focus on the policy must be enabling equitable global access for food and maximising the nutritional value of produce while at the same time minimising the climate and environmental impact of production.”

The 250-page report was drafted by an independent group of 15 scientists. The document will be at the centre of high-level talks on the SDGs on Sept 24-25, when Trump, Bolsonaro and others are expected in New York.

Peter Messerli, director of the Centre for Development and Environment at the Bern University in Switzerland, said leaders must start changing how we design cities, harness energy and feed growing populations.

“All these systems are currently we can say to a certain degree dysfunctional, but they hold the promise that if we address those trade-offs, that way, they will really leverage transformation,” Messerli told reporters.

But the politicians attending a U.N. climate summit on Sept 23. and other high-level talks in New York will be swamped with other hot issues, said Messerli, with wars in Syria and Yemen high up the global agenda.

“We will not change the world. But we need to change their minds in this direction. Because if we change the minds, I think we can change the world,” Messerli, a co-author of the report, said in answer to a question from IPS. 

Bolsonaro and Trump are the first two leaders listed to speak at the start of the U.N.’s general debate on Sept. 24, followed shortly afterward by Egyptian president Abdel Fattah el-Sisi and others.

Swedish teen climate change activist Greta Thunberg last month sailed across the Atlantic Ocean aboard a carbon-neutral racing yacht bearing the slogan “unite behind the science” to attend the summit and put pressure on leaders.