Monthly Archives: May 2013

Children with Disabilities Report launched by UNICEF

Download  - Download the report30 May 2013

Entitled Children with Disabilities, the report examines the discrimination and deprivations that these children  Children with Disabilities and their families confront. It describes the progress that is being made, albeit unevenly, in ensuring that children with disabilities have the fair access to services and opportunities that is their right. And it urges governments, their international partners, civil society, and employers to take concrete steps to advance the cause of inclusion – as a matter of equity and for the benefit of all.

In order to achieve this goal, international agencies and donors and their national and local partners should include children with disabilities in the objectives, targets and monitoring indicators of all development programmes.

Exclusion is often the consequence of invisibility. Few countries have reliable information on how many of their citizens are children with disabilities, what disabilities they have or how these disabilities affect their lives. As a result, few are capable of knowing what types and amounts of support these children and their families need – much less how best to respond. One of the report’s chapters is therefore devoted to exploring challenges, progress and opportunities in the area of data collection and analysis.

The report also contains a series of personal essays by young people with disabilities and some of the people who work with children and adolescents with disabilities – among them, parents, caregivers and advocates.

It is our hope that this report will inform the dialogue and nurture the action that is necessary to create a world in which children with disabilities enjoy their rights on a par with other children, even in the most remote settings and the most deprived circumstances.

[Courtesy of UNICEF]

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Asia-Pacific: HIV/Aids Laws Fail Most Vulnerable

Bangkok – 30 May 2013

Legal protections are unevenly enforced and human rights violations persist for people living with HIV in Asia and the Pacific. According to a new report released today by the United Nations Development Programme (UNDP), weak anti-discrimination laws affect the daily lives of those living with HIV by creating barriers to access to health care, prevention and treatment, and employment and education opportunities. Most people who experience rights abuses do not attempt to seek redress through legal means, according to the report.

Increasingly, countries in the region, including Cambodia, China, Fiji, Lao PDR, Micronesia, Mongolia, Papua New Guinea, the Philippines and Viet Nam, have put in place HIV laws to provide legal protections for people living with HIV. However, little is known on the protective impact of these laws. Legal Protections against HIV-related Human Rights Violations: Experiences and Lessons Learned from National HIV Laws in Asia and the Pacific systematically examines for the first time how these laws have been used and enforced to address rights violations.

Clifton Cortez, Regional Manager a.i. of the UNDP Asia-Pacific Regional Centre, said, “As a follow-up to the report on the Global Commission on HIV and the Law, this report reiterates the importance of investing in enabling legal environments in which legal protections are available, accessible and affordable and people living with HIV and key populations are empowered and supported to take legal action against human rights violations.”

The report highlights gaps in laws and law enforcement practices. For example, no countries in South Asia have national HIV laws, although HIV bills have been in existence for a number of years in India, Nepal and Pakistan. This creates uncertainty in relation to such issues as rights in relation to HIV testing, informed consent and confidentiality.

The report also identifies serious gaps that exist between ‘laws on the books’ and ‘laws on the streets’. In some countries good laws are in place, but people living with HIV still confront significant obstacles in gaining access to justice. Fear that mounting a legal challenge will result in disclosure of identity is a major concern in many countries.

“The report’s findings demonstrate the urgent need for practical measures to be taken to ensure people who experience violations can access the legal system to claim their rights,” says Shiba Phurailatpam, Regional Coordinator of the Asia-Pacific Network of People Living with HIV and AIDS (APN+). “It is not good enough for politicians to pass well-meaning laws if in reality people cannot access justice to enforce their rights. We call on governments and the donor community across Asia and the Pacific to help strengthen access to justice and legal empowerment among people living with HIV.”

The findings indicate that people living with HIV from socially marginalized communities lack the financial resources and access to state justice systems to challenge employers or large institutions in legal proceedings. Access to a lawyer or a human rights advocate can help to redress this power imbalance.

There are some success stories. The report also describes alternative legal approaches that have been pursued in the region to seek justice and enforce rights, as well as presents a detailed analysis of all HIV laws and bills. Legal assistance schemes in Viet Nam have enabled hundreds of cases to be resolved through negotiation and mediation, avoiding the expense of going to court. This has proved to be an effective approach to resolving cases of discrimination in employment, housing and attendance of children at schools. In Thailand, people living with HIV have been supported by non-governmental organizations to successfully challenge patents on HIV medicines to enable greater access to life-saving treatments.

Based upon the findings, the report provides a number of recommendations, including greater investments to enhance legal protections for people living with HIV and key populations, such as men who have sex with men, sex workers, transgender people and people who use drugs, through strengthened engagement of parliamentarians, judiciary, police, lawyers, national human rights bodies and other key institutions.

In support of these actions, donors, including the Global Fund, should promote and allocate greater resources to support government and civil society programming on HIV-related human rights programming. Additionally, national HIV strategies and plans should include specific targeted actions for the legal sector, including law reform, provision of legal aid services and education of people living with HIV, lawyers and the judiciary on HIV-related rights issues.

The findings from the UNDP study will be part of the agenda at the upcoming Judicial Dialogue on HIV, Human Rights and the Law in Asia and the Pacific to be held on 2-4 June 2013 in Bangkok, Thailand. Organized by UNAIDS, UNDP and the International Commission of Jurists (ICJ), this regional dialogue will bring together some 60 participants from 17 countries including judges, representatives from judicial training institutions, community resources persons and other regional experts.

Seattle: Global Effort Targets the Leading Killers of Children

25 May 2013:

PATH, a Seattle-based global health development organisation, is aiming to save two million lives by 2015 by jointly tackling diarrhoea and pneumonia, the leading killers of children globally.

Steve Davis, president and CEO of PATH, delivered the message at the ninth annual PATH Breakfast for Global Health held in Seattle on Tuesday.

“Today we placed a bold stake in the ground, with partners around the world, to save two million lives by the end of 2015,” Davis said.

PATH will begin its efforts in India, Cambodia and Ethiopia, where intervention is most urgently needed and PATH has resources. While all three countries have seen their child mortality rates from diarrhoea drop, India’s pneumonia death rate remains stagnant, accounting for 24 percent of deaths of children under five, the same as in 2000, according to 2013 World Health Organisation statistics.

“No parent should have to bury a child because of something we can help prevent or treat,” Davis said.

Diarrhoea and pneumonia are two diseases that overwhelmingly affect children in African and Asian countries, Davis said, with diarrhoea claiming around 760,000 lives a year. And while the number of children dying in Africa before the age of five has decreased, it still vastly outnumbers all other parts of the world, according to the 2013 WHO statistics.

Melinda Gates, philanthropist and founder of the Bill and Melinda Gates Foundation, which helps fund health development and vaccines world wide, spoke at the breakfast of the importance of vaccinating children as well as “appropriate” science that meets the needs of communities in the developing countries.

“[The] developing world is littered with pilot programmes,” Gates said.

As he took to the stage, Davis pointed to a tool belt around his suit jacket. A visual aid, the belt allowed Davis to show and carry some of the tools that can prevent the deaths of so many children from diarrhoeal disease, tools that will be used to achieve PATH’s life-saving goal.

Clean water, soap, zinc tablets for oral rehydration therapy and the rotavirus vaccine, which stops some diarrhoeal diseases before they start, were all included.

But it’s not just science and vaccines that can improve the lives of communities ravaged by diarrhoea. Deeply held cultural traditions and ideas about the disease have to be altered as well.

Dr. Alfred Ochola, PATH’s Technical Advisor for Child Survival and Development in Kenya, spoke about educating Kenyans on how to reduce the risk of diarrhoea in their communities through hygiene practices like hand washing.

But Ochola, who lost a brother and sister to a diarrhoea outbreak in Kenya as a child, has found that at first, people are reluctant to embrace change.

“A big [challenge] is combating old beliefs that diarrhoea is a curse and not an infection, and that the death of a child is an inevitable part of life. ‘God will give you another one’ is a common saying in Kenya,” Ochola said.

Many people believe a child who has diarrhoea is cursed, Ochola said. Vomiting and diarrhoea are welcomed because it rids the body of the evil inside it, while it should be taken as a sign that something is seriously wrong.

Poverty is another challenge in combating the diseases. Although heart disease and diabetes are becoming the new illnesses of poverty, according to Davis, diarrhoea and pneumonia still adversely affect children of developing countries in Africa and Asia.

In Africa and Southeast Asia, the percentage of child deaths are higher than the global average and have not significantly decreased in 10 years.

Both regions have seen child mortality from diarrhoea fall from 13 percent to 11 percent of deaths from 2000 to 2010, but in Africa, the rate of death from pneumonia has actually increased, from 16 percent to 17 percent.

“Too many people lack the financial means to seek care when it’s most needed, like paying for transportation to get to a health facility far from home… We often reach women and their children too late,” Ochola said.

Ochola told the story of Jane Wamalwa, a Kenyan woman who came to understand the reasons behind making a change in long-held practices in treating and preventing diarrhoea. Wamalwa lost three children to the disease, and has now become a trusted source of information on good anti-diarrhoea practice in her community, Ochola said.

“It has become her calling,” he added.

[Courtesy AllAfrica News]

Africa: 7 Million on HIV/Aids Antiretroviral Treatment

23 May 2013:

The number of people in Africa receiving antiretroviral treatment increased from less than 1 million to 7.1 million over seven years, according to a United Nations report which documents the progress in the AIDS response in the world’s second largest continent.

“Africa has been relentless in its quest to turn the AIDS epidemic around,” said the Executive Director of the Joint UN Programme on HIV/AIDS (UNAIDS), Michel Sidibé.

Antiretroviral treatment increased from less than 1 million in 2005 to 7.1 million in 2012, with nearly 1 million added in the last year alone. AIDS-related deaths were also reduced by 32 per cent from 2005 to 2011.

The UNAIDS Update on Africa, which was released to coincide with the beginning of the African Union’s (AU) 21st summit in Addis Ababa, which began Sunday and runs through 27 May, attributes this success to strong leadership and shared responsibility in Africa and among the global community. It also urges sustained commitment to ensure Africa achieves zero new HIV infections, zero discrimination and zero AIDS-related deaths.

“As we celebrate 50 years of African unity, let us also celebrate the achievements Africa has made in responding to HIV–and recommit to pushing forward so that future generations can grow up free from AIDS,” Mr. Sidibé said.

The report states that 16 countries–Botswana, Ghana, Gambia, Gabon, Mauritius, Mozambique, Namibia, Rwanda, São Tomé and Principe, Seychelles, Sierra Leone, South Africa, Swaziland, Tanzania, Zambia, and Zimbabwe–now ensure that more than three-quarters of pregnant women living with HIV receive antiretroviral medicine to prevent transmission to their child.

Despite positive trends, Africa continues to be more affected by HIV than any other region of the world, and accounts for 69 per cent of people living with HIV globally. In 2011 there were still 1.8 million new HIV infections across the continent, and 1.2 million people died of AIDS-related illnesses.

In the report, entitled Update, Mr. Sidibé emphasizes that sustained attention to the AIDS response post-2015 will enhance progress on other global health priorities. He also identifies five lessons in the AIDS response that will improve the world’s approach to global health. These are: focusing on people, not diseases; leveraging the strength of culture and communities; building strong, accountable global heath institutions; mobilizing both domestic and international financial commitments; and elevating health as a force for social transformation.

“These strategies have been fundamental to Africa’s success at halting and reversing the AIDS epidemic and will support the next 50 years of better health, across borders and across diseases,” he said.

The report also stresses AU leadership is essential to reverse the epidemic. At this year’s Summit, AIDS Watch Africa, a platform for advocacy and accountability for the responses to AIDS, tuberculosis and malaria founded by African leaders in 2001, will review progress on health governance, financing, and access to quality medicines, among other areas, and measure whether national, regional, continental and global stakeholders have met their commitments.

The AU, UNAIDS and the New Partnership for Africa’s Development (NEPAD) will also launch the first accountability report on the AU-G8 partnership, focusing on progress towards ending AIDS, Tuberculosis and Malaria in Africa.

[Courtesy AllAfrica News]

NIGER: Cholera Outbreak

NIAMEY, 22 May 2013:

Cholera has struck 248 people in Ayorou in the Tillabéry Region of northwestern Niger, killing six, two of them Malian refugees.

Among the sick are 31 Malian refugees who are living in Tabareybarey and Mangaize camps near the Mali border, according to the Tillabéry health services and the UN Refugee Agency (UNHCR).

In the camps and in surrounding villages, UNHCR has upped the supply of clean water to refugees, is distributing oral rehydration solution, soap, and disinfectant tabs to clean water, but more drugs are urgently needed, it said in a 21 May communiqué. NGO Médecins sans Frontières is treating those who have contracted cholera in camps.

UNHCR is worried that cholera could spread quickly due to the high concentration of refugees in the region.

Most of the cases were inhabitants of the town of Ayorou, which hosts a Sunday livestock market frequented by people from all across the region. The Ministry of Health is trying to temporarily shut down the market, which is just next to the River Niger, the suspected source of the contamination. The Health Ministry has also banned anyone from using, or drinking, water from the river, though this is very difficult to monitor.

The World Health Organization is supporting local health authorities to contain the disease’s spread.

Last year 5,785 people contracted cholera in Niger, and 110 of them died, according to UNHCR.

[Courtesy of IRIN]

DRC: Malaria “Leading Killer of Children”

DRC 21 May 2013

Gaps in the healthcare system in the Democratic Republic of Congo (DRC) are hampering the fight against malaria, a leading killer of children, say experts.

Malaria accounts for about a third of outpatient consultations in DRC clinics, Leonard Kouadio, a UN Children’s Fund (UNICEF) health specialist, told IRIN. He added, “It is the leading cause of death among children under five years and is responsible for a significant proportion of deaths among older children and adults.”

Kouadio continued: “Recent retrospective mortality surveys have revealed that in all regions of the country, the fever is associated with 40 percent of [deaths of] children under five.”

Malaria is also a leading cause of school absenteeism in DRC, and it may have other adverse effects. “In cases of severe malaria, children who survive face serious health problems such as epilepsy, impaired vision or speech,” he said.

According to UN World Health Organization (WHO) estimates, out of about 660,000 malaria deaths globally in 2010, at least 40 percent occurred in DRC and Nigeria.

In DRC, malaria accounts for about half of all hospital consultations and admissions in children younger than five, according to the government’s National Programme for the Fight against Malaria (NMCP).

On average, Congolese children under five years old suffer six to 10 episodes of malaria per year, according to UNICEF’s Kouadio.

Other leading causes of death among under-five Congolese children include acute respiratory infections, diarrhoeal diseases and malnutrition, according to UNICEF’s 2013-2017 DRC Country Programme Document.

“It is apparent that major deficiencies in the health system have contributed to the severity of recurrent outbreaks [of malaria],” Jan Peter Stellema, Médecins Sans Frontières (MSF) operational manager, told IRIN via email.

“Mosquito nets are not being sent to vulnerable areas, and there are shortages of rapid diagnostic test [kits and] drugs and the equipment for carrying out blood transfusions vital for children suffering from anaemia caused by malaria.”

Other problems include costly care and management challenges.

For example, the treatment of an uncomplicated bout of malaria ranges from about US$22 to $35, and treatment for severe cases can cost $75 to $100, according to NMCP. Such costs are prohibitive for a large number of people, many of whom live on about one dollar a day.

“In DRC, the absence of other healthcare providers and overstretched health systems leave people vulnerable to contracting malaria.

Too many health centres lack the supplies necessary for coping with a new outbreak, and as a result children are dying because they did not receive care for malaria,” MSF’s Stellema said.

According to the DRC Country Programme Document, “Governance, management and coordination problems plague the [health] system at the national, provincial and local levels, thereby undermining political commitment, planning, budgetary expenditure, coordination and alignment of partnerships, the accountability and transparency of service providers, and the participation of the population in management of the services.”

It adds, “Combined with extreme poverty, these factors create financial barriers hampering families’ access to nutrition and services, and weaken the social standards that are essential for keeping families together and maintaining a protective environment for children.

“The absence of government investment and the fragmentation of public assistance have eroded the capacity of civil society and of functional public facilities to maintain quality services,” adds the DRC Country Programme Document.

“The re-mergence and expansion of certain epidemics (polio, measles and cholera) are proof of that.

In addition, little has been done to modernize infrastructure. Essential supply systems, such as the cold chain, have not been put in place,” it states.

There is an urgent need to address the struggling health system to fight malaria, experts say.

“The fight against this scourge must remain a top priority of the country, despite the lack of financial resources,” said UNICEF’s Kouadio.

“The government and its partners should increase the funding for the fight against malaria in the DRC, in particular, acquisition and universal distribution of mosquito nets to households, provision of essential drugs and rapid diagnostic test [kits], and dissemination of environmental sanitation measures.”

Malaria occurs almost year-round in DRC due its tropical climate and its river and lake system.

The country has some 30 large rivers totalling at least 20,000km of shoreline, and 15 lakes totalling about 180,000km, which offer environments conducive to the proliferation of diseases and disease vectors, including the Anopheles mosquito, which spreads malaria.

According to MSF’s Stellema, the DRC government and national and international health actors need to take rapid and sustainable measures to prevent and treat malaria in order to avoid unnecessary child deaths.

In 2012, MSF treated half a million Congolese for malaria, many of them children under five.

“MSF’s emergency response is saving lives in the short term. But in the longer term, the organization cannot address the [malaria] crisis alone,” said Stellema.

[Courtesy of IRIN]

Uganda: Paediatric Vaccine Crisis

KAMPALA, 20 May 2013  – Ugandan children are going unimmunized as the country grapples with persistent and widespread vaccine shortages, the result of insufficient funds and inefficient procurement and supply systems, officials say.

“We are getting reports and calls from all the districts about the stock-outs of all types of anti-immunization vaccines. They don’t have anti-TB [tuberculosis] vaccines, anti-tetanus, polio [vaccines]. The ministry is faced with inadequate funding for most of our programmes,” Asuman Lukwago, permanent secretary in the Ministry of Health, told IRIN.

“The current major problem on the vaccines is the distribution issue. We are working around the clock to have the problem solved and sorted out immediately.”

Most of the health centres across the country are facing critical shortages of vaccines to protect against tuberculosis, polio, tetanus, diphtheria, rotavirus and pneumonia, putting children at risk of largely preventable diseases.

Health officials now fear these frequent shortages could prevent mothers from bringing their children in for immunizations.

“You can’t [ask] mothers to move to health facilities three to four times and they don’t find vaccines. This practice discourages some of them to go back to the hospitals,” said Huda Oleru Abason, chairperson of the Parliamentary Forum on Immunization.

Procurement woes

In 2011, the government of Uganda shifted the procurement of vaccines and drugs from the Uganda National Expanded Programme on Immunization (UNEPI), under the Ministry of Health, to the National Medical Stores (NMS), an autonomous government corporation. The move was intended to inject efficiency into the country’s drug procurement system, but the drug shortages have continued.

Yet officials at NMS are blaming the shortages on late requisitions for vaccines by UNEPI. The procurement of drugs is the responsibility of NMS.

“Placing of orders is not the responsibility of NMS, it’s [the job of] UNEPI,” Dan Kimosho, a spokesperson at the NMS, told IRIN. “So if they don’t put request in time or under-quantified for the supplies, it’s not our problem. Our responsibility is to procure, store and deliver the requested vaccines. We can’t begin delivering vaccines to districts and health [facilities] if the orders have not been placed to us. We have the competency to deliver the requested drugs and vaccines.”

An estimated 48 percent of children under age five in Uganda are either unimmunized or under-immunized, meaning they do not complete their immunization schedules, according to the 2011 Uganda Demographic and Health Survey.

Uganda has recently experienced a decline in immunization levels, in part due to inadequate funding, health staff shortages and  [parents’]poor adherence to vaccination schedules.

In April 2013, the government launched a countrywide rotavirus and pneumococcal vaccination program targeting over 1.7 million children.

In an interview with IRIN, Director General of Health Services Ruth Achieng noted that, “Uganda is not doing very well in [its] immunization programme… We don’t want our children to die from preventable diseases. We need to act now. Otherwise, we shall get an outbreak of polio and tetanus.”

Uganda’s budget support for the Expanded Programme on Immunization, EPI, – which had been hailed for increased vaccination coverage between 2000-2007 – decreased by more than half in recent years, falling from 7.7 percent in the 2006-2007 financial year to 3.6 percent in 2009-2010.

Officials say the government has plans to revitalize the country’s immunization programs.
“We have worked out the revitalization plan, and if implemented well, we shall be able to change the low status of immunization in Uganda. The government has mobilized some funds and, with support from GAVI, everything is revisable. We are going to embark on [an] aggressive campaign to ensure there are no vaccine stock-outs in the country and ensure all the children are immunized,” the Ministry of Health’s Lukwago said.

There is also a legal push to improve immunization. An immunisation bill currently pending in parliament will make it illegal for parents and guardians to fail to have their children immunized. It also seeks to punish health officials who fail to offer immunization services to children.

[Courtesy of IRIN)