South Africa, Which Once Led On Promoting LGBT Rights Abroad, Could Become A Roadblock
Young people, who understands them?
When David Cameron delivered a speech in 2006 calling for people to “hug a hoodie”, the British Prime Minister was trying to say that he got young people; that he saw them as loveable adolescents and not an urban menace.
“We – the people in suits – often see hoodies as aggressive, the uniform of a rebel army of young gangsters,” he said.
Whether it’s about crime or immigration, education or identity it seems that people in suits the world over are increasingly preoccupied by youth. And they have good reason to be.
Africa has the youngest population in the world with 200 million young people between the ages of 15 and 24. Though better educated than ever, and living in countries that are stronger economically than ever, many young people are “left behind” and “frustrated”.
That frustration is also shared by young people in the developed world. In a 2013 study from the International Labour Organisation, youth unemployment stood at 54% in Greece.
And so the suits continue to gather, trying to figure out what to do about joblessness and the ‘youth bulge’, publishing interminable reports and recommendations, but what do young people have to say for themselves?
On Friday 24 October, in an event that will span 24 countries in 24 hours, we intend to find out. The Guardian Global Development Professionals and the Guardian Public Leaders networks will be organising a global tweetathon. This is an opportunity for young people and their advocates to give their own answers to the question: “How do we better engage young people socially, economically and politically?”
Starting in Fiji at noon local time and finishing on the west coast of the USA (4pm there), each leg of our worldwide relay will have a national or regional host. Their details will be added soon.
To participate, here’s what you need to do:
Go to: http://www.theguardian.com/global-development-professionals-network/2014/oct/16/youthengage-tweetathon-employment-future?CMP=twt_gu
Locate your part of the world in the map above
Make a note of the time of the conversation you intend to join
Start tweeting to tell us and the world that you are taking part. Here is one tweet you could use: I’m joining @GuardianGDP’s #youthengage tweetathon in [insert nearest country] on 24 Oct. To me engaging young people means [...]
On the day, as your chat is about to start, take a picture of yourself and tweet it to @GuardianGDP
Still not sure how it works or what time the #YouthEngage discussion will be happening where you are, send an email to email@example.com
Join our community of development professionals and humanitarians. Follow @GuardianGDP on Twitter.
Editor’s note: Morocco, our hub for a debate that includes francophone Africa, will be added tomorrow.
GSK is one of several companies trying to fast-track a vaccine to prevent the spread of Ebola in West Africa.
But Dr Ripley Ballou, head of GSK's Ebola vaccine research, said full data on its safety and efficacy would not be ready until late 2015.
The World Health Organization (WHO) says more than 9,000 people have been infected and more than 4,500 have died.
Health workers are struggling to contain the spread of the virus, which is mostly affecting people in Liberia, Guinea and Sierra Leone.
The WHO has warned there could soon be 10,000 new cases a week.
Leading experts who have previously tackled Ebola believe the only way to contain the outbreak is with a vaccine.
Prof Peter Piot, director of the London School of Hygiene and Tropical Medicine, first discovered Ebola in 1976. He is worried that the outbreak could last well into next year.
"Then only a vaccine can stop it, but we still have to prove that this vaccine protects, we don't know that for sure," he said
There are several vaccine trials under way. The Public Health Agency in Canada has started human testing, and a Russian project is planning to do the same.
At GSK's vaccine research laboratories outside Brussels, they are trying to compress trials that would normally take up to 10 years into just 12 months.
They have already given the vaccine to volunteers taking part in the trial in Africa, the US – where they are working alongside the National Institute of Health – and the UK.
Volunteer Nick Owen was injected two weeks ago at the centre for Vaccinology and Tropical Medicine in Oxford and will have regular check-ups for the next six months.
He said he had not hesitated to take part.
"It's a horrific disease, it's unimaginable what people are going through and it seemed like a really small sacrifice to make," he said.
In the next phase of the trial, the company hopes it will have 20,000 doses ready to be tested by health workers early next year.
When the outbreak was first declared in March, GSK had discussions with the World Health Organization about accelerating the development of the Ebola vaccine, Dr Ballou said. But they had decided, together, not to.
"No-one anticipated we would need a vaccine," said Dr Ballou. "And so both internally and, I think at the WHO, we felt the best approach was to watch very closely".
Seven months on, with the virus out of control, he now concedes: "I think in retrospect we should have pulled that trigger earlier.
"But, you know, it is what it is and we are working very closely with WHO.
"There shouldn't be any finger pointing around this."
Dr Ballou said it would now take some time to assess all of the data to establish the correct dosage and for how long the vaccine was effective. He said that could not be done in time for this latest epidemic.
"At the same time we have to be able to manufacture the vaccine at doses that would be consistent with general use, and that's going to take well into 2016 to be able to do that," he added.
"I don't think this can be seen as the primary answer to this particular outbreak," he said, but the trials under way could help in the future.
"If it does work then to be able to be prepared so that we don't have to go through this again in five years, or whenever the next epidemic is going to break out."
Even if GSK's vaccine does not work, other Ebola vaccines being developed by researchers in Canada and Japan could provide hope for future outbreaks.
By Simon Cox
17 October 2014
To raise the funds needed to achieve transformative impact against AIDS, tuberculosis and malaria and other diseases, partners are coming together in a spirit of shared responsibility. Governments, the private sector, private foundations, individuals and implementing countries can each play a part.
On 13 October, partners from UNAIDS, the United Nations Economic Commission for Africa, African Union, African Development Bank and the Global Fund gathered in Marrakech, Morocco to examine and discuss this issue. Organized at the side lines of the African Development Forum, the meeting focused on urging low and middle income countries to raise more domestic finances for health. Participants called for a new paradigm in health financing.
Michel Sidibé, Executive Director of UNAIDS, gave the keynote address and said that as more and more low income countries transition into the middle income status, they should reconsider their investments in health. In the same spirit of shared responsibility and solidarity, Sidibé said, rich nations should also maintain their commitments to financing health programs.
Abdalla Hamdok, Deputy Executive Secretary of the United Nations Economic Commission for Africa, said that investments in health form a critical pillar of economic growth and should be strongly linked to other sectors. Unless Africa focuses on health in its totality, the continent cannot achieve economic transformation. "Health is at the heart of development," he said.
Itai Rusike of African Civil Society Platform made a passionate call for a country-level movement of partners for domestic financing for health made up of the civil society, parliamentarians, private sector and all other stakeholders. Such an effort, coupled with stronger governance mechanisms, would mean great African solutions to African health, he said.
Shu-Shu Tekle-Haimanot, Senior Specialist for Advocacy and Partnerships at the Global Fund, said the Marrakech meeting was a significant step toward better health in Africa. “Partnerships hold the key to progress,” she said. “With implementing countries leading the way, this partnership can achieve our goals of raising funds and saving many lives.”
14 October 2014
KAMPALA, UGANDA (13 October 2014) The AIDS Healthcare Foundation (AHF) mourns the loss of another Doctor, Dr. John Taban Dada who died due to Ebola Virus Disease (EVD) in West Africa. Dr. Dada, a Ugandan national, succumbed to the Disease on 9th October 2014 in Monrovia, Liberia. By the time of his death, Dr. Dada was working at Liberia’s largest hospital, JF Kennedy Memorial Center, and was consulting with the AIDS Healthcare Foundation partner in HIV service provision, People Associated for People’s Assistance (PAPA).
The Ebola outbreak in West Africa has continued a persistent spread pushing the death toll over 4,000 as of 9th October 2014. Having been declared an international public health emergency by the World Health Organization, Ebola Virus Disease has infected over 370 health workers and killed 216 doctors and nurses. In July, Dr. Sheik Humarr Khan, 39, who served as Medical Officer for AHF’s Sierra Leone Country Program, succumbed to the disease after being quarantined and cared for by medical providers from Médecins Sans Frontières at the isolation unit in the Kailahun District in Eastern Sierra Leone for several days. In Liberia, Dr. Dada’s death brought to four (4) the number of Doctors who have died since the outbreak.
“Our brothers and sisters in West Africa need accelerated action by commissions such as the African Union and the World Health Organization to expand provision of appropriate and adequate personal protective equipment, mobilize and deploy more health workers in the region, and increase and equip more isolation centers specifically established to cater for infected health workers,” said Dr. Penninah Iutung Amor, the AHF Bureau Chief for the African Region. “All these are achievable – but only if the commissions and the World Health Organization prioritize and scale up addressing obstacles that are holding us back in the response.”
There was hope late September when President Obama pledged support to the EVD response in the region however the actualization of this support has been delayed due to logistical challenges — inadequate human resources for health, poor state of the runway at the airport, and delays in setting up new isolation centers. “Since we have few isolation centers, we are seeing some people suffering from Ebola re-circulating into the community and therefore driving the infection further,” said Chinnie Sieh, Program Manager with People Associated for People’s Assistance (PAPA). “This is a crisis that requires all the Africa Commissions, the United Nations, all African governments and non-government actors to respond.”
“It is high time that the containment of this outbreak became a reality in the West African Countries of Sierra Leone, Guinea and Liberia,” said Dr. Lydia Buzaalirwa, the Director for Quality Management with AIDS Healthcare Foundation Africa Bureau. “Everybody needs to take part in the control of Ebola. We need to cut the chain of new transmissions, get in more volunteers, more logistics, and communities should be involved in building new isolation units. We demand that the African Union step up its leadership and exponentially accelerate its response to the Ebola outbreak in the region.”
By The AIDS Healthcare Foundation
Hundreds of pregnant women and girls are dying needlessly in South Africa. In part, this is because they fear their HIV status may be revealed as they access antenatal care services, according to a major report published by Amnesty International today.
Struggle for Maternal Health: Barriers to Antenatal Care in South Africa, details how fears over patient confidentiality and HIV testing, a lack of information and transport problems are contributing to hundreds of maternal deaths every year by acting as barriers to early antenatal care.
“It is unacceptable that pregnant women and girls are continuing to die in South Africa because they fear their HIV status will be revealed, and because of a lack of transport and basic health and sexuality education. This cannot continue,” said Salil Shetty, Amnesty International’s Secretary General.
“The South African government must ensure all departments work together to urgently address all the barriers that place the health of pregnant women and girls at risk.”
South Africa has an unacceptably high rate of maternal mortality. There were 1,560 recorded maternal deaths in 2011 and 1,426 in 2012. More than a third of these deaths were linked to HIV. Experts suggest that 60% of all the deaths were avoidable.
Antenatal care is free in South Africa’s public health system. However, Amnesty International’s research found that many women and girls do not attend clinics until the later stages of their pregnancy because they are given to believe that the HIV test is compulsory. They fear testing and the stigma of being known to be living with HIV. Nearly a quarter of avoidable deaths have been linked to late or no access to antenatal care.
Worryingly, these fears are not without foundation. Amnesty International’s report, based on field research conducted in Mpumalanga and KwaZulu-Natal provinces, contains testimonies from women and girls who say that health care workers inappropriately discuss HIV test results with others.
“The nurses are talking about people and their status”, a woman from KwaZulu-Natal explained.
Amnesty International also found that several clinics it visited use processes for pregnant women and girls living with HIV that disclose their status, including separate queues for antiretroviral medication, different coloured antenatal files and different days for appointments.
“[I]f I go for antiretroviral, my line is that side. All the people in this line they know these people are HIV. That’s why people are afraid to come to the clinic,” one woman in Mpumalanga told Amnesty International.
“During antenatal care, if women come out of the counsellor’s room with two files, then everyone knows they are HIV positive,” said another woman.
Women and girls said they feared discriminatory treatment even from partners and family members as a result of testing positive for HIV and that HIV-related stigma remained a problem in many communities.
“While HIV testing is an important public health intervention it must be done in a manner that respects the rights of women and girls and does not expose them to additional harm. It is deeply worrying that the privacy of pregnant woman and girls is not respected in health facilities. The South African government must take urgent steps to correct this,” said Salil Shetty.
“It is vital that health care workers in South Africa receive additional training on providing quality care that is both free of judgement and stigma and that women and girls accessing sexual and reproductive health services are able to trust that their confidentiality will be respected.”
Amnesty International’s report also identifies that a lack of information and knowledge about sexual and reproductive health and rights increases risks of unplanned pregnancies and HIV transmission, especially among adolescents. Likewise women and girls are often unaware of the importance of early antenatal checks.
The report also documents the lack of progress made in KwaZulu-Natal and Mpumalanga to ensure that women and girls can physically access health services. Problems persist relating to shortages of public transport and poor road infrastructure. The roads in some areas visited by Amnesty International are of such poor quality that they become impassable when it rains. Even when it is dry, ambulances will not go beyond a certain point on some roads. Amnesty International had documented the same problems in both provinces in a 2008 report.
“The South African government must build better road networks in these rural provinces to guarantee access to healthcare facilities. The government must also ensure that ambulances are always available to transport those who are in need,” said Salil Shetty.
This report builds on Amnesty International’s 2008 report, ‘I am at the lowest end of all’: Rural women living with HIV face human rights abuses in South Africa, in which the organisation documented gender, economic and social inequalities as barriers to health care for women living with HIV.
9 October 2014
By Amnesty International
AAI is inviting you to attend an international tele-conference that will help to initiate a process of supporting a co-ordinated African civil society response to the Ebola epidemic.
The tele-con will be held on Wednesday 8th October 2014 at 1pm (Central Africa Time).
The proposed process comes largely due to the fact that it seems that in recent weeks the Ebola epidemic in Africa has continued to rise and is increasingly overwhelming the current response. There is thus an urgent need to ensure there is accountability in the response, and transparency about what governments, civil society and all others are doing, and that human rights and access to health remain central.
In this regard, AAI is now pushing strongly for a co-ordinated African civil society response to the Ebola epidemic.
AAI believes that once civil society is more organised, it will also help to develop a broader co-ordinated African response that will include all relevant stakeholders such as governments, business, relief/aid agencies and donors/funders, among others.
Of particular concern are the following two crucial issues:
1. In West Africa: It seems the relief efforts and response so far is coming mostly through international initiatives from outside Africa. There is not much clarity at the moment on how far the Africans are owning and co-ordinating the response to the Ebola epidemic.
2. Rest of Africa: Even though the Ebola epidemic is yet to adversely affect the rest of the continent, there are some question marks as to the level of preparedness in the event that it eventually breaks out across Africa. Even worse, to date it seems very little has been done to massively invest in public/awareness campaigns about Ebola. Ignorance about Ebola is still a major concern.
We would like to start by ensuring there is transparency by doing a proper mapping process of all the relevant civil society organisations across Africa that could be mobilised to join a common platform for a co-ordinated response to the Ebola epidemic.
Secondly, we would like to initiate action by ensuring there is a co-ordinated civil society to take the lead in mobilising resources/commitment for an Ebola epidemic awareness campaign especially across the affected countries.
Can you please at least ask your various contact offices and networks especially at country level to help us with African civil society contacts they know are actively involved with the Ebola response.
You can also join this process especially by confirming your participation at the initial tele-con that AAI is planning to host for African civil society on 8th October because the situation seems to be getting dire with each passing day.
Email Daniel Molokele at daniel at aidsaccountability.org to join the call.
The sexual and reproductive health rights of young marginalized populations are often neglected and their collective voice in this critical area not always heard. To try to redress this imbalance young people from marginalized communities and key populations in Bangladesh, Ethiopia, Puerto Rico and Uganda met in New York this week to discuss how to put these rights issues firmly on the post-2015 development agenda, leaving no one behind.
Taking place on 25 September, the General Assembly side event which took the form of a panel discussion, examined the vital role of community engagement, advocacy and service delivery in protecting the rights and meeting the needs of young key populations. These include men who have sex with men, sex workers and young people living with HIV.
Young speakers, who were peer educators, directors of national and regional NGOs, actors and community leaders, argued that universal access to HIV services and health coverage could not be achieved without prioritizing the needs of the most marginalized. They also noted the contribution of comprehensive sexuality education to improving young people’s health and the role that communities can play in both promoting rights and challenging stigma and discrimination.
The event was hosted by the Government of Brazil and organized by the International HIV/AIDS Alliance, GESTOS, the Global Youth Coalition on AIDS, ATHENA, ICASO, International Civil Society Support, STOP AIDS NOW!, Stop AIDS Alliance, the HIV Young Leaders Fund, the African Services Committee, and the Global Forum on MSM and HIV, in collaboration with UNAIDS.
"Setting goals is only part of the story. Where we should look for change is the way that we will implement the goals. We need to change the way we are doing business and craft the space for civil society in the new post-2015 agenda."
Luiz Loures, UNAIDS Deputy Executive Director
“We are talking about development here and sexual and reproductive rights are development."
Pablo Aguilera, HIV Young Leaders Fund
26 September 2014
For the last three years, AIDS Accountability International’s (AAI) work to stimulate greater accountability from funding partners – particularly the Global Fund – has focused on countries in Southern Africa. Based on the impact and successes of that work and its publication as good practice (Oberth, 2013; Oberth, 2014), AAI has partnered with vested stakeholders in Kenya, Tanzania (Mainland and Zanzibar) and Uganda to scale up our work to East Africa and ensure that the Global Fund is accountable to women, young girls and LGBT communities there.
In August 2014, Daniel Molokele (Deputy Executive Director) and Gemma Oberth (Senior Researcher) represented AAI in three different national and regional forums to promote greater transparency around Global Fund country dialogue.
The AAI team started in Kenya where we were brought in as technical partners to facilitate civil society country dialogue for Kenya’s upcoming HIV/TB concept note to the Global Fund (to be submitted 15 January 2015). As impartial and unbiased facilitators, AAI is able to draw out key priorities from various marginalized groups, including MSM, sex workers, people with disabilities, the TB community and other civil society representatives. The workshop was a national level training for civil society focusing on the Global Fund and the use of data in planning for the New Funding Model. The training workshop was held from 20-22 August at Maanzoni Hotel, just outside Nairobi, and hosted by Aidspan, in partnership with various partners such as International HIV Alliance, EANNASO, KANCO, LVCT Health and KENAAM. The outcome of the workshop will be The Kenya Civil Society Priorities Charter, produced by AAI as part of an initiative we have led in eight African countries, in partnership with the Ford Foundation.
After supporting civil society in Kenya to set priorities for the Global Fund New Funding Model, AAI travelled to Zanzibar where we facilitated a multi-stakeholder Priorities Charter development workshop. AAI’s technical support was requested by the Secretariat of the Zanzibar Global Fund Country Coordinating Mechanism (ZGFCCM), based on our previous work supporting civil society and key populations dialogues (in partnership with the International HIV/AIDS Alliance) and developing the Zanzibar Civil Society Priorities Charter, an initiative led by AAI.
The multi stakeholder consultation in Zanzibar was held on 25 August 2014 and was attended by representatives from diverse sectors in Zanzibar that included government departments, civil society, key populations, development partners, academia and private sector. The outcome of this workshop will be the Zanzibar Key Stakeholder Priorities Charter, which AAI will produce based on the priorities set at the meeting. The Charter is intended to guide the concept note development process in Zanzibar for both their HIV/TB concept note and Malaria concept note (both to be submitted on 15 October 2015). Some of the top priorities among the key stakeholders were on issues around treatment, care and support, behaviour change and also on health systems strengthening, among others.
Lastly, from 26-28 August 2014, AAI travelled to Dar es Salaam, Tanzania to participate in a regional civil society meeting that was hosted by EANNASO. The meeting was attended by civil society members of CCMs across several countries in East Africa, including Kenya, Tanzania (Mainland and Zanzibar), Burundi, Rwanda, Uganda and Ethiopia. The participants shared their experiences and lessons learnt from their active participation on CCMs, particularly focusing on civil society engagement in the concept note development process for the Global Fund New Funding Model. At the meeting, AAI conducted a session on Accountability Literacy, building the capacity of the delegates to hold other CCM members accountable through greater transparency, dialogue and action. A key outcome of the meeting was the launch of a regional civil society CCM forum and also the election of steering Committee.
The AAI team was impressed with the level of commitment and support from the various partners across East Africa and now looks forward to developing more opportunities for programme partnerships in the region.
AIDS Accountability International's work on CCMs and GFATM are kindly funded by funding partner Ford Foundation, South Africa Office.
With each week that passes, the Ebola crisis in West Africa deepens. And amid the horror, the fear and a public health response described by Medicine Sans Frontières as “lethally inadequate”, public health systems face total collapse.
While the inadequate international response has loomed large, it is the region’s chronically weak and desperately resourced health infrastructure which is the critical factor. This was underlined by Bruce Ribner, an infectious disease specialist at Emory University Hospital in the US who led the successful treatment of two aid workers who contracted Ebola while working in West Africa.
According to Ribner: “They [West African Doctors] suffer from a terrible lack of infrastructure and the sort of testing that everyone in our society takes for granted, such as the ability to do a complete blood count – measuring your red blood cells, your white blood cells and your platelets – which is done as part of any standard checkup here. The facility in Liberia where our two patients were didn’t even have this simple thing, which everyone assumes is done as part of your annual physical.”
Health systems encompass hospitals, clinics, procurements structures, research programmes, community health workers and training provision, and are the first line of defence in the face of outbreaks such as Ebola. When that bulwark is breached so easily, as it was in Sierra Leone and throughout the region, it raises urgent and uncomfortable questions about the focus of our development priorities.
In fact, this crisis exposes the great fallacy of the West’s global development agenda. While the international health and development community obsesses about technocratic development goals, targets, and indicators; the basic building blocks of health provision in poor countries have been desperately neglected.
There is a contradiction here. Isn’t it recognised that global health has done well out of the last 15 years of development spending?
Three of the Millennium Development Goals(MDGs) are health related, new philanthropic actors such as the Bill and Melinda Gates Foundation have prioritised global health as an area of concern, and new financing mechanisms to support vaccinations and HIV/AIDS responses such as the Global Fund to Fight AIDS, Tuberculosis and Malaria were created.
The result: a swell of new money, big name endorsements, and targeted action in critical but singular areas.
This tide of resources, expertise and good will has led to a pre-occupation with “vertical interventions” – programmes that prioritise specific diseases such as malaria. This is of course, not a bad thing in itself. Malaria is a scourge on the health and lives of Africans, and programmes to mitigate its transmission and effects are both vital and badly needed. I’m not proposing that we cut off support for disease-specific programmes nor that development is a zero-sum game – but our limited resources can’t ignore the less glamorous but no less urgent areas of clinics, hospitals and systems.
The singular focus on specific diseases, to the detriment of health systems in general, is a major reason why we are where we are in West Africa. The failure of the healthcare infrastructure to cope with Ebola should not be a surprise; it is certainly not for those living and working in the region, many of whom have spent decades decrying the ramshackle state of hospitals, clinics and systems.
The WHO has stressed the importance of health systems, and the World Bank began to make them the focus of its regional efforts a few years ago. Yet, the idea that health systems should be a key feature of the new Millennium Development Goal process is gaining little traction in international development circles. In short, without a radical focus on health systems; the future is bleak.
The struggle to contain Ebola shows how strongly equipped and fully-functioning health systems are fundamental to the management of health emergencies as well as the everyday health and well-being of people in vulnerable, poorer regions.
The stubborn focus on goals and specific diseases over the last 15 years has led to a chronic and senseless neglect of health systems in developing countries. This focus has contributed to a catastrophic public health emergency. If we are to salvage anything from this human and regional tragedy, it should include a commitment to invest money and expertise in regional health infrastructure. That requires an urgent and radical shift in our accepted model of global health and development.