Africa

Dexter, a 25-year-old fisherman from Pohnpei in the Federated States of Micronesia, received treatment for Hansen’s disease, also known as leprosy, for over a year. He has been cured of the disease. Credit: Stella Paul/IPS

By Stella Paul
POHNPEI, Apr 8 2019 (IPS)

It’s a good day for Dexter, a 25-year-old fisherman from Pohnpei in the Federated States of Micronesia. He’s just been told that he is cured of leprosy.
“I have been sitting at home for nearly a year now,” Dexter, who doesn’t want to reveal his last name, tells IPS. “But now I can finally return to my job,” he says with a smile.

However, not every patient in Pohnpei State may be as fortunate as Dexter. The region is grappling with a shortage of leprosy drugs. Multidrug therapy (MDT) is provided for free by Novartis, through the World Health Organisation (WHO) and distributed across the globe. But Pohnpei has to send through an application for new stock to the national government.

“We have not received any fresh supply of drugs this year, so we are giving what we have in our stock although they are now expired,” reveals Dr. Elizabeth Keller. She is the acting chief of Pohnpei State’s Department of Health Services and also heads the region’s leprosy programme.

Pohnpei State has the largest number of leprosy cases in the country—nearly 100 new cases are reported here every year. And Micronesia still remains one of three Pacific island nations, along with the Marshall Islands and Kiribati, that is yet to eliminate leprosy or Hansen’s disease. In fact, according to the WHO, Micronesia has the highest prevalence of Hansen’s disease in the entire Pacific.

But the news of the shortage in Pohnpei State appears to take many by surprise, including Mayleen Ekiek, who heads the country’s National Leprosy Programme (NLP).

“I am surprised to hear this. This should not happen. I don’t know why they have not received the fresh stock because the supply is made once the requisition is submitted to the government,” she comments.

But it is easy to see how Ekiek could be unaware of the situation.
Providing healthcare to the country’s estimated 105,000 people, who are scattered over 65 of the country’s 607 islands, is complicated. While the Micronesia’s four states receive their funding directly from the national government, they work independently and usually only communicate directly with the federal government.

“The Department of Health Services in each state provides medical and public health services through a hospital, community health centres and dispensaries. Each state system is autonomous,” states the WHO.
As state health departments are not mandated to report to the NLP, Ekiek is sometimes caught unaware by developments, such as the current drug shortage.

However, Keller says that her department has already asked for the fresh supply and hopes it would come soon. Meanwhile, she assures that the medicine will not cause any adverse effect on the patients’ health. “These may not work as effectively as fresh drugs, but they will not harm,” she says.

Dr Arturo Cunanan with a patient at a leprosy clinic in the Federated States of Micronesia. Cunanan, a world expert on Hansen’s disease, says that a review of Micronesia’s national leprosy programme is overdue. Credit: Stella Paul/IPS

And while there is also a mechanism to bring the various states in Micronesia together to collaborate their leprosy services, Ekiek says that without funding it would be hard to do.

“I also lead the national programme on [tuberculosis] TB and I often piggyback on the TB budget to visit our leprosy programmes in the state. But I cannot organise a meeting of the state leprosy workers because it would require about 40,000 dollars-which is too big of an amount to be extracted from another programme budget,” Ekiek explains.

Budgetary allocations aside, Micronesia also has the challenge of a lack of credible data. Clear, defined parameters of data can help paint an accurate picture of leprosy in the country, and also provide information about the exact number of new cases.

In addition, a database of all the people affected by leprosy, and those who are undergoing treatment, can be created to make the information easily accessible.

Because without credible data, there is currently no uniformity in the statistics provided by the national and the state programmes.
“We received 89 new cases in 2018. This year, between January and March, we have seen 35 news cases,” Keller informs.
But according to Ekiek, there were probably just 75 new cases in 2018.
“Honestly, we cannot be sure because we don’t have a clear database yet. We don’t have a trained data analyst or staff who is skilled to compile and visualise statistics,” she admits.

While the confusion among the different government agencies continues, some experts feel that it is because of a lack of coordination and that a review of the national leprosy programme is overdue.

“The national leprosy programme has not been reviewed for a long time, so we don’t know what is working and what is not. Maybe they need a complete overhaul of the system or maybe they just need some training in data, records and office management,” says Dr. Arturo Cunanan, a world leprosy expert and chief of Cullion Sanitarium and General Hospital in Philippines. Cunanan, who is also recipient of the Gandhi Peace Prize for his work with leprosy, was visiting Micronesia with the Sasakawa Health Foundation/Nippon Foundation to review the current progress in eliminating leprosy.

“But without that review of the current programme, a true need assessment is not practically possible,” Cunanan, who has trained several health department staff across Micronesia region, including Ekiek, says.

* Additional reporting and writing by Nalisha Adams in Johannesburg

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The post Missing Data & Inefficient Drug Distribution Tops List of Micronesia’s Leprosy Challenges appeared first on Inter Press Service.

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By Thalif Deen
UNITED NATIONS, Apr 8 2019 (IPS)

As it paves a destructive path against international institutions and multilateralism, the Trump administration is slowly but steadily undermining the United Nations and its affiliated agencies.

The US has already withdrawn both from the Human Rights Council in Geneva and the UN Educational, Scientific and Cultural Organization (UNESCO) in Paris while, at the same time, it has either cut off, or drastically reduced, funding for the UN Population Fund (UNFPA), the UN Relief and Works Agency (UNRWA) and for UN peacekeeping operations (by a hefty $500 million).

The most recent attack has been directed at the International Criminal Court (ICC) in the Hague which was planning to investigate war crimes committed in Afghanistan, focusing both on the Taliban and US soldiers.

The US action to revoke the visa of Fatou Bensouda, Chief Prosecutor of the ICC, has not only triggered protests from academics and from human rights and civil society organizations (CSOs) but also left several lingering questions unanswered.

When the United Nations decided to locate its secretariat in the city of New York, the United States, as host nation, signed a “headquarters agreement” back in 1947 ensuring diplomatic immunity to foreign diplomats and pledging to facilitate the day-to-day activities of the world body– without any hindrance.

So, is the revocation of the visa a violation of the 1947 US- UN headquarters agreement? Or has the US a right to impose proposed sanctions on ICC judges when it is not even a member of the ICC?

And is the revocation of the visa the shape of things to come, with political leaders from countries such as Iran, Venezuela and Cuba– blacklisted by the Trump administration– being refused admission when they are due in New York next September for the annual General Assembly sessions?

The protests against the US decision have come from several CSOs, including the American Civil Liberties Union (ACLU), the International Commission of Jurists (ICJ), the International Service for Human Rights (ISHR) and the World Federalist Movement- Institute for Global Policy (WFM/IGP).

The letter from the three non-governmental organizations (NGOs) states “the purpose of the visa restrictions is to block and deter legitimate criminal investigation into serious crimes under international law”.

“Not only might they have a chilling effect on ICC personnel and others advocating for accountability, but they will set a dangerous precedent with serious implications on the overall fight for impunity, especially the right of victims and their legal representatives to seek justice and reparations without fear of retaliation.”

Dr. Tawanda Hondora, Executive Director of WFM-IGP, told IPS the Trump administration has been consistent in its reckless application of retrogressive policies that undermine a rules-based international order.

He said its policies are seriously damaging the post-WWII system of international law and practice, and have exponentially increased the risk of armed conflict in a world in which many more states now possess weapons of mass destruction.

“The revocation by the US of Fatou Bensouda’s visa violates Article IV of the UN-US headquarters agreement”.

There is no question that the US is applying its immigration laws with the objective of improperly influencing the ICC Prosecutor’s investigations into crimes committed by all parties to the conflict in Afghanistan, he argued.

“It is wholly unacceptable that this administration is using Bensouda’s personal situation to coerce her to breach her mandate under the Rome Statute and to the UN Security Council,” he declared.

Dr Martin S. Edwards, Associate Professor of Diplomacy and International Relations at Seton Hall University in the US, told IPS both civil society and other countries are right to be critical here.

“I would hope that this is solely intended to make life difficult for Bensouda and not part of a more general trend of denying visas for General Assembly visits”.

However, said Dr Edwards, there is little about this administration and its mix of insecurity and unwarranted bluster that should surprise anyone.

“I would think that this could lead to similar attempts to deny visas for General Assembly visits” He pointed out that the Venezuelan President Nicolas Maduro could be a natural target here as an extension of diplomatic efforts to isolate him.

It would be ironic that a President that frames his accomplishment as a reassertion of American power would be afraid of what he would say from the podium, said Dr Edwards.

But the hallmark of this US Presidency has been a singular focus on controlling perceptions and information, rather than confidently relying on our diplomatic prowess to produce results.

Historically, the US has grumbled about leaders coming to New York (denying Arafat was legally easier than a Head of State), but one can imagine this White House pushing the envelope here, since it’s perfect “red meat” for the President’s base, he added.

The legal basis for doing this is incredibly thin, based on a false reading of Section 6 of the Headquarters Agreement, which grants leaders a right to access to the UN, and the US would surely lose in arbitration, Dr Edwards noted.

Briefing reporters on March 15, US Secretary of State Mike Pompeo said since 1998, the United States has declined to join the ICC because of its broad, unaccountable prosecutorial powers and the threat it poses to American national sovereignty.

“We are determined to protect the American and allied military and civilian personnel from living in fear of unjust prosecution for actions taken to defend our great nation. We feared that the court could eventually pursue politically motivated prosecutions of Americans, and our fears were warranted,” he declared.

Dr Palitha Kohona, a former Chief of the UN Treaty Section, told IPS the US is not only, not a party to the Statute of the ICC, but it also inserted Article 98 of the Statute during its negotiations excluding US nationals from its jurisdiction.

Subsequently, the US formally advised the UN Secretary-General that it will not ratify the Statute thereby exempting it from any obligations arising from signature.

Thus, the US has emphatically signalled its position with regard to the Statute of the ICC. Therefore, denying a visa to the prosecutor only underlines its consistent opposition to the Statute, said Dr Kohona a former Permanent Representative of Sri Lanka to the United Nations.

While one could raise one’s eye brows about the US action, said Dr Kohona, one is reminded again that we still live in a world where the powerful dictate the terms and modify the rules to suit their convenience, despite the dreams of those idealists who had hoped to create a world governed by a transparent and predictable framework of rules equally applicable to all.

“Unfortunately, the rules, especially those relating to human rights and humanitarian affairs, tend to be applied with vigour only to the weak and the meek and not to the powerful. This is the reality of the world that we inhabit,” he noted.

Dr Edwards of Seton Hall University said: “As for the ICC, Bensouda is caught between a need to investigate non-African cases to signal her independence, but picking the biggest fight imaginable in the process”.

This does fit a general US pattern of using ICC as a tool against other countries while exempting itself from investigation in the process, so in one sense it is not surprising.

“The bigger danger for the ICC is that this might set a precedent for other countries to try to tamper with its work in similar ways moving forward,” he declared.

Dr Hondora of WFM-IGP called on the United Kingdom and France – members states to UN Security Council (UNSC) and the Rome Statute – to initiate a debate in the UNSC regarding the lawfulness and propriety of the US decision to revoke Bensouda’s visa in the peculiar circumstances of this case.

He said WFM-IGP calls on the UN General Assembly to object to the revocation of Bensouda’s US visa as it sets a precedence that will see representatives of governments and international bodies that different US administrations object to being personally targeted with punitive personal US sanctions with the intention of prejudicing how they discharge their roles and responsibilities under key treaties.

WFM-IGP also calls on the General Assembly to seek an Advisory Opinion from the International Court of Justice regarding the lawfulness – under the US-UN Hosting Agreement – of the US decision revoking Bensouda’s visa to the US in retaliation to a decision taken by the Office of the Prosecutor to investigate allegations of war crimes and crimes against humanity committed in Afghanistan.

The writer can be contacted at thalifdeen@ips.org

The post NGOs Blast US for Undermining Criminal Court appeared first on Inter Press Service.

Excerpt:

This article is part of a series on the role of civil society organisations (CSOs), which will be the focus of International Civil Society Week (ICSW), sponsored by CIVICUS, and scheduled to take place in Belgrade, April 8-12.

The post NGOs Blast US for Undermining Criminal Court appeared first on Inter Press Service.

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Representatives said that civil society and concerned citizens worldwide have started to respond with “renewed determination” to the unprecedented challenges facing the world, and that this resolve will be in the spotlight during International Civil Society Week (ICSW). Pictured here is a protest by France’s Gilets Jaunes (or Yellow Vests) from earlier this year. Credit: Olivier Ortelpa/CC By 2.0

By A. D. McKenzie
PARIS, Apr 7 2019 (IPS)

Amid rising attacks on rights campaigners, and mass protests in countries such as France and Serbia, civil society groups are urging governments to ensure the protection of “democratic values” and freedom of expression.

In Belgrade, some 850 human rights campaigners, civil society leaders and engaged citizens will meet Apr. 8 to 12 for the annual International Civil Society Week (ICSW) – a gathering co-hosted by the Johannesburg-based global civil society alliance CIVICUS and Serbian association Civic Initiatives, with the support of the Balkans Civil Society Development Network.

Under the theme, “The Power of Togetherness”, ICSW 2019 “seeks to generate deep conversations among civil society leaders, social justice advocates, development practitioners, members of the philanthropic community, diplomats and others on emerging global challenges and how civil society should be responding to these,” said Mandeep Tiwana, CIVICUS’ chief programmes officer.

“Defence of democratic values, civic space and participation, along with citizen action, will be among the topics of discussion,” he told IPS in an email interview while en route to Belgrade.

“Our message to governments is that the right to peaceful protest is a basic human right enshrined in constitutional and international law. Governments have an inherent responsibility to enable the right to peaceful protest as an integral element of the defence of democracy,” he added.

The ICSW meeting comes at a time when human-rights organisations, campaigners and media workers in many regions have experienced growing repression, including arrests, beatings and killings that have shocked and outraged international observers.

“In country after country, democracy is under attack, with populist and right-wing movements gaining ground and democratic regression being witnessed even in countries historically considered bastions of democracy,” CIVICUS says.

“Activists, journalists and people who speak out against growing restrictions are persecuted. A historic rise of populist leaders continues to erode fundamental freedoms, heightening political polarisation and sowing division,” the group adds.

Representatives said that civil society and concerned citizens worldwide have started to respond with “renewed determination” to the unprecedented challenges facing the world, and that this resolve will be in the spotlight during ICSW, which includes a large youth participation.

“This year’s event in Serbia comes at a critical and opportune time for civil society and the world’s citizens to realise the power of unified, collective action to challenge a global trend that threatens our fundamental freedoms,” said Lysa John, CIVICUS’ Secretary General.

The discussions will take place against a backdrop of unrest in various countries: massive public demonstrations have been continuing in Serbia, for instance, while France’s Gilets Jaunes (or Yellow Vests) marched again on Apr. 6 in Paris and other cities for the 21st weekend in a row.

This latest French strife began last November in response to fuel price increases, and the demonstrators say they won’t give up until their demands are met for a restructuring of French society so that the “elite” aren’t always in charge.

During earlier marches, rights groups such as Amnesty International and Human Rights Watch criticised the French police for using “excessive force” and “heavy-handed” crowd control and anti-riot measures.

But some protestors have also participated in violence, looting and the targeting of media professionals, as reporters covering the marches have come under attack.

Media workers, in fact, often find themselves between a rock and a hard place, caught amongst the security forces and protestors as they try to report on turbulent events. CIVICUS said that the role of the media and their relationship with civil society will be a key topic of discussion at ICSW, alongside the focus on protecting rights campaigners.

“CIVICUS is working in several ways to stop attacks on members of the media and civil society activists targeted for exposing rights violations or speaking truth to power,” Tiwana said. “We engage with a broad range of civil society organisations that support press freedom using several approaches ranging from in-depth participatory research and analysis to raising awareness of attacks on the media, strategic coalition building, and directly engaging decision-makers at the national and international levels.”

He told IPS that joint efforts had contributed to the “release of journalists and the scrapping of repressive bills that restrict media freedoms” in some instance, while in others the efforts had “helped put serious  violations of media freedoms on the UN’s radar through its various human rights mechanisms”.

The choice of Serbia’s capital as the 2019 ICSW venue will draw attention to current protests and also recall the bloody recent history of the Balkans, highlighting the need for international vigilance in protecting rights, according to civil society groups.

“During the 1990s, authoritarian regimes produced conflicts, severe human rights violations and genocide. Today, as we approach European Union membership, internal and international independent monitoring mechanisms show shrinking media freedoms, a lack of separation of power and rule of law, and deterioration of freedom of elections,” stated Maja Stojanovic, of Civic Initiatives.

“This region, and particularly Serbia, demonstrates that changing laws, strategies or governments offers no guarantees – democracy does not exist if it is not built constantly. By hosting this year’s event in Belgrade, we will convene and send messages rooted in local circumstances and, in the same time, fully reflecting global challenges,” she said.

Ahead of the meeting, Serbia and four other countries have been added to a global watchlist of countries that have seen an “escalation in serious threats to fundamental freedoms in recent weeks and months”, according to CIVICUS Monitor, an online platform that tracks threats to civil society across the world.

Citizens of all five countries (Afghanistan, Saudi Arabia, Sudan, and Venezuela are the others) are experiencing increasing rights violations that “include killings, attacks on protesters, media restrictions and arbitrary detentions of human rights defenders”.

“It is deeply concerning to see escalated threats to basic rights in these countries,” said Marianna Belalba Barreto, CIVICUS’ Civic Space Research Lead.

“It is critical that these five governments wake up to their failure to respect international law and take swift action to respect their citizens’ most basic freedoms in a democratic society,” Belalba said.

CIVICUS is also calling upon “neighbouring states and international bodies to put pressure on these countries to end the repression”.

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The post Civil Society Leaders Meet Amid Protests, Attacks on Rights appeared first on Inter Press Service.

Excerpt:

This article is part of a series on the current state of civil society organisations (CSOs), which will be the focus of International Civil Society Week (ICSW), sponsored by CIVICUS, and scheduled to take place in Belgrade, April 8-12.

The post Civil Society Leaders Meet Amid Protests, Attacks on Rights appeared first on Inter Press Service.

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