Tag: community

  • The economic cost of female genital mutilation

    The economic cost of female genital mutilation

    An interactive data tool launched by WHO reveals for the first time the current and future financial cost of health care for women living with conditions caused by female genital mutilation (FGM).

    The total costs amount to USD 1.4 billion annually.

    fgm-cost-thumbnail

    The FGM Cost Calculator is being launched on this year’s International Day of Zero Tolerance for FGM. This new tool shows that if FGM were abandoned now the associated savings
    in health costs would be more than 60% by 2050. This data, available for 27 of the 30 countries where FGM is practiced, will strengthen the economic argument of community activists, policy makers, programme planners and donors working to end this
    human rights violation.

    Q&As on the FGM Cost Calculator
    Access the FGM Cost Calculator

    A human rights violation with economic costs

    FGM includes procedures that intentionally alter or cause injury to the female genital organs for non-medical reasons. More than 200 million girls and women alive today have been cut in 30 countries in Africa, the Middle East and Asia where FGM is concentrated.
    [1] An extreme form of gender discrimination, it is recognized internationally as a violation of the human rights of girls and women: including the right to health, security and physical integrity and the right to be free from torture and cruel, inhuman
    or degrading treatment.

    FGM has no health benefits and causes only harm. Women and girls who are subjected to FGM are at risk of both short- and long-term negative health consequences – including for their physical, sexual, mental, and social well-being.

    The direct financial cost of treating the negative health complications caused by FGM can span generations, starting as early as childbirth. This puts a significant economic burden on health systems and national budgets, especially in countries with rates
    of FGM greater than 10%.

    Until now, there have been limited data on the financial costs associated with FGM, making it hard to demonstrate the cost-effectiveness of programmes and policies that can prevent FGM by 2030 – a global priority in the Sustainable Development Agenda.
    The new WHO Cost Calculator now provides an economic argument which can be used by those advocating for an end to FGM.

    Calculating health care costs of FGM

    Users of the new FGM Cost Calculator can choose a country and identify current costs of treating health conditions caused by FGM. Since the tool is interactive, it produces bespoke graphs showing the potential amount of money saved if FGM is prevented
    by a selected percentage.

    If no action is taken to prevent FGM, it is estimated that related health costs will soar by 50% by 2050, as populations grow and as more girls undergo the procedure.

    How it works

    The FGM Cost Calculator combines data on health risk associated with FGM, health costs and national FGM prevalence to analyze the economic impact on national health services of treating the consequences of these harmful practices.

    Health risk data were taken from a WHO database created for this analysis, pooling all available information from systematic reviews of health consequences of FGM. The following categories were used, each with a biological link to FGM: gynaecological,
    obstetric, urological, mental and sexual, as well as the immediate health complications that can result following the cutting.

    To be included in the calculator, a health condition needed to show evidence of increased risk when comparing women with and without FGM. It also needed to have a treatment which could be implemented and costed in the health sector.

    Health costs were calculated from the WHO One Health Tool and other data. The financial burden of treating selected health conditions was calculated at a national level.

    A strong case for investment in preventing FGM

    Rates of FGM have declined over the past 30 years, but not fast enough to keep up with population growth. If trends continue, the number of girls and women undergoing FGM will rise significantly in the next 15 years, in turn raising national health care
    costs of caring for them.

    Additional resources are urgently needed to scale up interventions that can prevent FGM in the future and reduce health complications.

    By providing quantifiable numbers on the cost of treating health conditions directly linked to FGM, for the first time, the FGM Cost Calculator can be a crucial tool in building an investment case for a future where no girl or woman is cut.


    [1] Female Genital Mutilation/Cutting: A Global Concern, UNICEF, New York, 2016
    The economic cost of female genital mutilation
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    https://www.who.int/news-room/detail/06-02-2020-economic-cost-of-female-genital-mutilation

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  • Statement on the meeting of the International Health Regulations (2005) Emergency Committee for Ebola virus disease in the Democratic Republic of the Congo on 12 February 2020

    Statement on the meeting of the International Health Regulations (2005) Emergency Committee for Ebola virus disease in the Democratic Republic of the Congo on 12 February 2020

    The meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (IHR) (2005) to review the current Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo (DRC) took place on Wednesday, 12 February 2020, from 14:00 to 16:45 Geneva time (CEST).

    Proceedings of the meeting

    Members and advisors of the Emergency Committee were convened by teleconference.

    The Secretariat welcomed the Committee and thanked them for their support. The meeting was turned over to the Chair, Dr Robert Steffen.

    Dr Steffen also welcomed the Committee and gave the floor back to the Secretariat.

    Representatives of WHO’s legal department and the department of compliance, risk management, and ethics briefed the Committee members on their roles and responsibilities.

    Committee members were reminded of their duty of confidentiality and their responsibility to disclose personal, financial, or professional connections that might be seen to constitute a conflict of interest. Each member who was present was surveyed and no conflicts of interest were judged to be relevant to the meeting.

    The Chair then reviewed the agenda for the meeting and introduced the presenters.

    Presentations were made by representatives of the Ministry of Health of the Democratic Republic of the Congo (DRC), the WHO Secretariat, and the UN Ebola Emergency Response Coordinator.

    The current situation in the DRC was reviewed. As of 10 February 2020, there were a total of 3431 cases, of which 3308 were confirmed and 123 were probable. 2253 persons have died (66%). Between 3 and 9 February 2020, three new confirmed cases were reported in Beni Health Zone, North Kivu. These three cases were already registered as contacts and two were under surveillance at the time of detection. More than 2000 contacts are being followed. There has been an increase in the number of security incidents in recent months.

    Challenges that remain include: strengthening of community acceptance for full commitment to response measures; protection of personnel at strategic health checkpoints; improvement of infection prevention and control practices in health facilities; strengthening of the local health system; and comprehensive treatment and support for patients in recovery.

    The WHO Secretariat gave an overview of the epidemiological situation, which shows an overall encouraging trend in case incidence and geographic spread. It was noted that sustaining this progress depends on the security situation and control of the well-known drivers of transmission, particularly in traditional health facilities, and on continued trust and communication with the community.

    A risk communication and community engagement programme has been developed, as has an EVD survivors programme. It is critical to ensure the long-term sustainability of these two initiatives.   

    The situation in countries neighbouring DRC was reviewed, as was preparedness in nonaffected areas of DRC. An EVD operational readiness standardized approach has been implemented in 9 priority countries. More than 2400 alerts have been investigated, and more than 14,600 health workers have been vaccinated.

    The UN Ebola Emergency Response Coordinator gave a brief report on operational support, focused on security challenges and preparations for any resurgence of disease.

    Context and Discussion

    The Committee noted a great deal of progress in the situation since its last meeting and commended the response, under the leadership of the DRC Ministry of Health and the multisectoral coordination commission established in July 2019. Support provided by WHO, UN agencies, nongovernmental organizations and other partners has also contributed to limiting the spread and impact of this virus in a difficult context. An increase in the number of alerts was attributed to strong and proactive community surveillance.

    Conclusions and Advice

    It was the unanimous view of the Committee that this event still constitutes a public health emergency of international concern (PHEIC) under the IHR (2005).

    The Committee acknowledged the revised risk assessment, which puts the risk now as high at national and regional levels, and low at the global level.

    The Committee was concerned that withdrawing the PHEIC now might have adverse consequences for the response efforts through diminishing focus. Additionally, although the primary concern of the Committee is EVD, there are serious ongoing outbreaks of other diseases, including measles and cholera, in DRC. The country continues to need support to combat infectious diseases as well as to strengthen its health system. Further, there remains an urgent need to maintain international solidarity for the response.

    The Committee noted the ongoing discussions about the interpretation in the text of the IHR (2005) of the terms international and regional spread, and about creating an intermediate level of response between the binary possibilities of PHEIC or no PHEIC, in a way that does not require reopening negotiations on the Regulations. The Committee supports these discussions, as an intermediate level would be as useful for gradually ending a PHEIC and for signaling the potential for one to be declared.

    The Committee provided the following advice to the Director-General for his issuance as revised Temporary Recommendations under the IHR (2005).

    For DRC:

    • Sustain the political commitment and multisectoral coordination approach to the response.
    • Continue to engage and build trust with associations of survivors to facilitate rapid detection of any cases arising from exposure to infected bodily fluids of survivors.
    • Continue to strengthen capacity, implementation, and coordination for community awareness and engagement, including a focus on hotspots, preventing resurgence where cases have declined, and to support survivors in their communities.
    • Further enhance the acceptance of response measures and address access and security issues by engaging influencers and decision makers for all interventions.
    • Strengthen measures to prevent and manage nosocomial infections, including systematic mapping of health facilities, targeting of IPC interventions and sustain support to those facilities through monitoring and supervision, including in private-sector and traditional health facilities.
    • Continue cross-border screening and step up monitoring at checkpoints around hotspots and at main roads.
    • Continue to implement and share real-time full-genome genetic sequencing of all new confirmed cases.
    • Strengthen measures to prevent and manage nosocomial infections, including systematic mapping of health facilities, targeting of IPC interventions and sustain support to those facilities through monitoring and supervision.
    • Strengthen preparedness in non-affected provinces of DRC, and more generally strengthen the health system across the country to respond to concurrent health emergencies.
    • Continue to implement optimal vaccine strategies that have proven maximum impact on curtailing the outbreak, as recommended by WHO’s Strategic Advisory Group of Experts (SAGE).

    For countries at risk:

    • At-risk countries should maintain their work with partners to improve their preparedness for detecting and managing imported or locally acquired cases, including the transparent sharing of detailed information on suspect cases, as required by the International Health Regulations (2005), and sharing laboratory samples of suspect cases for confirmatory testing in accordance with WHO norms and guidance.
    • Countries should continue to map population movements and sociological patterns that can predict risk of disease spread.
    • Risk communications and community engagement, especially at points of entry, should be maintained.

    For all countries:

    • As recommended previously, no country should close its borders or place any restrictions on travel and trade.
    • The Committee does not consider entry screening at airports or other ports of entry outside the region to be necessary.

    The Committee emphasized the importance of continued support by WHO and other national and international partners towards the effective implementation and monitoring of these recommendations.

    Based on this advice, the reports made by the affected State Party, and the currently available information, the Director-General accepted the Committee’s assessment and on 12 February 2020 maintained the Ebola outbreak in the Democratic Republic of the Congo as a Public Health Emergency of International Concern (PHEIC).

    The Director-General endorsed the Committee’s advice and issued them as Temporary Recommendations under IHR (2005) to reduce the international spread of Ebola, effective 12 February 2020. The Director-General thanked the Committee Members and Advisors for their advice and requested their reassessment of this situation within two months or earlier if the situation requires.

    Statement on the meeting of the International Health Regulations (2005) Emergency Committee for Ebola virus disease in the Democratic Republic of the Congo on 12 February 2020
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  • World experts and funders set priorities for COVID-19 research

    World experts and funders set priorities for COVID-19 research

    Leading health experts from around the world have been meeting at the World Health Organization’s Geneva headquarters to assess the current level of knowledge about the new COVID-19 disease, identify gaps and work together to accelerate and fund priority research needed to help stop this outbreak and prepare for any future outbreaks.

    The 2-day forum was convened in line with the WHO R&D Blueprint – a strategy for developing drugs and vaccines before epidemics, and accelerating research and development while they are occurring.

    “This outbreak is a test of solidarity — political, financial and scientific. We need to come together to fight a common enemy that does not respect borders, ensure that we have the resources necessary to bring this outbreak to an end and bring our best science to the forefront to find shared answers to shared problems. Research is an integral part of the outbreak response,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “I appreciate the positive response of the research community to join us at short notice and come up with concrete plans and commitment to work together.”

    The meeting, hosted in collaboration with GloPID-R (the Global Research Collaboration for Infectious Disease Preparedness) brought together major research funders and over 300 scientists and researchers from a large variety of disciplines. They discussed all aspects of the outbreak and ways to control it including:

    • the natural history of the virus, its transmission and diagnosis;
    • animal and environmental research on the origin of the virus, including management measures at the human-animal interface;
    • epidemiological studies;
    • clinical characterization and management of disease caused by the virus;
    • infection prevention and control, including best ways to protect health care workers;
    • research and development for candidate therapeutics and vaccines;
    • ethical considerations for research;
    • and integration of social sciences into the outbreak response.

    “This meeting allowed us to identify the urgent priorities for research. As a group of funders we will continue to mobilize, coordinate and align our funding to enable the research needed to tackle this crisis and stop the outbreak, in partnership with WHO,” said Professor Yazdan Yazdanpanah, chair of GloPID-R. “Equitable access – making sure we share data and reach those most in need,  in particular those in lower and middle-income countries, is fundamental to this work which must be guided by ethical considerations at all times.”  

    During the meeting, the more than 300 scientists and researchers participating both in person and virtually agreed on a set of global research priorities. They also outlined mechanisms for continuing scientific interactions and collaborations beyond the meeting which will be coordinated and facilitated by WHO. They worked with research funders to determine how necessary resources can be mobilized so that critical research can start immediately.

    The deliberations will form the basis of a research and innovation roadmap charting all the research needed and this will be used by researchers and funders to accelerate the research response.

    Note to editors

    GloPID-R is a global alliance of international research funding organizations investing in preparedness and response to epidemics.

    World experts and funders set priorities for COVID-19 research
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  • Pregnancy and breastfeeding during an Ebola virus outbreak

    Pregnancy and breastfeeding during an Ebola virus outbreak

    Women who are pregnant or breastfeeding in an Ebola outbreak face similar challenges as other population groups, but they have specific health needs which must be met.

    As the second largest Ebola outbreak in history continues in the Democratic Republic of Congo, WHO has released new clinical guidelines for healthcare providers supporting pregnant or breastfeeding women in the context of Ebola virus disease.

    Improving clinical care and reducing mortality

    92-4-000138-1Clear and coherent guidance is needed to meet the combined needs of women requiring Ebola treatment, pregnancy care and management of complications.

    Information on how to protect breastfeeding children and other members in the community from transmission of the disease is also critical.

    Limited scientific evidence on how to best manage these needs has previously been a challenge for affected countries. In addition, misconceptions that pregnant women have a higher mortality rate than other populations with Ebola may in some contexts have put pregnant women at risk of not receiving standard care.

    WHO’s Guideline on the management of pregnant and breastfeeding women in the context of Ebola virus reviews existing evidence and provides a single set of recommendations on the care continuum for women exposed to, diagnosed with, or recovered from Ebola.

    This will enable healthcare providers, emergency response teams and health policy-makers to improve prevention and treatment measures in an Ebola outbreak.

    Obstetric care at an Ebola Treatment Centre

    Optimal supportive care should be offered to all pregnant women with Ebola. Likewise, they should be offered experimental treatment and vaccination under the same conditions as non-pregnant populations.

    Ebola virus disease does increase the risk of miscarriage and early labour, requiring close clinical management at Ebola treatment centres. It is important to engage both obstetric providers and those trained in Ebola response.

    This dual expertise is also important because early Ebola and pregnancy-related symptoms can overlap. Pregnant women should be prioritised for testing to confirm an Ebola infection.

    Ebola virus can persist in pregnancy related fluids as well as breastmilk. If healthcare providers are not clear on how to manage Ebola infection risk, they may be less willing to provide care. This stigma can be life-threatening for women who experience complications during delivery.

    The new WHO guidelines advise healthcare workers on how to protect themselves while caring for pregnant women with Ebola virus disease. This includes induced labour or surgical procedures, which carry greater risk of transmission in cases of acute infection. Any invasive treatments should be carried out in full personal protective equipment.

    Breastfeeding recommendations in an Ebola outbreak

    WHO recommends that women with suspected or confirmed Ebola immediately stop breastfeeding and are prioritised for diagnostic testing. Any child exposed to Ebola through breast milk should be placed into safe care, closely monitored for symptoms over a 21-day period and fed with an appropriate breast milk substitute.  

    The guidelines strongly recommend that breastfeeding is only restarted following two consecutive negative tests of breast milk, separated by 24 hours.

    A breast milk substitute should be used even if infection is confirmed for both the mother and her child. Exceptions can be made for infants under 6 months of age who are already infected, if breast milk substitutes are not feasible, affordable, sustainable or safe and separation cannot be implemented safely.

    Women’s health and rights in a disease outbreak

    A disease outbreak does not change women’s and adolescent girls’ fundamental human right to sexual and reproductive healthcare, including evidence-based care during pregnancy and childbirth.

    Women need support to make informed reproductive health care choices for themselves and their children. Women living in an Ebola outbreak should have access to all relevant reproductive options, regardless of economic, cultural, racial or religious status, including contraception and safe abortion to the full extent of the law.

    Pregnant and breastfeeding women across affected communities need equitable and respectful care that considers the risks they face and supports the choices they make.

    Accessing the guidelines and further research

    These guidelines are now available online and may be freely downloaded. The executive summary will be available in French.

    WHO will closely monitor new data as it emerges, as there is still a pressing need to prioritise ongoing research related to Ebola virus transmission.

     

     

     

    Pregnancy and breastfeeding during an Ebola virus outbreak
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  • Online training as a weapon to fight the new coronavirus

    More than 25 000 people across the globe have accessed real-time knowledge from WHO experts on how to detect, prevent, respond to and control the new coronavirus in the 10 days since the launch of an open online training.

    The learning team of the WHO Health Emergencies Programme worked with technical experts to quickly develop and publish the online course on 26 January – 4 days before the 2019-nCoV outbreak was declared a public health emergency of international concern.

    Approximately 3000 new users have registered for the training every day since its launch, demonstrating the high level of interest in the virus among health professionals and the general public. In addition, more than 200 000 people have viewed the introductory video to the course on YouTube.

    The high engagement levels emerged as the international community launched a US$675 million preparedness and response plan to fight further spread of the new coronavirus and protect states with weaker health systems.

    The free learning resource is available to anyone interested in novel coronavirus on WHO’s open learning platform for emergencies, OpenWHO.org. The platform was established 3 years ago with emergencies such as nCoV in mind, in which WHO would need to reach millions of people across the globe with real-time, accessible learning materials.

    The online training – entitled “Emerging respiratory viruses, including nCoV: methods for detection, prevention, response and control” – is currently being produced in all official UN languages and Portuguese.

    “Our job is to work with technical health experts to package knowledge using adult learning principles, quickly so that it is most useful to health workers and our staff,” said Heini Utunen, who manages OpenWHO for the WHO Health Emergencies Programme (WHE). “Our online platform – OpenWHO – is already accessed by users from every country on earth, providing more than 60 courses in 21 languages. Delivering trainings in the local language of responders is really important, especially in an emergency”.    

    WHE has been investing in learning and training to strengthen preparedness and real-time response to health emergencies. The programme developed its first-ever learning strategy in 2018 and has a small dedicated Learning and Capacity Development Unit that allows WHE to develop trainings quickly and get know-how to those who most need it at the front line.  

    For the latest information on the new coronavirus, visit the 2019-nCoV page.

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    https://www.who.int/news-room/detail/07-02-2020-online-training-as-a-weapon-to-fight-the-new-coronavirus

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  • WHO to accelerate research and innovation for new coronavirus

    WHO to accelerate research and innovation for new coronavirus

    WHO is convening a global research and innovation forum to mobilize international action in response to the new coronavirus (2019-nCoV). 
    “Harnessing the power of science is critical for bringing this outbreak under control,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “There are questions we need answers to, and tools we need developed as quickly as possible. WHO is playing an important coordinating role by bringing the scientific community together to identify research priorities and accelerate progress.”
    The forum, to be held 11-12 February in Geneva, is organized in collaboration with the Global Research Collaboration for Infectious Disease Preparedness.
    The forum will bring together key players including leading scientists as well as public health agencies, ministries of health and research funders pursuing 2019-nCoV critical animal health and public health research and the development of vaccines, therapeutics and diagnostics, among other innovations. 
    Participants will discuss several areas of research, including identifying the source of the virus as well as sharing of biological samples and genetic sequences.
     
    Experts will build on existing SARS and MERS coronavirus research and identify knowledge gaps and research priorities in order to accelerate scientific information and medical products most needed to minimize the impact of the 2019-nCoV outbreak.  
    The meeting is expected to produce a global research agenda for the new coronavirus, setting priorities and frameworks that can guide which projects are undertaken first. “Understanding the disease, its reservoirs, transmission and clinical severity and then developing effective counter-measures is critical for the control of the outbreak, to reduce deaths and minimize the economic impact,” said Dr. Soumya Swaminathan, WHO Chief Scientist.
    This will also fast-track the development and evaluation of effective diagnostic tests, vaccines and medicines, while establishing mechanisms for affordable access to vulnerable populations and facilitating community engagement.
    “The WHO R&D Blueprint is a global strategy and preparedness platform that drives coordinated development of drugs and vaccines before epidemics, and allows the rapid activation of R&D activities during epidemics. It speeds up the availability of the diagnostics, vaccines and treatments and technologies that ultimately save lives,” added Dr Michael Ryan, Executive Director, WHO Health Emergencies Programme.  
    Setting clear global research priorities for the novel coronavirus should lead to more efficient investments, high-quality research and synergies among global researchers.

    WHO to accelerate research and innovation for new coronavirus
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  • US$675 million needed for new coronavirus preparedness and response global plan

    US$675 million needed for new coronavirus preparedness and response global plan

    To fight further spread of the new coronavirus (2019-nCoV) outbreak in China and globally, and protect states with weaker health systems, the international community has launched a US$675 million preparedness and response plan covering the months of February through to April 2020.

    “My biggest worry is that there are countries today who do not have the systems in place to detect people who have contracted with the virus, even if it were to emerge,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Urgent support is needed to bolster weak health systems to detect, diagnose and care for people with the virus, to prevent further human to human transmission and protect health workers.”

    The Strategic Preparedness and Response Plan (SPRP) for the new coronavirus lays out activities and resources needed by international health organizations globally, including WHO, to implement priority public health measures in support of countries to prepare and respond to nCoV-2019 for a period February-April 2020. The objectives of the plan are to  limit human-to-human transmission of the virus, particularly in countries most vulnerable if they were to face an outbreak; identify, isolate and care for patients early; communicate critical risk and event information; minimize social and economic impact; reduce virus spread from animal sources; and address crucial unknowns.

    The plan focuses on:

    • Rapidly establishing international coordination and operational support;
    • Scaling up country readiness and response operations;
    • Accelerating priority research and innovation.

    “The effectiveness of outbreak response depends on the preparedness measures put in place before outbreaks strike,” said Dr Mike Ryan, head of WHO’s Health Emergencies Programme. “That is why we are seeking resources to safeguard the most vulnerable countries to protect people from the new coronavirus before it arrives on the doorstep.”

    As noted in the SPRP, WHO assesses that the outbreak poses a very high risk in China, and high risk regionally and globally. The risk assessment was based on factors including the likelihood of further spread, the potential impact on human health, and the varying levels of effectiveness in national preparedness and response measures. Accelerated action, as called for in the plan, can address these risks and areas requiring support.

    As of 10 a.m. Central European Time on 5 February, 25 countries have reported confirmed cases of the new coronavirus, including China, where 24,363 people had contracted the virus, or over 99% of all cases. In all other countries, 191 cases have contracted the virus.

    US$675 million needed for new coronavirus preparedness and response global plan
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    https://www.who.int/news-room/detail/05-02-2020-us-675-million-needed-for-new-coronavirus-preparedness-and-response-global-plan

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  • Unleashing Youth Power:A Decade of Accelerating Actions Towards Zero Female Genital Mutilation

    Joint statement by UNFPA Executive Director Dr Natalia Kanem, UNICEF Executive Director Henrietta Fore and UN Women Executive Director Phumzile Mlambo-Ngcuka and WHO Director-General Dr Tedros Adhanom Ghebreyesus on the occasion of International Day of Zero Tolerance for Female Genital Mutilation

    – “When Tabitha was growing up in rural Kenya, most of her 16-year-old peers were subjected to female genital mutilation – a human rights violation that more than 4 million girls worldwide are at risk of this year. Yet Tabitha remains unharmed, thanks to the unwavering support of her parents, who, in spite of enormous social pressure, saved their daughter from the same fate. 

    “On the International Day of Zero Tolerance for Female Genital Mutilation, we join with Tabitha and young people around the world who are standing up for their rights with urgency and energy. They are engaging their peers, families, communities and governments with a call to end this harmful act of gender-based violence once and for all, as promised by the international community in the 2030 Agenda for Sustainable Development.

     “While significant progress in eliminating the practice has been made in the last 30 years, approximately 200 million girls and women alive today have had their genitals mutilated. This can lead to long-term physical, psychological and social consequences.        

    “Support for the practice is dwindling. Adolescent girls aged 15 to 19 in countries where female genital mutilation is prevalent are less supportive of continuing the practice than are women aged 45 to 49. And in many countries, young girls are at much lower risk of being subjected to female genital mutilation than their mothers and grandmothers were. However, rapid youth population growth in countries where female genital mutilation is prevalent could lead to a significant rise in the number of girls at risk by 2030.

    “Today’s young people can play a critical role in ending the practice. Unleashing the power of youth means investing in youth-led movements to champion gender equality, an end to violence against women and girls and the elimination of harmful practices. This requires including young people as partners when designing and implementing national action plans, building relationships with youth-led organizations and networks that work to end female genital mutilation and recognize it as a form of violence against women and girls, empowering young people to lead community campaigns that challenge social norms and myths, and engaging men and boys as allies.

    “But this is not a goal young people can achieve alone, nor can it be addressed in isolation from other forms of violence against women and girls or from gender inequality. It also requires strong political leadership and commitment.

    “Last year, at the Nairobi Summit on ICPD25, governments, civil society, faith-based organizations and private companies recommitted to ending gender-based violence and harmful practices – such as female genital mutilation – in 10 years, the same timeframe for achieving the Sustainable Development Goals. In March, we mark 25 years since the Beijing Platform for Action, a global commitment to advance women’s rights across 12 critical areas, including the elimination of all harmful practices against girls and women. This year, we will announce the creation of a new Generation Equality to drive further investment and results for gender equality.

     

    “Now is the time to invest, translating the political commitments already made into concrete action. Now is the time to do more and do it better and faster to end the practice once and for all. Now is the time to keep our promise to Tabitha and all girls of reaching zero female genital mutilation by 2030.”

     

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    https://www.who.int/news-room/detail/06-02-2020-unleashing-youth-power-a-decade-of-accelerating-actions-towards-zero-female-genital-mutilation

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  • Changes needed to increase access to colorectal cancer screening

    Changes needed to increase access to colorectal cancer screening

    Colorectal cancer is the second highest cause of cancer death in the United States, expected to claim the lives of an estimated 49,190 people in 2016. The Affordable Care Act (ACA) aimed to increase access to CRC screening by not holding patients responsible for all costs of the procedure, yet current Medicare insurance beneficiaries lacking supplemental insurance may not be able to afford colon cancer screening and treatment. This policy disproportionally puts low-income Americans at risk and adds unnecessary strains on overall health care costs, according to a commentary in the May issue of the journal Gastroenterology.

    “Study after study shows that screening saves lives,” said Chyke A. Doubeni, MD, MPH, chair and the Presidential Associate Professor of Family Medicine and Community Health at the Perelman School of Medicine at the University of Pennsylvania, and lead author of the commentary. “Yet many of those in the group most affected by this deadly disease are unable to afford the screening they critically need. We must renew efforts to ensure equitable access to and use of disease prevention, detection, and treatment services for colorectal cancer.”

    For CRC screening, a full colonoscopy is necessary, where the doctor inspects the rectum and entire colon through a flexible lighted tube, and can remove any abnormal growth. The entire colon has to be cleansed before the colonoscopy, for which the patient is usually sedated

    There are currently an estimated 55.5 million Medicare beneficiaries in the U.S. A 2010 Kaiser Family Foundation survey found that 14 percent lacked supplemental coverage. Until recently, colon cancer screening has been viewed as a one-time activity, while in practice, screening is a series of clinical activities to identify and test patients and perform diagnostic confirmation when necessary. This series of tests and steps include a diagnostic workup, which can include a biopsy to obtain a tissue sample or polypectomy, in which polyps are removed to prevent them from becoming cancerous.

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  • Spinoza’s Ethics of Strength of the Emotions in W Somerset Maughm’s Of Human Bondage

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    The writer probes on the complex world of W. Somerset Maughm’s protagonist in the novel Of Human Bondage, using the propositions the Jewish Portuguese philosopher Baruch Spinoza postulated in his book Ethics in 1674. Some of Spinoza’s propositions are as follows( Morgan, 2006, pp 108-120):

    The following propositions of Spinoza enlighten the changing character of Philip in his own bildungsromans of his life. The force and increase of any passive emotion and its persistence in existing is defined not by the power whereby we ourselves endeavour to persist in existing, but by the power of external causes compared with our own power;

    The force of any passive emotion can surpass the rest of man’s activities or power so that the emotion stays firmly fixed in him;

    An emotion cannot be checked or destroyed except by a contrary emotion which is stronger than the emotion which is to be checked;

    Knowledge of good and evil is nothing other than the emotion of pleasure or pain insofar as we are conscious of it;

    An emotion whose cause we think to be with us in the present is stronger than it would be if we did not think the said cause to be with us;

    We are affected toward a future thing which we imagine to be imminent mo intensely than if we were to imagine its time of existence tofarther away from the present. We are also affected by a remembrance of a thing we imagine to belong to the near past more intensely if we were to imagine it to belong to the distant past;

    An emotion toward a thing which we think of as inevitable [necessarius] is more intense, other things being equal, than emotion toward a thing possible or contingent, that is, not inevitable;

    Emotion toward a thing which we know not exist in the present, and which we imagine to be possible, is, other things being equal, more intense than emotion toward a contingent thing;

    Emotion toward a contingent thing which we know not to exist in the present, is, other things being equal, feebler than emotion toward a thing past;

    No emotion can be checked by the true knowledge of good and evil, insofar as it is true, but only insofar as it is;

    Desire that arises from the true knowledge of good and evil can be extinguished or checked by many other desires that arise from the emotions by which we are assailed;

    The desires that arises from a knowledge of good and evil insofar as this knowledge has regard to to the future can be the more easily checked or extinguished by desire of things that are attractive in the present;

    Desire that arises from the true knowledge of good and evil insofar as this knowledge is concerned with contingent things can be even more easily checked by desire for things which are present;

    Desire arising from pleasure is, other things being equal, stronger than desire arising from pain;

    Every man, from the laws of his nature, necessarily seeks or avoids what he judges to be good or evil.

    The more every man endeavours and is able to seek advantage, that is, to preserve his own being, the more he is endowed with virtue. On the other hand insofar as he neglects to preserve what is to his advantage, that is, his own being to that extent he is weak.

    Philip is highly affected by nature. There is in Nature no individual thing that is surpassed in strength and power by some other thing. Whatsoever thing there is, there is another more powerful by which the said thing can be destroyed. And he was able to surpass all his problems because of the incoming different emotions, problems which proved to make him stronger if not released from “Human Bondage”.

    The force whereby a man persist in existing is limited, and infinitely surpassed by the power of external causes.

    Philip’s deformity limits his own persistence to live. But his meeting with Hayward, Clutton and Lawson, his former classmates in France, who taught him that life is all about passion and the pursuit of it, he became engross in his art. France did not also care about his clubfoot. Cronshaw taught him more philosophy in life about living in let live. Cronshaw even on his death bed, defied doctors’ prohibition. His life is anyway to end just like any other’s lives.

    Set in Kent, England, a sub-urban near London, the novel presents the multifaceted personal, social, political and religious experiences of Philip carey from his childhood to his middle age of thirty. A bildungsroman (1991, Smiley) in style, which highlights the formation of a youngman’s character through education, travels and early life experiences. Philip at the age of nine, as a young boy, is set apart from his peers by some misfortune and undergoes a humiliating experience that later proves strengthening. his first experience of love is unsuccessful or problematic one that nevertheless paves the way to a happy marriage with a suitable mate. The novel has ample observation, if not criticism, with the character’s institutions such as schools, churches and class structures.

    Philip’s personal life is truly an amalgam of life’s tragedies. But how he surpassed the seemingly insurmountable heap of oppressing weight, if not the meaninglessness or nothingness of life, is the focus of this attempt anchored on Spinoza’s propositions. To enumerate, at an early age, his mother died of tuberculosis and his father, a medical doctor, died of lung cancer. His innocence never understood the situation. He has only the temporary joy of travelling to Blackstable to live with his uncle William and childless Auntie Louisa. Forcibly liking his second family as an orphan, he is left reading his books without noise for his uncle, a Vicar in the community, is irated with children’s unruly behaviour. Aunt Louisa is incapable of understanding Philip. he is left with the care of the governess. His personal disability or deformity, being born with a club-foot, proves to be the stigma of his life forever. His early education in Kingston School, caused his early childhood bitter as his peers laughed at him, mocked and physically abused him because of his physical abnormality. Then, his adolescence which brings him to Heidelberg, Germany to study foreign languages, is never sweet. Girls chided him for his deformity. the consolation is meeting friends like Hayward and Miss Wilkinson, who flirted with him, to his disgust. His sojourn to France, albeit, his uncle’s disappointment, proves to be annihilating. His lack of talent in painting plus his deformity, made him a mediocre student. His classmate Fanny Price, who fell in love with him, on the pretext of sharing the same abnormality (hers is lack of beauty), committed suicide out of hunger and wretchedness.

    Then everything escalated to its height, when realizing that painting is not his passion, he goes back to England. He decides to change again to pursue what his uncle William tells him to do: to follow the footsteps of his father. To be a doctor. feeling he has nothing to do, he embraces the new idea. Sauntering along the Parliamentary Street of London, he is driven to dine in a cafe where he meets the slatternly waitress Mildred Rogers who awakens his sexual desire. But his languid mien, caused by his club-foot proves to be a disadvantage. the waitress prefers rugged and rich men. But his desire to pursue the pale, anaemic, aloof Mildred, beomes a challenge to him. Gradually, the two becomeclose. But the ambitious and materialistic waitress always insults him because of his deformity. to slander him cripple, would totally “cripple” his mood and emotion. Even when Philip is generous to the moody Mildred, she hurt him by marrying a German businessman Miller. His desperation is tantamount to his yearning for Mildred. He is left believing that one day, he would see Mildred again. His concentration with his medical study is forlorned. And Mildred came back,looking sickly, with a child. His generosity and forgiveness for his first love, who hurts him the most, is even greater than life. The ingrate waitress after a little recovery from poverty, elopes with Griffith, Philip’s handsome and robust classmate. That is the height of Mildred’s shamelessness. So her expected return is welcomed with derision by the newly awakened Philip. Even when Mildred turns into a prostitute, Philip is only capable of compassion, without passion or sexual desire. She is freed at last. And Philip is extricated from the pains excruciatingly caused by the destitute Mildred.

    His obsession to Mildred costs Philip his fortune and gradually his savings is left with seven pounds. He is forced to stop from his medical studies that brings him to experience unbelievable poverty. He meets the generous Athelneys who fed and sheltered him in his misery. His uncle’s death, leaving an average fortune, helps him to finish his medical studies. His fateful shelter with the Athelneys brings him to his final, harmonious and peaceful resolution to marry Sally Athelney and go on with his life beautifully. Shakespeare is affirmed by saying that “all is well that ends well.

    At this juncture, it is noteworthy to enumerate Spinoza’s propositions to elucidate Philip’s “bondage” and his strength of his emotion. Spinoza in his preface to his philosophical treatise wrote:

    I assign the term “bondage” to man’s lack of power to control and check the emotions. For a man at the mercy of his emotions is not his own master but is subject to fortune, in whose power he so lies that he is often compelled, although he sees the better course, to pursue the worse. In this Part I have set myself the task of demonstrating why is so, and also what is good and what is bad in emotions. But before I begin, I should like to make a few preliminary observations on perfection and imperfection, and on good and bad ( Morgan, 2006).

    In the beginning, Philip is a slave if not a victim of his emotion. His physical deformity, his club-foot, caused him too much pain. He learned to hate his classmates and,worst, abandoned his belief in God. He could not appreciate the God of his uncle vicar when God cannot give him the miracle he wanted to have normal feet. His painful childhood in school changed him to be rough character. He never wanted to become a vicar anymore. His obsession to Mildred indeed showed his real weakness as a man, and even wretchedness as a human being because of his deformity. he would always think that women cannot love him as he is because of his deformity.

    He who has undertaken something and has brought it to completion will say that the thing is completed; and not only he but everyone who rightly knew, or thought he knew, the intention and aim of the author of that work. For example, if anyone sees a work (which I assumed is not yet finished) and knows that the aim of author is to build a house, he will say the house is imperfect. On the other hand, as soon as he sees that the work has been brought to the conclusion that its author had intended to give it, he will say that the house is perfect. But if anyone sees a work whose like he had never seen before, and he does not know the artifecer’s intention, he cannot possibly know whether the work is perfect or imperfect.

    This appears to have been the original meaning of these terms. But when men began to form general ideas and to devise ideal type of houses, buildings, towers, and so on, and to prefer some models to others, it came about that each called “perfect” that which he saw at variance with his own preconceived ideal, although in the artifecer’s opinion it had been fully completed. There seems to be no other reason why even natural phenomena (those not made by human hand) should commonly be called perfect or imperfect. For men there are wont to form general ideas both natural phenomena and artifacts, and these ideas they regard as models, and they believed that Nature (which they consider does nothing without an end in view) looks to this ideas and holds them before herself as models. So when they see something occurring in Nature at variance with their preconceived ideal of the thing in question, they believed that Nature has then failed or blundered and has left that thing imperfect from their own preconceptions rather than from true knowledge.

    So perfection and imperfection are in reality only models of thinking, notions which we are wont to invent from comparing individuals of the same species or kind; and it is for this reason that I previously said (Def. 6, II) that by reality and perfection I mean the same thing. For we are wont to classify all the individuals in Nature under one genus which is called the highest genus, namely, the notion of Entity, which pertains to all the individuals in Nature without exception. Therefore insofar as we classify individuals in Nature under this genus and compare them with one another and find that some have more being or reality than others, to that extent we say that some are more perfect than the others. And insofar as we attribute to them something involving negotiation, such as limit, end, impotence and so on, to that extent we call them imperfect because they do not affect our minds as much as those we call perfect, and not because they lack something of anything except that which follows from the necessity of nature of its efficient cause; and whatever follows from the necessity of the nature of its efficient cause must be necessarily be so.

    To be a master of his emotion is to attain perfection. It may not be physical but spiritual, mental and emotional. His challenges may have hardened him but enlightened him to loosen up and later, embrace the beauty of life. The unattainable perfection, was answered, through his friend Cronshaw, a poet whom he met in France, that the meaning of life cannot be answered unless one lives it. he realized that men are born, study, work, marry, have children and die is the most beautiful pattern that the Persian rug edifies.

    As for the terms “good” and “bad,” they likewise indicate nothing positive in things considered in themselves, and nothing but models of thinking, or notions which we form from comparing things with one another. For one and the same thing can at the same time be good and bad, and also indifferent. For example, music is good for one who is melancholy, bad for one in mourning, and neither good or bad for the deaf. However, although this is so, these terms ought to be retained. For since we desire to form the idea of man which we may look to as model of human nature, we shall find it useful to keep these terms in the sense I have indicated. So in what follows I shall mean by “good” that which we certainly know to be the means for our approaching nearer to the model of human nature that we set before ourselves, and by “bad” that which we certainly know prevents us from reproducing the said model. For it is important to note that when I say somebody passes from a state of less perfection, to a state of greater perfection, and vice versa, I do not mean that he changes from one essence or to form to another (for example, a horse is as completely destroyed if it changes into a man as it would be if it were to change into an insect), but that we conceive his power of activity, insofar as this is understood through his nature, to be increased or diminished.

    Philip may have been both good and bad due to circumstances. he was good in the Blackstable with his Auntie Louisa and Uncle William. he became bad in school because his classmates taunted him because of his clubfoot. In Heidelberg, he is good to all the people even if he did not understand their silence and even their insolence. In France, was forced to become bad, to protect himself from the looming abuses of other foreigners. The death of an anti-social fanny Price, showed him to be the only compassionate painting student.

    Hence, after a series of Philip’s tragedy, his experiences, his meeting with different people, his education, his travel to Heidelberg, to Paris and to London, his affluence and reversal of his fortune to poverty taught him greatest lessons in life. That life can be beautiful if man knows to master his emotion, moderate his desire and be reasonable in every decision. A man is finally freed from the chains and cufflinks ” Of Human Bondage”.

    References:

    Maughm, Somerset W. (1991). Of Human Bondage.

    Canada: Bantam Book Doubleday.

    Morgan, Michael (ed.). (2006). The Essential Spinoza: Ethics And Related Writings.

    Cambridge: Hackett Publishing, Inc.

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    Source by Wilfredo M. Valois

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