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The unmet need for social context in family planning

New evidence on the relationship between sexual health and social context finds a strong association between gender equality, education and family planning

Twenty-five years ago, two global events – the International Conference on Population and Development and the Fourth World Conference on Women in Beijing – formally recognized that women’s health and reproductive choices cannot be separated from the social context of their lives.

Now, researchers have created a dataset which brings together national surveys from 74 countries, representing 3 million women. For the first time, it allows them to describe trends in demand/use of modern contraceptives alongside social and economic indicators.

The data is published in The Lancet Global Health and is authored by the London School of Hygiene & Tropical Medicine and the World Health Organization.

It shows that, over time, women are more likely to have their demand for modern contraception met in countries where gender equality and their educational opportunities improve.

Gender equality and education increases access to modern contraception

Trends in sexual activity and demand for use and use of modern contraceptive methods in 74 countries: a retrospective analysis of nationally representative surveys finds that met need for modern contraception is strongly correlated with positive shifts in social structures.
For every 0.1-point increase in a country’s gender development index, it found a 6.7% rise in women who were sexually active and did not want to conceive. Of those women, an additional 13.5% used modern methods to prevent a pregnancy.

Expectations of every girl’s right to education also made a difference. Each extra year in schooling is linked to an increase of 2.3% in demand, and a 4.7% increase in use of modern contraceptive methods.

“This study shows how every woman must negotiate her reproductive autonomy within the social framework in which she lives, responding to barriers and opportunities as they emerge,” says Dr Lale Say, one of the authors of the study and Unit Head at WHO and HRP.

“Gender equality is both a precondition and a driving force for securing women’s reproductive health and rights – as well as the sustainable development targets, which are our best chance for delivering health and well-being for all.”

Global trends reveal new challenges in family planning

Overall, the data reinforce global trends: more time spent sexually-active and single, postponement of parenthood, and the near-universal desire for smaller families.

The study also highlights where action is needed at country-level to avoid family planning services falling behind demand.

Out of the 74 countries analyzed, 42 showed an increase in demand for contraception. Only 37 countries show an increase in use of a modern method to prevent pregnancy.

Although unmet need for contraception declined in 34 countries, it increased in 14 countries. Significantly more progress is needed, and faster, to ensure each girl and woman is able to access the sexual and reproductive health services she needs.

Barriers and solutions to reproductive health and rights

Gender equality can affect contraceptive use in many ways. From the personal and political degree to which women are free to choose their sexual activity, to accessing family planning services it can also shape any power imbalances within personal relationships. This study supports recent efforts by WHO to adopt a broader, integrated concept of sexual and reproductive health – and to translate it into a framework for policy and practice.

The authors argue that family planning targets in the 2030 Agenda for Sustainable Development will not be met without a profound shift: from focus on ‘access to contraception’, to broader aspects of sexual health and social context.

Since reproductive health and women’s empowerment are intertwined, trends in contraceptive use can also reveal progress towards another global target: progress towards gender equality.

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https://www.who.int/news-room/detail/10-03-2020-the-unmet-need-for-social-context-in-family-planning

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March 11, 2020
Cervical cancer elimination initiative updates

February: Garnering international support on the path to eliminate cervical cancer

On
5 February, the WHO Executive Board recommended to the 73rd World
Health Assembly the adoption of the draft Global Strategy to accelerate
the elimination of
cervical cancer as a public health problem, and urged its
implementation. The proposed resolution urges Member States to implement
the strategy, calling for the support of international organizations
and other relevant stakeholders, and includes a request
for the Director General to support Member states in this endeavor.
The WHA will consider the resolution when it convenes in May 2020. The
session included 23 interventions from EB Member States, most of them
in full support of the Strategy and resolution;
18 from other Member States, 6 observers and 6 non-state actors. Dr
Nono Simelela, ADG and Special Adviser to WHO Director-General Dr
Tedros, responded at the end of the session, thanking delegates for the
broad support, and addressing some of the comments
by sharing some of the ongoing work such as the efforts with the
immunization partners to address HPV vaccine supply challenges and
transparency in pricing.

Read the full story

Read the full draft resolution

Download the
Draft Strategy

Dr Nono Simelela presented the draft Global Strategy towards Eliminating Cervical Cancer as a Public Health Problem during a webinar with partners. This presentation was given as part of
the Us vs. HPV Prevention Week webinar series hosted by the Global
Initiative Against HPV and Cervical
Cancer. While highlighting WHO’s life-course approach to cervical
cancer control, Dr Simelela also explained the proposed elimination
threshold and targets as laid out in the strategy. She also discussed
addressing salient challenges such as redressing inequities
and taking special considerations for women living with HIV.

Read the full story

Listen to the full webinar “Gathering momentum for the global elimination of cervical cancer”

Watch the video: Cervical Cancer Elimination – developed by Basic Health International (BHI), Union for International Cancer Control (UICC) and the Global Initiative Against HPV and Cervical Cancer (GIAHC)

Read the story:To eliminate cervical cancer in the next 100 years, implementing an effective strategy is critical

Dr
Simelela was invited to Rwanda to support the kick off for a national
cervical screening program set to put Rwanda on the path towards the
Global Strategy goals
for elimination of cervical cancer.

Amongst
others, Rwanda’s First Lady Jeannette Kagame received her for a
discussion on how WHO can support efforts against cervical cancer in her
own country and
throughout Africa. Dr Simelela held discussions on cervical cancer
screening and treatment services, including building radiotherapy
capacity, with the dedicated staff of Ruhengeri Hospital, Butaro
Hospital, the Muhoza health center and hospital and the Rwanda
Military Hospital. While cervical cancer and breast cancer are the most
prevalent cancers among the women in the country, Rwanda has
impressively reached a 97% HPV vaccination rate since introducing a
vaccination programme in 2011, with a target to reach 70%
screening coverage in five years. We look forward to a continuing and
fruitful partnership with Rwanda and all the countries who have pledged
their commitment to eliminate this preventable cancer. Together we can
answer WHO’s call and improve the lives of
girls and women around the world.

Follow us for more updates!

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For
news and real-time updates from around the world,
follow Dr Princess Nono Simelela on Twitter
@DrNonoSimelela
ADG, Special Adviser to the Director-General on Strategic Programmatic Priorities

Upcoming events

International Women’s Day
8 March 2020

64th Session of the Commission on the Status of Women/Beijing+25
9 – 20 March 2020

World Immunization Week
24 – 30 April 2020

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https://www.who.int/news-room/detail/04-03-2020-cervical-cancer-elimination-initiative-updates-december-2019

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March 11, 2020
Autonomous on-demand buses underway in the streets of Europe

Would you like to take a ride on a driverless bus? This will be possible in five European cities between April and October 2020, where autonomous buses will be tested in real-life traffic conditions. Three international consortia have been awarded with contracts for the final phase of the pre-commercial procurement under the EU-funded FABULOS project. These consortia will pilot autonomous buses as part of the existing public transport systems. The initial tests will run in Gjesdal (Norway), Helsinki (Finland) and Tallinn (Estonia) in the spring and autumn. Pilots will also be launched in Lamia (Greece) and Helmond (the Netherlands).

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March 10, 2020
Qantas grounds planes, CEO forgoes pay as virus spreads

Qantas announced Tuesday it was grounding most of its Airbus A380 fleet and its CEO would forgo his salary as the airline slashed international flights in response to the coronavirus epidemic.

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March 10, 2020
Ultrathin organic solar cell is efficient and durable

Scientists from the RIKEN, in collaboration with international partners, have succeeded in creating an ultrathin organic solar cell that is both highly efficient and durable. Using a simple post-annealing process, they created a flexible organic cell that degrades by less than 5 percent over 3,000 hours in atmospheric conditions and that simultaneously has an energy conversion ratio—a key indicator of solar cell performance—of 13 percent.

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March 9, 2020
Women’s health and rights: 25 years of progress?

The 1995 Beijing Declaration and Platform for Action remains the world’s most progressive blueprint for advancing gender equality worldwide. Twenty-five years after it was affirmed by 189 countries, what progress has been made in raising this blueprint
off the page?

On International Women’s Day the World Health Organization, United Nations University – International Institute for Global Health and the British Medical Journal have launched a special series marking ‘Beijing+25’.

It shines a spotlight on health, education, environment, work and other critical foundations of life as they empower or restrict the rights and well-being of girls and women.

Women’s rights are human rights

Every person’s right to control their sexuality and sexual and reproductive health is linked to their human rights. This makes sexual and reproductive health and rights a cornerstone of the Beijing strategy: both as a driver towards gender equality,
and a fundamental part of it.

The first article in the series, ‘25 years after the Beijing Declaration we need to reaffirm that women’s rights are human rights,’ highlights recent advances in gender equality and celebrates
the rise of a new and determined generation of activists, working together to empower girls and women.

It also expresses concern that progress has been superficial and not fast enough. Some critical areas of work have slowed or even been pushed back, such as comprehensive sexual and reproductive health information, services and rights.

The authors ask for increased and direct investment in women and girls, to meet their specific health needs and accelerate equal rights for all.

Uneven progress in sexual and reproductive health and rights

The Beijing Declaration affirms that the human rights of women cannot be separated from the universal human rights of every person – but that without concrete actions to strengthen them, they will remain rights in name only.

Some advances in this area since 1995 can be measured by health outcomes, including a reduction in both maternal mortality and rates of female genital mutilation. Positive change is also reflected in public awareness: concepts of period poverty and sexual
harassment, once taboo, are being taken up in day-to-day language.

And yet today, sexual and reproductive health conditions remain one of the leading causes of mortality and morbidity for women and girls. Violence against women and girls is the most frequent human rights abuse worldwide.

Twenty-five years on, the Beijing agenda is still relevant and still unfinished.

Defending the defenders of women’s health and rights

Although The Platform for Action is repeatedly affirmed in international and governmental forums, women and girls still face social, political and cultural barriers to controlling their sexuality, sexual and reproductive health.

Their decisions cannot be free from coercion, discrimination and violence if they are made in the context of power imbalances, harmful gender norms and inequalities.

The authors from HRP, the Institute on Inequalities in Global Health, the Supreme Court of Nepal, the WHO and Women Deliver call for a system of protection for women’s human rights defenders everywhere.

They celebrate new communities of frontline defenders, civil society movements holding governments to account, and vibrant coalitions such as Generation Equality as drivers of achievements in girls and women’s rights over the last twenty-five years.

An anniversary is an opportunity for change

Governments are preparing for the 64^th Commission on the Status of Women in late March, where they will review implementation of the Beijing Declaration and Platform for Action and challenges affecting full realization of the 2030 Agenda for
Sustainable Development.

They will recognize that no country has fully achieved equality, and that women and girls who experience multiple forms of discrimination throughout their lives are still the most held back.

If this collective reflection can be shifted into action, 2020 will become a new anniversary: a pivotal year for the accelerated realization of gender equality and the empowerment of all women and girls, everywhere.

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https://www.who.int/news-room/detail/08-03-2020-women-s-health-and-rights-25-years-of-progress

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March 8, 2020
WHO statement on cases of COVID-19 surpassing 100 000

As of today’s reports, the global number of confirmed cases of COVID-19 has surpassed 100 000. As we mark this sombre moment, the World Health Organization (WHO) reminds all countries and communities that the spread of this virus can be significantly slowed or even reversed through the implementation of robust containment and control activities.

China and other countries are demonstrating that spread of the virus can be slowed and impact reduced through the use of universally applicable actions, such as working across society to identify people who are sick, bringing them to care, following up on contacts, preparing hospitals and clinics to manage a surge in patients, and training health workers.

WHO calls on all countries to continue efforts that have been effective in limiting the number of cases and slowing the spread of the virus.

Every effort to contain the virus and slow the spread saves lives. These efforts give health systems and all of society much needed time to prepare, and researchers more time to identify effective treatments and develop vaccines.

Allowing uncontrolled spread should not be a choice of any government, as it will harm not only the citizens of that country but affect other countries as well.

We must stop, contain, control, delay and reduce the impact of this virus at every opportunity. Every person has the capacity to contribute, to protect themselves, to protect others, whether in the home, the community, the health care system, the work place or the transport system.

Leaders at all levels and in all walks of life must step forward to bring about this commitment across society.

WHO will continue to work with all countries, our partners and expert networks to coordinate the international response, develop guidance, distribute supplies, share knowledge and provide people with the information they need to protect themselves and others.

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https://www.who.int/news-room/detail/07-03-2020-who-statement-on-cases-of-covid-19-surpassing-100-000

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March 8, 2020
End in sight, but flare-ups likely in the Ebola outbreak in the Democratic Republic of the Congo
Remarks by Dr Ibrahima Socé Fall, World Health Organization Assistant Director-General, Emergency Response

Good afternoon.

I hope that your busy week was interrupted, like mine, with a moment of joy on Tuesday.

That moment was the celebration of a woman being discharged from an Ebola treatment centre in Beni. Her name is Masiko.

She was the last person in the Democratic Republic of the Congo confirmed to have Ebola.

Health workers and other responders sacrificed a lot to get to this point.

Since the outbreak was declared in August 2018 there have been 420 attacks on health facilities in DRC, resulting in 11 deaths and 86 injuries among health care workers and patients.

It’s been a huge amount of work. At the peak of the outbreak, more than 120 cases were being reported each week. 28 health zones were affected, with cases appearing 1200 kilometres apart. In response:
- 11 labs have been set up to test around 3500 samples each week
- 11 Ebola treatment centres were set up to care for people with Ebola
- 300 000 people have been vaccinated
- 250 000 contacts have been registered
- 26 000 safe and dignified burials have been conducted
- More than 3000 health facilities were identified for infection prevention and control support
- More than 1000 metric tonnes of supplies have been delivered
- An Ebola vaccine has been licensed, and two treatments found to be highly effective
- Almost 160 000 million people have been screened for Ebola symptoms at borders or other points of control
This work is continuing. The outbreak isn’t over. WHO recommends waiting two full incubation periods – that’s 42 days – after the last person tests negative a second time before declaring the end of the outbreak.

We must stay in active response mode to get us over that finish line.

We have to be prepared for other cases emerging. It’s is a very real risk.

Remember that during the Ebola outbreak in West Africa flare-ups of new cases occurred after the end of the outbreak.

There are four reasons why new cases may emerge during this 42-day period, or even after the end of the outbreak.
- First, because of the complex security environment, Ebola transmission outside of groups under monitoring is possible.
- Second, Ebola virus can persist in used needles, syringes or vials for several weeks.
- Third, Ebola virus can persist in the body fluids of survivors for many months, and can be transmitted well after recovery, or in rare cases can result in relapse – as we’ve already seen during this outbreak.
- Finally, Ebola virus is present in an animal reservoir in the region, and there is always a risk of a new spillover to humans.
This is why it’s critical to maintain surveillance and rapid response capacities.

And that’s what we are doing. We’re still in full response mode.

In addition to the activities I already mentioned, I have to underline how critical it is to continue supporting the Survivor Programme, which provides follow-up care for almost all of the 1169 survivors in 26 health areas in North Kivu and Ituri. The programme also helps reduce the risks of re-introduction events.

We need to continue this work until the end of the outbreak, to keep the capacity in place to rapidly respond to flare-ups, to keep supporting survivors after the outbreak, and to transition the capacities built in this response toward building a stronger health system.

But to be very frank, right now the world risks dropping the baton at the finish line. WHO faces an immediate US $20 million funding gap. If no new resources are received, we will run out of money before the end of the outbreak.

We appreciate the generosity of donors who have supported the response since August 2018. Now we need to get over the finish line. WHO is calling on the international community to help us end this outbreak, and keep our promises to communities to build a stronger health system.

If we are forced to scale back operations because of a lack of funds, and then a new case emerges, we might not have the people and resources on the ground that we need to shut down transmission quickly. Just a single case could re-ignite the epidemic.

That would be a tragedy. An avoidable tragedy.

It is important that the global community doesn’t only focus efforts when there is an immediate threat, then walk away when the threat subsides.

The health system has to be strong to stop much more than Ebola. It has to stop malaria, measles, cholera, and now COVID-19.

There is a lot more work to do.

Thank you.

Read More
https://www.who.int/news-room/detail/06-03-2020-end-in-sight-but-flare-ups-likely-in-the-ebola-outbreak-in-the-democratic-republic-of-the-congo

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March 7, 2020
More wind, less hot air

Predictions about how much wind power will be in place by the year 2040 have been too conservative according to research published in the International Journal of Energy Technology and Policy.

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March 5, 2020
Global gathering of ministers determines road safety agenda to 2030

The 3rd Global Ministerial Conference on Road Safety convened 1700 delegates from around 140 countries, including more than 70 ministers and vice-ministers and heads of international agencies, civil society organizations, foundations and private companies. Hosted at the request of the UN General Assembly by the Government of Sweden in collaboration with WHO, the theme was “Achieving Global Goals 2030”, highlighting the connections between road safety and achievement of other Sustainable Development Goal targets.

Through its 6 high-level panels and 18 parallel sessions, the Ministerial Conference addressed a range of topics, from building effective leadership for road safety to promoting sustainable cities and communities, mitigating climate change through road safety, and ensuring the safety of pedestrians and cyclists. The gathering was instrumental in reviewing progress in the Decade of Action for Road Safety 2011-2020 and defining ways to accelerate action on proven strategies to save lives. Among many pre-events, the 2nd World Youth Assembly for Road Safety hosted by YOURS: Youth for Road Safety and co-hosted by WHO, brought 200 young leaders together proclaiming “Enough is enough!” and claiming their space at the decision-making table for sustainable mobility.

The Ministerial Conference culminated in the forward-looking “Stockholm Declaration”, which calls for a new global target to reduce road traffic deaths and injuries by 50% by 2030. In addition, it invites strengthened efforts on activities in all five pillars of the Global Plan for the Decade of Action: better road safety management; safer roads, vehicles and people; and enhanced post-crash care. It also calls for speeding up the shift to safe, affordable, accessible and sustainable modes of transport like walking, cycling and public transport. WHO is asked to continue to produce the series of global status reports, as a means of monitoring progress towards achievement of the 12 Global Road Safety Performance Targets.

Today, around 1.35 million people lose their lives on the world’s roads every year, and as many as 50 million are injured. More than one quarter of those killed and injured are pedestrians and cyclists. Road traffic injuries are now the leading cause of death for children and young adults aged 5-29 years. Given the enormous human suffering and major economic losses for families and societies, road traffic deaths remain an unacceptable price to pay for mobility.

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https://www.who.int/news-room/detail/20-02-2020-global-gathering-of-ministers-determines-road-safety-agenda-to-2030

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March 5, 2020