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Underfunded and Deadly Tuberculosis Needs Its Own Bill Gates

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Community support workers are key in raising awareness about TB and promoting diagnosis and treatment. Credit, Busani Bafana/IPSby Busani Bafana (bulawayo, zimbabwe)Friday, January 07, 2022Inter Press Service

“TB is a disease that is not a darling of donors and investors,” Lucica Ditiu, the Executive Director of the Stop TB Partnership, told IPS in an interview from Geneva.

“We do not have a Bill Gates that can support TB research, yet TB remains a disease of concern with deaths increasing for the first time in over a decade,” she added.

TB, a bacterial disease mainly affecting the lungs, has been around for over millennia and remains one of the top killer diseases globally. But it is preventable and curable with the right investment in diagnosis and treatment.

Ditiu attributed the rise in TB incidents to several factors; many people diagnosed and on treatment for TB have defaulted owing to the disruption of health services in the wake of the COVID-19 pandemic and global lockdown. Furthermore, many people remain undiagnosed because they have not been reached.

Dr Lucica Ditiu, Executive Director of the Stop TB Partnership. Credit: Stop TB Partnership

“Southern Africa has done a good job in respect of Zambia, Zimbabwe and South Africa as well as Rwanda in trying to disrupt as little as possible the treatment and diagnosis of people with TB,” Ditiu said. She commended awareness programmes in the media and community door-to-door campaigns to promote diagnosis and treatment.

Countries need to invest more in finding people with TB and putting them on treatment. Until you find people, you cannot put them on treatment, and this is where we are very much lagging, she said.

Ditiu fears the worst should the world fail to change the current TB transmission trend. An estimated 5.8 million people received treatment for TB in 2020; a drop of 21 percent from 2019, and more than 4 million people worldwide remain untreated. According to Stop TB Partnership, half of those untreated are likely to die from the disease.

Admitting that funding for TB has always been insufficient, Ditiu said TB was the poor cousin compared to the deep pockets for HIV and AIDS.

“In general, we have available only 30 percent of the funding needed globally. We have places that have done well in preventing TB in people living with HIV. Prevention of TB in people living with HIV is going well, especially in African countries because HIV has resources.”

According to the Stop TB Partnership, a network of international organisations established in 1998 to help end TB as a public health problem, funding for TB research and development (R&D) has remained flat since 2018.

Global funding for tuberculosis (TB) research totalled 915 million US dollars in 2020 – less than half the goal of 2 billion US dollars set forth by participating country governments at the 2018 United Nations High-Level Meeting on TB.

In 2021, TB had a funding gap of 13 billion US dollars globally, with only 5,3 billion US dollars available for its programmes. It experienced a drop in funding amounting to 500 000 US dollars in 2020 as many countries took money away from TB to respond to COVID-19.

A new report, Tuberculosis Research Funding Trends, 2005–2020 by Treatment Action Group (TAG) and the Stop TB Partnership, found that TB received less than 1 percent of the amount invested in COVID-19 Research and Development over the first 11 months of the pandemic.

“The mobilisation of over 100 billion US dollars for COVID-19 research and development in the first 11 months of the pandemic shows us just how powerful a coordinated effort against a disease can be,” noted Ditiu.

While the pandemic has shown that effective vaccines can save lives, the world is still banking on a 100-year-old vaccine, Bacillus Calmette-Guérin or BCG. However, a more effective vaccine could have higher efficacy rates, especially for adults. Why has it taken so long to develop a new, more effective TB vaccine when the health burden of TB is increasing?

“This is the drama,” Ditiu commented. “We have a vaccine for a hundred years that we know for the last 40 years does not work (effectively) except for newly-born babies, and yet we have not done much about it.”

While ongoing research on new vaccines had been slow because of poor funding, Ditiu said several potential vaccines were in the pipeline, and a vaccine could be expected by 2027.

“It takes a long time to get a vaccine. But because of COVID (we realised), it is possible to have a vaccine much quicker, and we hope to use the learnings from COVID-19 to get a TB vaccine,” Ditiu told IPS.

Tuberculosis vaccine research has been slowed by chronic underfunding with only one moderately effective century-old TB vaccine, compared to over 20 COVID-19 vaccines.

“What’s enabled the development of dozens of COVID-19 vaccines in less than a year has essentially been money,” noted Austin Aurinze Obiefuna, Executive Director of the Afro Global Health Alliance and incoming Vice-Chair of the Stop TB Partnership Board.

“I think that the same enormous amount of funding should be applied with equal vigour to the development of TB vaccines. But that simply doesn’t seem to be happening.”

According to the Stop TB Partnership, making much-needed progress against TB demands investment that matches the threat of the disease around the world. This includes a commitment to rectify the inadequate funding of the past. Over the next two years, 10 billion US dollars are needed to close the tuberculosis R&D funding gap.

“Wealthy countries need to step up and put more money into correcting global health inequalities, which COVID-19 vaccine allocation inequities laid bare,” urged Mark Harrington, Executive Director of TAG, an independent activist, and community-based research and policy think tank.

“COVID-19 made more people around the world aware of the importance of R&D spending than ever before. Now is the time to finally start making investments ambitious enough to end TB for good.”


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From Milan to Glasgow, Young Moroccans Commit to Fighting Climate Change

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A new way to recycle large amounts of coffee grounds; a platform connecting young African activists; technology to produce electricity from ocean waves or recycle plastic. A new energy-efficient construction method – an innovative carpooling app. 

Read the full story, “From Milan to Glasgow, young Moroccans commit to fighting climate change”, on globalissues.org

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Health Workers Lauded for Role in Leprosy Treatment During Pandemic

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Yohei Sasakawa, WHO Goodwill Ambassador for Leprosy Elimination and Chairperson of the Nippon Foundation, thanks participants at a webinar ‘Raising Awareness about Leprosy, Role of Health Professionals at the Grassroots Level’ organized by the Sasakawa Leprosy Initiative. He is with other participants from Japan, India and Nepal in the “Don’t Forget Leprosy” campaign event. by Joyce Chimbi (nairobi, kenya)Thursday, January 20, 2022Inter Press Service

Sasakawa, the WHO Goodwill Ambassador for Leprosy Elimination and Chairman of the Nippon Foundation, was speaking at a webinar ‘Raising Awareness about Leprosy, Role of Health Professionals at the Grassroots Level’ organized by the Sasakawa Leprosy Initiative.

A leprosy-free world was one where “patients and those cured of leprosy live free of discrimination and, people around them will be free of the misunderstanding, ignorance and fear that perpetuate discrimination”, he told the webinar.

Sasakawa Leprosy Initiative is a strategic alliance between WHO Goodwill Ambassador for Leprosy Elimination, the Nippon Foundation and Sasakawa Health Foundation for achieving a world without leprosy and problems related to the disease. The initiative spearheaded a campaign, “Don’t Forget Leprosy”, to raise awareness about the condition in the face of the coronavirus pandemic.

The WHO Goodwill Ambassador envisions a post-COVID world where those affected by leprosy will be liberated from such stigma and discrimination in keeping with human rights.

Sasakawa says this world is now at risk of delaying leprosy elimination due to the COVID-19 pandemic, as there was a 37 percent drop in reported new cases and leprosy programs in many countries have stalled or scaled back.

Participants heard about the role of health professionals in combating leprosy, recognition of this role and the successes and challenges faced in addressing leprosy during the ongoing health pandemic.

Their role, Sasakawa said, was a central pillar to the vision of a leprosy free world as it helps reduce transmission and disability.

An estimated three to four million people live with some form of disability caused by leprosy, also known as Hansen’s disease.

“The ‘Don’t Forget Leprosy’ is a global campaign because our voices alone are not enough. Stopping leprosy requires (the involvement of) all of us, from India and Nepal to all other countries around the world,” he said.

Dr Rashmi Shukla outlined efforts in India to identify and treat patients with leprosy. He was speaking at a webinar ‘Raising Awareness about Leprosy, Role of Health Professionals at the Grassroots Level’ organized by the Sasakawa Leprosy Initiative. Credit: Joyce Chimbi/IPS

Dinesh Basnet, Central President of the International Association for Integration, Dignity and Economic Advancement (IDEA) in Nepal, said he was happy to see progress in recent years.

“More so Nepal’s efforts to track and eliminate leprosy. Even during the pandemic, detection and treatment interventions were uninterrupted, and this has been possible due to government commitment and unrelenting efforts of health professionals,” said Basnet.

“People affected by leprosy were not forgotten as communication continued through WhatsApp groups, and this was critical during the lockdown.”

Dr Indra Napit, a senior Orthopedic Surgeon at Anandaban Hospital, Nepal, spoke about innovative technology in the trial of Autologous Blood products to promote ulcer healing in Leprosy. He added that a new drug was on trial to manage reactions to this form of treatment at this leprosy mission.

In a video message, Birodh Khatiwada, Nepal’s Minister of Health and Population, spoke of Nepal’s undisrupted program to address leprosy, including the continued supply of leprosy medication despite the pandemic.

He says Nepal has already prepared the National Leprosy Roadmap, 2021-2030, National Leprosy Strategy 2021-2025, in line with the Global Leprosy Strategy, Neglected Tropical Diseases Roadmap and the Sustainable Development Goals (SDGs).

Sasakawa emphasized that it was indeed the ultimate goal for India and other affected countries worldwide to reach zero leprosy cases by 2030.

Despite challenges in the fight to eliminate leprosy, a ray of hope shines through, with Anju Sharma sharing good practices in case finding in India amid the ongoing health pandemic.

Sharma is an accredited Social Health Activist and is considered a driving force behind India’s public health system and an essential link between the community and the public health system.

“Screening for leprosy during the pandemic is much more difficult. As COVID-19 cases increase, so does my responsibilities because I have to strictly follow COVID-19 protocols, and this takes a lot of time,” Sharma explained.

“Due to the pandemic, people are hesitant about getting screened. But I reassure them that protocols will be observed and remind them that failure to detect and treat leprosy can lead to disability.”

Dr Venkata Ranganadha Rao Pemmaraju, acting team leader, WHO Global Leprosy Programme, emphasized that discussing the role of health workers was critical, and hearing from those in the frontlines helps efforts to eliminate the pandemic move forward.

WHO, he said, subscribes to the Don’t Forget Leprosy campaign. He lauded ongoing efforts to sustain counselling for those affected by leprosy and those who tracked and managed Nepal-India cross border leprosy cases despite challenges COVID-19 protocols like restrictions on movement and lockdowns.

Dinesh Basnet, a person affected by leprosy thanked health care workers and others for their efforts in eliminating the disease. He was talking at a webinar ‘Raising Awareness about Leprosy, Role of Health Professionals at the Grassroots Level’ organized by the Sasakawa Leprosy Initiative. Credit: Joyce Chimbi/IPS

Similarly, Dr Rabindra Baskota, the Leprosy Control and Disability Management Section director in Nepal’s Ministry of Health and Population, confirmed that health workers had been relentless to find new cases, raising awareness on leprosy and treating patients despite ongoing challenges.

“Still, there is a need to train community health workers to detect new cases and manage reactions to leprosy treatment even as older and more experienced health workers retire,” he said.

Dr Anil Kumar, the deputy director-general (Leprosy) in India’s Ministry of Health and Family Welfare, who spoke about good practices in combating leprosy said that a leprosy-free India was not very far off.

Despite a notable decline in screening and detecting cases due to COVID-19, he said critical interventions were nonetheless rolled out, and that leprosy-related services continued at the grassroots level.

“Migrant labourers were screened for leprosy at point of return to home districts and patients on treatment tracked. Treatment defaulters were cross notified based on the address in treatment record,” Kumar said.

“A WhatsApp group titled Leprosy Action Group was created for cross notification, and members included state leprosy officers and partners. Supportive supervision and monitoring up to sub-district level using virtual platforms continues.”

Executive Director of the Sasakawa Health Foundation, Dr Takahiro Nanri, moderated a panel discussion that included a session to further shed light on additional support needed to achieve leprosy elimination milestones.

Sasakawa suggested that health workers’ training included human rights, and the panel lauded health workers for their passionate and proactive steps to eliminate the disease.


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Ominous History in Real Time: Where We Are Now in the USA

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US President Joseph R. Biden Jr. addresses the general debate of the UN General Assembly’s 76th session last year. In his inaugural address to the annual gathering of world leaders at the UN, Biden called for a new era of global unity against the compounding crises of COVID-19, climate change and insecurity. Credit: UN Photo/Cia PakOpinion by Norman Solomon (san francisco, usa)Monday, January 17, 2022Inter Press Service

Dollar figures can look abstract on a screen, but they indicate the extent of the mania. Biden had asked for “only” $12 billion more than President Trump’s bloated military budget of the previous year — but that wasn’t enough for the bipartisan hawkery in the House and Senate, which provided a boost of $37 billion instead.

Overall, military spending accounts for about half of the federal government’s total discretionary spending — while programs for helping instead of killing are on short rations at many local, state, and national government agencies. It’s a nonstop trend of reinforcing the warfare state in sync with warped neoliberal priorities. While outsized profits keep benefiting the upper class and enriching the already obscenely rich, the cascading effects of extreme income inequality are drowning the hopes of the many.

Corporate power constrains just about everything, whether healthcare or education or housing or jobs or measures for responding to the climate emergency. What prevails is the political structure of the economy.

Class war in the United States has established what amounts to oligarchy. A zero-sum economic system, aka corporate capitalism, is constantly exercising its power to reward and deprive. The dominant forces of class warfare — disproportionately afflicting people of color while also steadily harming many millions of whites — continue to undermine basic human rights including equal justice and economic security.

In the real world, financial power is political power. A system that runs on money is adept at running over people without it.

The words “I can’t breathe,” repeated nearly a dozen times by Eric Garner in a deadly police chokehold, resonated for countless people whose names we’ll never know. The intersections of racial injustice and predatory capitalism are especially virulent zones, where many lives gradually or suddenly lose what is essential for life.

Discussions of terms like “racism” and “poverty” too easily become facile, abstracted from human consequences, while unknown lives suffocate at the hands of routine injustice, systematic cruelties, the way things predictably are.

An all-out war on democracy is now underway in the United States. More than ever, the Republican Party is the electoral arm of unabashed white supremacy as well as such toxicities as xenophobia, nativism, anti-gay bigotry, patriarchy, and misogyny.

The party’s rigid climate denial is nothing short of deranged. Its approach to the Covid pandemic has amounted to an embrace of death in the name of rancid individualism. With its Supreme Court justices in place, the “Grand Old Party” has methodically slashed voting rights and abortion rights.

Overall, on domestic matters, the partisan matchup is between neoliberalism and neofascism. While the abhorrent roles of the Democratic leadership are extensive, to put it mildly, the two parties now represent hugely different constituencies and agendas at home. Not so on matters of war and peace.

Both parties continue to champion what Martin Luther King Jr. called “the madness of militarism.” When King described the profligate spending for a distant war as “some demonic, destructive suction tube,” he was condemning dynamics that endure with a vengeance.

Today, the madness and the denial are no less entrenched. A militaristic core serves as a sacred touchstone for faith in America as the world’s one and only indispensable nation. Gargantuan Pentagon budgets are taken for granted, as is the assumed prerogative to bomb other countries at will.

Every budget has continued to include massive outlays for nuclear weapons, including gigantic expenditures for so-called “modernization” of the nuclear arsenal. A fact that this book cited when it was first published — that the United States had ten thousand nuclear warheads and Russia had a comparable number — is no longer true; most estimates say those stockpiles are now about half as large.

But the current situation is actually much more dangerous. In 2007, the Doomsday Clock maintained by The Bulletin of the Atomic Scientists pegged the world’s proximity to annihilation at five minutes to apocalyptic Midnight.

As 2022 began, the symbolic hands were at one hundred seconds to Midnight. Such is the momentum of the nuclear arms race, fueled by profit-driven military contractors. Lofty rhetoric about seeking peace is never a real brake on the nationalistic thrust of militarism.

With the withdrawal of U.S. troops from Afghanistan, the third decade of this century is shaping up to unfold new wrinkles in American hegemonic conceits. Along the way, Joe Biden has echoed a central precept of doublethink in George Orwell’s most famous novel, 1984: “War is Peace.”

Speaking at the United Nations as the autumn of 2021 began, Biden proclaimed: “I stand here today, for the first time in twenty years, with the United States not at war. We’ve turned the page.” But the turned page was bound into a volume of killing with no foreseeable end.

The United States remained at war, bombing in the Middle East and elsewhere, with much information withheld from the public. And increases in U.S. belligerence toward both Russia and China escalated the risks of a military confrontation that could lead to nuclear war.

A rosy view of the USA’s future is only possible when ignoring history in real time. After four years of the poisonous Trump presidency, the Biden strain of corporate liberalism offers a mix of antidotes and ongoing toxins. The Republican Party, now neofascist, is in a strong position to gain control of the U.S. government by mid-decade.

Preventing such a cataclysm seems beyond the grasp of the same Democratic Party elites that paved the way for Donald Trump to become president in the first place. Realism about the current situation — clarity about how we got here and where we are now — is necessary to mitigate impending disasters and help create a better future. Vital truths must be told. And acted upon.

This article is adapted from the new edition of Norman Solomon’s book “Made Love, Got War,” just published as a free e-book.

Norman Solomon is the national director of RootsAction.org and the author of a dozen books including Made Love, Got War: Close Encounters with America’s Warfare State, published in a new edition as a free e-book in January 2022. His other books include War Made Easy: How Presidents and Pundits Keep Spinning Us to Death. He was a Bernie Sanders delegate from California to the 2016 and 2020 Democratic National Conventions. Solomon is the founder and executive director of the Institute for Public Accuracy.


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