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Fight against tuberculosis set back 12 years by Covid pandemic, report finds | Global development

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Twelve months of Covid-19 has reversed 12 years of global progress against tuberculosis, worse than previously estimated.

The pandemic has resulted in nearly a 25% decrease in diagnosis and treatment around the world, according to research published on Thursday by a coalition working to end TB.

Due to the impact of the Covid pandemic on services, the number of people diagnosed and treated for TB in the worst-affected countries has dropped back to 2008 levels, said Stop TB Partnership’s executive director, Lucica Ditiu. A modelling study published last year estimated a setback of five to eight years.

“Twelve years of impressive gains in the fight against TB – including in reducing the number of people who were missing from TB care – have been tragically reversed by another virulent respiratory infection,” said Ditiu.

“I hope that in 2021, we buckle up and smartly address, at the same time, TB and Covid-19 as two airborne diseases with similar symptoms.”

The effect on countries has depended on their existing disease burden. Data from India and South Africa showed people infected with both TB and Covid-19 are three times more likely to die than those infected with TB alone, meaning preventive steps such as contact tracing and testing are essential in keeping rates low.

Heath officials in Johannesburg prepare to check for HIV and tuberculosis while carrying out Covid-19 tests
Heath officials in Johannesburg, South Africa, prepare to check for HIV and tuberculosis while carrying out Covid-19 tests. Photograph: Jérôme Delay/AP

“After less than a year, a vaccine was developed and is now being deployed to help contain, and hopefully end, the Covid-19 pandemic,” said Thokozile Phiri Nkhoma, a Stop TB Partnership board member.

“But although TB has been around since the time of the pharaohs, the only approved vaccine is 100 years old and doesn’t fully work, especially in adults. First-line treatment for TB is several decades old, and drug resistance is on the rise, while the millions of people with TB who are not found and treated remain at risk of spreading the disease.”

Every year TB infects 10 million people and kills 1.5 million, more than any other infectious disease. Although Covid-19 overtook TB in 2020 as the most common cause of death from an infectious disease, TB still kills more people than Covid in low- and middle-income countries.

Some countries have fought hard to reverse the setbacks. India’s health ministry, after seeing a 70% drop in TB notifications in the first four months of 2020, integrated TB outreach into Covid-19 programming.

“TB didn’t go anywhere when the Covid-19 pandemic hit,” said India’s minister of health, Harsh Vardhan. “People just got distracted, health workers were redirected and health systems became overwhelmed.

Rural children in Bangladesh are vaccinated
Rural children in Bangladesh are vaccinated against tuberculosis, poliomyelitis, diphtheria, tetanus, pertussis and measles. Photograph: Anadolu Agency/Getty

“Recovery efforts succeed with political leadership and substantial resources, along with an insistence that Covid-19 outreach and prevention efforts include TB work, instead of replacing it.”

Last week the US administration approved $3.5bn (£2.5bn) in emergency funding for low- and middle-income countries to fight Covid-19 and help mitigate the impact of the pandemic on efforts to tackle TB, malaria and HIV, all of which have been severely affected by resources being redirected.

Peter Sands, executive director of the Global Fund, said that while it feels there may be light at the end of the tunnel as far as Covid goes, “for the communities we’re talking about here, those most at risk of TB, we’re right at the darkest point”.



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Andrés Manuel López Obrador: Mexican president downplays tensions with US over Americas summit | International

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Mexican President Andrés Manuel López Obrador sought on Tuesday to downplay the tensions that have risen with the United States over the upcoming Summit of the Americas in Los Angeles. The leftist leader has said he would skip the summit and send a representative instead, if Cuba, Venezuela and Nicaragua were excluded from the meeting. But he argued on Tuesday that this position is not going to harm bilateral relations with the US. “One shouldn’t think that, if, in this case, we don’t agree on the summit, there is going to be any break [in relations]. That is not going to happen under any circumstance,” he said at his morning press conference.

A US delegation was set to arrive in Mexico on Wednesday to discuss the upcoming summit, which will be held from June 6 to 10. The delegation, led by Senator Christopher Dodd, seeks to ensure that López Obrador will participate in the regional meeting. Ahead of the visit, the US ambassador to Mexico, Ken Salazar, said on Monday that “it is very important that Mexico participates” in the summit. If López Obrador boycotts the event, Foreign Minister Marcelo Ebrard will attend in his place.

The White House has not yet made a decision about whether to invite Cuba, Venezuela and Nicaragua, but Assistant Secretary for Western Hemisphere Affairs Brian Nichols told EL PAÍS that the US government is currently leaning toward excluding “countries that disrespect democracy.”

López Obrador supported his position to skip the meeting by invoking the Mexican Constitution, which enshrines the principle of non-intervention in foreign policy. “We have to stick to the principles of our foreign policy, of non-intervention and self-determination of the people, and we believe that no one should be excluded and that the independence and sovereignty of the peoples must be asserted,” he said on Tuesday. However, by actively supporting Havana, the government has shaken up regional policy and created a separate bloc with countries such as Bolivia, Chile and Argentina, which also want all countries to be included in the summit.

While maintaining his position, the Mexican president was also at pains to highlight Mexico’s strong relationship with the US administration of President Joe Biden. “There is a very good relationship. And we are working in a coordinated manner in economic, trade, and of course migration and security matters,” he said. “Independently of how it is resolved, we are always going to have a relationship with the US that is based on respect and friendship, and even more so with the people of the United States. The US government has treated us with respect and we also have a lot of respect and admiration for the American people.”

Since Biden’s arrival at the White House in January 2021, the two leaders have been in frequent contact. While they have had disagreements on issues such as security, migration and energy policy, both want to address the bilateral agenda through negotiation, which marks a change from the threats and intimidation that characterized the Trump administration.

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Learn lessons of Rwandan genocide and act now to stop Ethiopian war, UN urged | Global development

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African civil society groups have accused the United Nations of inaction over atrocities in Ethiopia, warning in a letter that it had not learned the lessons of the 1994 Rwanda genocide and that the “situation risks repeating itself in Ethiopia today”.

Tens of thousands of people are thought to have been killed and millions more displaced since war broke out between Ethiopia’s federal government and the Tigray People’s Liberation Front (TPLF), the ruling party of the country’s northern region, in November 2020.

All of the parties in the war have been accused of crimes including arbitrary killings, mass rape and torture, while ethnic Tigrayans across the country have been subject to mass arrests amid a spike in hate speech, which has seen the prime minister, Abiy Ahmed, refer to the Tigrayan rebels as “weeds” and “cancer”.

In the letter to the UN secretary general, António Guterres, 12 African civil society groups including the Kampala-based Atrocities Watch Africa, the Institute for Human Rights and Development in Africa and Nigeria’s Centre for Democracy and Development called on him to “provide leadership in ending the ongoing war in Ethiopia”.

“Twenty-eight years ago, the security council similarly failed to recognise the warning signs of genocide in Rwanda or act to stop it,” the signatories said, adding: “We are concerned that the situation is repeating itself in Ethiopia today. We call on you to learn the lessons from Rwanda and act now.”

In November 2021, the UN security council issued a statement expressing concern over the fighting, but it has yet to take any concrete steps towards resolving the conflict.

Last month, a report by Amnesty International and Human Rights Watch accused forces from the Amhara region of waging a campaign of ethnic cleansing against Tigrayans “with the acquiescence and possible participation of Ethiopian federal forces”.

Dismas Nkunda, head of Atrocities Watch Africa, said: “With reports of ethnic cleansing coming out of western Tigray, there is real reason for concern that some of these crimes reach the level of genocide, and it’s essential that the United Nations grasp the seriousness of the current situation and respond accordingly.”

The UN human rights council has appointed a team to investigate abuses committed during the conflict, although the government has vowed not to cooperate.

Tigray has been largely cut off from the rest of Ethiopia since the fighting began, with transport and communications links cut. About 90% of the region’s 5.75 million population are in need of aid, and the region’s health bureau estimates that at least 1,900 children under the age of five died of starvation in the past year.

In March, the government unilaterally declared a “humanitarian truce” to allow supplies to reach the region, but only a handful of aid trucks have arrived since then.

The letter urges the UN security council to press for “immediate and unimpeded humanitarian access [to Tigray]” and “impose an arms embargo on all parties to the conflict”.

The signatories also call for deployment of an international peacekeeping force led by the African Union, which has its headquarters in the Ethiopian capital, Addis Ababa.

“Such action will be vital to assisting the Ethiopian men, women and children who have been suffering both direct hostilities, associated human rights violations and obstructed humanitarian aid,” they said.

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‘Narco-tunnels’ become a factor in US-Mexico relations | International

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The US ambassador to Mexico, Ken Salazar, shows a ‘narco-tunnel’, May 2022.
The US ambassador to Mexico, Ken Salazar, shows a ‘narco-tunnel’, May 2022.Manuel Ocaño (EFE)

More than 300 meters long, 10 meters deep and fully illuminated: so is the latest narco-tunnel that authorities have found in Tijuana, on the border between Mexico and the United States. The underground corridor was used to traffic drugs to San Diego, California, and has since been closed. The discovery was not an accident: US Ambassador Ken Salazar had warned last week of the presence of over 200 tunnels during a visit to the border city.

The tunnel was discovered last weekend after a joint operation by the Mexican Army, the Tijuana Police and the Attorney General’s Office. The entrance is located under a house in the Nueva Tijuana neighborhood, a few meters from the Otay border crossing where Salazar made those statements. The passageway, reinforced with metal beams, remains under police protection. Authorities have not identified which criminal group used it, nor have any arrests been made.

Mexican authorities emphasized that communication with their US counterparts had been “close” and that bilateral collaboration had been key to finding the tunnel. Less than 48 hours earlier, Salazar had made the same points. “Working with the Mexican government, we have a very good collaboration in trying to eradicate these tunnels, which should not be here, because this is where a lot of crime happens, a lot of suffering,” said the ambassador in statements collected by the weekly newspaper Zeta. “This must stop,” he added.

A ‘narco-tunnel’ in Tijuana, Mexico.
A ‘narco-tunnel’ in Tijuana, Mexico.Cortesía

Salazar’s visit to Tijuana included a tour of a narco-tunnel discovered in 2009. The passageway, which also crosses the border wall, is known as Gálvez and is 270 meters long and 30 meters deep. The structure’s construction was attributed to the Arellano Félix cartel, a criminal organization created in the 1980s, which dominated the movement of drugs to the United States in that area for decades.

After the tour, Salazar, senior US anti-narcotics officials and Mexican Foreign Minister Marcelo Ebrard held a press conference announcing a $4.2 billion investment to reinforce the border. Ebrard exhorteed the authorities of both countries to “be more effective at the border against fentanyl, drugs and weapons that come and go on both sides.”

“[We intend] to ensure that this border is a place where people can walk from one place to another safely and where trade continues in a better way than now,” Salazar said. Last month, Texas governor Greg Abbott imposed tough security checks that virtually paralyzed cross-border trade. (More than 2,000 of the 3,000 kilometers between the two countries pass through Abbott’s state.)

After the White House’s urging to stop drug trafficking from Mexico, the government of Andrés Manuel López Obrador has urged the United States to do the same with the smuggling of firearms. More than 500,000 US weapons arrive in the Latin American country each year, according to Mexican authorities, who began working to prosecute the US arms industry last year.

Less than a week ago, another tunnel made headlines in Culiacán, the stronghold of the Sinaloa Cartel, the organization historically led by Joaquín “El Chapo” Guzmán. A young man who was sleeping on the sofa in his house fell after a hole opened in the ground. The hole in the floor was attributed to the existence of the underground passageway, found in 2011.

El Chapo had escaped in July 2015 from the Altiplano prison, a high-security prison in central Mexico, through a tunnel that took members of his criminal organization more than a year to build. In the videos broadcast from his cell, the criminal leader is seen disappearing from one moment to another after climbing into a hole in the floor. Guzmán traveled more than a kilometer underground on a motorcycle. The capo was captured in early 2016 and extradited to the United States a year later. Guzmán had previously managed to evade several capture operations through underground networks of passages. The first tunnel attributed to him dates from 1989.

The longest known narco-tunnel measured more than two kilometers, and its discovery was announced in January 2020. It had tracks, air conditioning, an elevator and electricity. The entrance was in Tijuana and the exit in San Diego. “The sophistication of this tunnel demonstrates the determination and monetary resources of the cartels,” the US border patrol said at the time. Despite the spectacular announcement, the news came with no information about arrests, as with the last tunnel discovered last weekend.

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