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Neglected tropical diseases are the landmines of global health | Global health

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In January the World Health Organization launched a new strategy for eradicating neglected tropical diseases, boldly setting targets to eliminate 20 of them by 2030.

But what are neglected tropical diseases (NTDs)? There is no easy answer. The concept was first proposed in the early 2000s to bring to light a group of diseases that disproportionately affect poor people yet, despite their collective impact, do not attract as much attention as diseases such as HIV/Aids, malaria or tuberculosis.

The common denominator of poverty and the dearth of prevention efforts is largely what binds these diseases together, even though they may be extremely disparate in presentation and approaches to solutions – snakebite v schistosomiasis, for example. Currently, the WHO identifies 20 NTDs and the differences between them make it difficult to talk about them all together.

How can we succinctly describe 20 different conditions that are caused by parasites, bacteria, viruses, fungi and toxins? How can we summarise complex transmission cycles involving multiple vectors – mosquitoes, sandflies or dogs? And routes – oral, , through the skin or congenital? How can we explain in a simple way the diversity of control strategies, including mass drug-administration campaigns, multiple vector-control tools, active screening of cases, dog vaccinations and facilitating the use of footwear? Most vitally, how can we illustrate the devastating impact that NTDs have on individuals and communities across Africa, Latin America and Asia?

And how can we explain to funders, governments, researchers, aid organisations and the public why we should invest money, time and effort to control and eliminate them?

Here’s an analogy that might help.

Neglected tropical diseases are the landmines of global health. Landmines have been described as “indiscriminate weapons of mass destruction in slow motion” and are well known thanks to movies and international awareness campaigns.

Landmines are designed to incapacitate, injure or kill their victims, and especially affect poor rural communities, where people are trying to make a living through activities that place them in direct contact with the ground, expose them to the elements and ultimately to pathogens, vectors and animal reservoirs; such as herding, farming or collecting water.

Landmine survivors often suffer permanent disability, with physical, mental, socialand economic consequences. Landmines have a dire impact on victims’ caregivers, families and communities. Children are often the victims of landmines and women and girls are more likely to give up their jobs or drop out of school to take care of the injured. As Michelle Bachelet, the UN high commissioner for human rights, said at the 2019 mine ban convention: “Landmines continue to kill, burn and damage limbs and other body parts in horrific ways. They cause lifelong impairments, including visual and auditory impairments. They destroy livelihoods […] and even impede national economic recovery.”

Similar language can be used to describe the impact of NTDs. Though medically diverse, NTDs can slowly kill, blind, disfigure and debilitate their victims. They cause untold suffering to victims and caregivers in the poorest communities and contribute to perpetuating a cycle of disease, stigma and poverty.

Collectively, NTDs killed more than 80,000 people and caused the loss of more than 18m disability-adjusted life years (a measure of the burden of disease burden, expressed as the years lost to ill health, disability or early death) in 2019 alone. Unfortunately, these staggering figures, which are grossly underestimated, still do not get NTDs the kind of attention they deserve.

The 1997 mine ban treaty represents an international commitment and responsibility to eliminate landmines around the world. The roadmap for NTDs sets a similar goal – to “control and eliminate the NTDs by 2030”.

Nonetheless, the resources allocated to help people suffering from NTDs remain scarce. Despite recent successes (for example, 33 countries have eliminated at least one NTD since 2012) and communication efforts (30 January has been declared World NTD Day), we have largely turned a blind eye to these conditions.

A clear and powerful message on the terrible impact that NTDs have on individuals and communities would help to raise awareness and engender the required international commitment to control and eliminate these “slow-motion, indiscriminate weapons of mass destruction” by 2030.

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Why is offshore wind the ‘Cinderella’ of EU climate policy?

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Last year, 2020, saw seismic energy policy shifts across the industry. The global gas-market remains bearish and extraordinarily oversupplied, with gas prices seeing increasing downward pressure and volatility. Whereas, in the face of global turmoil, the offshore wind power industry continues to thrive.

The unprecedented year of new offshore wind farm installations resulted in a total of over 35 GW capacity operating across the globe by the end of 2020.

From the long-term perspective, the Ocean Renewable Energy Action Coalition (OREAC) has set a goal of 1,400 GW by 2050, which means an accelerated pace of global roll-out of offshore wind generation projects.

On 14 July, the European Commission unveiled its long-awaited ‘Fit for 55’ package, seeking to overhaul EU regulation that lines up with the bloc’s target of reducing greenhouse gas emissions by 55 percent by 2030. This involves a new 2030 renewable energy goal. According to the latest European Commission’s impact assessment it ought to be at least 38-40 percent, in place of the current 32 percent renewables target.

That means that the EU requires 433-452 GW of wind energy capacity by 2030 – a threefold increase on the 179 GW installed today.

Wind power will be the principal delivering technology of the Green Deal in the European Commission’s strategic long-term vision for climate-neutral economy.

Hitting the bloc’s decarbonisation goal will require a 25-fold increase in offshore wind capacity. And an even bigger build-up in the number of new onshore wind capacity.

Industry can deliver the volumes pending a robust EU industrial renewables policy that guarantees that such a grand huge wind power expansion is made in Europe and that the industry is cost-competitive both within and outside the EU.

Technology is not the main barrier to the deployment of wind energy needed for the Green Deal however.

The European energy market is quite complex, serving millions of households and business round the clock. Presently, there are no market mechanisms for offshore grid development projects to be bankable. Countries have diverse capital programmes and market operation rules which hinder investment flows in offshore hybrid projects from being discharged.

The vagueness on future market design and revenues for offshore wind farms prevents the process of an integrated offshore grid deployment.

Grid gridlock?

Today, Europe invests about €40bn a year on grids, which is not enough. In order to expand and optimise Europe grid infrastructure. annual investments in grid infrastructure shall go up to €66-80bn per year over the next 30 years.

Efforts will be needed at offering clarity via regulatory changes to the EU Electricity Regulation, particularly it shall be better addressed how offshore wind projects will be dealt with when it comes to congestion income distribution and cross-border capacity allocation.

The benefits of an accelerated development will be substantial. The EU wind energy sector generates €37bn to EU GDP, operates 248 factories across the EU, and each new wind turbine installed in Europe would contribute €10m of economic activity.

Offshore wind energy is one of the most promising and cost-competitive source of power generation in Europe.

But present policies will not deliver these numbers – neither on volumes, nor on economic benefits. Higher goals are necessary but not sufficient.

Europe requires stronger delivery, monitoring, and enforcement mechanisms to make sure that 2030 is a stepping stone towards a climate-neutral energy system.

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Delta COVID Variant Reportedly Draws Biden’s Attention, Resources Away From Other Priorities

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Despite high overall rates of vaccinations in the US, more and more Americans are getting infected with the new, rapidly spreading ‘delta’ variant of the coronavirus, once again testing the limits of hospitals and reportedly sparking talks about new mask-up orders from authorities.

The rapidly increasing number of new COVID-19 cases in the US caused by the more infectious delta strain of the virus is frustrating the Biden administration, as the problem draws attention and resources away from other priorities that the White House would like to concentrate on, the Washington Post reported, citing several anonymous sources. Among the problems that the administration reportedly had to de-prioritise are Biden’s infrastructure initiatives, voting rights, an overhaul of policing, gun control and immigration.

The White House reportedly hoped that the pandemic would be gradually ebbing by this time, allowing it to focus more on other presidential plans. Instead, the Biden administration is growing “anxious” about the growing number of daily COVID-19 cases, the newspaper sources said. The White House press secretary indirectly confirmed that Biden is currently preoccupied with the pandemic the most.

“Getting the pandemic under control [and] protecting Americans from the spread of the virus has been [and] continues to be his number-one priority. It will continue to be his priority moving forward. There’s no question,” Press Secretary Jen Psaki said on 22 July.

The administration had reportedly expected new outbreaks in the country, but not as many as they’re seeing. Current analytical models predict anything between a few thousand new cases and 200,000 new infected daily, the Washington Post reported. Washington also fears that daily deaths might reach over 700 per day, up from the current average of 250. However, the White House doesn’t expect the pandemic numbers to return to their 2020 peak levels.

At the same time, the Biden administration is trying to find scapegoats to blame for the current shortcomings in fighting the coronavirus pandemic in the country. Namely, Biden  last week accused the social media platform of failing to combat the spread of disinformation on COVID-19 and thus “killing people”. The statement raised many eyebrows since many platforms mark COVID-related posts and insert links to reliable sources of information regarding the disease and the vaccination efforts aimed at fighting it. The White House also hinted that the Republican-controlled states became the main sources of new COVID cases, while often underperforming in terms of vaccination rates.



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Sierra Leone abolishes death penalty | Global development

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Sierra Leone has become the latest African state to abolish the death penalty after MPs voted unanimously to abandon the punishment.

On Friday the west African state became the 23rd country on the continent to end capital punishment, which is largely a legacy of colonial legal codes. In April, Malawi ruled that the death penalty was unconstitutional, while Chad abolished it in 2020. In 2019, the African human rights court ruled that mandatory imposition of the death penalty by Tanzania was “patently unfair”.

Of those countries that retain the death penalty on their statute books, 17 are abolitionist in practice, according to Amnesty International.

A de facto moratorium on the use of the death penalty has existed in Sierra Leone since 1998, after the country controversially executed 24 soldiers for their alleged involvement in a coup attempt the year before.

Under Sierra Leone’s 1991 constitution, the death penalty could be prescribed for murder, aggravated robbery, mutiny and treason.

Last year, Sierra Leone handed down 39 death sentences, compared with 21 in 2019, according to Amnesty, and 94 people were on death row in the country at the end of last year.

Rhiannon Davis, director of the women’s rights group AdvocAid, said: “It’s a huge step forward for this fundamental human right in Sierra Leone.

“This government, and previous governments, haven’t chosen to [put convicts to death since 1998], but the next government might have taken a different view,” she said.

“They [prisoners] spend their life on death row, which in effect is a form of torture as you have been given a death sentence that will not be carried out because of the moratorium, but you constantly have this threat over you as there’s nothing in law to stop that sentence being carried out.”

Davis said the abolition would be particularly beneficial to women and girls accused of murdering an abuser.

“Previously, the death penalty was mandatory in Sierra Leone, meaning a judge could not take into account any mitigating circumstances, such as gender-based violence,” she said.

Umaru Napoleon Koroma, deputy minister of justice, who has been involved in the abolition efforts, said sentencing people on death row to “life imprisonment with the possibility of them reforming is the way to go”.

Across sub-Saharan Africa last year Amnesty researchers recorded a 36% drop in executions compared with 2019 – from 25 to 16. Executions were carried out in Botswana, Somalia and South Sudan.

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