Five inspiring cities and their exemplary efforts to deal with the silent urban killers | Society
Ella Kissi-Debrah died when she was 9 from an asthma that was aggravated by the exposure to excessive air pollution in London. That is not what her death certificate stated, however – although it was recognized by the court some time later. That was a decade ago. Today, her mother, Rosamund Kissi-Debrah, is still in the fight to prevent premature deaths due to poor air quality. “There are lives that can be saved. I’m telling all the mayors: you have to do something. We want clean air to be a human right,” she pleaded before the delegations of 50 cities from all around the world, who gathered at the first Summit of the Alliance of Healthy Cities, held on March 15 in the British capital.
The vast majority of the 41 million annual deaths from chronic diseases (74% of all deaths in the world) happen among the elderly. However, according to data from the World Health Organization (WHO), 17 million people die prematurely each year from these non-communicable diseases before reaching 70. Of those deaths, 86% occur in low- and middle-income countries; poverty and a greater exposure to environmental risk factors (poor air quality) or unhealthy habits (an inadequate diet or drug abuse) go hand in hand, the agency points out.
“There are low-cost solutions for governments and other stakeholders to reduce common modifiable risk factors,” states the WHO. The goal established in the UN 2030 Agenda is to reduce by one third the probability of dying prematurely from a non-communicable disease, and cities, which bring together more than half of the world’s population, are one of the main battlefields against such factors.
“Polluted air is a silent killer. But it can be reduced. If national governments don’t do it, we mayors will have to assume that leadership,” stated Sadiq Khan, mayor of London, one of the 70 members of the Partnership for Healthy Cities, which is supported by the WHO and the Bloomberg Philanthropies and Vital Strategies organizations and has the goal of assisting cities in their unpopular war against these enemies of health. In that context, five initiatives were honored at the Summit for their actions in this regard, and will receive $150,000 to continue their work.
Montevideo (Uruguay): Guaranteeing a healthy diet for public employees
Uruguay (3.4 million inhabitants) is one of the countries where the percentage of overweight and obese people has increased fastest in the last decade: 65% of adults and almost 40% of children suffer from these diseases, which trigger and aggravate problems such as hypertension or diabetes. “Montevideo has a long history of defending the health of its population, starting in the 1990s with the ban on smoking in the City Hall building,” explains Mayor Carolina Cosse, one of the honorees for her latest effort to stop malnutrition: ensuring that public employees have access to healthy diets in their workplace.
We will exempt canteens in public institutions accredited as healthy from certain taxes
Carolina Cosse, Mayor of Monevideo
After the introduction of the 2018 decree to reduce the consumption of salt in restaurants — having it on the table or offering it to customers is forbidden – city authorities have been working to increase the supply of healthy food through other means. On June 30, 2022, the Uruguayan capital approved new nutritional standards for the food and beverages served in its 48 public institutions and hospitals, as well as the restriction on the sale and advertising of ultra-processed products. Its latest measure, which earned it the recognition of the Partnership for Healthy Cities, is the Healthy Cafeterias program.
“We will exempt from certain tax burdens the cafeterias in public institutions that have been accredited as healthy by meeting certain conditions such as not displaying products with excess fat, sodium or sugar. They can sell them, but not display them,” explains Cosse. In addition, their menu should include inexpensive healthy options, created with the help of a nutritionist. “Now it’s up to us to carry out a great promotional campaign and convince them one by one. We can’t do it in schools because they are regulated by the federal government, but we are going to expand the program to the private sector.”
Bangalore (India): Creating tobacco-free spaces
According to the WHO, tobacco kills half of its users. Each year, there are more than eight million deaths in the world, of which 1.2 million are non-smokers who die as a result of exposure to second-hand smoke, which also increases the risk of lung cancer by 30% and that of suffering from coronary diseases by 25%.
Most measures to reduce consumption – the most effective being price hikes – are the responsibility of national governments, explains Kelly Henning, head of the Public Health program at Bloomberg Philanthropy. “But local authorities can implement very interesting interventions such as banning smoking in certain areas or advertising tobacco on city billboards,” she says. City administrators also have a responsibility to monitor compliance with the country’s anti-tobacco laws. The Indian city of Bangalore (population 13.6 million) was recognized for its determination in this regard.
Bangalore launched a training program for local police officers on how to detect and punish violators of the national anti-smoking law
A 2018 survey revealed that the anti-smoking law was only complied with in 10% of the city’s public spaces. With the support of the Partnership for Healthy Cities, the authorities came up with two strategies to deal with this: the mayor’s office launched a training program for police officers on how to detect and sanction offenders, and it also launched awareness campaigns in the local media. “Studies have shown that this can change individual behavior and build popular support for tobacco control policies. And they are quite profitable. Research confirmed that for every six cents spent, one person tried to quit smoking; for every $2.60, one did it; and for every $9.20, one death was prevented. Think about it for a moment: for less than $10, these ads can save a life,” says Dr. Vishal Rao, head of Head and Neck Surgical Oncology at the Healthcare Global Enterprise Hospital in Bangalore.
Among other actions, the Indian state of Karnataka, whose capital is Bangalore, launched the Stop Tobacco app earlier this month: to denounce a “violation against their right to health,” reports The Indian Times, citizens can upload a photograph of any smoker who violate the rules, so that a brigade can take the proper measures. The tool also makes it possible to denounce people who sell cigarettes outside schools.
Athens (Greece): Reducing overdose deaths
Kostas Bakoyannis, mayor of Athens, assures that his priorities are public health and protecting the most vulnerable population. With this in mind, he decided to replicate a model that has already been tested in other cities around the world to prevent overdose deaths among drug users (mainly homeless people) by opening supervised injection rooms with proper materials.
Naloxone is an opioid antagonist medication that acts as an antidote in case of an overdose. Administered in time, it can save the life of a user. However, in most countries, it can only be obtained with a prescription. Until very recently, Greece used to be one of them. Bakoyannis had a crucial role in advocating for the newly passed national law allowing the over-the-counter distribution of this treatment. His program to provide naloxone to relatives and close friends of addicts, with the aim of preventing their death in case of fatal acute poisoning, can now move forward without legal obstacles.
“We have one of the highest levels of drug abuse-related mortality in Europe,” explains the mayor. Despite the fact that the number of opioid users has decreased since 2008, the most recent data shows that in 2018 there were 274 drug-induced deaths in Greece: 38 per million inhabitants between the ages of 15 and 64, twice the European average of 16.7. “Now that we can ensure 24/7 accessibility to naloxone, we’re going to see a big change. It has been proven to work in other countries with a drastic reduction in overdose deaths,” he explains.
Mexico City (Mexico): Improving road safety
Every year, 1.25 million people die and 50 million are injured in traffic accidents. The WHO warns that this is the leading cause of death among persons aged 15 to 29. These incidents have increased in Mexico City, becoming a most significant public health problem: only in the third quarter of 2022, according to official data, 157 people died and 9,042 were injured – a 24% increase compared to the same period of the previous year.
The city’s actions to stop this have been recognized. The road safety plan promoted by Mayor Claudia Sheinbaum in 2021 includes the construction of 28 and a half kilometers of bike lanes, which has prompted a 275% increase in cyclists in the city, reports Bloomberg Philantropist. The committee that selected the winning cities also took into account the elaboration of a guide for safe school environments that offers strategies to optimize the design, management, maintenance and operation of accesses and routes, after discovering that 80% of all trips to school are made on foot or by public transport.
Vancouver (Canada): Using data to improve health
This Canadian city has been recognized for making public health data more inclusive and accessible by launching an online tool that tracks population health indicators, as well as by collaborating with urban indigenous communities to improve data management, states the Partnership for Healthy Cities.
Specifically, the program that made it win the financial award is its Healthy City Dashboard, created with the support of the Partnership, which monitors its progress in relation to 23 indicators of well-being: from the number of homeless people to the diet of the population or the amount of time they spend exercising.
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Boris Johnson says ‘partygate’ untruths were an honest mistake | International
Former U.K. Prime Minister Boris Johnson acknowledged Tuesday that he misled Parliament about rule-breaking government parties during the coronavirus pandemic — but insisted he never intentionally lied. Johnson said it never occurred to him that the gatherings — which variously included cake, wine, cheese and a “secret Santa” festive gift exchange — broke the restrictions his own government had imposed on the country.
Britain’s boisterous former leader is set to be grilled by lawmakers on Wednesday over whether he lied when he denied there had been parties in his Downing Street offices in violation of Covid-19 lockdown rules that barred socializing. If found to have lied deliberately, he could be suspended or even lose his seat in Parliament.
In a dossier of written evidence to the House of Commons Committee of Privileges, Johnson acknowledged that “my statements to Parliament that the Rules and Guidance had been followed at all times did not turn out to be correct.”
But he said his statements “were made in good faith and on the basis of what I honestly knew and believed at the time. I did not intentionally or recklessly mislead the House.”
The committee will quiz Johnson in person on Wednesday afternoon about “partygate,” the scandal over a string of gatherings in government offices in 2020 and 2021. Police eventually issued 126 fines over the late-night soirees, boozy parties and “wine time Fridays,” including one to Johnson, and the scandal helped hasten the end of his three years in office.
Revelations about the gatherings sparked anger among Britons who had followed rules imposed to curb the spread of the coronavirus, unable to visit friends and family or even say goodbye to dying relatives in hospitals.
Becky Kummer, spokesperson for the group Covid-19 Bereaved Families for Justice, said Johnson’s claim to have acted in good faith was “sickening.”
“He isn’t fit for public office,” Kummer said.
When reports of the parties first emerged in late 2021, Johnson initially said that no rules had been broken. He later apologized and said there had been “misjudgments.”
But in the 52-page dossier he said he “honestly believed” the five events he attended, including a sendoff for a staffer and his own surprise birthday party, were “lawful work gatherings.”
“No cake was eaten, and no one even sang ‘Happy Birthday,’” he said of the June 19, 2020, celebration, for which he received a police fine. “The primary topic of conversation was the response to Covid-19.”
Johnson said suggestions that people in government considered themselves to be “in a guidance-free bubble where the requirements we imposed on the rest of the country did not apply” could not be further from the truth.
“Drinking wine or exchanging gifts at work and whilst working did not, in my view, turn an otherwise lawful workplace gathering into an unlawful one,” he said.
Johnson said he was assured by “trusted advisers” that no rules had been broken — assurances that turned out to be wrong. He said he was later “genuinely shocked” by the rule-breaking uncovered by police and by senior civil servant Sue Gray, who led an investigation into partygate.
Johnson and his supporters have also questioned the impartiality of Gray because she has now accepted a job as chief of staff to the leader of the opposition Labour Party.
If the committee finds Johnson in contempt, it could recommend punishments ranging from an oral apology to suspension or even expulsion from Parliament, or it could recommend no sanction at all. Any punishment would have to be approved by the House of Commons.
Johnson was forced to resign in July after a slew of scandals over money and ethics finally proved too much for Conservative colleagues, dozens of whom quit the government.
For Prime Minister Rishi Sunak, Wednesday’s televised hearing will be an unwelcome reminder of the turmoil that engulfed the Conservative government under Johnson — just as the party’s poll ratings are starting to edge upward.
Sunak took office in October, replacing Liz Truss, who stepped down within weeks of becoming prime minister after her tax-cutting budget plans caused turmoil on financial markets.
Johnson, once considered a secret weapon with voters, is now a liability, said Robert Hayward, a polling expert and Conservative member of the House of Lords.
“He is a serious negative for most people,” Hayward said. “Boris’s polling is far worse than is the case for Rishi (Sunak).”
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Drought caused 43,000 ‘excess deaths’ in Somalia last year, half of them young children | Global development
A new report released by the Somalian government suggests that far more children died in the country last year due to the ongoing drought than previously realised.
The study estimates that there were 43,000 excess deaths in 2022 in Somalia due to the deepening drought compared with similar droughts in 2017 and 2018.
Half of the deaths are likely to have been children under five. Up to 34,000 further deaths have been forecast for the first six months of this year.
Released on Monday by Somalia’s federal health ministry together with Unicef and the World Health Organization, the report was compiled by researchers at the London School of Hygiene and Tropical Medicine and Imperial College London, who looked at retrospective estimates of mortality across Somalia from January to December 2022.
Accurate statistics are difficult to compile from a population spread across remote areas, and with about three million people displaced from their homes. The highest death rates are thought to be in the regions of south-central Somalia, including Bay, Bakool and Banadir, that are the worst hit by drought.
Somalia’s health minister, Dr Ali Hadji Adam Abubakar, found cause for optimism that famine had so far been averted.
“We continue to be concerned about the level and scale of the public health impact of this deepening and protracted food crisis in Somalia,” he said.
“At the same time, we are optimistic that if we can sustain our ongoing and scaled-up health and nutrition actions, and humanitarian response to save lives and protect the health of our vulnerable, we can push back the risk of famine for ever.”
If this did not happen, he said, “the vulnerable and marginalised will pay the price of this crisis with their lives.”
“We therefore urge all our partners and donors to continue to support the health sector in building a resilient health system that works for everyone and not for the few,” said Abubakar.
For the first time, a prediction model was developed from the study. A forecast from January to June 2023 estimates that 135 people a day might also die due to the crisis, with total deaths projected at being between 18,100 and 34,200 during this period.
The estimates suggest the crisis in Somalia is far from over and is already more severe than the 2017-18 drought.
Wafaa Saeed, Unicef’s representative in Somalia, said he was saddened by the grim picture of the drought’s impact on families, but added: “We know there could have been many more deaths had humanitarian assistance not been scaled up to reach affected communities.
“We must continue to save lives by preventing and treating malnutrition, providing safe and clean water, improving access to lifesaving health services, immunising children against deadly diseases such as measles, and providing critical protection services.”
There have now been six consecutive failed rainy seasons in the climate crisis-induced drought, which coincides with global food price rises, intensified insecurity in some regions, and the aftermath of the pandemic.
The study is the first in a planned series and was funded by the UK’s Foreign, Commonwealth and Development Office.
War crimes committed on all sides in Ethiopia’s Tigray conflict, U.S. says | International
The Biden administration announced Monday that it has determined all sides in the brutal conflict in Ethiopia’s northern Tigray region committed war crimes and crimes against humanity. The move carries no immediate U.S. policy implications but lends weight to calls for such allegations to be prosecuted.
Secretary of State Antony Blinken announced the determination less than a week after he returned from a visit to Ethiopia during which he met with Ethiopian government and Tigrayan officials as well as victims of the conflict, but said little about the U.S. view of prospects for accountability.
His determination covers members of the Ethiopian and Eritrean national armies as well as the Tigray People’s Liberation Front and forces aligned with the Amhara region. Blinken said those responsible for atrocities must be held accountable.
He said after “careful review of the law and facts” he had determined that members of the Ethiopian National Defense Forces, Eritrean Defense Forces, Tigray People’s Liberation Front forces and Amhara forces committed war crimes during the conflict in northern Ethiopia.
Members of the Ethiopian, Eritrean and Amhara forces also committed crimes against humanity, “including murder, rape and other forms of sexual violence, and persecution,” Blinken said. “Members of the Amhara forces also committed the crime against humanity of deportation or forcible transfer and committed ethnic cleansing in western Tigray.”
Blinken announced the determination as he rolled out the State Department’s annual global human rights reports, which cover 2022 and also called out Afghanistan, China, Cuba, Iran, Myanmar and Nicaragua for abuses.
“I condemn the unspeakable violence against civilians and destruction that occurred in northern Ethiopia,” he said. “Recognizing the atrocities committed by all parties is an essential step to achieving a sustainable peace.Those most responsible for atrocities, including those in positions of command, must be held accountable.”
The formal determination is more measured than his assertion early in the two-year conflict that “ethnic cleansing” was taking place in parts of Tigray.
Last year, a United Nations commission of inquiry said it had turned up evidence of war crimes and crimes against humanity by Ethiopian government forces, Tigray forces and Eritrea’s military. But the commission also said Ethiopian forces had resorted to “starvation of civilians” as a tool of war and that Ethiopian and Eritrean forces were found to be responsible for “sexual slavery” — while Tigray forces were not.
The conflict, which ended with a peace deal in November, killed an estimated half-million civilians in Tigray alone, according to Ghent University researchers, a death toll echoed by U.S. officials.
Blinken called on all sides to respect the agreement and follow through on pledges “to implement an inclusive and comprehensive transitional justice process.”
He said Afghanistan’s ruling Taliban, which took power after the U.S. withdrawal from the country two years ago, “relentlessly discriminates against and represses women and girls” and has taken action that threatens humanitarian assistance to all Afghans.
On China, Blinken said Beijing continues abuses, including genocide and crimes against humanity, against Uyghur Muslims in it western Xinjiang area. It also continues the repression of Tibetans and pro-democracy activists in Hong Kong, along with mainland Chinese citizens who have tried to exercise basic freedoms.
In Myanmar, also known as Burma, Blinken said human rights “have further eroded,” and in Nicaragua, he said “the authoritarian government continues to detain political prisoners and hold them in appalling prison conditions.”
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