‘Join Me on this Journey’ to Eliminate Leprosy – WHO Ambassador

By Stella Paul
MANILA, Sep 10 2019 – Octogenarian Yohei Sasakawa has travelled to more than 90 countries across the globe; from areas of conflict, to the jungles of Brazil, shaking hands, hugging and washing the feet of Hansen’s disease-affected people. His message is simple: Stop stigmatisation and eliminate the disease.

Sasakawa, who has spent more than 40 years working towards elimination of Hansen’s disease, is the World Health Organization’s (WHO) Goodwill Ambassador for Leprosy Elimination and chairperson of The Nippon Foundation (TNF). Since 1975, TNF and its sister organisation, the Sasakawa Health Foundation (SHF), have contributed over USD200 million in financial support for the WHO’s Global Leprosy programme. Both foundations support elimination of the disease globally and provide information and awareness about the disease through the Leprosy Today website.

Sasakawa told IPS in an exclusive interview that he does not believe in sitting in “air-conditioned rooms” looking at data and making decisions about the elimination of the disease. “That will not be helpful to people. You must go to the actual site. That is why I travel across the world — even if it’s scorching deserts or the jungles of Brazil or areas that are difficult to reach or even areas that are dangerous.”

Sasakawa, who says that discrimination and stigmatisation against people affected by Hansen’s disease was the original human rights violation, advocated for this to be included in the United Nations human rights agenda.

Yohei Sasakawa, the World Health Organization’s (WHO) Goodwill Ambassador for Leprosy Elimination and chairperson of The Nippon Foundation, has dedicated more than four decades towards eliminating Hansen’s disease and putting an end to the stigmatisation that people affected by the disease face globally. Courtesy: Sasakawa Health Foundation/The Nippon Foundation

In 2010, his efforts bore fruition when the United Nations General Assembly Resolution on elimination of discrimination against persons affected by leprosy and their family members and accompanying principle and guidelines was passed.

“If you look around us, there are multiple issues in front of us. When it comes to leprosy, people discriminating against people started in the age of the Old Testament. So it goes back a long time in our past history. So I think leprosy is the origin of human rights violation because of the fact that it started such a long time ago,” the recipient of the 2019 Order of the Rising Sun and 2018 Gandhi Peace Prize winner told IPS.

He said that 60 percent of the more than 210,000 new global leprosy cases for 2017 originated in India, adding that India’s Prime Minister Narendra Modi had made a strong commitment to make 2030 the year of zero leprosy in the country.

Sasakawa is currently in Manila, Philippines, to attend the TNF/SHF-sponsored Global Forum of People’s Organisations on Hansen’s Disease, which is being held Sept. 7 to 10. He will also deliver a keynote address at the 20th International Leprosy Congress (ILC), which takes place Sept. 11 to 13.

Through his work Sasakawa has met more than 150 national leaders, including presidents and prime ministers, sharing his message and gaining their support and commitment to eliminate leprosy.

However, he stressed, that his efforts alone would not eliminate the disease and called on the youth to “take action in their own countries” and encouraged them to begin discussions for solutions on social media platforms.

“I would definitely ask young people to join me on this journey.”


The Geneva Centre to organize on 18 September a panel debate on the rights of the child

By Geneva Centre
GENEVA, Sep 10 2019 (IPS-Partners)

(Geneva Centre) – A panel debate will be organized by the Geneva Centre for Human Rights Advancement and Global Dialogue and the Permanent Mission of the United Arab Emirates (UAE) to the UN in Geneva on the enhancement of access to justice for children in the UAE and the implementation of the Convention on the Rights of the Child (CRC).

The debate entitled “Enhancing access to justice for children in the United Arab Emirates“ will take place on 18 September from 15:00 to 16:30. It will be held in room XXIII, at the United Nations Office in Geneva, on the margins of the 42nd regular session of the Human Rights Council.

The purpose of the conference will be to raise awareness about the need to protect the rights of children in vulnerable situations and to gain deeper understanding of the root causes and risk factors of child abuse and neglect.

In this connection, the conference will take stock of the progress achieved in the UAE to enhance the legal empowerment of children, and identify areas of improvement in line with the provisions set forth in the CRC and other relevant international legal frameworks. It will include the participation of Safety Ambassadors, designed under the precept of the Wadeema Law, who will present the main objectives of Safety Ambassadors programmes and the means available to protect children from any violations they may be subjected to, and raise their awareness of remedies available to address violations.

The panel debate will be opened by HE Obaid Salem Al Zaabi, Ambassador and Permanent Representative of the UAE to UN in Geneva.

It will be moderated by Dr Umesh Palwankar, Executive Director ad interim of the Geneva Centre.

The conference will benefit from the participation of the following high-level panellists:

      • (1) Ms Fatma Ghulam Murad – Head of Section of the Department of Child and Woman Protection. General Department of Human Rights, Dubai Police;
      • (2) Professor Velina Todorova – Vice-Chairperson and Member of the Committee on the Rights of the Child;
      • (3) Ms Beate Andrees – Chief, Fundamental Principals and Rights at Work Branch, ILO;
      • (4) Mr Phenny Kakama – Child Protection Specialist, UNICEF Regional Office for Europe and Central Asia.

India Promotes South-South Cooperation, but Key Questions Unaddressed

Indian Prime Minister Narendra Modi advocated, “greater South-South cooperation in addressing climate change, biodiversity and land degradation.” Courtesy: GCIS

By Joydeep Gupta
Sep 10 2019 (IPS)

At his speech at the United Nations Convention to Combat Desertification (UNCCD) summit in Delhi, Prime Minister Narendra Modi emphasised South-South cooperation and technology solutions, but issues of land ownership dog the ongoing negotiations.

As the second week of the UNCCD Conference of Parties (COP) kicked off in Delhi, Indian Prime Minister Narendra Modi highlighted South-South cooperation and issues of land degradation.


Speaking at the opening ceremony of the high level segment, he said that it was increasingly accepted that climate change impacts were leading to a loss of land, plants and animal species, and that it was causing, “land degradation of various kinds (including) rise of sea levels, wave action, and erratic rainfall and storms”.

All of these issues have a significant impact on India, and other developing countries, and as such, the Prime Minister advocated, “greater South-South cooperation in addressing climate change, biodiversity and land degradation.”

He said India would act both internally and externally on this. Domestically, he said that India was increasing its commitment to restore 21 million hectares of land by 2030 to 26 million hectares, an increase of 5 million hectares. The co-benefit of this would be that it would help create a carbon sink for 2.5-3 billion tonnes of carbon through increased tree cover.

On external action, he said that India was, “happy to help other friendly countries cost-effective satellite and space technologies,” and that it would be creating a Centre for Excellence at the Indian Council for Forestry Research and Education in Dehradun to promote South-South cooperation, where other countries could access technology and training.

Hard questions

Nevertheless, this avoids some of the hard questions that have been dogging the UNCCD COP. Who owns the land? Who is responsible when the land is no longer able to support a livelihood, and a farmer is forced to migrate?

These are not questions anyone thought about when they launched the UNCCD 25 years ago. But since degradation of land due to a variety of reasons precedes desertification, these questions are increasingly worrying policymakers, especially from developing countries. At the ongoing New Delhi summit, the issues have come to the fore, and have divided governments along the lines of developed and developing nations, a process familiar to observers of UN climate negotiations.

Despite Narendra Modi’s speech at the high level segment, these issues remained unresolved, with bureaucrats awaiting instructions from the 100-odd ministers gathered at the Indian capital.

The NGOs who work on farming issues are clear that land degradation cannot be halted unless farmers around the world have guaranteed rights over the land on which they grow food for everyone. This may sound like a no-brainer, but estimates show that globally only around 12% of all farmers can claim legal rights over the land they till. To this, experts would like to add the land held in various forms of community ownership, sometimes by indigenous communities. But few countries have strong laws to protect such ownership.

In the first week of the New Delhi summit, developing country governments have wanted this issue of land tenure being discussed at the UNCCD forum, and developed countries – led by the US delegation – have opposed the inclusion. The industrialised countries say it is an issue of different laws in different countries, and discussing it in the UN is not going to help.

Land tenure

But, with land degradation being inextricably tied up with climate change and biodiversity, the urgency of the situation may force UNCCD to discuss land tenure in this and future meetings, and to come up with possible solutions.

The solutions are not always as straightforward as they may seem, warned UNCCD chief scientist Baron Orr in a conversation with thethirdpole.net. Think of what a farmer – especially a smallholder farmer – is likely to do if offered a high price for land. Most of them are likely to sell, as evidenced by the mushrooming malls, offices and homes all around the current summit venue, which was all farmland just about a decade ago. And what happens to our food supply if this replicated globally?

Land tenure is important to halt degradation because people naturally provide better protection to land they own. But it is not enough. A farmer faced with competitors using chemical fertilisers and pesticides is not going to move to organic farming just because that is better for the soil.

Most farmers cannot afford to do that. They need help, as was seen in India when the state of Sikkim pledged to do only organic farming. Sikkim is a relatively small state – replicating that kind of help on a global or even national scale may need far more money than is available for the purpose, as Orr pointed out.

Land tenure is also an area where women face discrimination in a big way. Data journalism site IndiaSpend reported that 73.2% of the country’s rural women workers are farmers, but have only 12.8% of India’s land holdings.

Migration: the hot potato

Farmers being forced to migrate because their farms can no longer support them due to land degradation and climate change is the hottest potato of them all. Developed countries are united in opposing this major “push” factor in migration, insisting that people migrate only due to “pull” factors such as better economic opportunities. Developing countries, especially those from the Sahel belt stretching from the western to the eastern coast of Africa, point to numerous instances where farmers are forced off land gone barren, and insist on this issue being discussed by UNCCD.

Former UNCCD chief Monique Barbut has said almost all Africans trying to move to Europe are doing so due to land degradation and drought. Without putting it in words that strong, current UNCCD chief Ibrahim Thiaw has backed the inclusion of migration in the conference agenda.

As host government and conference president, India may have to use all its diplomatic skills if this knot is to be untied during this summit – an especially tricky manoeuvre because India has consistently refused to accept that immigrants from Bangladesh are entering this country because their farms can no longer support them.

And it is not just migration across countries. At a meeting organised on the sidelines of the summit by local government organisation ICLEI, mayor after mayor got up to say farmers are coming into their cities in increasing numbers due to land degradation and climate change, but they have no budget to provide any housing, water, electricity, roads or any form of livelihood to these millions of immigrants.

Still, developed country delegations insist UNCCD is not the right forum to discuss migration. What all 196 governments and the European Union agree upon in the next day or two remains to be seen.

Human efforts

Prakash Javadekar, India’s Minister of Environment, Forests and Climate Change and the conference president, had said at the opening, “If human actions have created the problems of climate change, land degradation and biodiversity loss, it is the strong intent, technology and intellect that will make (the) difference. It is human efforts that will undo the damage and improve the habitats. We meet here now to ensure that this happens.” This foreshadowed what the Prime Minister said today.

He pointed out that 122 countries, among them Brazil, China, India, Nigeria, Russia and South Africa, which are among the largest and most populous nations on earth, “have agreed to make the Sustainable Development Goal of achieving land degradation neutrality a national target.”

Thiaw drew attention to the warnings sounded by recent scientific assessments and the growing public alarm at the frequency of weather-related disasters such as drought, forest fires, flash floods and soil loss. He urged delegates to be mindful of the opportunities for change that are opening up, and take action. The response of governments from developed countries will decide how useful the current summit will be.

The world is in trouble otherwise. The current pace of land transformation is putting a million species at risk of extinction. One in four hectares of this converted land is no longer usable due to unsustainable land management practices. These trends have put the well-being of 3.2 billion people around the world at risk. In tandem with climate change, this may force up to 700 million people to migrate by 2050.

This story was first published on thethirdpole.net and can be found here.

Eritrea Tops Watchlist of World’s Most-Censored Countries

In Eritrea, many of the journalists who were jailed in the 2001 media crackdown remain behind bars, the Committee to Protect Journalists says.
Courtesy: UN Photo

By James Reinl
UNITED NATIONS, Sep 10 2019 – Eritrea has the world’s highest levels of censorship and the most active government in jailing reporters and stifling newspapers, radio and television, a study by the Committee to Protect Journalists (CPJ) watchdog says.

The authoritarian Horn of Africa nation, which shuttered all independent media in 2001 and currently has some 16 journalists behind bars, is followed by North Korea and Turkmenistan as the world’s worst places to work as a reporter, the CPJ says.

“The internet was supposed to make censorship obsolete, but that hasn’t happened,” the group’s executive director Joel Simon said in a statement upon releasing the annual report Tuesday.

“Many of the world’s most censored countries are highly wired, with active online communities. These governments combine old-style brutality with new technology, often purchased from Western companies, to stifle dissent and control the media.”

The top 10 watchlist of countries that “flout international freedom of expression norms and guarantees” also includes Saudi Arabia, China, Vietnam, Iran, Equatorial Guinea, Belarus, and the Caribbean island of Cuba. 

In Eritrea, many of the journalists who were jailed in the 2001 media crackdown remain behind bars, the CPJ says. The government controls most broadcast outlets; internet connections are hard to find, and foreign radio signals are jammed.

Eritrean law says reporters must promote “national objectives”. Journalists at the country’s state-run media outlets “toe the government’s editorial line for fear of retaliation”, the CPJ said in a nine-page report.

Eritrea’s mission to the United Nations did not answer an interview request from IPS.

In North Korea, the official Korean Central News Agency (KCNA) runs nearly all the country’s newspapers and broadcasters and sticks to reporting on the latest comments and activities of the reclusive nation’s leader Kim Jong Un.

KCNA has typically been “highly restrictive in its coverage of foreign news”, but that changed in recent months, allowing for reporting on talks between Kim and United States President Donald Trump over Pyongyang’s nuclear weapons program.

Free media also remains largely absent in Turkmenistan, where President Gurbanguly Berdymukhamedov “enjoys absolute control” over newspapers and broadcasters and wields this power to “promote his cult of personality”, the CPS says.

“A handful of independent Turkmenistan-focused media outlets, such as Khronika Turkmenistana, operate in exile, and anyone who attempts to access the website can be questioned by the authorities,” the report says.

The group also names Saudi Arabia as an offender, spotlighting the murder and dismemberment of Saudi journalist and government critic Jamal Khashoggi in the country’s consulate in Istanbul, Turkey, in October 2018.

The oil-rich kingdom has witnessed a “sharp deterioration” in media freedoms during the ascendancy of the country’s crown prince and de facto ruler Mohammed bin Salman, with new anti-terror and cybercrime laws helping to silence journalists, the CPJ says. 

The CPJ report was released only days after the hardline religious militant Taliban group kidnapped six local journalists in Afghanistan last week, as they were travelling to a media workshop in Paktika province. 

CPJ researchers noted that journalists struggled with war and instability in such countries as Afghanistan, Syria and Somalia, but said that these issues were “not necessarily attributable solely to government censorship”.

The CPJ media freedom ranking is similar to the list compiled by Reporters Without Borders, another watchdog, which also shames Eritrea, North Korea and Turkmenistan as the world’s worst three countries for independent journalism.

The Costs of Heightened Conflict in the Himalayas

As a series of conflicts in the Hindu Kush Himalayan region come into sharp focus, sidelining local populations, the long-term environmental costs may leave the region degraded, poor and desperate. Courtesy: CC by 2.0/Lensmatter

By Omair Ahmad
Sep 10 2019 – As a series of conflicts in the Hindu Kush Himalayan region come into sharp focus, sidelining local populations, the long-term environmental costs may leave the region degraded, poor and desperate.

It has been a month since India cut off communications and implemented a security lockdown in the part of Kashmir it governs. While India has explained that the governance changes it is implementing – rendering significant legislative changes in territory it governs – as an internal matter, the move has drawn strong reactions from Pakistan and China, both of which claim the territory, at least in some part. The political outcome of these changes are a matter for both international relations and domestic politics within the various countries, but this move is one of many political factors that will make cooperation over the environment in the Hindu Kush Himalayas (HKH) far more difficult.

The Indus, a river of troubles

The impact of any political troubles will be felt the most along the Indus, which rises in Tibetan territory controlled by China, winds through the part of Kashmir under Indian control, enters Pakistan, with one stretch entering and exiting Afghanistan, before reaching the sea after traversing Pakistani territory. The two countries where most of the Indus basin is located are India and Pakistan, and their management of the river is largely governed by the Indus Waters Treaty (IWT) signed in 1960. The Treaty has survived the outbreak of the 1965 war and the 1971 war between the two countries, as well as a host of skirmishes and conflict, and it is unlikely to be negatively affected now, as it was not affected in the last such crisis in 2017.

The problem, though, is less about the treaty as it has functioned in the past, but how it will function in the future. The IWT was a product of its times, and thus issues like environmental impact were not covered. The recent Hindu Kush Himalayan Monitoring and Assessment Programme (HIMAP) project led by the International Centre for Integrated Mountain Development highlighted that climate change impacts – everything from irregular rainfall to glacier retreat – in the HKH region would be felt most within the Indus basin. These are new factors that the treaty is not designed to cover. The hope that these could be brought into the treaty has now receded. With the Pakistani government withdrawing its High Commissioner from India, and lowering its diplomatic engagement, it seems unlikely that these issues will get the attention they deserve.

More importantly the Kabul river, part of the Indus, is not covered by any treaty. Pakistani policymakers have been hoping for an IWT-type treaty between Pakistan and Afghanistan would deal with many outstanding issues. But with lowered cooperation between India and Pakistan, the IWT looks less and less like a good example to follow. The idea of including China as well, so that the four countries could all be involved in the joint management of a river basin that they all share now seems almost impossible to imagine.

In the meanwhile conflict will continue to degrade the environment, while also limiting scientific access to the more remote parts of the HKH region. Both Indian and Pakistani troops continue to be deployed on the Siachen glacier, the highest battlefield in the world, costing both countries significant amounts of expenditure and significant loss of lives due to the harsh climatic conditions. The material and garbage accumulated on a glacier has significant negative effects for the environment, not to mention cutting off areas like this from any kind of scientific assessment. Reports like HIMAP, dependent on the cooperation of the various governments, will have to continue to deal with these blind spots.

The dangers of over-centralisation

By its very nature, conflict centralises decisionmaking, as security issues take precedence over everything else. This can have disastrous results on the local environment. This was most clearly demonstrated by the Rohingya crisis in Mayanmar and Bangladesh. The million refugees created due to the crisis led to the environmental destitution of the areas where the refugees were settled in camps.

By laying mines across the areas the routes that the Rohingya took, the Myanmarese military may have meant only to restrict human movement, but these were also traditional elephant corridors. Insurgency and civil war in India’s northeast and Nepal, had a deleterious impact on the rhino population, as poachers found it easy to operate. All 30 rhinos translocated to the Bardiya National Park where killed during the Nepalese civil conflict. In Kashmir, the decades of conflict have led to extensive poaching, the destruction of delicate habitats, and a timber mafia operating with impunity. With militarised borders, populations of key species, such as the yak, will find it difficult to travel freely, leading to limited cross breeding, and the decline of their populations.

The centralising tendencies of governments when it comes to “internal security” issues can possibly be best seen in the Tibetan region, where Beijing insisted on implementing agricultural and animal husbandry practices out of sync with local cultures. The local practices had evolved in consonance with the environment of the region, and had been more sustainable, something that China is now discovering, decades after putting into place self-harming practices. Nevertheless this sidelining of local populations remains a significant part of China’s investments abroad, with the China Pakistan Economic Corridor offering a very clear example. Due to its high political value for Pakistan, the investments are handled at high government levels with military support. Local factors are rarely factored in, so the heavy investment at the Gwadar port being built at the end of CPEC has managed to isolate and marginalise local fisherfolk.

Making the mountains poorer

Lastly, there are significant financial costs of the conflict on local people. Fear of violence undermines the confidence of outsiders willing to invest in a region, leaving people dependent on either government funds or their own limited means. The HKH region is one of the most biodiversity rich regions on the planet, and yet its mountain population are significantly poorer than their fellow citizens in their own countries. Despite potential opportunities for innovation and investment, the remoteness of the communities means that other than heavy infrastructure such as dams – which tend to marginalise local communities even more – investment does not reach these areas.

Fear of conflict will only make this more difficult, depriving the 240 million people that live in the mountainous areas of the HKH region that much poorer. This is at a time when climate change is already negatively impacting traditional crops such as apples, and half of the springs in the HKH region have either dried up, or become seasonal from perennial. Desperate people, who have few options, and whose involvement in governance is limited, make for poor caretakers of the environment.

While discussion of conflict between the countries of the Himalayan region is often spoken of in the same breath as nuclear war, the clear and present danger of a breakdown of cooperation in the region may be simpler. The price of conflict may simply mean that the environment is degraded, species are lost, scientific enquiry is stifled, investment is hobbled, and the hundreds of millions of people dependent on the delicate ecosystem of the HKH region will be made poorer and more miserable. It may not be a global catastrophe, but it will certainly be a series of local catastrophes.

This story was first published on thethirdpole.net and can be found here.

Vaping Fad Boosts Dangerous Nicotine Addiction

By Wan Manan Muda and Jomo Kwame Sundaram
KUALA LUMPUR, Malaysia, Sep 10 2019 – Smoking-related diseases are the major causes of premature death worldwide. Every year, six million smoking-related deaths are reported worldwide. If current smoking trends persist, 8 million deaths can be expected by 2030, of which four-fifths will occur in lower- and middle-income countries.

Start them young
Many studies show that smoking is typically learned and started during adolescence. Owing to nicotine addiction, the earlier someone starts to smoke, the higher the likelihood he or she will continue the habit into adulthood, and the smaller the likelihood of stopping smoking.

Jomo Kwame Sundaram

Early smoking initiation is associated with greater risk of developing lung cancer. The younger the age of smoking initiation, the greater the harm it causes. Early initiation is associated with subsequent heavier smoking, higher dependency, less chance of stopping smoking, and higher mortality.

The first Global Youth Tobacco Survey (GYTS) in 2003 found that 20.2% of 13-15 year-old school-based adolescents were already smoking. Prevalence was much higher among males (36.3%) compared to females (4.2%). Subsequently, the 2009 GYTS reported reduced prevalence (18.2%) of current cigarette smoking among adolescents, mainly due to less male smokers (30.9%) while female smokers increased (5.3%).

Electronic cigarettes new threat
Many studies have reported increasing e-cigarette usage worldwide. E-cigarettes were touted as a means to help smokers stop smoking. However, studies suggest no difference between e-cigarette users and non-users in rates of successfully quitting.

As the vaping epidemic spreads, health risks associated with nicotine rise dangerously. Young people are vaping in record numbers in many parts of the world. “Adolescents don’t think they will get addicted to nicotine, but when they do want to stop, they find it’s very difficult,” notes Yale neuroscientist Marina Picciotto.

Despite many research reports highlighting its dangers and marketing tactics to hook teenagers and young adults, the number of vaping users continues to climb. And while it is possible to buy liquid or pod refills without nicotine, it is much harder to find them.

Many observers, including policymakers, overlook or underestimate the role of nicotine, a key ingredient in the vapours inhaled. Most teens do not realize that nicotine is deeply addictive. Studies show that young people who vape are much more likely to move on to cigarettes, which cause a broad range of diseases.

Wan Manan Muda

Why nicotine is so dangerous for youth
Nicotine is dangerous to health at any stage in life, but is especially dangerous before the brain is fully developed, around age 25. Studies show that nicotine can physically change the teenage brain. Adolescents do not think they will get addicted to nicotine, but find it very difficult to stop as “the adolescent brain is more sensitive to rewards”, according to Picciotto, who has studied nicotine addiction for decades.

The mesolimbic dopamine ‘reward’ system is a more primitive part of the brain which positively reinforces behaviour needed to survive, such as eating. As the mechanism is etched into the brain, it is hard to resist. When a teen inhales vapour with nicotine, the drug is quickly absorbed through blood vessels lining the lungs, reaching the brain in about 10 seconds. There, nicotine particles fit ‘well’ into receptors on nerve cells (neurons) throughout the brain.

Why nicotine cravings persist
“Nicotine, alcohol, heroin, or any drug of abuse works by hijacking the brain’s reward system”, according to Yale addiction neurobiologist, Nii Addy. The reward system was never meant for drugs, but evolved, enabling nicotine to biochemically interact well with natural neurotransmitters which activate the muscles in our body.

Once nicotine binds to the receptor, it signals the brain to release dopamine, a well-known neurotransmitter which generates a ‘feel-good’ feeling. Dopamine is part of the brain feedback system signalling that “whatever just happened felt good”, training the brain to repeat the action.

Unlike other drugs such as alcohol, nicotine quickly leaves the body once it is broken down by the liver. And once it is gone, the brain craves nicotine again. Craving, due to the drug that causes the dopamine rush, makes it difficult for addicted youth to quit nicotine.

Recent research, including human brain imaging studies, shows that “environmental cues, especially those associated with drug use, can change dopamine concentrations in the brain”. Simply seeing a person one vapes with, or visiting a school toilet where teens vape during the school day, can unleash intense cravings, making it difficult not to relapse.

Physical changes caused by nicotine
Nicotine also causes physical changes to the brain, some temporary, while others could be long-lasting. Cigarette smoking research has long shown that acetylcholine receptors in the brain increase with continuous exposure to nicotine, intensifying cravings.

But the receptors decrease after the brain is no longer exposed to nicotine, implying that such changes are reversible. Animal studies also show nicotine adversely affecting brain functions, relating to focus, memory and learning, which may be long-lasting.

According to Picciotto, nicotine can cause a developing brain to increase connections among cells in the cerebral cortex region in animals, which would cause cognitive function and attention problems, if also true for humans.

Vaping vs regular cigarettes
Comparing the pros and cons of vaping versus smoking is complicated. On the one hand, unlike regular combustible cigarettes, e-cigarettes probably do not produce 7,000 chemicals, some of which cause cancer. However, aerosol from vaping devices contains lead and volatile organic compounds, some of which are linked to cancer, while the long-term health effects of vaping are still unresearched.

E-cigarettes have not been approved by the US Food and Drug Administration (FDA) as smoking cessation devices. But according to the US Centers for Disease Control and Prevention (CDC), e-cigarettes may be better for adult smokers if they completely replace smoking.

The ‘pod mod’ is a newer, popular vape device outcompeting many other e-cigarettes. The nicotine in these pods is two to ten times more concentrated than most ‘free-base’ nicotine in other vape liquids. A single pod from one vape manufacturer contains 0.7 mL of nicotine, about the same as 20 regular cigarettes.

Despite its highly addictive nature, people can successfully quit nicotine, particularly with personalized approaches under the guidance of suitably trained physicians. For young people, early intervention could significantly improve the quality of the rest of their lives.

To learn more, visit yalemedicine.org

Professor Wan Manan Muda was professor of nutrition and public health at Universiti Sains Malaysia. Jomo Kwame Sundaram was an economics professor and United Nations official.

The Emergence of a Global Voice for Hansen’s Disease Affected Persons

Her experience and the chance “to help strengthen Colombia, the world, and my family” through participating in the Global Forum of People’s Organisations on Hansen’s Disease, sponsored by the Nippon Foundation and the Sasakawa Health Foundation, was like “rising from the ashes” for Lucrecia Vazques from Felehansen Colombia. Vazques’ family was hit hard by leprosy, with not only herself, but her son and one-month-old granddaughter being afflicted. Credit: Ben Kritz/IPS

By Ben Kritz
MANILA, Sep 10 2019 – The Global Forum of People’s Organisations on Hansen’s Disease, which was attended by members of people’s organisations from 23 different countries, wrapped up in Manila, Philippines, today Sept. 10 after four days of discussion and deliberation.

The main outcome was a set of recommendations, which included participants stating that those affected by the disease should have more inclusive roles in the global campaign against leprosy.

Asked to share his impressions of the forum with his fellow participants, Joshua Oraga, who is a member of ALM Kenya, a local Hansen’s disease non-profit, told the audience, “We should all familiarise ourselves with the WHO [World Health Organisation] guidelines on strengthening the participation of persons affected by leprosy in leprosy services. That should be our creed, because if you look at that document, you will see that we are the only stakeholders who have an end-to-end role.”

He said that those affected by leprosy or Hansen’s disease had a role in overcoming stigma and discrimination.

“We have a role in the promotion of equity, social justice, and human rights, we have a role in addressing gender issues, we have a role in the dissemination of information, education, communication…. We have a role in advocacy, we have a role in counselling and psychological support, we have a role in training and capacity-building, we have a role in referral services, we have a role in resource mobilisation…. So, we are everywhere!”

Oraga’s enthusiastic impressions in a way defined the outcome of the forum organised by Japan’s Sasakawa Health Foundation (SHF) and The Nippon Foundation (TNF), which support elimination of the disease globally and provide information and awareness about the disease through their dedicated website titled Leprosy Today.

The recommendations will be presented on the first day of the International Leprosy Congress (ILC), which is also being held in Manila from Sept. 11 to 13. The recommendations addressed increasing awareness of Hansen’s Disease among the public and governments, calling for greater government support for people’s organisations’ advocacies, taking a larger role in helping to form anti-leprosy policy, and working to build sustainability and more effective networks among organisations spread around the world.

A true people’s forum

To Dr. Takahiro Nanri, Executive Director of SHF, the real value of the recommendations lies not in their details, but in the manner in which they developed.

Nanri noted that the forum’s carefully-planned agenda was quickly thrown off-schedule by the spirited discussions among the participants. “The people really led the forum, and did the work they wanted to do, and I am very happy about that.”

“The recommendations were good ones, but what I think is really important is the process we saw,” he added.

Oraga was likewise pleased and motivated by his experience. Oraga, who had leprosy as a youth, said, “This is the first time I have had the opportunity to take part in a meeting at this level, so imagine my excitement and happiness to be able to come here.”

Oraga also expressed his gratitude for the work that Yohei Sasakawa, World Health Organization’s (WHO) Goodwill Ambassador for Leprosy Elimination and chairperson of TNF, has done over the last four decades. Sasakawa’s foundations have contributed over USD200 million in financial support for the WHO’s Global Leprosy programme. He also advocated for discrimination and stigmatisation against people affected by Hansen’s disease to be included in the United Nations human rights agenda. The resolution was passed in 2010.

“He has done so much for leprosy around the world, and personally I am grateful. Just think of it, because of Mr. Sasakawa, in three years, maybe leprosy will just be like any ordinary sickness,” Oraga said.

Lucrecia Vazques of Felehansen, Colombia also felt the forum was an extraordinary experience. “It’s been wonderful,” she told IPS through a Spanish translator. “It is like resuscitating after a hard moment.”

Vazques’s bubbly personality belies her own difficult experience with Hansen’s disease, which not only afflicted her, but her one-month-old granddaughter and her son, who was diagnosed first.

“It was hard,” Lucrecia said. “I had no knowledge whatsoever.We thought we would die.”

“But there was something to fight for, and to live for, and here I am. This forum means rising from the ashes. And if I had the choice, I would rise from the ashes again, and I would be right here, to help strengthen Colombia, and the world, and my family,” she said.

Looking ahead

But there is much work to still do.

“Because this was a people-led forum, it gives us direction. As you know, our resources are not limitless. We have an obligation, but it is of course better if we can maximise our efforts, and the recommendations help,” Nanri said.

Nanri reiterated the value of the “process” that he saw evolve during the forum, particularly in the context of the Joint Campaign on World Leprosy Day 2020, which will be observed on Jan. 26 next year.

“This was a step. You don’t go from the ground to the 10th floor in one jump. So now the first step has been taken. The next step is to get the groups around the world to do the activities at the same time,” which is the goal of the joint campaign. “When these recommendations are presented at the ILC, the next step can begin,” he said.

Fairer Fashion Begins with Better Access to Water & Toilets For Workers in Clothing Supply Chains

Ian Gavin is WaterAid’s Regional Programme Manager, who attended last week’s Hong Kong Fashion Summit

By Ian Gavin
HONG KONG, Sep 10 2019 – Last year, WaterAid and HSBC launched a programme that delivers essential water, sanitation and hygiene services (known collectively as WASH) to apparel factories and nearby worker communities in Bangladesh and India.

The supply chains projects ensure that the investments in WASH extend beyond the workplace, improving not only the health and quality of life for workers and their families, but also increasing supply chain resilience and business productivity. Sustainable water use means more sustainable fashion through fairer working environments.

Meet Momena, whose life has been transformed by the simple yet vital introduction of clean water, decent toilets and somewhere to wash her hands whilst at work, thanks to WaterAid’s work.

Momena Khatun, 32, works as a sewing operator at a ready-made garment factory in Dhaka, Bangladesh. Her husband Kabir Mia also works in the factory and, although the family faces struggles financially, their two sons attend school, improving their life-chances for the future.

WaterAid, together with the factory owners, had already lowered water-abstraction rates through the construction of rainwater-harvesting systems. The next focus moved to improve access to drinking water, toilets and handwashing facilities not only in the factory, but also at home – where the situation is invariably far worse.

The family’s rented room in Naraynaganj, south-east of Dhaka, is convenient for work, but the standard of living in the building was dire. There were only two toilets for the entire block of at least 40 people, and they were filthy, unhygienic and hazardous.

To make matters worse, there was nowhere to wash your hands. Unsurprisingly, the children often prefered to go outside instead, increasing their vulnerability to diarrhoeal diseases, sickness and days off school.

With no other option, every morning the tenants argued over who was next in line for the bathrooms. Every day, Momena faced the grim choice of either being late for work, which reflected negatively on her performance; or leaving home without going to the toilet at all, ultimately leading to health problems and pain.

That horrendous situation has now changed. WaterAid, with funding from HSBC, has renovated the facilities in this tenancy and others like it. Three new toilet facilities have recently been constructed, all with separate cubicles for men and women, ensuring dignity, safety and privacy. In addition, the residents now have segregated bathing facilities with handwashing facilities and safe drinking water points.

“Separate female toilets and bathing facilities have dramatically changed our living conditions for the better! We faced real difficulties in using toilets in the morning in front of men”, explained Momena.

“Now I am comfortable and not hesitant to use the toilets and take showers when I need. The new look and cleanliness of the toilet and hygiene messages have encouraged us to maintain our toilets well. I am very happy and thankful to the project for their support to our community”.

A feeling of ownership of these new facilities has increased their chances of being properly managed and sustainably maintained. With this in mind, both the tenants and landlords were fully engaged in the project, and they discussed how everyone can play a part in ensuring the new water, sanitation and hygiene facilities remain hygienic and clean.

This renovation work has undoubtedly been transformational. The enhanced living conditions – now giving the garment workers access to clean water and decent sanitation facilities – have made a huge impact on the community’s lives. Now, Momena has a smoother morning bathroom routine and is rarely late for work.

Clean water, sanitation and hygiene have the power to change-for-good millions of lives like Momena’s. She and her community now have the potential to live healthy, productive and dignified lives.

WaterAid is leading work to improve WASH provision in the factory where Momena works. This collective work by WaterAid, funded by HSBC, will enable the trial and testing of the financial return on investment in these basic human rights of water and sanitation.