Three Ways to End HIV Stigma and Discrimination

By Ifeanyi Nsofor
ABUJA, Oct 7 2019 – As a Public Health Doctor, I often meet people who experience stigma simply because they live with HIV. One person who still haunts me is a woman who is HIV positive and when she was in labor, a midwife would not help her. Instead she shouted at her to just push out the baby and then she stood far away from the bedside, disgusted by the woman’s HIV status.  No one should go through such stigma at a vulnerable situation when they are about to birth life.

Another lady I met was denied university admission because she is HIV positive. She was screened for HIV without her consent, her HIV-positive status was disclosed publicly, and she was asked to leave the private university.

This is not okay. All forms of HIV-related stigma must stop. When people experience stigma and discrimination they may be afraid or ashamed to access HIV services. This fear of stigma has far-reaching implications – it could cause people to delay being tested and knowing their HIV status and getting help, before it’s too late.

Globally, there are approximately 37.9 million people living with HIV, with 770,000 deaths, based on 2018 data. In 2018, there were 1.7 new HIV infections. Seventy-five million people have been infected by HIV since the epidemic began and 32 million have died as a result. HIV-related stigma can have serious consequences.

These are ways to deal with it.

Americans wrongly believe that HIV can be transmitted through sharing glass (27%); touching toilet seat (17%); and swimming in a pool with someone who is HIV positive (11%)

First, government across the globe should increase investments in health education to improve people’s knowledge of HIV and its modes of transmission. It should not be taken for granted that people are aware.

For instance, according to a survey of Americans by the Kaiser Family Foundation, Americans wrongly believe that HIV can be transmitted through sharing glass (27%); touching toilet seat (17%); and swimming in a pool with someone who is HIV positive (11%). Instead, one can get HIV when there is contact with body fluids such as blood, semen, vaginal fluids and breast milk.

Targeted information should be deployed on platforms where people congregate and interact. Social media platforms such as Facebook, Instagram, Twitter and WhatsApp serve this purpose and should be used. Globally, there about 3.5 billion social media users – an estimated than 2.7 billion of these are Facebook users.

In 2016 at peak of the Zika virus epidemic in Brazil, Facebook pulled anonymized posts about conversations on Zika virus. This was shared with UNICEF to design a campaign that provided the right information for individuals to protect themselves against Zika virus. Facebook can replicate the same to tackle misinformation about HIV and reduce stigma.

Second, enforce HIV antidiscrimination laws to deter offenders from discriminating against people living with HIV. For instance, In 2015, the Nigerian President Jonathan signed the HIV/AIDS Anti-Discrimination law.

One of the objectives of the law is to help more Nigerians to seek testing, treatment and care services without fear of facing stigma and discrimination. The law does not permit HIV screening as a prerequisite for employment and school admissions.

There are fines of $1400 for individuals and $5,700 for institutions who violate the law. The fines could come with prison term of up to one year in addition to these fines. Although not as robust as Nigeria’s HIV antidiscrimination law, Ghana’s patient’s charter protects individuals from discrimination based on type of illness.

Third, end the discrimination against key populations like men who have sex with men, sex workers and transgender people as this discourages them from accessing care, pushes them underground and increases their risk of transmitting HIV.

Globally, these populations account for 54% of new HIV infections – 88% in Western and central Europe and North America; 95% in Middle East and North Africa; and 64% in Western and central Africa.

Compared to non-key populations, the risk of acquiring HIV is 22 times higher among men who have sex with men and injection drugs users; 21 times higher among sex workers and 12 times higher for transgender people.

Specific changes include ending discriminatory laws. Countries including Algeria, Morocco, Nigeria, Pakistan, Kenya, Zambia and others criminalize LGBT folks and that needs to change. Further, transgender people are harmed and killed without consequences for the perpetrators.

For example,  recently, a black transgender woman was burned to death in Florida. Therefore, donors must keep working with governments to repeal these laws and punish those who perpetrate violence against key populations.

The Former Wales rugby captain, Gareth Thomas’ revelation this month that he is HIV positive because someone threatened to blackmail him, shows that no one is immune to stigma. As long as new HIV infections occur, governments, donors, private sector and communities must continue work to end HIV-related stigma and discrimination.

Africa’s Mineral Wealth May Just have to Stay in the Ground to Protect a Changing Climate

The extraction of natural resources across Africa, including minerals like gold, is being affected by a changing climate. Credit: Busani Bafana/IPS

By Busani Bafana
BULAWAYO, Zimbabwe, Oct 7 2019 – As a result of climate change, resource extraction industries in Africa will be impacted by asset stranding, researchers say.

“Stranding implies that several natural assets are going to become commercially unviable around the world as a result of climate change and the inability of countries to exploit them,” said Vanessa Ushie, manager of the policy analysis division at the African Natural Resources Centre of the African Development Bank (AfDB), which supports African countries to leverage their natural resources for sustainable development.

Ushie told IPS stranding is an increasingly important policy issue that African countries should consider because they are highly dependent on natural resources, with an average 70 percent of their exports being minerals.

As the content struggles to reach its Sustainable Development Goals (SDGs), a set of global goals identified by the United Nations to end poverty and inequality among member states, a wealth of natural resources that could be used for Africa’s development remain  largely untapped.

  • Some 30 percent of the world’s mineral reserves including platinum, gold, diamonds and coal are found in Africa, yet the continent still has high levels of poverty. 
  • Africa also has 10 percent of the world’s oil reserves and 8 percent of natural gas, according to the African Development Bank.
  • Climate change is threatening the exploitation of these resources and more importantly of the non-renewable energy sources; coal, oil and gas.

Keep them in the ground

As a result of the impact of climate change, Africa has difficult options when it comes to its mineral resources, researchers say. Can it keep the resources in the ground and risk economic stagnation or find profitability in clean energy sources?

“We are aware of the Paris Agreement and the commitment of African countries, just like their global counterparts, to reduce carbon emissions in order to meet the target of keeping global warming below 2°Celsius,” Ushie said. “With that warming target, it is clear that certain minerals will have to be left below the ground especially those that emit the highest carbon into the atmosphere.”

  • The AfDB says “stranded assets” have in recent years attracted a lot of interest, as climate-driven changes justify a shift to low-carbon development in the natural resources sector. More than 185 countries have agreed to leave two-thirds of proven fossil fuels in the ground to meet the Paris Agreement climate target.
  • In 2017, the International Energy Agency warned that oil and gas assets worth 1.3 trillion dollars could be left stranded by 2050, if the fossil fuel industry does not adapt to greener climate policies.

Speaking at the end of the U.N. Climate Action Summit recently, Nobel Peace Prize laureate and former president of Ireland, Mary Robinson, said world leaders should act on the outrage of millions of people around the world who marched against climate change and calling for and end to the use of fossil fuels.

“We urge all nations to commit to achieving carbon neutrality before 2050 to immediately end construction of, and investment in, coal power and to implement a green transition that is just and equitable,” Robinson said.

Stranded assets

But many African countries are extracting coal, gas and oil with new discoveries, signalling future fortunes that could be difficult to forfeit.

  • In 2019, French oil firm Total made public its discovery of a large “gas condensate” in South Africa. The gas condensate – effectively a liquid form of natural gas – is a more prized than crude oil.
  • In Kenya, British oil company Tullow Oil projected 2024 as the earliest likely date by which the country can expect gains from its Turkana oil. Vast oil reserves have also been discovered in Uganda.

For the African continent, a latecomer to the fossil fuel boom, arguments for asset stranding could influence development gains and also interrupt economic growth.

Ushie said some assets will be stranded due to changes in markets and investment flows, as global extractive companies and investors adjust their portfolios to meet new, low-carbon regulations. Other extractive assets are at risk due to changing consumer demand, such as the growing use of solar energy and electric vehicles in developed countries.

An opportunity or obstacle?

“With growing climate change and the ensuing low-carbon transition, Africa’s mining sector faces serious risks, and some opportunities,” Ushie told IPS, noting that African countries need to understand and respond to the new normal.

The AfDB is promoting a diversified approach to energy provision and integrated natural resource management.  The solution lies in investing in localised and resource-efficient energy options like decentralised, community-owned local solar, wind and biomass projects.

By 2020, the Bank will have contributed $17 billion to climate finance for African since it developed a funding mechanism through its Climate Change Action Plan. Besides, the Bank’s Africa NDC Hub has supported African countries to implement their Nationally Determined Contributions (NDCs) under the Paris Agreement and helping countries attract sustainable financing opportunities such as green bonds to support climate change adaptation in high risk countries.

Research evidence for low carbon policies

“We want to model scenarios under which stranding could occur for various minerals and fossil fuels, and provide policy advice to governments on how they could respond to this risk,” said Ushie. “There should be a robust public debate on stranded mineral assets and resources, and this is why the AfDB is engaged in policy platforms such as the Inter-Governmental Forum on Mining, Metals and Sustainable Development.”

The Intergovernmental Forum on Mining, Minerals, Metals and Sustainable Development to be held in Geneva, Oct. 7-11 , has the theme; “Mining in a changing climate’”, indicating that even at a global level, there is recognition that resource extraction is being impacted by climate change.

The forum is a good opportunity for the Centre and the Bank to be engaged in global policy dialogue on the future of mining, which is a critical industry in Africa, she said.

Fatima Denton, Director of the U.N. University’s Institute for Natural Resource, told IPS the global shift from fossil fuels and the drop-in technology costs of renewables are an opportunity for the African continent to increase investment in green energy sources.

With rapid urbanisation of most African economies, coupled with a rising demand for electricity, African nations have begun taking advantage of this opportunity to increase investment in renewables, Denton said.

A 2018 study by Bloomberg Finance indicates that developing countries are beginning to lead the global clean power transition. A total 114GW zero-carbon power capacity was added in developing countries in 2017 compared to 63GW added in wealthier nations.

With the drop in global gas prices, more African nations were focusing on growing their gas economies. Renewables have greater need for metals and materials, creating opportunities for African countries with reserves of these resources essential to the construction of wind, solar, electricity transmission.

“Despite the opportunities mentioned above there is the challenge of when African economies will actually strand their fossil fuel assets and the lack of funding to invest in green growth opportunities as stated in their NDC’s,” Denton said.

Energy security in a low carbon future entails transition towards clean renewable sources, not as an end in itself, but as a means to achieving sustainable development in critical sectors such as agriculture, mining, health and education, said Denton.

South Sudan’s Authorities Allow Serious Human Rights Abuses to Flourish and go Unpunished – Report

By Maged Srour
ROME, Oct 7 2019 (IPS)

Human rights movement Amnesty International has accused South Sudanese authorities for lack of independence as they have allowed allowing human rights abuses, war crimes and crimes against humanity to go unpunished.

In a report released today, Oct. 7, Amnesty noted that despite investigation committees and various reports that are compiled on the violence that resulted from the internal war that broke out in December 2013, authorities continue to “deny credible reports implicating the armed forces in serious human rights violations. When the President does respond by setting up investigation committees, they lack independence and impartiality and, with the one exception, do not result in criminal trials”.

 

Brief Reflection on Trump’s Impeachment

It is very likely that the idea of impeaching Donald Trump will be a boomerang. Trump fans are listening to a furious campaign which smacks of coup d’etat and call his accusers traitors who deserve to go to jail. In the first three hours after the announcement of the Speaker of the House of Representatives, Nancy Pelosi, that an impeachment process would be launched, Trump received a million dollars, five million in 24 hours, and 8.5 million in two days. His campaign received 50,000 new donors.

Donald Trump addresses the UN’s General Assembly. Credit: UN Photo/Cia Pak

By Roberto Savio
ROME, Oct 7 2019 – It is very likely that the idea of impeaching Donald Trump will be a boomerang. Trump fans are listening to a furious campaign which smacks of coup d’etat and call his accusers traitors who deserve to go to jail.

In the first three hours after the announcement of the Speaker of the House of Representatives, Nancy Pelosi, that an impeachment process would be launched, Trump received a million dollars, five million in 24 hours, and 8.5 million in two days. His campaign received 50,000 new donors.

Trump won the election by just under 80,000 votes. It should be borne in mind that the US electoral system does not elect the president by the majority of the votes of its citizens, but by delegates that each State elects to vote the president. For historical reasons related to how the Union was created, the less populated and less developed states have proportionately more delegates than the large and wealthy states.

Roberto Savio

Trump ran his campaign in the less developed and less populous states, and in practice ignored the big cities and the most populous states, like California. In the popular vote, that is of citizens, Democratic candidate Hilary Clinton won by three million votes.

I think the Democrats have done Trump a great favour. In any case, even if the impeachment passes in the House of Representatives (where the Democrats have a majority), it has very little chance that it will pass in the Senate where, again for historical reasons linked to the creation of the United States of America, each state has two senators, regardless of its population.  Wyoming, with 578,000 inhabitants, has two senators, as does California, the most populous state in the country, with 37.2 million people.

And it is precisely the less developed states and those with smaller populations that allow Republicans to have the majority in the Senate. For the impeachment to be successful, a two-thirds majority of senators would be needed, which is highly unlikely.

I think the Democrats have done Trump a great favour. In any case, even if the impeachment passes in the House of Representatives (where the Democrats have a majority), it has very little chance that it will pass in the Senate

The only possibility is to increase the number of voters, who do not exceed 50% of those who have the right to vote. But will the impeachment have this impact? Are the citizens of the less developed states going to increase their electoral participation in protest at Trump’s actions? There is no evidence of this, and much will depend on who the Democratic candidate is going to be.

The camapign of demonising Joe Biden is going to have some impact. And the progressive candidates, Bernie Sanders and Elizabeth Warren, are the kind of politicians who seem too elitist in the states that vote for Trump. They are very conservative regions, and Trump has the unconditional support of the Evangelical Church, which is estimated at 40 million parishioners, while the Catholic Church is very conservative.

Obviously, if there is an economic crisis, this could have a transverse impact since Americans traditionally vote with their pockets. But, for the moment, 90% of Republican voters – as well as his parliamentarians – remain loyal to Trump.

Herein lies the fragility of democracy, when it is based on non-democratic rules. Boris Johnson was elected prime minister, not by the British people, but by around 160,000 members of the Conservative Party. The difference is that Johnson has had to expel 21 members of his party, all high-profile parliamentarians.

He has been blocked on his personalist and authoritarian path by the Supreme Court, which has annulled his decision to prorogate Parliament. In the United States, no like-minded parliamentarian has criticised Trump, and the Supreme Court has a Republican majority, which will change the American legal system considerably.

The lesson that comes out of all this is that democracy works if it has laws that guarantee the balance of powers and there is a conscious and interested citizenship in the common good, not divided in a partisan way, where the other is considered an enemy and not one that has different ideas.

The case of Brexit and Trump are good examples. But let’s not forget the case of Hungary, where Viktor Orban, after being democratically elected, developed a xenophobic policy against migrants, carried out tight control of the press, the National Election Commission and the judiciary, enriched his faithful with funds from the EU, changed the entire electoral system accommodating it to his party and then declared himself follower of an illiberal democracy.

Given the possibility that the united opposition will win the municipal elections in Budapest on October 13, Minister Gergely Gulyas, chief of staff of Orban, has warned that in this case, the government would cut funding to the capital city.

The style has been similar to that of Hitler and Mussolini, who came to power in a democratic way and then eliminated democracy by identifying an enemy of the people, in whose name they said they spoke: Jewish power.

Today the main targets of the populist and xenophobic right for raising its electoral quotas are immigrants.

Brexit was largely due to the announced arrival of millions of Turks, who were not even in the European Union. Trump made the Mexican and Central American “invasion” the strong point of his defence of the American people, along with the Chinese threat. If the voter swallows these mythologies, democracy is certainly in danger.  Trump and Johnson are just the tip of the iceberg.

 

Publisher of OtherNews, Italian-Argentine Roberto Savio is an economist, journalist, communication expert, political commentator, activist for social and climate justice and advocate of an anti neoliberal global governance. Director for international relations of the European Center for Peace and Development.. He is co-founder of Inter Press Service (IPS) news agency and its President Emeritus.

Reforms Will Grant Nationality to Children of Iranian Women

By Rothna Begum
GENEVA, Oct 7 2019 – After more than a decade of women’s rights activism, Iran’s Guardian Council has finally approved an amendment that would grant Iranian citizenship to the children of Iranian women married to foreign men.

The Guardian Council was the last body needed to approve this long overdue reform to Iran’s discriminatory citizenship law.

Previously, Iran’s civil code granted children and spouses of Iranian men citizenship automatically, while children born in Iran to Iranian women and foreign fathers must live in Iran at least until they are 19 before they can apply.

It is unclear how many children in Iran have Iranian mothers and foreign fathers. However, the issue has come to prominence in recent years because of tens of thousands of registered and unregistered marriages between Iranian women and Afghan men whose children are unable to obtain citizenship on an equal basis.

Rothna Begum

Research in other countries has shown that such discrimination can harm children’s access to education, health care, housing, and employment when they become adults.

The latest attempt to reform the law was inspired by Maryam Mirzakhani, a world-renowned Iranian mathematician and Fields Medal recipient who passed away from cancer in 2017. Because her husband is not Iranian, her daughter cannot obtain Iranian nationality.

In May, Iran’s Parliament finally adopted the proposed reform, but it went back and forth from the Guardian Council, a body of 12 Islamic jurists, to determine whether it is in accordance with Iran’s Constitution and Sharia (Islamic law). They approved the amendment last week.

While this is a long-awaited victory for Iranian women, the newly-amended law does not equalize access to citizenship completely. Iranian women must apply for nationality for their children, while children of Iranian men are granted nationality automatically.

Children who turn 18 can apply for nationality themselves. A security check is required in both cases.

Most concerning is that that the amended law requires the Intelligence Ministry or the Intelligence Organization of the Islamic Revolutionary Guard Corps (IRGC) to certify that there is no “security problem” before approving citizenship in these specific applications.

This vaguely defined provision can be used to arbitrarily disqualify applicants if they or their parents are seen as critical of the government, particularly in eastern and western border areas where cross-border marriages are more common and where authorities keep a tight grip over peaceful activism.

In a matter of weeks, Iran’s newly-amended law will finally see children of Iranian women able to apply for the same benefits that children of Iranian men have.

But Iran should remove the remaining obstacles to ensure that children of Iranian citizens, whether men or women, are granted citizenship on an equal basis. They are all, after all, Iranian children.

‘Salty’ Concern: Tackling High Salt Consumption in China

Veena S. Kulkarni, Associate Professor, Department of Criminology, Sociology and Geography, Arkansas State University, USA; and Raghav Gaiha, (Hon.) Professorial Research Fellow, Global Development Institute, University of Manchester, England.

By Veena S. Kulkarni and Raghav Gaiha
NEW DELHI, India and JONESBORO, US, Oct 7 2019 – China’s almost meteoric transition from a being a low income to a middle income country within a span of four decades is often perceived as a miracle analogous to the post Second World War Japanese economic development experience. China’s GDP rose from $200 current United States dollars (US$ henceforth) in 1978 to $9,470 current US$ in 2018 (World Development Indicators, The World Bank). Unsurprisingly, China’s rapid and near sustainable growth has attracted widespread interest among academics and policy makers alike.

Veena S. Kulkarni

China embarked on a set of systematic reforms of its centrally planned economy in the year 1978, which ignited this spark of economic growth. In nearly three decades after the reforms, China increased its Gross Domestic Product (GDP) eightfold with an average growth in GDP and GDP per capita of 9.5% and 8.1% percent (measured in constant US$), respectively (Hofman and Wu 2009). These figures appear more exceptional when seen relative to China’s performance: a) in the pre-reform period and b) by its contemporaries at that time. While China with an average GDP per capita rate of 2.1% was out ranked by several countries during a two-decade period before the reforms, its GDP per capita was the highest across a list of 105 countries for the years 1978-2005 (Hofman and Wu 2009). The extraordinary growth in income levels seem to have been replicated with respect to other economic indicators such as poverty rates and wealth per adult. The poverty head count ratio declined by more than one fifth in less than a decade from 17.2% in 2010 to 3.1% in 2017 (World Development Indicators, The World Bank). Additionally, there is a notable increase in the wealth per adult from US$4,292 in 2008 to US$47,810 in 2018 (Global Wealth Data Book 2018, Credit Suisse Research Institute). Further, convergence between the timings of the economic reforms with that of the demographic transition led to low dependency ratios (low share of non-working relative to working age population) creating a ‘perfect storm’ for bolstering economic growth. The more recent trends of the economy growing between 6-7% do admittedly indicate a downward trajectory but the prospects in absolute terms remain high.

However, this more seldom than not favorable scenario is projected to have an expected and significant impact on the age composition and epidemiological profile of China. All the standard health indicators show that China has completed what demographers would call mortality/epidemiological transition. Mortality/epidemiological transition is characterized by two interrelated components: a) a greater concentration of deaths at older ages, and b) a dominance of deaths by degenerative illnesses as compared to communicable diseases. Life expectancy at birth in China between 1990 and 2017 rose by nearly a decade for women (from 70.7 years to 79.9 years) and over third quarter of a decade for men (from 66.9 years to 74.5 years) (Global Burden of Disease). Such dramatic rises in life expectancy obviously translates into increasing share of the elderly total population. The percentage of population 65 years or older has more than doubled from 4.43% in 1950 to 9.33% in 2015 and is projected to increase to 11.97% in 2020. An examination of the trend indicates the rate of growth of the elderly unlike the period between 1950 and 1970 has not only been consistently on the rise, it has done so noticeably after 1990. The projected percentage of elderly population at 11.97% in 2020 is more than twice that in 1990 (5.63%) (World Population Prospects 2019, United Nations Population Division). The projection for year 2040 considering the age of 60 as the benchmark predict more than one in four persons to be elderly (World Health Organization).

On the second component of the epidemiological transition, Non-Communicable Diseases (NCDs) affect for more than 80% of the 10.3 million premature deaths and 77% of Disability Adjusted Life Years (DALYs), the statistic that is not that distant from other OECD countries. A review of the ranking of the top ten most causes of major deaths for the years 2007 and 2017 reflects the realization of the second part of the mortality/epidemiological transition. Except for the road injuries, the ten major causes of deaths fall in the category of degenerative illnesses. Further, both in 2007 and in 2017, the first four causes, stroke, ischemic heart disease, COPD and lung cancer are nearly unequivocally related to lifestyle factors. Stroke and ischemic heart diseases that are highly correlated with hypertension rose by 27% and 54% between 2007 and 2017. Additionally, there was 95.7% spike in percentage of most deaths caused by hypertensive heart disease between 2007 and 2017. Hypertensive heart disease moved from a rank of 11 to a rank of eight. In a similar vein, the ranking of the impact of diseases with respect to the number of years of life lost (YLLs) or causing premature deaths shows stroke and ischemic heart disease as topping the list both in 2007 and in 2017. Further, between 2007 and 2017 the increase in that ‘deadly’ impacts were 21.8% (stroke) and 43.9% (ischemic heart diseases). The corresponding rise for hypertensive heart disease was 79.8%. Yet another disconcerting evidence on the growing detrimental effect of hypertension can be gleaned from the climbing in the ranking of diseases causing disability. Stroke moved from being the thirteenth highest in 2007 to being fifth highest in 2017. The combined effects of causing most deaths and disability owing to stroke and ischemic heart disease is respectively more than 25% and 40%. Also, relative to ten countries in the comparison group delineated by the Global Burden of Disease (GBD) Project, based on GBD’s regional classification, trade partnerships and sociodemographic indicators, YLLs and DALYs due to stroke and ischemic heart diseases is the highest in China.

Raghav Gaiha

The above patterns and trends clearly evince a transition to a lifestyle that is more prone to incidence of cardiovascular diseases, a change that has been empirically observed to accompany usually interrelated reasons such as rising levels of income, urbanization, globalization and consumption of processed food as substitute to home made and fresh food. The latter appears to be a prominent contributor to China’s epidemiological profile tilting toward cardiovascular illnesses such as stroke, ischemic heart disease and hypertensive heart disease. Dietary risk has been found to be the most significant factor in explaining most of the deaths and disability in 2007 and in 2017. Additionally, there was a 29.6% increase in the risk caused by dietary patterns between 2007 and 2017 (Global Burden of Disease).

One of the integral ingredients for making food edible and/or enhance taste is salt. However, salt is the primary source of sodium and increased intake causes hypertension and consequently heightens the probabilities of stroke, heart attack and other related cardiovascular ailments. The average salt consumption for a healthy Chinese is 10.5 grams as opposed to the recommended 6 grams as per the Chinese Dietary Guidelines (World Health Organization). This higher than optimal quantity of salt utilization has been attributed in addition to putting salt in home cooked food and at the table (such as soy sauce, fish sauce and table salt), increasing eating of packaged food combined with lower consumption of fresh fruits, vegetables, dietary fiber like whole grains. The diet part is in particular significant given the high dietary risk. The Food Sustainability Index, a weighted average of indicators in the health and nutrition category, has been created by the Economist Intelligence Unit and the Barilla Centre for Food and Nutrition (BCFN). China ranks 21 among the 38 countries for which the Nutritional Challenge Index has been created also by The Economist.

The enormity of role of salt in determining people’s healthy diet and consequently healthy years of life acquire prominence when coupled with the facts that China’s population is aging quite rapidly and elderly are more susceptible to hypertension and other cardiovascular diseases. Moreover, reduction of salt is considered as one of the most cost effective strategies to improve health outcomes and reduce number of deaths. World Health Organization estimates 2.5 million deaths globally could be prevented if salt consumption is reduced to the recommended level.

Expectedly, World Health Organization in collaboration with the local organizations and with the Chinese government has initiated public service campaigns to increase knowledge, awareness and support to homes, schools, work places and the food industry to reduce amount of salt. The State Council as part of the Healthy China 2030 Initiative has set a goal of reducing the salt intake by 20%. Also, at the forefront of recognizing the urgency of reforming the food industry to align with ensuring a sustainable production of healthy food is the Barilla Foundation as evidenced by its unveiling of the report, ‘Fixing the Business of Food, the Food Industry and the SDG Challenges’ on September 24, 2019.

In addition to the advocacy and the activism aspects, an area that demands a careful assessment is governmental expenditure on health care. The slowing of economic growth coupled with the shifting demographics toward the elderly enhances the urgency of planning for the future. It is estimated that government expenditures on health would increase three times to about 10% of the GDP by 2060 (The World Bank and World Health Organization 2019). This is all the more critical considering illnesses such as hypertension that are usually a consequence of high salt consumption. As hypertension does not cause symptoms at the early stages, it can easily go undiagnosed. In China it is estimated that only 13.8% of the 270 million people who have hypertension have the disease managed (World Health Organization). Thus, it is pivotal to focus on both preventative and curative measures with respect to the occurrence of illnesses caused by unhealthy dietary lifestyle that include high salt consumption. Not doing so implies high cost to the society with respect to loss of productive years through death and/or disability. Based on China’s compliance with the mission of World Health Organization and Sustainable Development Goals (SDGs) that are founded on the ambition of ‘leaving no one behind’, it appears that China is committed to the goal of reducing the salt intake within the next decade as part of the larger initiative of providing a healthy productive life to all of its citizens.