Historically, migrants, particularly asylum seekers and refugees, experience several barriers when it comes to accessing health care and also face increased risks of various illnesses and health complications. Difficulties faced by refugees have intensified amid the COVID-19 pandemic and with the introduction of the Nationality and Borders Act, a piece of legislation that increases the standard of proof required to obtain permission to receive asylum and support in the U.K. By educating the public and advocating for vital policy changes, the U.K. is striving for improved health care access among asylum seekers and refugees.
An Interview with Dr. Dominik Zenner
Dr. Dominik Zenner is a general practitioner in London and also specializes in infectious disease epidemiology. Prior to this, he worked as the senior migration health advisor for the European Union and European Economic Area.
Dr. Zenner confirms the increased vulnerabilities of migrant populations to infectious diseases. He cites a systematic review from the 2018 Lancet Commission series on migration and health, which found that, on average, deaths from infectious diseases are higher among migrants than among native populations.
One can attribute these vulnerabilities to infectious diseases in part to migrants’ “origin and circumstances,” Dr. Zenner says. Furthering this vulnerability are barriers to effective treatment. According to Dr. Zenner, health workers in the U.K. may be “less familiar with some illnesses, including tropical diseases, risking a delay in diagnosis.”
The Pandemic
The COVID-19 pandemic has likely increased existing vulnerabilities in both direct and indirect ways. Even before the pandemic, many migrants were unsure of their health care entitlements and how to access health care. The WHO ApartTogether survey shows that during the pandemic itself, one out of every six undocumented migrants did not seek medical support for themselves or their household when suffering from COVID-19 symptoms. However, twice as many respondents with citizenship or permanency accessed health care services when faced with these symptoms.
Dr. Zenner names “closures and inaccessibility” as significant barriers to health care, specifically “the shift to teleconsultations,” which can be more difficult for migrants to access. A study by his colleagues revealed an approximate 20% drop in consultation rates for migrants during the first year of the pandemic. This stands in sharp contrast to the approximate 9% drop in consultations for non-migrants.
Housing and COVID-19
Poverty, housing and COVID-19 are also closely connected, with the COVID-19 mortality rate increasing for those from low-income backgrounds. The living conditions of poorer people, such as densely populated living spaces, increase the risk of COVID-19 transmission.
Dr. Zenner also discusses living conditions in refugee camps. These camps face “increased transmission of respiratory viruses, alongside decreased access to care, with high-density camps seeing the worst of this.” Some camps’ locations in remote areas may heighten risks, meaning that “emergency care and ambulances might not arrive there fast enough.” In general, Dr. Zenner states that camps are definitely “not ideal human habitats.”
The Nationality and Borders Act
The Nationality and Borders Act may exacerbate the health care access struggles faced by migrants. The act’s introduction of a higher burden of proof to gain refugee status could make it harder for asylum seekers to access health care support and security. Dr. Zenner highlights the concern of the increased difficulty gaining refugee status with these changes, which could lead to “adverse health outcomes and worse health care access for those seeking safety.”
Dr. Zenner’s travels and visits to refugee camps support his view that “health care access should be universal, not just in terms of legal eligibility but accessibility.” However, this is currently “not always the case for many migrants and definitely not for asylum seekers,” he says.
Roles and Responsibilities of the UK Government
Dr. Zenner says U.K. aid cuts have resulted in “research projects promoting our knowledge of infectious diseases being downsized or canceled, further limiting scientific advances.” He argues that access to care can be an even bigger issue than eligibility and that more signposting and support services for migrants are necessary. “The government should ensure that there is access to free care for everyone. We have witnessed tragedies; mothers unable to access maternity care and being criminalized when they can’t afford treatment. These tragedies are entirely preventable,” he says.
When asked about the U.K.’s divergence from WHO guidelines, Dr. Zenner says “for most areas, divergence is for good reasons.” For example, the U.K. has “conducted more TB screenings than initially recommended by WHO, but this turned out to be the right idea and set a precedent.” In fact, the U.K. plays a key part in informing WHO guidance.
Provisions for Future Improvement
Some measures to improve health care among asylum seekers and refugees are visible in the U.K. These are available at a local level, from organizations offering mental health support services, and at a government level with the NHS Low Income Scheme, through which migrants and other disadvantaged groups can apply for financial aid to cover health costs.
Also, GP practices can register new patients without a passport and there is no obligation to ask for proof of immigration status. Doctors should not deny registration to those who cannot provide documents and the rules are flexible in this regard.
Dr. Zenner strongly feels that “the needs of migrants should be addressed as a matter of urgency,” not only to benefit individuals but also for public health reasons in general. This includes sustainable and robust funding and a recognition that there will be no equality until vulnerable communities receive sufficient support.
– Lydia Tyler
Photo: Flickr
Campaigning to Address Period Poverty
Period poverty affects those who menstruate in both developing and developed countries. According to the United Nations Population Fund, “period poverty describes the struggle many low-income women and girls face while trying to afford menstrual products.” Period poverty also includes a lack of access to hygiene and sanitation facilities to properly manage menstruation. The World Bank highlights that, across the world, “an estimated 500 million lack access to menstrual products and adequate facilities for menstrual hygiene management.” Furthermore, “1.25 billion women and girls have no access to a safe, private toilet” and 526 million females have no access to any toilet. Despite this form of poverty affecting women and girls globally, period poverty affects developing countries the most. In many developing countries, 50% of all females resort to using “items like rags, grass and paper” to manage their menstruation rather than safe sanitary products, a 2022 article by ActionAid said. For these reasons, campaigns for governments to address period poverty are essential.
Comments from a Youth Campaigner
Sixth former Ellie Massey is a former member of the Youth Parliament for Northern Ireland. Massey played an instrumental role in campaigning for Northern Ireland to pass legislation for the free provision of sanitary products. In an interview with The Borgen Project, she highlighted that there needs to be further progress on the scheme within universities. Many tertiary-level students live away from their families and are already facing student debt in order to access university education, meaning that “period products are a lot less accessible for them.”
Massey speaks on useful techniques campaigners can use when campaigning to address period poverty. For instance, writing a personal plea for politicians and lawmakers to address the issue as opposed to “generic letters” that flood their inboxes.
Massey detailed that within a personal plea regarding addressing period poverty should be reasons why it is the politician’s responsibility to make legislative progress on the issue and specific details on the actions the politician can take to help.
During her time of campaigning for progress in the realm of period poverty in the United Kingdom, she wrote a letter to the education minister at the time, Peter Weir, and reached out to organizations such as the Human Rights Commission. She also interviewed students that period poverty affected and included these personal quotes in her letter to give it more standing.
Massey said that advocacy on the issue works better via in-person meetings or Zoom as politicians can put a face to a name and campaigners tend to argue points better when talking face-to-face. Once politicians actually realize the devastating impact of the issue, most of them are happy to help, so it is just about getting the message across in the most effective and impactful way.
Campaigning for Change
Amika George is a British youth activist who at the age of 17 began the Free Periods campaign in the U.K. to address period poverty and its impacts on girls’ education. The campaign began as an online petition after George learned that students in the U.K. would miss as much as a week of school per month due to the inability to afford sanitary products while menstruating.
Speaking on the issue, the activist commented to Cherwell that “the existence of period poverty only came to public consciousness as recently as [2018] when reports of girls routinely missing school because they couldn’t afford menstrual products were thrust into the media glare.”
“What’s been depressing since then is the lack of any affirmative action by the government, despite outrage and horror that girls were using socks stuffed with tissue or newspaper,” George said. The petition called on the U.K. government to take action by providing free period products to students who are eligible for free school meals and to work toward addressing period poverty.
Organizations Addressing Period Poverty Internationally
The Gift Wellness Foundation works to address period poverty in the U.K. and beyond. In August 2022, volunteers and Dr. Zareen Roohi Ahmed, the Foundation’s chair, delivered sanitary products to Syrian women across six refugee camps in Lebanon. The delivery included 500 boxes of menstrual products as well other essentials such as “shampoo, soap and washing powder.”
Commenting on the trip to Lebanon, Roohi Ahmed said on the Foundation’s website that the Syrian women refugees showed inspiring “resilience and bravery in the face of such upheaval.” However, “no one should be without basic menstrual products. The children in these camps need their mums to be empowered if they are to have any future at all.”
The Gift Wellness Foundation also donated sanitary pads to Rohingya women in Bangladesh. This took place within Cox’s Bazaar refugee camp, which is “the largest refugee camp in the world.” The Communities Against Poverty (CAP) Foundation runs a women’s health center in the camp, where many women give birth. In fact, “60,000 Rohingya women and young girls have given birth in the camp after being raped in Myanmar.”
The Gift Wellness Foundation provided more than 10,000 pads to support these women. Iqra International partners with the Foundation to give out sanitary pads in schools across the most impoverished areas of Bangladesh.
Looking Ahead
In the face of alarming statistics regarding period poverty and the impacts on female health and education, young activists and campaigners are taking a stand to create change.
– Claire Dickson
Photo: Flickr
Energy Crisis in Germany Threatens to Push Thousands into Poverty
Thousands of Germans have received distressing letters in the mail about expensive gas bills. With utility companies such as Vattenfall, passing on the ever-increasing costs to consumers, more and more Germans cannot pay the bills. In fact, prices have increased by more than 100% since the end of 2021. Record prices of €0.13 ($0.13) per kilowatt hour up to €0.25 per kilowatt hour by utility giant Vattenfall have become the norm. With 55% of the natural gas, 52% of the coal and 34% of mineral oil coming from Russia, Germany is as dependent on Russia as very few other Western countries. Without many alternatives, politicians fear social unrest, rationing and deep recession should the energy crisis in Germany not be under control soon.
Russian Pressure
Even worse, higher prices aren’t the tip of the iceberg. The energy crisis in Germany, due to the Russian energy sanctions that have affected the Nord Stream 1 pipeline, is becoming more and more visible. The presidential palace is no longer lit up at night, the city of Hannover is turning off warm water in public pools and gyms and the light has been switched off for 200 tourist attractions.
Daunting Energy Predictions for the Lower-Income Classes
Much more daunting are the consequences that the population could suffer from the already existing energy crisis in Germany as well as further energy cuts. The economic and energy minister Robert Habeck predicted “mass unemployment, poverty, people who can’t heat their homes, people who run out of petrol” if Russian oil and gas became no longer available in March 2022. The German research institute IW is in agreement with the green party and warns of energy poverty” which arises when “the share of energy bills of an individual’s net income exceeds ten percent.” This was the case for 25% of all German citizens in May 2022, a 10% increase from the previous year.
Unfortunately, these figures do not favor the lower and middle classes but divide the top and bottom even further. A middle-class family household uses 18,000-kilowatt hours of energy per year on average, which cost €1,080 ($1,099) in 2021. With the price increase, the same consumption would cost a family €3,240 — an average monthly income. Citizens from the “lower middle class” that have a net income of 60 to 80% of the median income, are twice as likely to become energy poor in 2022 as in the years before. The research institute highly recommends extended social schemes to support lower-class households with their utility bills.
Prospects of Government Relief
So far, the German government has spent €30 billion to support citizens in paying their electricity bills since the end of 2021. Chancellor Olaf Scholz added in a recent interview that the government is not planning additional social schemes but could implement them if necessary. The government is working hard to find alternative energy solutions and to get German citizens through the winter. Yet, despite requests from the Christian democratic party to cut the Russian energy supply once and for all, the government’s hands are tied and in desperate need of alternative solutions that are universally accessible to all Germans.
– Pauline Luetzenkirchen
Photo: Wikimedia Commons
COVID-19’s Impact on Bangladesh
Since 2020, the world has turned upside down while facing the COVID-19 pandemic. Despite every country living through the same traumatic experience, the consequences were not the same for everyone. Especially developing and underdeveloped countries took a harder hit from the pandemic than any developed nations. The pandemic did destroy not only global health but also disrupted the national economy, education system, social values and more. Even after national recovery, some failed to recover from the unforgettable past on a personal level which included losing loved ones, unemployment, hunger, health deficiency and so on. For example, in some cases, women were more likely to stop working after the pandemic, and low-skilled workers were more likely to lose their jobs than more educated workers. Notably, COVID-19’s impact on Bangladesh raised many domestic and global concerns. Here are four facts about COVID-19’s impact on Bangladesh.
4 Facts About COVID-19’s Impact on Bangladesh
Solutions
Like many other countries, COVID-19’s impact on Bangladesh was unthinkable. The severity of COVID-19’s impact on Bangladesh gradually disintegrated due to much foreign support and social unity. One of the most significant foreign support was from the United States. The U.S. has provided Bangladesh with more than $96 million. These aids included 5.5 million doses of the Moderna vaccine, medical supplies, ventilators, oxygen equipment, pulse oximeters and personal protective equipment (PPE).
Moreover, since the start of the pandemic also the World Bank has provided about $3 billion to Bangladesh, which has been effective in improving the emergency health response, the private sector, creating jobs, boosting human capital development and more. Besides foreign aid, the Bangladesh government also took many precautions and strict domestic policies to reduce the spread as much as possible. Some remarkable actions from the government were closing the government buildings, offices, schools and universities, prohibiting social gatherings and canceling federal holiday celebrations.
In the end, COVID-19’s impact on Bangladesh was traumatizing. However, it also showed people how vulnerability can spread through a nation in a short time period. The government and its people learned to be patient, understanding and generous to each other. COVID-19’s impact on Bangladesh did not stop yet, but the world has seen a great deal of recovery from the country.
Photo: Flickr
Food Systems in Sri Lanka
Food systems globally are having to adapt to increasing numbers of challenges; a growing population, supply chain inadequacies and an overwhelming strain on the environment that in itself disrupt harvests and crop growth. Food systems in Sri Lanka are experiencing major shortages in recent years due to government mismanagement and a failed transition to organic agriculture, alongside crippling economic conditions and mounting foreign debt. People’s food security is a growing concern.
The World Food Programme (WFP) reported an estimated 6.3 million people, nearly 30% of the population believed to be experiencing moderate to severe acute food insecurity in September 2022. This follows after successive poor harvests and a limit on imports of food grains as a result of a depreciating currency and rising prices of goods.
Imports account for 22% of the country’s food consumption. Previously self-sustained in the production of rice, meat, fish, eggs and fruit and vegetables, poor harvests have rendered domestic supplies inadequate, forcing Sri Lanka to import $450 million worth of rice, despite the price for the staple crop rising some 50%. Maintaining a nutritious diet has become increasingly difficult for the average household as inflation rises to 57.4% and incomes fall.
How it Happened
One can attribute poor harvests to environmental impacts and government policy. Former president Gotabaya Rajapaksa in April 2021 imposed a national ban on synthetic fertilizers and pesticides in an effort to transition Sri Lanka’s agriculture sector to organic production methods. This was carried out without an integration period, effectively ordering 2 million of the countries’ farmers to go organic overnight.
Whilst the notion of organic farming is appealing through the environmental benefits it offers, the use of synthetic fertilizers attains consistency in yield that is difficult to replicate. Consequently, since the imposition of the ban, Sri Lanka’s rice production has substantially declined.
The foreign exchange felt the economic drawbacks of this policy after tea production took a hit and Sri Lanka’s export revenue decreased, weakening a key industry that employs many across rural areas. The significant decline in agricultural output sent many Sri Lankan farmers into poverty.
Intrinsically altering the nature of production and operations of food systems in Sri Lanka in such a way requires education programs to introduce farmers to alternative methods of crop growth. Unfortunately, Sri Lanka did not take such measures.
Following public outcry, in October 2021 the government went back on its synthetic fertilizer ban. Despite this, the global rise in prices has seen farmers struggling to afford imports of fertilizer, resulting in continued shortages of harvest and food.
The need for sustainability in agriculture is irrefutable; for the attainment of various SDGs as well as the health of the consumer. A gradual approach, alongside a holistic framework, reappraising all the involved sectors and stakeholders will be necessary to ensure vulnerable communities are provided with the required subsistence levels.
Solutions
To curb the effects of current shortages, NGOs and foreign governments are actively sending remittance packages targeting vulnerable communities and Sri Lankan food systems.
In September 2022, the United States embassy announced a package worth $40 million supplying Sri Lankan farmers with fertilizer needed to resume crop growth. A crucial step in kickstarting the agricultural sector. The embassy also announced a package worth $20 million addressing immediate humanitarian needs across the country, focusing on the groups that the shortages most affected, including pregnant women and children.
The WFP appealed for $63 million in emergency funds earlier in the year to supply those most affected by the crisis, including vulnerable groups, pregnant women and children. It aims to offer food vouchers to help cover expenses and provide emergency nutrition and school meals until the end of the year.
Australia was the first country to meet the WFP’s appeal, from whom Sri Lanka received a donation of rice worth $15 million in September. The Australian government has scheduled further donations of rice and cooking oil to be shipped to Sri Lanka in the coming months.
Many are hungry and much rely on a successful harvest in the coming season. However, with the measures in place, some pressure on the agricultural sector and food systems in Sri Lanka is being relieved, and the immediate needs of the most vulnerable groups are receiving attention.
– Bojan Ivancic
Photo: Flickr
What the 2022 Annual Goalkeepers Reports Says About the Future of Poverty
The Bill & Melinda Gates Foundation recently released its annual Goalkeepers Report aimed at analyzing data relating to the U.N.’s Sustainable Development Goals (SDG) and insights on the future of poverty. The Bill & Melinda Gates Foundation is a nonprofit with the goals of fighting poverty, disease and inequalities around the world. Bill and Melinda Gates formed it in 1994. As philanthropists, they made it their Foundation’s mission to use their resources to fulfill the U.N.’s SDGs which also aligns with the work of their Foundation.
The SDGs
The SDGs are 17 economic, social or environmental goals that the U.N. implemented to protect the planet, achieve prosperity and end poverty. The 2022 Goalkeepers Report is ambitious and complex, in that the expectations of enduring a pandemic and multiple wars were non-existent while setting the SDGs. However, the report stated that the magnitude of these events may have had ill effects on the data but a positive one on the actual reality of working towards those goals. The report also stated that there are two things no data point can prove: crisis and innovation.
Major Takeaways and Analyses from the 2022 Goalkeepers Report
Going back to the effects of the pandemic and conflicts such as the Ukraine-Russia war, it is not unusual for these events to negatively affect the data. The pandemic left 114 million people unemployed in 2020, meaning 114 million people lost stable livelihoods. Not only the pandemic left people without jobs, but it also caused severe disruptions in the supply chain due to border closures, a lack of workforce and financial instability. Panic buying and deficiency in stocks were major consequences of the inadequate supply chain, making goods less and less accessible.
Another disruption that hit the supply chain was the Russia-Ukraine War. Many African nations heavily depended on wheat imports from Ukraine. With the emergence of war stopping the shipments, the price of wheat-based products surged to the highest level its been in 40 years. Even though prices have relatively stabilized, the small shock showed how modern famine could present itself and how little the world is prepared for it.
After turbulent times for the world economy, Goalkeepers Report data shows promise not necessarily in the numbers themselves, but in the intangible potential for human ingenuity. Gates commented in the report that “No projection can ever account for the possibility of game-changing innovation” on the data projections on the SDGs for the next 10 years.
Financial Autonomy for Women
A significant step in reducing poverty is firstly making sure all people have access to money. Gender equality is essential in making sure both men and women have the same opportunities and means of accessing their money. Making financial platforms available and secure for women, especially in low-income countries, is necessary for achieving financial autonomy for both genders.
Data shows there has been an upwards trend in the last 5 years in the number of women owning a financial account and mobile money account. Mobile money account ownership of women in low-income countries increase from approximately 12% in 2017 to 24% in 2021. What this dataset indicates is more than the concrete number of women owning bank accounts, but the subject of women taking ownership of their livelihoods.
Tieing this to the initial message of the report, even though data is just data, the human aspect behind it is what makes the future more hopeful and brighter. Another take on the future of poverty from the report is the need for a replanning of the strategy behind food and humanitarian aid.
Strategy for Humanitarian Aid
Gates highlights that “The goal should not simply be giving more food aid. It should be to ensure no aid is needed in the first place.” Numbers on the report show the money spent on food aid keeps getting more and more every year, hitting a high of $57 billion in 2020. Whereas funding for agricultural research which will help developing countries create food security in the long run barely increase in the last 10 years, with only $9 billion in 2020. Comparing the money spent on a temporary solution such as food aid to agricultural research, numbers seem promising yet the truth behind it is that our strategy needs improving.
Taking into account the severe climate stress the agriculture industry will endure in Sub-Saharan Africa, “32 million more people in Africa are projected to be hungry in 2030” the report states. Solving world hunger is key to reducing poverty in the future, as more food on the market means cheaper and more accessible it is for the more disadvantaged. It is a very achievable challenge, as long as people change the strategy in their approach to food crises and look beyond the data.
As Gates states, “That challenge (solving food hunger) can’t be solved with donations. It requires innovation.” This is exactly what the Gatekeepers 2022 report suggests and promotes. A look beyond data and a vision larger than just numbers are what will define the future of poverty.
– Selin Oztuncman
Photo: Flickr
Increasing Efforts in Poverty Reduction in Uganda
In January 2022, Uganda’s economy grew by 4.6% an uptick from 3.4% in 2021 and 3% in 2020. Despite facing challenges during the pandemic, the country’s economy quickly recovered as the services sector and industries resumed activity. However, the East African nation with a population of 47.1 million people has an international poverty rate of 42% making poverty reduction efforts more critical than ever.
The Slowdown in Poverty Reduction in Uganda
The slowdown in poverty reduction in Uganda was in part due to rising commodity prices and disruptions in the global supply chain exacerbated by the war in Ukraine. This triggered high inflation which reached 6.8% from only about 2.7% in 2021. In response, the Bank of Uganda increased its policy rate by 1% in 2022 to 7.5%. This monetary policy slows the economy to keep inflation stable and return to lower price levels. A more stable economy in January 2022 allowed Uganda to experience increased private investment and higher activity in construction and manufacturing and export diversification.
The Impact of COVID-19 on Poverty Reduction in Uganda
One cannot dismiss COVID-19’s impact on poverty reduction in Uganda. In 2020, the government closed the borders and issued a nationwide lockdown and curfew. In addition, it also shut down schools, shops and churches. Economic growth slowed down and the government’s free health care programs reduced access to health care. In this period, relief aid went to urban areas and the poorest in rural areas ended up vulnerable. After seeing the impact of the pandemic the government gave out credit facilities, offered waivers of interest on tax, tax deductions and lowered interest rates to finance the private, agribusiness and manufacturing sectors.
The Village Enterprise Microenterprise Program
NGOs have also stepped in to boost Uganda’s economic growth and development. The Village Enterprise microenterprise program partners with governments and NGOs to eradicate extreme poverty primarily in rural East Africa. It works directly with poor households through entrepreneurship with the objective of lifting 20 million people out of extreme poverty by 2030. Over a period of one year, it provides them with mentorship, cash transfers, business training and the formation of saving groups. In Uganda, more than 30,000 businesses started through this program and 113,000 first-time entrepreneurs have received training. The impact created more consumption and income and improved the standard of living of hundreds of thousands of households.
The Strengthening Education Systems for Improved Learning (SESIL) Program
Uganda’s low education level presents another challenge directly contributing to poverty. Two out of five secondary school teachers did not have undergraduate degrees in 2017. Additionally, most classrooms have too many students, in some cases more than 60 which does not provide an environment that facilitates quality education. Uganda has one of the fastest-growing youth populations but government spending on education has fallen from about 25% in the early 2000s to only 11% in 2018.
The government recognized the growing youth population and in 2018 launched the Strengthening Education Systems for Improved Learning (SESIL) program. This U.K. aid-funded program improved the quality and equity of education in lower primary schools by focusing on an approach called Managing for Results (M4R). Teachers and ministry officials used data collection and analysis to monitor student progress. Based on their interpretation they were able to make decisions to improve students’ learning outcomes. This program has undergone implementation in more than 1,800 schools and trained more than 6,000 teachers in Uganda. There has already been evidence of the value of the program and its data collection approach to spot challenges and sustainable solutions in lower education.
The youth is what makes poverty reduction in Uganda and in other parts of the world important. They make up the future generation of this world. Their education is of the highest priority. It not only provides them with opportunities and pathways away from poverty but it also guarantees a more sustainable future.
– Hans Harelimana Hirwa
Photo: Flickr
The Path Towards Democracy: Combating Domestic Corruption in Moldova
Moldova, a nation with one of the highest poverty rates among European countries, has a long history of political corruption that has stood in the way of progress. Though the nation’s path toward realizing democracy and greater economic prosperity has been complicated, recent democratic reforms offer hope for successfully combating domestic corruption in Moldova.
Moldova’s History of Corruption and Recent Embrace of Democracy
Discordant efforts towards combating domestic corruption in Moldova have taken place since 2005, when former President Vladimir Voronin, the Moldovan Communist Party leader, embraced a pro-democracy platform. While Moldova passed subsequent acts of legislation to address corruption, its justice system remained corrupt in many respects, as prosecutors and judges frequently received bribes or pressure to deliver court rulings that favored kleptocrats. In 2015, officers arrested and charged Moldovan Prime Minister Vlad Filat for his role in a massive corruption scandal the previous year in which someone stole around $1 billion from Moldova’s three main banks.
In 2020, Moldova elected its first female president, Maia Sandu, who ran on an anti-corruption platform. During her campaign, Sandu pledged to reform Moldova’s courts. While President Sandu’s pro-European Party of Action and Solidarity (PAS) won a majority in parliament, the government is still fighting an uphill battle to root out corruption. Going forward, these anti-corruption efforts will require increased support from civil society organizations, grassroots movements and NGOs to increase pressure on Moldova’s political elite. The nation has already adopted proportional representation in parliament, and Sandu’s government is actively promoting democratic reforms by working to improve Moldova’s business environment and limit monopolistic competition, promoting a free and independent press and improving labor conditions.
US Policymakers’ Efforts to Help Moldova
In light of Moldova’s recent democratic reforms and anti-corruption agenda, U.S. lawmakers have expressed views that more can occur in Washington to further these efforts. On July 29, 2022, ranking members of the House Foreign Affairs and Senate Foreign Relations committees sent a joint bipartisan letter to the Biden Administration, urging the President to resolutely support Moldova’s reform efforts by announcing new sanctions on corrupt Moldovan figures. These sanctions, in accordance with the Global Magnitsky Human Rights Accountability Act of 2016, are necessary to further the Moldovan government’s aims to stabilize the nation, continue on a pro-democracy trajectory and build resilience against hostile Russian influence.
These sanctions are the latest development in the broader context of the U.S. government’s efforts to foster a strong diplomatic relationship with Moldova and encourage democratic governance in recent years. Over the past three decades, the U.S. has given more than $1.7 billion in humanitarian and economic aid to Moldova, and the top priorities for ongoing assistance to the nation include strengthening Moldova’s economic resilience, bolstering democratic institutions, preventing encroachments on the nation’s sovereignty, and reforming Moldova’s justice system. In April 2022, following the Russian invasion of Ukraine (which shares a border with Moldova), USAID administered an additional $50 million in aid, intended to reinforce the Moldovan economy’s ability to withstand the significant strain and the war’s projected consequences. U.S. Secretary of State Antony Blinken visited the nation the month prior.
Looking Ahead
The positive trajectory towards democracy and combating domestic corruption in Moldova, as well as the remarkable ways in which the nation has helped Ukrainian refugees in the aftermath of Russia’s invasion of Ukraine, have captured the attention of U.S. policymakers. While there are still great strides for Moldova to make, the recent indications of progress in Moldova are promising, and they have ignited a sense of global urgency to further aid the nation, on the cusp of realizing democracy and greater economic prosperity, in its ongoing efforts.
– Oliver De Jonghe
Photo: Wikimedia Commons
3 Books Explaining the Relationship Between Health care and Poverty
Living in poverty is one of the primary obstacles to accessing health care. The financial relationship between income and proper health care is often linear: the more money an individual has, the better care they will receive. Poor health, however, is also a major cause of poverty. This is partly due to the costs of receiving care but also other costs such as transport, informal payments to providers and loss of income. Here are three books to read to learn more about the relationship between poverty and health care inequalities.
3 Books Explaining the Relationship Between Health Care and Poverty
These three books clearly indicate the correlation between poverty and limited access to health care. These books help highlight potential solutions for those living in poverty who need to access quality health care.
– Opal Vitharana
Photo: Flickr
Health Care Access Among Asylum Seekers and Refugees
Historically, migrants, particularly asylum seekers and refugees, experience several barriers when it comes to accessing health care and also face increased risks of various illnesses and health complications. Difficulties faced by refugees have intensified amid the COVID-19 pandemic and with the introduction of the Nationality and Borders Act, a piece of legislation that increases the standard of proof required to obtain permission to receive asylum and support in the U.K. By educating the public and advocating for vital policy changes, the U.K. is striving for improved health care access among asylum seekers and refugees.
An Interview with Dr. Dominik Zenner
Dr. Dominik Zenner is a general practitioner in London and also specializes in infectious disease epidemiology. Prior to this, he worked as the senior migration health advisor for the European Union and European Economic Area.
Dr. Zenner confirms the increased vulnerabilities of migrant populations to infectious diseases. He cites a systematic review from the 2018 Lancet Commission series on migration and health, which found that, on average, deaths from infectious diseases are higher among migrants than among native populations.
One can attribute these vulnerabilities to infectious diseases in part to migrants’ “origin and circumstances,” Dr. Zenner says. Furthering this vulnerability are barriers to effective treatment. According to Dr. Zenner, health workers in the U.K. may be “less familiar with some illnesses, including tropical diseases, risking a delay in diagnosis.”
The Pandemic
The COVID-19 pandemic has likely increased existing vulnerabilities in both direct and indirect ways. Even before the pandemic, many migrants were unsure of their health care entitlements and how to access health care. The WHO ApartTogether survey shows that during the pandemic itself, one out of every six undocumented migrants did not seek medical support for themselves or their household when suffering from COVID-19 symptoms. However, twice as many respondents with citizenship or permanency accessed health care services when faced with these symptoms.
Dr. Zenner names “closures and inaccessibility” as significant barriers to health care, specifically “the shift to teleconsultations,” which can be more difficult for migrants to access. A study by his colleagues revealed an approximate 20% drop in consultation rates for migrants during the first year of the pandemic. This stands in sharp contrast to the approximate 9% drop in consultations for non-migrants.
Housing and COVID-19
Poverty, housing and COVID-19 are also closely connected, with the COVID-19 mortality rate increasing for those from low-income backgrounds. The living conditions of poorer people, such as densely populated living spaces, increase the risk of COVID-19 transmission.
Dr. Zenner also discusses living conditions in refugee camps. These camps face “increased transmission of respiratory viruses, alongside decreased access to care, with high-density camps seeing the worst of this.” Some camps’ locations in remote areas may heighten risks, meaning that “emergency care and ambulances might not arrive there fast enough.” In general, Dr. Zenner states that camps are definitely “not ideal human habitats.”
The Nationality and Borders Act
The Nationality and Borders Act may exacerbate the health care access struggles faced by migrants. The act’s introduction of a higher burden of proof to gain refugee status could make it harder for asylum seekers to access health care support and security. Dr. Zenner highlights the concern of the increased difficulty gaining refugee status with these changes, which could lead to “adverse health outcomes and worse health care access for those seeking safety.”
Dr. Zenner’s travels and visits to refugee camps support his view that “health care access should be universal, not just in terms of legal eligibility but accessibility.” However, this is currently “not always the case for many migrants and definitely not for asylum seekers,” he says.
Roles and Responsibilities of the UK Government
Dr. Zenner says U.K. aid cuts have resulted in “research projects promoting our knowledge of infectious diseases being downsized or canceled, further limiting scientific advances.” He argues that access to care can be an even bigger issue than eligibility and that more signposting and support services for migrants are necessary. “The government should ensure that there is access to free care for everyone. We have witnessed tragedies; mothers unable to access maternity care and being criminalized when they can’t afford treatment. These tragedies are entirely preventable,” he says.
When asked about the U.K.’s divergence from WHO guidelines, Dr. Zenner says “for most areas, divergence is for good reasons.” For example, the U.K. has “conducted more TB screenings than initially recommended by WHO, but this turned out to be the right idea and set a precedent.” In fact, the U.K. plays a key part in informing WHO guidance.
Provisions for Future Improvement
Some measures to improve health care among asylum seekers and refugees are visible in the U.K. These are available at a local level, from organizations offering mental health support services, and at a government level with the NHS Low Income Scheme, through which migrants and other disadvantaged groups can apply for financial aid to cover health costs.
Also, GP practices can register new patients without a passport and there is no obligation to ask for proof of immigration status. Doctors should not deny registration to those who cannot provide documents and the rules are flexible in this regard.
Dr. Zenner strongly feels that “the needs of migrants should be addressed as a matter of urgency,” not only to benefit individuals but also for public health reasons in general. This includes sustainable and robust funding and a recognition that there will be no equality until vulnerable communities receive sufficient support.
– Lydia Tyler
Photo: Flickr
How UNICEF Addresses Malaria
The World Health Organization (WHO) defines malaria as “a life-threatening disease caused by parasites that are transmitted to people through the bites of infected female Anopheles mosquitoes.” People are at most risk of malaria in countries with warmer temperatures as the disease spreads at a faster rate due to the weather conditions. In 2020, the WHO estimated the existence of a total of 241 million cases of malaria throughout the world, and at this stage, the number of deaths arising from the disease stood at 627,000. The WHO African region holds the highest number of malaria cases globally. In 2020, the region accounted for 95% of malaria incidents and 96% of malaria-related fatalities. Furthermore, children younger than 5 made up about 80% of all malaria-related fatalities in this region. Due to these statistics, UNICEF addresses malaria through several initiatives and programs.
How UNICEF Addresses Malaria
Long-lasting insecticidal nets (LLINs) are one of the most effective malaria prevention methods. These chemically- treated nets form a physical barrier to protect against malaria-infected mosquitos while an individual is sleeping. The net itself blocks the mosquito from getting to the individual and the insecticide kills the mosquito once it touches the net.
Data shows that LLINs have reduced malaria cases by about half in sub-Saharan Africa. For this reason, UNICEF uses LLINs as its first line of defense against malaria in affected regions. In 2021 alone, UNICEF utilized 40.9 million of these nets in its malaria prevention programs. UNICEF first began using LLINs in 2000 and has procured more than 275 million nets since 2012. These nets are affordable and last “up to three years or 20 washes.”
A Malaria Vaccine
In October 2021, the WHO recommended the use of the GlaxoSmithKline (GSK) RTS,S malaria vaccine among children in high-risk countries. According to GSK, long-term clinical studies show that it is “the first and only malaria vaccine” to remarkably decrease cases of malaria among children. The vaccine is the culmination of more than 35 years of research by GSK, PATH and partners.
In December 2021, Gavi, the Vaccine Alliance, announced that it would finance the rollout of this vaccine across child vaccination programs in eligible nations.
UNICEF addresses malaria through its announcement in August 2022 of an award of a contract of up to $170 million to GSK for the “first-ever supply of a malaria vaccine.” This contract will allow for the distribution of 18 million doses of the vaccine over the following three years. UNICEF highlights the importance of this vaccine by stating that in 2020, “nearly half a million children died from malaria in Africa alone, a rate of one child death per minute.”
UNICEF’s supply division director, Etleva Kadilli, commented on a UNICEF press release that “the vaccine rollout gives a clear message to malaria vaccine developers to continue their work” as these vaccines are both necessary and in demand. The vaccine is effective against the Plasmodium falciparum malaria parasite, which takes many lives across the world, to the greatest extent in Africa. As malaria is a global concern, demand for the vaccine is high and plans are already in motion to increase production of it with the hope of eventually immunizing every child against the disease.
Thanks to the work of researchers and organizations such as UNICEF, in endemic areas of the globe, vulnerable children under 5 will receive protection against malaria mortality.
– Claire Dickson
Photo: Flickr