Pakistan: PTI government and polio | Editorial | Pakistan Today.
[3rd September 2020]
The PTI had come to power without any preparation for the arduous job of running a country with a population of over 213 million and scores of serious problems. It was claimed that once an honest Prime Minister was holding the levers of power, every serious problem would soon get resolved. Within two years the self-serving claim has turned out to be false in several spheres, including polio eradication. WPV cases that were gradually going down from 54 in 2015 to 20 in 2016, 8 in 2017 and 12 in 2018, sharply rose under PTI rule to 147 in 2019. During the last few months the number has already reached 67. Pakistan and Afghanistan remain the only two countries in the world reporting polio cases and being considered a potential source of dissemination of the virus to other countries.
The two years of the PTI rule are marked by an upsurge in polio cases. There are two major reasons behind the phenomenon. First, appointment of incompetent focal persons handpicked by the PM, like Mr Babar bin Ata and Dr Zafar Mirza. In both cases the government discovered, though much after the harm had been done, that the choice was inappropriate. The second reason was the sheer political opportunism which stood in the way of enforcing the writ of the state. The PTI government was simply reluctant to alienate the clerics, especially in KP, who opposed vaccination. The PTI feared that if the religious leaders turned hostile, this could result in loss of votes.
The task of controlling polio has now been handed over to the newly appointed Special Assistant to PM (SAPM) on health Dr Faisal Sultan. On Wednesday Dr Sultan paid his first visit to the National Emergency Operation Centre (NEOC) where he expressed the government’s determination to eradicate the virus. The task ahead will test the new focal person’s competence. But as long as political exigencies are allowed to stand in the way of the enforcement of the state’s writ, polio cannot be eradicated. Two years after paying monthly salaries to prayer leaders, who deliver Friday sermons in KP, and allocating millions of rupees to seminaries, the time has come when he who pays the piper must call the tune.
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Recuperando las coberturas vacunales perdidas en la pandemia COVID-19 [Recovering lost vaccine coverage due to COVID-19 pandemic] | Vacunas.
[Journal Pre-proof PDF] [Received 17 June 2020, Accepted 2 July 2020, Available online 4 July 2020] [Article in Spanish]
La pandemia de la enfermedad por coronavirus 2019 puede tener un impacto alarmante en las coberturas de vacunación. La OMS, la UNICEF y la Gavi advierten de que al menos 80 millones de niños menores de 1 año corren el riesgo de contraer enfermedades como la difteria, el sarampión y la poliomielitis por la interrupción de la inmunización sistemática y la suspensión temporal de 93 campañas de vacunación a gran escala.
En España, un nuevo escenario asistencial, que prioriza lo telemático sobre lo presencial, el miedo al contagio por acudir a los centros sanitarios y las recomendaciones de distanciamiento físico y de movilidad restringida, reducen la asistencia a los centros de atención primaria. A pesar de las recomendaciones establecidas por las autoridades sanitarias, las coberturas vacunales han descendido en todas las comunidades autónomas entre un 5% y un 60%, dependiendo de la edad y del tipo de vacuna. Las vacunaciones en las escuelas se han suspendido y solo se ha mantenido, en general, la cobertura de la vacuna frente al tétanos, la difteria y la tosferina en las embarazadas. La disminución ha sido más manifiesta para las vacunas no financiadas: la primera dosis de vacuna antimeningocócica B disminuyó un 68,4% en la Comunidad Valenciana, y en Andalucía se observó un descenso de las dosis totales de esta vacuna (39%) y de la del rotavirus (18%).
La reanudación de las vacunaciones debe ser planificada, organizaday realizada en el menor tiempo posible.
En este artículo se comentan algunos aspectos de la recuperación de las coberturas vacunales para diferentes grupos: niños, adolescentes y adultos, y pacientes de riesgo y en situaciones especiales.
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The 2019 coronavirus disease pandemic can have an alarming impact on vaccination coverage. WHO, UNICEF and Gavi warn that at least 80 million children under the age of 1 are at risk of contracting diseases such as diphtheria, measles and polio due to the interruption of routine immunization and the temporary suspension of 93 campaigns of large-scale vaccination.
In Spain, a new healthcare scenario, which prioritizes telematics over in person, fear of contagion by going to health centers, and recommendations for physical distance and restricted mobility, reduce attendance at primary care centers. Despite recommendations established by the health authorities, vaccination coverage has decreased in all Autonomous Communities between 5% and 60%, depending on the age and type of vaccine. School vaccinations have been suspended and only vaccination of pregnant women against tetanus, diphtheria and pertussis has been maintained. The decrease has been more evident for non gratuity vaccines: the first dose of meningococcal vaccine B has decreased by 68.4% in the Valencian Community, and Andalusia has observed a 39% decrease in the total doses of this vaccine and of 18% for that of rotavirus.
The recovering of vaccinations should be planned, organized and carried out in the shortest possible time.
This article discusses some aspects of the recovery of vaccination coverage for different groups: children, adolescents and adults, and patients at risk and in special situations.
Briefing to the United Nations Security Council by the Secretary-General’s Special Representative for Afghanistan, Ms. Deborah Lyons, New York, 3 September 2020 | ReliefWeb.
[News and Press Release] [Source: UNAMA] [Posted: 3 Sep 2020] [Originally Published: 3 Sep 2020] [Origin: View original]
As I speak, Afghans representing the Islamic Republic of Afghanistan are preparing to sit with other Afghans representing the Taliban to discuss, at long last, a political settlement to the conflict. This is truly a historic moment. After four decades of war, the people of Afghanistan have more reason than ever to hope that this devastating conflict, which has brought so much suffering, may finally come to an end.
But let’s be clear - this will be a long and challenging process. Already, the pre-talks phase has raised difficult issues related to prisoner releases, which have taken some time to resolve - actually, 5 months. Eventually the negotiations will have to tackle a range of profound questions about the kind of country Afghans want. These can only be addressed by Afghans talking with other Afghans. Solutions will not be found on the battlefield, we know this, nor can they be imposed from the outside.
At the same time, Afghans need and deserve our support to ensure that peace, when it arrives, can be sustained. I would like to spend some time today updating you on UNAMA’s efforts to prepare the ground for peace, and the role of the international community as the peace process unfolds.
Despite the air of cautious optimism, the level of violence on the battlefield remains deeply worrying. The last few weeks have seen near-record numbers of security incidents, including egregious attacks by spoilers targeting civilians involved in the peace process.
We must keep in mind the terrible consequences of this violence. The conflict continues to kill and injure hundreds of Afghans every week. It has displaced millions of people, most of whom have no immediate prospect of returning to their homes. It impedes humanitarian access, at this critical time, depriving many of life-saving assistance, and hindering the response to the COVID-19 pandemic. And – as we look towards the peace talks – this violence also creates an atmosphere of mistrust that risks derailing negotiations.
Let us recall what four decades of war have brought to Afghanistan. Despite significant progress in the last two decades, Afghanistan remains one of the worst places in the world to be a woman, and one of the worst to be a child. According to UNHCR, Afghans comprise the largest protracted refugee population in Asia, and the second largest refugee population in all the world. After two decades of substantial financial assistance from donors, millions of Afghans continue to live in conditions of extreme poverty. And as we congratulate Africa, as we must and as we willingly do, for the eradication of polio, we face a sobering statistic: Afghanistan is now one of only two countries in the world where polio still threatens the health of our young population.
But it does not have to be this way. We continue to call on all parties to reduce the level of violence. Along with many Afghans, we hope that one of the first items on the agenda of intra-Afghan negotiations will indeed be a humanitarian ceasefire. For Afghanistan’s most vulnerable people, the stakes could not be higher. I urge all member states to amplify this call as the negotiations begin. And the negotiations will begin.
The coming days will hopefully bring the formal launch of intra-Afghan negotiations. I said the coming days, not the coming weeks. We thank member states, including Qatar, the United States, and Pakistan, as well as so many others who have engaged in intensive diplomatic efforts to get us to this point. For our part, the UN will be working with international partners to support both parties and the host countries throughout the process. But a peace process, and even a peace agreement, does not peace make. All of us must each do our part to create a conducive environment for peace talks. In parallel, we must ensure that the ground is prepared for peace to flourish once an agreement is reached.
As the UN, one of our flagship issues will, of course, be the role of human rights in achieving a sustainable peace. We know from long experience that peace processes are more robust when they take into account the concerns of the victims of war. For that reason, we have initiated a dialogue with the conflict parties on the inclusion of victims’ voices in peace negotiations, and mechanisms for incorporating victim-centred justice. This is a difficult topic, but it is an essential one. And it must be dealt with during the negotiations. Only when victims’ grievances are acknowledged and addressed will true reconciliation be possible. And I appreciate the work of the Kingdom of Netherlands in taking responsibility for the Group of Friends on victim-centred justice.
We have spoken as well, a great deal, in this forum about the necessity of including women in the process. Most recently, I was impressed by the strong declarations of support for Afghan women by member states during the Arria-formula meeting in July. And again, I appreciate the work of Afghanistan, the United Kingdom, heading the Friends of Afghan Women and Indonesia and Germany in supporting that event.
But we all know that talking will not be enough. Women’s rights are already emerging as one of the most difficult issues confronting the conflict parties as they enter negotiations, and one where any compromises could pose, will pose, a difficult dilemma for member states. The issue will be more central, this issue of women’s rights, will be more central in the Afghan peace process than we have ever seen in any other peace negotiation in recent memory. In Kabul, I have initiated a series of meetings with a countrywide network of Afghan women on the peace process, which is giving us important insights into their concerns, as well as possible avenues for greater engagement.
But we all know that it is women’s representation at the peace table that offers the best opportunity to ensure that their own rights are upheld, and that their vision for elements of a peaceful Afghanistan is reflected in all aspects of the talks. I commend the women members of the Islamic Republic negotiating team and other peace structures for their energetic outreach and substantive preparations for intra-Afghan talks. As of this moment, we are not yet aware of any women’s representation on the Taliban side, but we remain hopeful that they, too, will find a way of meaningfully including women, the other 50 per cent of the population, in their negotiation team.
Afghanistan’s vibrant media will also be crucial in fostering an inclusive and sustainable peace. I pay tribute to Mr. Mohseni, joining us this evening, for his leadership on this issue, and to the many brave Afghan journalists who have taken considerable risks in the course of their work. Next week, I will be hosting the first of what I hope will be many meetings with a wide consortium of national media to discuss how we can work, together with civil society, to stimulate an active and ongoing dialogue throughout the period of the peace negotiations, so that we have a lively vibrant discussion amongst Afghans during the months of the talks.
Peace will only truly take hold if it delivers material benefits for the Afghan people. This, too, will require substantial preparation by all parties: by the Government of Afghanistan; by regional countries; and by the international community. Alongside the Government, we have been working with the World Bank, the Asian Development Bank, and the private sector in Afghanistan to identify the challenges to economic development, and to identify the great economic dividends of peace.
Regional cooperation will be a vital element of this – the neighbourhood – both as a contributor to, and a beneficiary of peace. By deepening its regional relationships in the areas of trade and transit, infrastructure connectivity, counter-narcotics, people movements, knowledge transfer and so many other areas, Afghanistan can begin to realize its enormous untapped potential, and take full advantage of its strategic location at the heart of Asia.
At the same time, a stable Afghanistan will bring about a more prosperous neighbourhood. In the spirit of the Tashkent Conference, and work that has been done by others in the region before me, the Mission has initiated an ambassadors’ working group here in Kabul, bringing together the six bordering countries to Afghanistan, to discuss concrete work in key areas. I have been gratified, I have been overwhelmed by the response that we have received from the six border countries – China, Iran, Pakistan, Tajikistan, Turkmenistan and Uzbekistan – and will continue to work with them, with the Government and the many UN agencies, because this is not just about UNAMA, this is about the UN agencies working here in Afghanistan and the UN agencies working in these six neighbouring countries. How do we bring that full wealth of resource, of knowledge of intellect and capability to focus on a richer, more prosperous, more peaceful, more stable neighbourhood. And as this exercise develops, it will be linked into the other regional formats that many of you know well, such as the Heart of Asia-Istanbul Process, the Regional Economic Cooperation Conference on Afghanistan, the Shanghai Cooperation Organization, and many others.
For peace to take hold, Afghanistan needs, and will need, strong, trusted public institutions. I am pleased to note the Government’s announcement, this past week, of the formation of its cabinet, as well as appointments to the High Council of National Reconciliation. But there is still much more work to be done. The most recent UNAMA anti-corruption report identified significant institutional gaps, which have stymied progress and undermined confidence. We are working with the Government, civil society, and the donor community to encourage concrete initiatives, including a comprehensive anti-corruption strategy and the most needed independent anti-corruption commission.
In the lead-up to the pledging conference in November, tackling corruption is essential to building donors’ confidence. In preparation, we are working closely with the conference co-chairs, Afghanistan and Finland, as well as line ministries and donors, to promote strong alignment between the Government’s priorities and the expectations and conditions of the international donor community. This year, we must admit that we are facing the added complication of the global fiscal crisis caused by COVID-19, which will constrain the financial commitments of key donors. But we are determined to help Afghanistan make the best case possible for ongoing donor support. And to that end, issues of trusted public institutions dealing with corruption and so many other issues will need to be addressed. Just as peace can pave the way for development, however continued international support for development must be forthcoming if we want to consolidate peace.
It is noteworthy that the pledging conference will be taking place in parallel with the intra-Afghan negotiations. Each process must reinforce the other. Combined, these two processes will set the course for Afghanistan’s future along with the political will and the incredible resilience of the Afghan people. For this reason, we are engaging regularly, as UNAMA, with the Taliban to ensure that they are well-informed of Afghanistan’s obligations as a member of the global community, including discussions with them on expanded understanding of development and governance issues, as well as our ongoing human rights dialogue. I consider this work to be of utmost importance.
This year, the COVID-19 pandemic has hit Afghanistan hard. Over 38,000 confirmed cases of COVID have been reported, and over 1,400 people have lost their lives to this disease – although the actual figures we know are probably many times higher. Millions of Afghans have suffered lost income and livelihoods. Children have missed crucial months of school. Anecdotally – and, sadly, as in so many countries around the world – women have suffered an increase in gender-based violence. Rebuilding these lives will be a painstaking task.
I thank the members of the Council for their support of Afghanistan’s national COVID-19 response, and for the concern that so many of you have expressed to me about our staff here on the ground. Fortunately, the situation has stabilized, and the resilient Afghan people have managed to endure the first wave of COVID-19. But the pandemic has affected our operations on the ground dramatically and we do everything we can to overcome the limits it has imposed. We do not know what the autumn has in store.
Despite these challenges, let me assure you that it remains a great privilege for all of us to execute the mandate given to us by the Security Council in the service of the people of Afghanistan. I am confident that, the next time we meet, we will discuss the progress that will have been made by then in the intra-Afghan negotiations. Your support, and that of Afghanistan’s neighbours and international donors, will be essential for the success of these negotiations. The people of Afghanistan have heard your strong voices of support, and appreciate the UN’s ongoing commitment to their future. I echo this daily. We stand ready to assist them in every way that we can.
UNAMA supports the Afghan people and government to achieve peace and stability. In accordance with its mandate as a political mission, UNAMA backs conflict prevention and resolution, promoting inclusion and social cohesion, as well as strengthening regional cooperation. The Mission supports effective governance, promoting national ownership and accountable institutions that are built on respect for human rights. UNAMA provides 'good offices' and other key services, including diplomatic steps that draw on the organization’s independence, impartiality and integrity to prevent disputes from arising, escalating or spreading. The Mission coordinates international support for Afghan development and humanitarian priorities.
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Can pandemics affect educational attainment? Evidence from the polio epidemic of 1916 | Cliometrica (Berl) | Nature Public Health Emergency Collection | PubMed Central®.
[Open Access] [2020 Jul 27 : 1–35] [Epub ahead of print] [Received 2020 Feb 4; Accepted 2020 Jul 11]
We leverage the largest polio outbreak in US history, the 1916 polio epidemic, to study how epidemic-related school interruptions affect educational attainment. Using polio morbidity as a proxy for epidemic exposure, we find that children aged 10 and under, and school-aged children of legal working age with greater exposure to the epidemic experienced reduced educational attainment compared to their slightly older peers. These reductions in observed educational attainment persist even after accounting for the influenza epidemic of 1918.
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