Women on the Move - Migrant Women in the Health Professions
The World Health Organization (WHO) has published a report and a policy brief addressing the issue of female migrant care workers. The goal of both the policy brief and report is to raise awareness of the importance of ensuring migrant workers – who in most cases are women - providing home-based care, are given a legal working status in the receiving country, accompanied by appropriate working conditions and access to health and social services. The project was initiated in 2017 at a meeting in Berlin supported by the Federal Ministry of Health.
Considering the current debate around care provision and the lack of qualified personnel in Germany, a translation of the policy brief was considered to be a valuable contribution to the discussion, highlighting the importance of legal protection and health insurance for the migrant care workers the German population increasingly relies upon. While Germany’s laudable contract regulations with care workers from the Philippines are often highlighted, with an ageing population the need for care workers is increasing. This means that new constructs will have to be developed at a larger scale.
This event launches the translation of the short version of the report, aiming to contribute to the discussion about care workers in Germany and raise awareness of the often precarious situation of the migrant care workers our system relies upon.
The event is supported by the World Health Summit Foundation GmbH and the German Federal Ministry of Health.
Moderator: Prof Dr Dr h.c. Ilona Kickbusch
16.00-16.15 - Introduction (Deputy Professor Dr Sabine Ludwig, founder WGH-GER; Katharina Klohe, Coordinator Center for Global Health at TUM)
16.15-16.40 - Dr Ibadat Dhillon, World Health Organization (WHO), Health Workforce Department (confirmed)
16.40-17.05 - Dr Dominik Zenner, International Organization for Migration (IOM), Department of Migration Health: "Migrant women in the health professions – benefits and difficulties" (confirmed)
17.05-17.30 - Marie-Luise Eßrich, Charité - Universitätsmedizin Berlin, Directorate of Nursing, Integration Management (confirmed)
17.30-17.55 - Prof Dr Ulrike Kluge, Charité - Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy & Humboldt Universität zu Berlin, Berlin Institute for empirical integration and migration research (confirmed)
17.55-18.20 - German Federal Ministry of Health (tbc)
18.20-18.45 - Prof Dr Jalid Sehouli, Charité - Universitätsmedizin Berlin, Department of Gynecology (confirmed)
18.45-19.15 - Plenary Discussion
19.15-20.00 - Reception
International Day of Education
January 24 marks the first International Day of Education, a day proclaimed by the General Assembly of the United Nations whose importance is reflected in the 2030 Agenda for Sustainable Development. The Agenda is an ambitious plan adopted in September 2015 by Heads of State, Government and High Representatives that seeks to end poverty, fight inequalities and counter climate change by 2030. At its core, the agenda contains 17 comprehensive goals, also referred to as the 17 Sustainable Development Goals. One of the goals stated is to obtain quality education, in particular to ensure that all girls and boys have the opportunity to complete primary and secondary education and have access to pre-primary education. In addition, efforts are being made to ensure that women and men are given equal chances of receiving high-quality higher education, such as in university institutions, and that gender imbalances in education are eliminated. To read all related objectives in the context of the goal of quality education, please refer to this page.
Of course it is interesting to have a look at where we stand at the moment, what has been achieved and which tendency we can expect. Mr. Hans Rosling has observed and documented encouraging trends in his book ‘Factfulness – Ten Reasons We’re Wrong About the World’, published in April 2018, which illustrate positive developments in the field of global education. The findings include that around 60% of all girls in low-income countries now finish primary school and that the gender gap in education is indeed closing: on average, women worldwide have spent 9 years in school, while men have spent 10 years in school. According to the World Bank Group, the literacy rate among adults aged 15 and above has increased steadily between 1970 and 2016. The global literacy rate was about 69% in 1970 and approximately 86% in 2016. This represents an increase of almost 17% as shown in the graphic below.
According to the United Nations Population Division, the number of children (0-14 years) will not continue to grow, as most assume, but will remain at around 2 billion by 2100. So there will be as many children in 2100 as there are today, in 2019.
The challenge we still face today is access to education for girls and boys from poor families who simply have no choice to attend school as their families have such poor prospects that their children are needed to help with work and earn money. With regards to education, povertyis a stronger determinant than gender differences and most likely the reason why today 262 million children still do not attend school. In this sense, girls once enrolled in school are in most cases supported and do not drop out of school at a higher rate than boys. To quote Mrs. Audrey Azoulay, Director General of the UNESCO on the occasion of the first International Day of Education:
"This day is the occasion to reaffirm fundamental principles. Firstly, education is a human right, a public good and a public responsibility. Secondly, education is the most powerful force in our hands to ensure significant improvements in health, to stimulate economic growth, to unlock the potential and innovation we need to build more resilient and sustainable societies. Lastly, we urgently need to call for collective action for education at global level."
More information on the International Day of Education can be found in here.
The International Day of Education is a good day to remember one of our most recent heroes in the fight for universal access to education: the Pakistani child rights activist Malala Yousafzai, who received the Nobel Peace Prize in 2014, and who is particularly committed to the rights of girls and the right to education. In her blog on her personal homepage, she gives girls from all over the world a voice and the opportunity to be heard, to share difficulties from their home countries and to share achievements. You can find this blog here. She has already experienced many setbacks in her young years. She was born in Pakistan in 1997, and at the age of 11 the Taliban denied her and all the other girls in her home town access to school. In 2012 she started to fight for education, especially for girls. Her courageous nature made her a target and she was shot in a school bus. In spite of this, she did not allow herself to be intimidated and continued to fight for her rights after her recovery. You can read her moving story either here on her homepage or watch it in her documentary film "He Named Me Malala".
Rolling Back Malaria: a Multi-Sectoral Challenge
Obreniokibo I. Amiesimaka
Rebranded RBM logo ©RBM
October 2018 marked the 20th anniversary of the now-rebranded RBM Partnership to End Malaria. Originally called Roll Back Malaria, RBM was founded by the World Health Organisation (WHO), the United Nations Children's Fund (UNICEF), the United Nations Development Programme (UNDP) and the World Bank.
With its foundation build on collaboration, it was charged with building a partnership of stakeholders in order to spearhead the global effort in combatting malaria.
The RBM Partnership has brought together over 500 partners from diverse fields; ranging from the academia and malaria-endemic countries to the donor, public and also private sectors, amongst many others. This collaborative approach – and work in line with Millennium Development Goal (MDG) 6: “combat HIV/AIDS, malaria and other diseases” – yielded fruits. In the 17 years from its inception to 2015, the WHO records that more than 6 million lives were saved and there was a significant reduction of about 18% in the global burden of malaria.
Its technique is succinctly described in the Stanford Social Innovation Review thus: “RBM …has never treated a patient; nor has it delivered a single bed net or can of insecticide. Rather, RBM has worked across the field of malaria eradication by helping to build public awareness, aggregate and share technical information with a system of global stakeholders, and mobilize funding“.
In 2016, RBM underwent a governance overhaul, which led to its rebranding, in order to reposition it to better meet the malaria challenge. With the launch of the Sustainable Development Goals (SDGs) the year previous, RBM and other global health initiatives are adopting more holistic strategies which recognize the linkages between other social factors and health.
The WHO issued its Global Technical Strategy (GTS) for Malaria 2016 – 2030, which has a similar timeline to the SDGs. Compared to 2015 figures, by 2030, it aims to reduce malaria mortality and incidence rates both by 90%. The elimination of malaria from a minimum of 35 countries and prevention of re-establishment in already malaria-free countries are further targets.
In congruence with the GTS, RBM also published its Action and Investment to defeat Malaria 2016-2030 (AIM) policy. The fulcrum of the AIM document is four-fold: ‘Combine forces to defeat malaria’; ‘Demonstrate continued progress’; ‘Expand partnerships’ and ‘Accelerate efforts’. The AIM document also highlights the importance of malaria eradication to the achievement of the SDGs.
Progress made in the execution of the GTS and AIM documents has been monitored and is explored below.
Great strides but a long way to go
Progress in childhood malaria reduction 2000 – 2015 ©DW
There is no gainsaying that RBM has achieved remarkable success in the fight against malaria. As a result of its work, countries with less than 10,000 malaria cases have risen to an unprecedented 44. Further, whereas 10 countries are poised to completely eradicate malaria by 2020, eight (8) have already done so since 2010; with two joining the ranks after 2016. They include Armenia, Kyrgyzstan, Maldives, Morocco, Paraguay, Sri Lanka, Turkmenistan and United Arab Emirates.
More so, the proportion of the African population with access to long-lasting insecticide treated nets, has increased from a 2001 figure of just 2% to more than 50%. Notwithstanding the progress made, malaria still remains a top-10 killer in low-income countries and a major burden on global health.
The WHO World Malaria Report 2017 estimates that there was an unfortunate rise in the number of people with malaria of 5 million between 2015 and 2016. Similarly, the number of deaths stagnated at about 445,000 between those two years. Although there was still an overall decrease in malaria cases from 273 million in 2010 to 216 million in 2016, it is worrying to see that the progress made thus far could be reversed.
Africa bears the majority of the malaria burden with 91% of deaths and 90% of cases globally. Even more troubling is the fact that 80% of cases are found in just 15 African countries. Malaria is also a sizeable problem in South-East Asia and South America.
Additionally, inadequate funding continues to hamper the achievement of the GTS goals. An estimated USD 2.7 billion was spent in 2016 on malaria but this is less than half the amount needed annually – USD 6.5 billion by 2020 - as stated in the GTS.
According to the WHO, groups at high risk of malaria infection include: patients with HIV/AIDS, infants, children less than 5 years old and pregnant women, coupled with non-immune migrants, mobile populations and travellers.
Given the impact of malaria on these vulnerable groups, many of whom constitute the future of society, the need for progress in the fight against malaria cannot be overemphasized.
Some social factors which play a role in the spread of malaria, and are thus of substantial importance, are explored below.
To continue reading please follow the link to the PDF...
The WHO REPLACE Trans Fat Action Package – From Policy to Practice
Obreniokibo I. Amiesimaka
In May 2018, the World Health Organisation (WHO) introduced an action package for the elimination of industrially-produced trans fats globally by 2023. The action package, called REPLACE Trans Fat, is in keeping with the Sustainable Development Goal (SDG) 3.4, which aims to reduce non-communicable diseases (NCDs).
Here, we consider the action package and some of the potential challenges to its practical implementation.
Trans fats in brief
Trans fats are produced through the addition of hydrogen to unsaturated vegetable oils via the partial-hydrogenation process. This increases the stability of the oils and prevents 'rancidity‘; thus extending their shelf-life. It also modifies the oils into (semi-)solid fats at room temperature, which are used widely in processed and baked foods.
Small quantities of trans fats can be found naturally in meat and dairy, but most trans fats in human consumption come from industrially-produced fat and oil goods e.g margarine, shortening etc.
Trans fats, however, do not have any nutritional benefit. In fact, trans fats have been majorly implicated in causing cardiovascular diseases; especially as they decrease HDL (good) cholesterol whilst increasing LDL (bad) cholesterol in the body.
Further, about 540,000 deaths annually have been ascribed to the consumption of trans fats; with high intake raising the risk of death generally by 34% and specifically deaths from coronary heart disease, by 28%.
The WHO recommends that trans fatty acids (TFAs) constitute below 1% of total energy intake; in other words, for a 2000 Calorie diet, TFA intake should be below 2.2g/day.
There is a dearth of evidence on TFA intake globally. However, available research, shows that the TFA content of diverse street and processed foods considerably exceeds the recommended levels.
The aforementioned evidence necessitated this WHO policy to ban trans fats globally. Trans fat bans/mandatory limits are not entirely novel as up to 20 countries - mainly in the upper middle and high income bracket - have instituted policies regulating the trans fat content of foods. They include: Denmark, Canada, Argentina, South Africa and Iran, amongst others. As most countries without such regulations are Low and Middle Income Countries (LMICs), health equity concerns also formed part of the rationale for the WHO REPLACE Trans Fat policy, discussed below.
To continue reading please follow the link to the PDF...
Kick-Off Meeting "HELMVIT" Study in Lambaréné, Gabon
A joint seminar was held at the Albert-Schweizer-Hospital and the CERMEL (Centre de Recherches Médicales de Lambaréné) in Lambaréné in Gabon from 7th-9th January 2019 to kick-off the consortial project „HELMVIT“ (Full title: “Impact of maternal helminth infection on Vitamin D regulation and on the immune system of the infant”) which is coordinated by Prof. Clarissa Prazeres da Costa, Kodirector of the Center for Global Health, Institute for Medical Microbiology, Immunology and Hygiene of TUM. Collaboration partners are Prof. Akim Adegnika (CERMEL) and Dr. Meral Esen (Institute for Tropical Medicine, University of Tübingen). The consortium is funded for three years by the DFG within the call “German-African Cooperation Projects in Infectiology”.
This seminar had three aims.
1) The first one was to discuss results of a successful pilot study, which took place in Munich and Lambaréné and was performed by students of the Technical University Munich and which will pave the way for the upcoming study.
2) The second aim was to discuss the details of the new DFG study on the influence of maternal helminth infection on Vitamin D regulation and the immune system of the children. Amongst many other staff members, two Gabonese PhD students will be part of this collaborative research project which will cover basic science aspects as well as general women health topics. In this line, a joint German-Gabonese workshop will take place in January 2020 with new partners from other TUM departments as well as representatives from the Ministry of Health in Gabon and other international researchers.
3) Thirdly, new avenues in terms of capacity building (joint teaching, student exchange, knowledge transfer) and timely Global Health-related research topics were explored with the overall intention to intensify and sustain this collaboration.
Women in Global Health - Germany - 2nd Network Meeting
Global Health Day
© Photos: Susanne Dürr, TUM Institute for Medical Microbiology, Immunology and Hygiene