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Antiretroviral treatment for people with HIV is increasing in Latin America and the Caribbean

CARIBBEAN - Nearly 600,000 more people today than in 2003 are receiving antiretroviral treatment for HIV in Latin America and the Caribbean, according to data released by the Pan American Health Organization/World Health Organization (PAHO/WHO) in the lead-up to World AIDS Day, December 1.

PAHO's theme for World AIDS Day this year is "Close the gap – for an AIDS-free generation." The goal is to bridge the gap between people who have access to HIV prevention, treatment, care and support services and those who are being left behind.

"Over the past decade, countries in Latin America and the Caribbean have increased access to health services needed by people with HIV, including medicines," said PAHO Director Carissa F. Etienne. "Controlling the epidemic by 2030 would be possible if countries implement a combined prevention strategy and if everyone knows their HIV status, gets the treatment they need, and live free of stigma and discrimination."

The 2014 PAHO/WHO report Antiretroviral Treatment in the Spotlight: A Public Health Analysis in Latin America and the Caribbean reveals that the number of people receiving antiretroviral treatment in Latin America and the Caribbean increased from an estimated 210,000 in 2003 to 795,000 in 2013, representing 56% of those who need treatment and 44% of all people with HIV.

"We still face a gap that we urgently need to close," said PAHO Director Etienne. "The challenge now is to make further progress and ensure we do not backslide on our achievements so far."

In 2013, 106,000 people became newly infected with HIV in Latin America and the Caribbean, 9% less than in 2003. New infections could be reduced even more through the implementation of a prevention strategy that combines evidence-based services and interventions based on the needs of those they serve. These interventions range from the distribution of condoms and information on HIV to offering HIV testing and timely treatment, among others.

Just as new infections have declined, so are HIV deaths. Last year, 58,000 people in the region died from HIV, a 40% decline since 2003.

"Timely treatment is fundamental for saving the lives of people who contract HIV and to prevent transmission to others. Providing testing and counseling together is a crucial strategy to link people who have the virus with comprehensive healthcare services," said Massimo Ghidinelli, chief of PAHO/WHO's HIV/AIDS, STI and Hepatitis Unit. "Simplifying treatment regimens can help reduce the emergence of resistance and adverse side effects and help keep medications effective."

The number of mothers receiving treatment also increased significantly, according to preliminary data from PAHO/WHO and UNICEF. In 2010, fewer than 59% of pregnant women with HIV received treatment. In 2013, this proportion reached 93%, close to the 95% target adopted by the region's countries for 2015.

The proportion of children 14 and under with HIV who are receiving treatment reached 51% last year. Some 52,000 children in the region are believed to be living with the virus.

In Latin America and the Caribbean, 3 in 10 people with HIV are unaware that they have the virus, and 35% of new cases are diagnosed late, impeding timely treatment. The new PAHO/WHO report is the region's first to present this type of data.

PAHO/WHO supports the region's countries in updating care and treatment guidelines for HIV based on new WHO recommendations and the latest scientific evidence, and also helps countries optimize the rational use of antiretroviral medications. This contributes to improving the effectiveness of treatment and advances the regional goal of reaching 90% viral suppression in people under treatment by 2020.

World AIDS Day is observed each December 1 to raise awareness of HIV/AIDS. It provides an opportunity to disseminate information and stimulate progress in prevention, treatment and care for people with HIV in countries with high prevalence and throughout the world.

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Violence against women is linked to reproductive health problems

INTERNATIONAL - Unintended pregnancies, sexually transmitted infections, and miscarriages are more frequent among women who report having experienced violence at any point in their lives, studies from multiple countries around the world show.

On the International Day for the Elimination of Violence against Women, observed each year on November 25, the Pan American Health Organization/World Health Organization (PAHO/WHO) called for the health sector—especially sexual and reproductive health services—to be involved in efforts to prevent and respond to violence against women.

"This is a major problem with many health implications," said Dr. Carissa F. Etienne, PAHO’s Director. "The health sector has a role to play in both prevention and response."

Violence against women continues to be a serious public health problem in the Americas, where one in three women experiences physical or sexual violence by a partner or sexual violence by a non-partner during their lifetime, and 20% of women report being sexually abused as children. Young women aged 15-19 years are most at risk of suffering physical or sexual partner violence, with many reporting their first sexual encounter as unwanted or forced.

This violence not only results in physical injury or death but also has an under-recognized impact on women’s reproductive health, leading to more complications of pregnancy, unwanted pregnancy, miscarriage and sexually transmitted infections (STI), including HIV. In some countries in the Americas, levels of unwanted pregnancy are two to three times higher among women who report partner violence compared with women who do not. Pregnancy loss is twice as high among women who report experiencing violence, and the risk of premature labor is 1.6 times greater.

Studies have also found violence to be a significant cause of maternal mortality. Partner violence was the main cause of maternal death—responsible for 20% of such deaths— in three U.S. cities during 1993-1998. Hemorrhage was found to be three times more common in pregnant women suffering violence in one province in Canada in 2003. Between 3% and 44% of pregnant women in Latin America and Caribbean report experiencing partner violence during pregnancy.

The role of health sector should include collecting data on violence prevalence that can be used to inform policy and programming, while training personnel to provide comprehensive, non-judgmental care for survivors of domestic violence. Healthcare workers should also refer survivors to legal services and social support. Public health strategies should include efforts to change social norms and behaviors that are linked to violence.

Additionally, in the case of women who experience sexual assault, health services should asses their need for HIV or STI prophylaxis, make emergency contraception available, offer safe abortion in accordance with national law (when a woman accesses health services too late for emergency contraception or if emergency contraception fails), and provide mental health support.

In 1999, the United Nations General Assembly designated November 25 as the International Day for the Elimination of Violence against Women, which also marks the start of 16 Days of Activism that will culminate on December 10, Human Rights Day.

By the numbers

Proportion of women who report ever experiencing physical or sexual partner violence*:

  • Bolivia (2003): 53.3%
  • Colombia (2005): 39.7%
  • Peru (2007-08): 39.5%
  • Ecuador (2004): 32.4%
  • Nicaragua (2006-07): 29.3%
  • Guatemala (2008-09): 27.6%
  • El Salvador (2008): 26.3%
  • Paraguay (2008): 20.4%
  • Jamaica (2008-09): 19.6%
  • Haiti (2005-06): 19.3%
  • Dominican Republic (2007): 17%
  • Peru (2007-08): 11.3%
  • Colombia (2005): 9.7%
  • Dominican Republic (2007): 6.6%
  • Haiti (2005-06): 5.6%
  • Bolivia (2003): 3.3%
  • Colombia (2005): 1.7%

Reported prevalence of partner violence during pregnancy*:

Proportion of women who reported losing a pregnancy as a result of partner violence*:

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Ahead of World AIDS Day, more investment and access to treatment needed

INTERNATIONAL – An estimated 1.1 million HIV infections among children under 15 have been averted, but disparity in access to treatment is hampering progress towards reaching a global goal of reducing new infections in children by 90 per cent, the United Nations Children's Fund (UNICEF) said on Friday, November 28, 2014 ahead ofWorld AIDS Day.

New cases of HIV infections declined by more than 50 per cent between 2005 and 2013, as a result of expanding the access of millions of pregnant women living with HIV to services for the prevention of mother-to-child transmission, UNICEF said in apress release. These services include lifelong HIV treatment that markedly reduces the transmission of the virus to babies and keeps their mothers alive and well.

“If we can avert 1.1 million new HIV infections in children, we can protect every child from HIV – but only if we reach every child,” UNICEF Executive Director Anthony Lake said.

“We must close the gap, and invest more in reaching every mother, every new-born, every child and every adolescent with HIV prevention and treatment programmes that can save and improve their lives,” he added.

The agency stressed that the global goal of reducing new HIV infections in children by 90 per cent between 2009 and 2015 is still out of reach. In fact, in 2013 only 67 per cent of pregnant women living with HIV in all low- and middle-income countries received the most effective antiretroviral medicines for the prevention of mother-to-child transmission.

Among people living with HIV in low- and middle-income countries, adults are much more likely than children to get antiretroviral therapy, UNICEF noted. In 2013, 37 per cent of adults aged 15 and older received treatment, compared with only 23 per cent of children aged 0 to 14 – or less than 1 in 4.

The sharpest declines in new HIV infections among children took place between 2009 and 2013 in eight African countries: Malawi (67 per cent); Ethiopia (57 per cent); Zimbabwe (57 per cent); Botswana (57 per cent); Namibia (57 per cent); Mozambique (57 per cent); South Africa (52 per cent); and Ghana (50 per cent), according to UNICEF.

In addition, the agency emphasized that AIDS mortality trends for adolescents are also of significant concern. While all other age groups have experienced a decline of nearly 40 per cent in AIDS-related deaths between 2005 and 2013, adolescents aged 10 to 19 are the only age group in which AIDS-related deaths are not decreasing.

UNICEF's Statistical Update on Children, Adolescents and AIDS provides the most recent analysis of global data on children and adolescents from birth to 19 years of age.

World AIDS Day, celebrated annually on 1 December, was launched in 1988 and was the first-ever global health day.

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Obesity-related cancers on the rise

INTERNATIONAL – Being overweight or obese have become major risk factors for developing cancer, particularly among women and in more developed countries, the specialized cancer agency of the United Nations World Health Organization (WHO) reported on Wednesday, November 26th, 2014.

Overweight and obesity are responsible for an estimated 481,000 – or 3.6 per cent – of all new cancer cases in 2012, and reducing such health issues at the population level could have significant health benefits, according to a new study by the International Agency for Research on Cancer (IARC).

The study, which was published inThe Lancet Oncology on Wednesday, November 26th, also shows that one quarter of all cancers attributable to overweight and obesity worldwide – 118,000 cases – could have been prevented if populations had simply maintained their average body-mass index of 30 years ago.

“The number of cancers linked to obesity and overweight is expected to rise globally along with economic development,” Dr. Christopher Wild, Director of IARC, said in apress release.

“This study stresses the importance of putting in place efficient weight control measures, to curb the high number of cancers associated with excess body weight and to avoid the problems faced by rich countries being repeated in those now undergoing rapid development,” he added.

Cancer due to overweight and obesity is currently far more common in more developed countries – which reported 393,000 cases, or 5.2 per cent of all new cancer cases – than in less developed countries – which reported 88,000 cases, or 1.5 per cent of all new cancer cases.

North America remains the most affected, with an estimated 111,000 obesity-related cancers in 2012, accounting for 23 per cent of the total global cancer burden linked to high body-mass index, the agency said.

In Europe, the proportion of cancers due to overweight and obesity is also large, particularly in Eastern Europe – which reported 65,000 cases, or 6.5 per cent of all new cancer cases in the region, according to the study.

Overall, the countries with the highest cancer burden attributable to overweight and obesity in men are the Czech Republic (5.5 per cent of the country’s new cancer cases); Jordan (4.5 per cent); the United Kingdom (4.4 per cent); and Malta (4.4 per cent).

Among women, Barbados (12.7 per cent), the Czech Republic (12.0 per cent) and Puerto Rico (11.6 per cent) are most affected. In the United States – one of the largest contributors of global cancers associated with high body-mass index – 3.5 per cent and 9.5 per cent of the country’s new cancer cases are linked to excess body weight in men and women, respectively.

Although in most Asian countries the proportion of cancers associated with overweight and obesity is not large, it still translates into a considerable absolute number of cases due to the large population size, the study noted.

For example, in China, about 50,000 cancer cases in women and men are associated with overweight and obesity, accounting for 1.6 per cent of the country’s new cancer cases, according to the study.

In contrast, the contribution of overweight and obesity to cancer burden remains low in Africa – which had 7,300 cases, or 1.5 per cent of all new cancer cases in the continent.

“Overall, we see that while the number of cancer cases associated with overweight and obesity remains highest in richer countries, similar effects are already visible in parts of the developing world,” said Dr. Isabelle Soerjomataram, one of the study’s lead authors and the project’s principal investigator.

A high body-mass index is a known risk factor for cancers of the oesophagus, colon, rectum, kidney, pancreas, gall bladder, postmenopausal breast, ovary and endometrium, as well as for other non-communicable diseases, notably cardiovascular disease and diabetes.

A body-mass index is a measure of body fat that is calculated by dividing the weight in kilograms by the square of the height in metres.

The study also highlights that the proportion of cancers related to obesity is higher in women than in men, with population-attributable fractions of 5.3 per cent and 1.9 per cent, respectively.

“Women are disproportionately affected by obesity-related cancers,” said IARC’s Dr. Melina Arnold, one of the study’s lead authors.

“For example, for postmenopausal breast cancer, the most common cancer in women worldwide, the study suggests that 10 per cent of these cancers could have been prevented by having a healthy body weight.”

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Alarm sounded to end ‘global pandemic’ of violence against women

INTERNATIONAL – Violence against women and girls is a global pandemic that destroys lives, fractures communities and holds back development, United NationsSecretary-General Ban Ki-moon said as the world body ON Tuesday, November 25th marked the International Day to End Violence against Women.

“But violence against women and girls does not emerge from nowhere. It is simply the most extreme example of the political, financial, social and economic oppression of women and girls worldwide,” Mr. Bansaidat an Economic and Social Council (ECOSOC) event at Headquarters.

Joining Mr. Ban at Tuesday’s panel discussion were UN Women Executive-Director Phumzile Mlambo-Ngcuka; First Lady of New York, Chirlane McCray, and actor Teri Hatcher, among others.

This year’s theme ofOrange Your Neighbourhoodpromises grassroots action to raise awareness in local communities. For example, the UN Secretariat building and the Empire State Building were lit orange last night, and many wore orange today to show support and solidarity in ending the scourge that affects one in three women worldwide.

Violence against women is not confined to just one region, political system, culture or social class, Mr. Ban explained today. It is present at every level of every society in the world. It happens in peacetime and becomes worse during conflict.

This year alone, we have seen the kidnapping of more than 200 girls in Nigeria; the Indian schoolgirls who were raped, killed and hung from a tree; graphic testimony from Iraqi women of rape and sexual slavery during war; the continued bullying of women on the internet.

Governments, workplaces, universities and sports authorities are stepping up much-needed action to end sexual violence. More than 80 per cent of governments have passed laws on domestic violence and sexual harassment.

However, their implementation is often slow and uneven. And fragile gains continue to be threatened by extremism and a backlash against women’s rights.

“It is up to everyone to play their part; women’s rights are not only women’s business. Men and boys are finally taking their place as partners in this battle. TheHeForShe campaignI launched two months ago brings together one half of humanity in support of the other,” Mr. Ban said.

Echoing that, UN-Women’s Ms. Mlambo-Ngcuka explained that this Day is an opportunity to “shine an orange light” on violence against women that takes place at home, in schools, nations, cities, and villages. She urged for support to confront that “horror” and “extinguish it.”

“This is an important moment as the world is getting ready to gear up to the post-2015 plan of action,” Ms. Mlambo-Ngcuka said, highlighting that the issue of fighting violence against women will be high on the future global development agenda.

“No culture, no nation, no woman – old or young – is immune to this human rights violation,” she added.

“And these women are determined to reclaim their lives,” she said, urging that “there is no time for complacency or excuses, the time to act is now.”

“We need young people, members of Parliament and political parties, religious and traditional leaders as well as men and boys to play their roles,” the UN-Women chief explained.

“We know what works now. The Millennium Development Goals (MDGs) initiative, along with other studies, has generated quite some data and best practices that demonstrate that the importance of protecting women and girls and providing services to those who fall victim to these horrendous crimes.”

“We are in a unique position in history and a lot of will among the people of the world to forge ahead and conquer violence against women,” she said.

Recalling meeting women who have been victims of violence, Ms. Mlambo-Ngcuka said that she “forever will be haunted by their suffering” but also inspired by their courage.

One of those personal stories shared today was that of actress Teri Hatcher, who hoped her experiences would “shed light on the dangers of remaining silent about sexual abuse.” Ms. Hatcher was abused by her uncle and after she remained silent about it, the man went on to abuse a young woman who later committed suicide.

Upon learning of that tragedy, Ms. Hatcher spoke up against her uncle, who was then convicted and sentenced to prison, where he died. “But nothing could undo the devastating violence he had caused,” she acknowledged.

“I’m the ‘one in three women,’” Ms. Hatcher said referring to statistics on the one billion women worldwide who suffer from violence, which forever affects self-esteem, self-worth and self-happiness.

“When society shames the victim by asking why did you stay instead of asking ‘why did he abuse her,’ we just…foster a society where the abuser continues to abuse,” Ms. Thatcher said stressing the need to break stigma so that victims are unafraid to speak up.

“As long as violence is a part of any woman’s story, silence will not be a part of mine,” she said.

Chirlane McCray, First Lady of New York, said that the Mayor’s office is “working day and night” to connect with women and girls in communities to inform them about the city centres available to those who suffer from violence.

“We know that violence against women and girls is a global problem that requires a global solution,” said Ms. McCray. But cities and local Governments such as New York’s can help in such efforts.

For instance, New York’s official first agreement with the UN – a Memorandum of Understanding (MOU) signed today by the First Lady and UN Women’s Executive Director – commits to making areas in the city safe for all women and girls and free of sexual harassment.

“Every day, in cities across the globe, women and girls are trapped in lives defined by fear and violence. Here in New York City, we have launched a comprehensive effort to connect victims to the resources they need to break the cycle and establish their independence. But we must do even more, which is why we are joining the UN Women’s Safe Cities Global Initiative,” said Ms. McCray.

“We are committed to doing our part to create a world – and a city – where all women and girls can live their lives without fear of violence.”

New York is the first city in the United States to join the safe city initiative. The city is also leading on women’s leadership roles, as the city government’s majority is female and universal prekindergarten, a “game-changer” for many working mothers.

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Ebola: December 1 target for response may not be met in some areas of West Africa, UN reports

INTERNATIONAL - The United Nations World Health Organization (WHO) said on Tuesday, November 25 that while Ebola response targets for December 1 in West Africa may be reached in many places, they may not be met in some areas, and confirmed two new cases in Mali amid ramped up efforts to reduce the likelihood that additional cases will be imported from neighbouring Guinea.

“The identification of patient contacts for daily monitoring has reportedly reached 99 per cent,” WHO said. “Based on experiences in Senegal and Nigeria, this achievement could augur well for rapid containment of Mali’s outbreak.” Senegal and Nigeria, which had been affected, are now Ebola-free.

“Most of these patients had symptom onset in early to mid-November, indicating ongoing chains of transmission,” WHO said in apress releasethat confirmed the two additional cases that brings to eight the total number of reported cases in Mali.

“With WHO support, staff from Mali’s Ministry of Health will be meeting with health officials from Guinea to discuss cross-border measures for coordinating control efforts and reducing the likelihood that additional cases will be imported from Guinea into Mali,” the UN health agency said.

The United Nations, as part of its intensified support to both the preparedness and response efforts of the Malian Government, will be opening on Wednesday, November 26th an office of the UN Mission for Ebola Emergency Response (UNMEER) in Bamako, the capital.

UNMEERs’ Guinea office, meanwhile, reported that community reticence in many areas remains the main obstacle to contact tracing. Ebola is spreading in the north up to the border with Mali, an area with no functioning treatment centres or transit centres.

In response to a question at the UN press briefing in Geneva, WHO Spokesman Tarik Jasarevic said the December 1 targets for treatment and burials and set by his organization in its response to Ebola would likely be reached in many places, but not in others.

UNMEER head Anthony Banbury had said in media interviews that the mission is already exceeding its 1 December targets in some areas, but that it is almost certain the targets will not be reached in all areas.

The targets are the so-called “70-70-60 plan” which aims to try to get 70 per cent of the cases isolated and treated, and 70 per cent of the deceased safely buried within 60 days from the beginning of October to 1 December.

UNMEER also reported that 150 health workers from the West African countries of from Benin, Ghana, Ivory Coast, Mali, Niger and Nigeria will be trained in Accra, Ghana this week to help tackle Ebola in Guinea, Liberia and Sierra Leone.

In Liberia, UNMEER said it plans have two or three of its helicopters positioned in Monrovia by next week to ensure immediate dispatch of teams and supplies to any outbreak.

And as of today, according to the Office for the Coordination of Humanitarian Affairs (OCHA), $807.5 million of the $1.5 billion Ebola response plan for West Africa was funded, which represented 54 percent of the appeal met.

Meanwhile, theUN Global Compactwill convene an event in New York on December 11 in cooperation with the Ebola Private Sector Mobilization Group, a coalition of over 35 companies with major assets and operations in West Africa mobilizing business resources, to support front-line Ebola humanitarian relief efforts while also advocating for a more concerted global response to the outbreak and recovery.

Along with counterparts from the UN, governments and civil society, CEOs will gather at this event to share examples of interventions by business to support the Ebola response, identify lessons learned, explore how successes can be replicated and discuss the role of business in long-term recovery, according to the UN Global Compact.

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Aruba and Curacao Ports Authority pen an MoU to Promote Southern Caribbean Cruise Tourism

POINT BLANCHE – The port authorities of Aruba and Curacao have made a strategic agreement where they will pursue cruise tourism in the Southern Caribbean and seek relationships with other ports that are in the process of developing their own cruise product.  The main objective is to strengthen shipping in this part of the Caribbean from the perspective of commerce and cruise.

Aruba received in 2013 over 688,000 cruise passengers, an 18.2 per cent increase when compared to 2012 when the country catered to over 582,000 cruise passengers. 

Curacao in 2013 received over half a million cruise passengers (585,381) or a 34.2 per cent increase when compared to 2012 when the island received 436,068 cruise passengers.

Cruise destinations in the North Eastern and Western Caribbean will be analysing this move to see what it will mean for their destinations and how the Florida-Caribbean Cruise Association (FCCA) will view this as well. 

The Southern Caribbean cruise market is seen as a developing market which offers a variety of Southern Caribbean, Central and South American cruise stops.

With a number of cruise ships being constructed by the cruise industry annually, cruise watchers are of the opinion that things will balance out and destinations in the North Eastern and Western Caribbean won’t have anything to worry about.

Curacao Ports Authority (CPA) and Aruba Ports Authority (APA) recently signed a Memorandum of Understanding (MoU) for a one-year period.  This is an agreement of mutual interest to promote economic prosperity for both countries through commerce.

The MoU promotes the exchange of information between both ports; as well as looking at competitive advantages within the Caribbean Basin; exploring joint marketing opportunities; and exchanging information about other aspects of the maritime industry.  Part of the planning is to sign other agreements with ports in the Southern Caribbean.

The two ports will review the MoU after a year. (SOUALIGA NEWSDAY REPORT)

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Ebola: Outbreak’s end by mid-2015 foreseen; UN to set up response office in Mali

INTERNATIONAL – Secretary-General Ban Ki-moon said that by continuing to scale up the global fight against Ebola, there is hope the outbreak could be contained by mid-2015, but he emphasized that results to date are still uneven, and announced that the Organization’s top health officials will head to Mali, where the situation is still a cause of "deep concern.”

At a press conference at World Bank headquarters in Washington, D.C. after what he said were “in-depth” discussions with the UN System Chief Executives Board for Coordination (CEB) on the joint UN response to counter the Ebola outbreak in West Africa, the Secretary-General said he had also asked the UN Mission for Ebola Emergency Response (UNMEER) to set up an office in Mali, where “the new chain of transmission…is a cause of deep concern.”

Saying that “the rate of transmission continues to increase in too many places,” Mr. Ban made an urgent appeal for ramped up resources. Earlier today, the UN World Health Organization (WHO) said there have been six reported cases in Mali, all of whom have died, as of 20 November. A total of 327 contacts are being followed-up, it said.

“We need more international responders – trained medical teams and volunteer health workers – especially in remote districts,” he said.

But Mr. Ban noted “some welcome progress,” saying: “We are seeing the curve bending in enough places to give us hope.”

He also said “if we continue to accelerate our response, we can contain and end the outbreak by the middle of next year.”

"I appeal to the international community to stay engaged," he said. "The United Nations system will continue to scale up our response until the very last case of Ebola is identified and treated.”

Mr. Ban said he had spoken to President Ibrahim Boubacar Keita of Mali and informed him that, as a way to show solidarity and unity and immediate support, WHO Executive Director Dr. Margaret Chan, and Dr. Michel Sidibé, Executive Director of the Joint UN Programme on HIV/AIDS (UNAIDS), are travelling to Mali immediately to have in-depth discussions on how the UN system can eradicate the virus and prevent further outbreaks there.

Dr. Chan told reporters: “We must smother this fire…before it gets out of control.

“I am confident that if we work together as one, we would be able to bring this outbreak under control,” she added.

The CEB is made up of 29 Executive Heads of UN Funds and Programmes, specialized agencies, including the Bretton Woods Institutions, and related organizations – the World Tourism Organization and the International Atomic Energy Agency.

Later Friday at UN Headquarters, the Security Council met and heard a briefing by Dr. David Nabarro, the Secretary-General’s Special Envoy on Ebola. UNMEER chief Anthony Banbury, addressed the Council via video link from Ghana.

Dr. Nabarro said the UN system will need $1.5 billion dollars through to March 2015 to assist with ending the outbreak.

“Much has been committed, but there is a shortfall of over $600 million,” he said.

He said “the primary credit for progress in the fight against Ebola goes to the communities that have made difficult decisions to abandon generations of traditional practices,” but warned that “if we take our eye off the ball, case numbers will climb again.”

“We must remain vigilant and persevere with a flexible and well-adapted response,” Dr. Nabarro said.

Speaking from Accra, Mr. Banbury, told Council members: “We must work hard, we must work fast, we must work smart and work until the disease is finished.”

Foreign Minister Julie Bishop of Australia, which holds the Council’s presidency for the month, read out a wide-ranging statement approved by the 15-member body that included a request to the Secretary-General to accelerate efforts to scale-up UNMEER’s presence and activities at the district and prefecture level outside of the capital cities.

In this regard, UNMEER subsequently announced it will immediately open an office in Mali to support national efforts against the Ebola virus.

“UNMEER is committed to supporting the Government of Mali's Ebola response efforts,” said Mr. Banbury, who visited the country earlier this week. “[Mali] has a small number of cases now and this means there is a chance to end it quickly before it becomes a true crisis the way it has become in other countries.”

According to UNMEER’s press release, the Mission’s office will be tailored to support Mali’s response efforts, with three expected areas of focus: reinforcing the country’s operational response, strengthening the country's level of preparedness and assisting with cross-border coordination of Ebola efforts between Malian and Guinean authorities.

UNMEER will review the needs of its Mali office’s operations in two months.

WHO released its latest report on Ebola cases dated November 18, which put the number of cases at 15,351 cases in Guinea, Liberia, Mali, Sierra Leone, Spain, and the United States and in the previously affected countries of Nigeria and Senegal, with 5,459 reported deaths.

A separate, unrelated Ebola outbreak in the Democratic Republic of the Congo has now been declared over, WHO reported, commending the country’s strong leadership and effective coordination of the response to the seventh outbreak of Ebola in the DRC since the virus was first identified there in 1976.

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Anaemic growth for shipping industry amid ‘stumbling’ global economy

INTERNATIONAL – The growth of global seaborne shipping over the past year has reflected the “stumbling” progress of the world economy, the United Nations trade and development body announced as it presented its latest report on the “volatile and gloomy” state of the shipping industry.

In itsReview of Maritime Transport 2014, the UN Conference on Trade and Development (UNCTAD) warned that the rate of growth in world fleets was “lower than that observed during any of the previous 10 years” and that the prospects for the current year suggested an even lower growth rate – a trend reflecting the downturn of the largest historical shipping cycle which peaked in 2012.

In addition, noted the report, maritime shipping grew by an average of just 3.8 per cent in 2013, the equivalent of nearly 9.6 billion tons in total volumes. Much of the expansion in seaborne trade was limited to dry cargo flows such as bulk commodities, which grew by 5.6 per cent while world container port throughput grew by roughly the same amount.

Against that backdrop, UNCTAD reported that 2013 was largely marked by what it described as a “gloomy and volatile” maritime freight rates market.

“All shipping segments suffered substantially, with freight rates in dry bulk and tanker markets reaching a 10-year low in 2012 and similarly low levels in the liner market,” the agency said.

“Low performance of freight rates was mainly attributable to the poor world economic development, weak or hesitant demand and persistent supply overcapacity in the global shipping market.”

Maritime transport is considered to be the “backbone” of international trade and the global economy, according to UNCTAD. Around 80 per cent of global trade by volume and over 70 per cent of global trade by value are carried by sea and are handled by ports worldwide. These shares are even higher in most developing countries.

The report added that regulations to reduce emissions of toxic substances from burning fuel oil, as well as environmental and other provisions of the draft international code for ships operating in polar waters continued to be negotiated. Meanwhile, “continued progress” has been made regarding the implementation of the existing framework as well as programmes covering maritime security including measures against piracy.

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Drowning claims over 40 people every hour in ‘needless loss of life’

SINT MAARTEN – Drowning’s among the local population is very far and few.  Many learn from their parents and siblings to swim and we are an island surrounded by water.  Some would say that it becomes a natural instinct to learn to swim because of this especially when looking at the 37 beaches that surround the island of Saint Martin/Sint Maarten. 

The first United Nations World Health Organization (WHO) report on drowning released this week reveals that more than 370,000 people drown every year in bathtubs, buckets, ponds, rivers, ditches and pools as people go about their daily lives in a “serious and neglected public health threat.”

“This death toll is almost two thirds that of malnutrition and well over half that of malaria – but unlike these public health challenges, there are no broad prevention efforts that target drowning,” according to theGlobal Report on drowning: Preventing a leading killer.

More than 90 percent of these deaths occur in low- and middle-income countries such as Bangladesh, Cambodia, China, India, Philippines, Thailand and Viet Nam, the report said, and the highest rates for drowning are among children under 5 years of age.

Accordingto WHO Director-General Dr. Margaret Chan: “Efforts to reduce child mortality have brought remarkable gains in recent decades, but they have also revealed otherwise hidden childhood killers. Drowning is one. This is a needless loss of life.”

“Action must be taken by national and local governments to put in place the simple preventive measures articulated by WHO,” Dr. Chan said.

The report recommends strategies for local communities including: “installing barriers to control access to water; providing safe places such as day care centres for children; teaching children basic swimming skills and training bystanders in safe rescue and resuscitation.”

“At national level, interventions include: adoption of improved boating, shipping and ferry regulations; better flood risk management and comprehensive water safety policies,” WHO said.

In the first global report on the problem released in Geneva, the UN health agency said: “Drowning is a serious and neglected public health threat claiming the lives of 372,000 people a year worldwide,” which translates into more than 40 people every hour.

Former New York City Mayor Michael R. Bloomberg, whose foundation funded the report, said: "I believe that you can’t manage what you don’t measure – and there’s never been a comprehensive effort to measure drowning around the world until now.”

“The more evidence we can gather, the better we’ll be able to tailor our prevention efforts – and the Global Report on drowning is a big step in the right direction,” he said.

“Almost all water presents a drowning risk, particularly inside and around our homes,” says Dr. Etienne Krug, WHO Director for the Department for Management of Non-communicable Diseases, Disability, Violence and Injury Prevention.

“Drowning occurs in bathtubs, buckets, ponds, rivers, ditches and pools, as people go about their daily lives. Losing hundreds of thousands of lives this way is unacceptable, given what we know about prevention,” according to Dr. Krug.

Alarmingly, according to a number of studies from high-income countries, deaths due to drowning may be considerably underestimated, WHO said. Official data do not include drowning from suicide, homicide, flood disasters or incidents such as ferry capsizes.

The report also draws attention to the need to make drowning prevention an integral part of a number of debates, such as climate change which leads to increased flooding; mass migrations, including of asylum seekers traveling by boat; and issues such as rural development and water and sanitation. Improving coordination across these various agendas will save lives, according to WHO.

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