Rising Temperatures, Rising Inequalities: How a New Insurance Protects India’s Poorest Women

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Climate Change Justice

For streetside sellers of artificial jewelry and for recyclers toiling under the increasingly torrid temperatures caused by climate change, innovative insurance means not all is lost when their wares are ruined or it is too hot to work. But is this a panacea or an opportunity for the authorities to ignore their responsibilities to the poorest workers of India?

Street vendor Deviben Dhaundhaliya waits by her iron-frame mobile ‘shop’ to be shifted to the marketplace for evening-time sales in Ahmedabad city in Gujarat state. Credit: Manipadma Jena/IPS

Street vendor Deviben Dhaundhaliya waits by her iron-frame mobile ‘shop’ to be shifted to the marketplace for evening-time sales in Ahmedabad city in Gujarat state. Credit: Manipadma Jena/IPS

BHUBANESWAR/AHMEDABAD, India, Jun 26 2025 (IPS) – As Deviben Dhaundhaliya, 45, a streetside seller of artificial jewelry, waits for her husband Devabhai to arrive and help her shift their iron-frame mobile ‘shop’ to the Bhadra Fort open-air marketplace in Ahmedabad city, she tells of how “as heat increased, my wares started melting under the direct exposure to the sun, or they got discolored.”


It was not the first time Deviben’s wares got heat-damaged. It has been happening most years ever since Gujarat’s Ahmedabad city in May 2010 experienced an unprecedented week-long deadly heat wave spiking to 46.8°C. Deviben says she feels an unrelenting anxiety deep within her as summer approaches.

“For over a decade our income plummets, sickness stalks us through the hottest months.”

However, succour has arrived in India in the form of a newer kind of income protection insurance against extreme heat. A parametric microinsurance has informal sector self-employed women like Deviben covered, building their resilience to growing extreme heat in India.

Parametric insurance depends on one or a few predetermined indexes or parameters, and if these are triggered, a pre-agreed payout happens quickly, which is its attraction. The payout is regardless of the quantum of loss. This creates a much lower risk and time-effort for daily-wage-dependent insurance participants. Whereas traditional indemnity-based insurances necessitate a loss-assessing survey, taking months for compensation payout.

Parametric insurance beneficiaries often pay a small premium, which is subsidized in these initial stages, but group insurers like SEWA visualize beneficiaries realizing benefits and eventually paying.

“Livelihoods and incomes decrease by 30-50 percent due to decreased work efficiency, reduced work hours, increased raw material expenses, spoilage of goods, loss of customers, and reduced workdays due to heat-related illnesses,” according to Sahil Hebbar, Senior Coordinator in charge of the parametric micro-insurance pilot at Self-Employed Women’s Association (SEWA).

WMO chart: The 1991-2024 warming average trend has almost doubled from that of 1961-1990.

WMO chart: The 1991-2024 warming average trend has almost doubled from that of 1961-1990.

The World Meteorological Organization’s (WMO) just-released State of the Climate in Asia 2024 finds that in 2024, Asia’s average temperature was about 1.04°C above the 1991–2020 average, ranking as the warmest or second warmest year on record, depending on the (final) dataset.

WMO warns that the region is warming nearly twice as fast as the global average, driving more extreme weather and posing serious threats to lives, ecosystems, and economies. The 1991-2024 warming average trend has almost doubled from that of 1961-1990.

Extreme heat is one of the deadliest climate risks, responsible for almost half a million deaths per year globally, said Swiss RE one of the world’s leading providers of reinsurance. It partnered with SEWA’s group insurance in 2024.

Beyond the impacts on worker health and well-being, extreme heat can also cause a myriad of economic impacts. Globally, 675 billion hours are lost every year because of excessive heat and humidity, amounting to roughly 1.7% of global GDP, according to Swiss RE.

Women in informal employment face climate heat and exclusion

Waste recycler Hansaben Ahir checks a discarded tarpaulin sheet in Ahmedabad city, Gujarat state. Credit: Manipadma Jena/IPS

Waste recycler Hansaben Ahir checks a discarded tarpaulin sheet in Ahmedabad city, Gujarat state. Credit: Manipadma Jena/IPS

Around 90 percent of women workers participate in the informal employment sector in India. If they are unable to go out to work due to extreme heat conditions, they lose their daily wages. Overall, developing nations are the most exposed to the frequency of climate shocks and chronic onset of mainly extreme heat and floods. Women workers are the most impacted.

A workers’ union, SEWA members total 2.9 million informal sector women workers. Salt-pan workers, recyclers from ship-breaking yards, construction site workers, street vendors, farmers, street waste recyclers, head loaders and home-based workers are included as beneficiaries. These women survive from one day to another on daily wages averaging 150-450 rupees (USD 1.74 –  USD 5.22).

Deviben sells bangles, neck pieces and eardrops of brightly colored fiber material inset in crudely worked metal and gaudy wristwatches with Tissot or CK emblazoned on their dials.

“Because we all streetside sellers sit directly exposed to the sun, dehydration is common. Sometimes my head reels like a carnival merry-go-round; I can barely stand. I go under a tree shade but for only a short while, fearing I’d lose customers,” Deviben said.

When it is really bad, she buys a packet of Oral Dehydration Solution but cannot always afford the 20 rupees (US 0.23 cents) cost.

Hansaben Ahir, 49, a waste collector and recycler, has been a SEWA member for 15 years. She said dehydration, a resultant urinary tract infection, and sudden heat cramps in her legs are so painful, she just has to sit herself down, even if on a road. Last summer she also developed hypertension, mainly stressing over a rising-cost home loan and plummeting income.

“Late-March till the end of June almost every year, my daily earnings fall to 250 rupees (USD 2.90), just half of my normal income, because customer footfall drops drastically,” Deviben, the street vendor, said.

Out-of-pocket medical expenses for the entire family take a chunk from their meager savings. “The insurance payout helps us meet medical expenses,” she said.

Where traditional insurance hesitates, parametric climate insurance can spread its reach

Home-based worker Dipikaben with her teenage friends in Odni Chawl slum, gluing stones and beads on a fabric length in Ahmedabad city in Gujarat. Credit: Manipadma Jena/IPS

Home-based worker Dipikaben with her teenage friends in Odni Chawl slum, gluing stones and beads on a fabric length in Ahmedabad city in Gujarat. Credit: Manipadma Jena/IPS

While SEWA’s 2023 parametric heat insurance pilot was a non-starter, nevertheless, “It was a pilot, and we learned a lot of lessons,” Sahil Hebbar told IPS earlier when the parametric insurance failed to trigger any payout although 2023 was the second warmest on record in the country since 1901 according to the India Meteorological Department.

The single parameter that was considered for the 6-week pilot was satellite-determined maximum daytime temperature. Only when a consecutive 3-day average temperature topped 45-46 degrees Celsius would the women have seen a payout.

Hebbar said there is a difference between satellite-recorded temperature and that on the ground where SEWA women worked. Wet-bulb effect, that dangerous effect of heat combined with humidity that inhibits sweating to cool off the body, should be another parameter. So should high nighttime temperature, which is more harmful for health than daytime heat. Hebbar is also a consulting physician with SEWA.

The challenge, in this case of extreme temperatures, was that the perception of heat and its tolerance can be relative, with significant degrees of variation depending on the location (even within the same Indian province). Somehow local climate variations need to be reflected in the final design of the solution, according to Swiss RE which designed SEWA’s 2024 parametric insurance.

That year, with modifications to design, mainly using locale-by-locale historic temperature data, the parametric insurance was scaled up to 50,000 members across 22 districts in three provinces—Gujarat, Rajasthan, and Maharashtra—up from the pilot’s 21,000 members across just 5 districts in Gujarat alone.

From getting zero payout in 2023 because of the unrealistically high trigger of 45-46 degrees Celsius, in 2024, the insurance was triggered in 17 out of the 22 districts, and 46,339 SEWA members received payouts ranging from 151-1651 rupees (USD 1.75-USD 19).

In 2023 the climate adaptation equipment that the insurance beneficiaries got for the USD 3 premium they paid were umbrellas and cooler water flasks for urban workers, while rural workers got tarpaulin and solar lanterns. In the summer of 2024, these were replaced by a cash assistance layer that triggered in all 22 districts, and members received cash assistance of 400 rupees (USD 4.64).

The two-layered combination of insurance payouts and a direct cash assistance programme helps reduce marginalized women workers’ burden of income losses from climate events.

Similarly, another Gujarat women-centric non-profit, Mahila Housing Trust (MHT), has also, in 2024 introduced parametric heat insurance as a financial safety net for urban poor communities vulnerable to extreme heat.

However, parametric insurance is now also bailing out extreme monsoon victims, and this time not non-profits but a provincial government itself, the first in India, has disaster-insured the entire State of Nagaland in India’s northeast.

Nagaland’s annual rainfall averages between 70 and 100 inches, concentrated over May to September. However, torrential rainfall squeezed into just a few days can cause havoc, triggering landslides and home and crop damage in the mountainous topography.

The pre-agreed payouts here are based on high, medium, or low flood risk zones. The parametric monsoon coverage by the Nagaland State Disaster Management Authority (NSDMA) is provided under the Disaster Risk Transfer Parametric Insurance Solution (DRTPS). It saw its first successful payout in May this year for damages during the monsoons of 2024.

However, the new insurance may not be the panacea it’s being visualized to be. A section of policy experts and climate activists questions the long-term sustainability of parametric insurance.

Such mechanisms nudge governments to abdicate responsibility, providing social safeguards

“In the face of escalating climate impacts, the notion that insurance can serve as a panacea is not only misguided but dangerous. As climate impacts grow more severe, large areas of our planet are becoming impossible to insure. This means that the safety net of insurance is disappearing, even in the most developed parts of the world. Moreover, the structure of parametric insurance, which disburses funds based on predetermined triggers rather than actual losses, starkly fails those in dire need, often leaving them with a fraction of what is required to rebuild their lives,” climate activist Harjeet Singh told IPS.

“Such mechanisms not only deepen existing inequalities but also perilously nudge governments towards abdicating their duty to provide essential social safeguards. These very protections are vital for communities to rebuild their livelihoods and homes after disasters,” Singh, a lead campaigner for the United Nations’s Loss and Damage movement, added.

“We must pivot towards social protection mechanisms, such as unconditional cash transfers post-disaster, subsidized food grains, guaranteed wage employment for the able-bodied, and financial support for reconstructing homes, livelihoods, and ecosystem restoration. These not only assist in immediate recovery but also strike at the heart of vulnerability, fostering a resilient recovery from the climate-induced devastation,” he said.

“This is not merely a matter of policy preference but a fundamental human right for communities on the front line of the climate crisis. Robust social protection is required for genuine resilience and a fairer, more equitable response to the climate emergency,” he asserted.

Note: This feature is published with the support of Open Society Foundations.

PS UN Bureau Report

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Women in Afghanistan Face a Total Lack of Autonomy

Asia-Pacific, Civil Society, Crime & Justice, Education, Gender, Gender Identity, Headlines, Health, Human Rights, Humanitarian Emergencies, Inequality, TerraViva United Nations, Women’s Health

A young Afghan girl studies at home following the Taliban’s banning of women and girls from pursuing secondary education. Credit: UNICEF/Amin Meerzad

UNITED NATIONS, Jun 23 2025 (IPS) – Nearly four years ago, the Taliban took control of Afghanistan and issued a series of edicts that significantly restricted women’s rights nationwide. This has resulted in a multifaceted humanitarian crisis, one marked by a notable decline in civic freedoms, stunted national development, and a widespread lack of basic services.


On June 17, UN-Women published its 2024 Afghanistan Gender Index, a comprehensive report that details the gender disparities and worsening humanitarian conditions for women and girls across the country. According to the report, the edicts issued by the Taliban have restricted women’s rights to the point that women and girls in the country have fallen far below the global benchmarks for human development.

“Since [2021], we have witnessed a deliberate and unprecedented assault on the rights, dignity and very existence of Afghan women and girls. And yet, despite near-total restrictions on their lives, Afghan women persevere,” said Sofia Calltorp, UN Women’s Chief of Humanitarian Action. “The issue of gender inequality in Afghanistan didn’t start with the Taliban. Their institutionalised discrimination is layered on top of deep-rooted barriers that also hold women back.”

It is estimated that women in Afghanistan have 76 percent fewer rights than men in areas such as health, education, financial independence, and decision-making. In addition, Afghan women are afforded, on average, 17 percent of their rights while women worldwide have 60.7 percent.

This disparity is projected to further widen following the Taliban’s ban on women holding positions in the health sector, removing one of the final strongholds for female autonomy in Afghanistan. Today, roughly 78 percent of Afghan women lack access to any form of formal education, employment, or training, nearly four times the rate for Afghan men. UN Women projects that the rate of secondary school completion for girls will soon fall to zero percent for girls and women.

Furthermore, Afghanistan has one of the widest workforce gaps in the world, with 89 percent of men having roles in the labour force, compared to 24 percent of women. Women are more likely to work in domestic roles and have lower-paying, more insecure jobs. Additionally, there are zero women that hold roles in national or local decision-making bodies, effectively excluding them entirely from having their voices heard on a governmental level.

“Afghanistan’s greatest resource is its women and girls,” said UN Women’s Executive Director Sima Bahous. “Their potential continues to be untapped, yet they persevere. Afghan women are supporting each other, running businesses, delivering humanitarian aid and speaking out against injustice. Their courage and leadership are reshaping their communities, even in the face of immense restrictions.”

The exclusion of all Afghan women from the workforce has had significant impacts on the local economy. According to the United Nations Sustainable Development Group (UNSDG), since 2021 Afghanistan’s economy has seen losses of up to 1 billion USD per year, representing roughly 5 percent of the nation’s gross domestic product. This has led to an overall increase in poverty levels and food insecurity.

“Overlapping economic, political, and humanitarian crises — all with women’s rights at their core — have pushed many households to the brink. In response – often out of sheer necessity — more women are entering the workforce,” Calltorp said.

Furthermore, women in Afghanistan lack any form of economic independence. UN Women estimates that only 6.8 percent of women have access to basic financial resources such as bank accounts and mobile money services. Edicts that prevent women from accessing financial independence will leave the vast majority of Afghan women unequipped for a self-sustainable future.

Afghanistan has also seen a significant surge in rates of gender-based violence since the Taliban’s rise to power. According to the report, Afghan women are exposed to nearly three times the global average rates of intimate-partner violence. Other practices, such as forced and child marriages and honor killings, exacerbate the national levels of gender inequality. Amnesty International states that non-compliance often results in retaliation from the Taliban, with women and girls facing arrests, rape, and torture.

In November 2023, Afghanistan’s de-facto Ministry of Public Health banned women’s access to psychosocial support services, leaving the vast majority of victims of gender-based violence without the adequate resources to recover while perpetrators receive impunity. Additionally, the elimination of women’s healthcare, including women’s access to reproductive health and education services, has made it difficult for many women to find basic care.

Due to these challenges, UN Women believes that Afghan women are less likely than men to live the majority of their lives in good health. It is estimated that the life expectancy of Afghan women is far lower than the global average and is projected to worsen in the coming years.

According to CIVICUS Global Alliance, current civic space conditions in Afghanistan are listed as “closed”, representing one of the worst environments for civic freedoms in the world. Josef Benedict, the Monitor Asia Researcher of CIVICUS, states that the women’s rights issues in Afghanistan have deteriorated to the point that it resembles a “gender apartheid”.

“There has been severe repression and systemic gender-based discrimination faced by Afghan women and girls under the Taliban. Women and girls are being systematically erased from public life and are being denied fundamental human rights, including access to employment, education, and opportunities for political and social engagement,” said Benedict.

“The international community must do more to provide support for women and girls in and from Afghanistan by calling for dismantling of the institutionalized system of gender oppression, ensure the representative, equal, meaningful and safe participation of Afghan women in all discussions concerning the country’s future and support community-led initiatives promoting gender equality and women’s rights.”

Additionally, activists and dissenters are routinely punished by the Taliban, facing harassment, intimidation, and violence. Journalists are often targeted, underscoring the risks of speaking out against a repressive government in an increasingly volatile environment.

“The rating is also due to the crackdown on press freedom,” said Benedict. “Nearly four years on, governments have failed to ensure a strong, united international response to counter the Taliban’s extreme repression, take steps to hold the Taliban accountable or to effectively support Afghan activists in the country and those in exile.”

IPS UN Bureau Report

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Lawyer-Turned-Activist Bhuwan Ribhu Honored for Leading a Campaign to End Child Marriage

Active Citizens, Asia-Pacific, Child Labour, Civil Society, Crime & Justice, Editors’ Choice, Education, Featured, Gender, Gender Violence, Headlines, Human Rights, Human Trafficking, Humanitarian Emergencies, Latin America & the Caribbean, Sustainable Development Goals, TerraViva United Nations, Women’s Health, Youth

Human Rights

Dominican Republic’s Minister of Labor Eddy Olivares Ortega and Javier Cremades, President of the World Jurist Association, hand the Medal of Honor award to Just Rights for Children founder Bhuwan Ribhu.

Dominican Republic’s Minister of Labor Eddy Olivares Ortega and Javier Cremades, President of the World Jurist Association, hand the Medal of Honor award to Just Rights for Children founder Bhuwan Ribhu.

NEW DELHI, May 6 2025 (IPS) – Bhuwan Ribhu didn’t plan to become a child rights activist. But when he saw how many children in India were being trafficked, abused, and forced into marriage, he knew he couldn’t stay silent.


“It all started with failure,” Ribhu says. “We tried to help, but we weren’t stopping the problem. That’s when I realized—no one group can do this alone. Calling the problem for what it truly is—a criminal justice issue rather than a social justice issue—I knew the solution needed holistic scale.”

Today, Bhuwan Ribhu leads Just Rights for Children—one of the world’s largest networks dedicated to protecting children. In recognition of his relentless efforts to combat child marriage and trafficking, he has just been awarded the prestigious Medal of Honor by the World Jurist Association. The award was presented at the recently concluded World Law Congress in the Dominican Republic.

But for Ribhu, the honor isn’t about recognition. “This is a reminder that the world is watching—and that children are counting on us,” he tells IPS in his first interview after receiving the award.

Looking Back: One Meeting Changed Everything

For Ribhu, a lawyer by profession, it has been a long, arduous, and illustrious journey to getting justice for children. But this long journey began during a meeting of small nonprofits in eastern India’s Jharkhand state, where someone spoke up: “Girls from my village are being taken far away, to Kashmir, and sold into marriage.”

That moment hit Ribhu hard.

“That’s when it struck me—one person or one group can’t solve a problem that crosses state borders,” he says. He then started building a nationwide network.

And just like that, the Child Marriage-Free India (CMFI) campaign was born. Dozens of organizations joined, and the number grew steadily until it reached 262.

So far, more than 260 million people have joined in the campaign, with the Indian government launching Bal Vivah Mukt Bharat—a national mission towards ending child marriage in India.

Across villages, towns, and cities, people are speaking up for a child marriage-free India.

“What used to feel impossible is now within reach,” Ribhu says.

Taking the Fight to Courtrooms

Ribhu is a trained lawyer, and for him, the law is a powerful weapon.

Since 2005, he’s fought—and won—dozens of important cases in Indian courts. These have helped define child trafficking in Indian law; make it mandatory for police to act when children go missing; criminalize child labor; set up support systems for abuse survivors; and remove harmful child sexual abuse content from the internet.

One big success came when the courts accepted that if a child is missing, police should assume they might have been trafficked. This changed everything. Reported missing cases dropped from 117,480 to  67,638 a year.

“That’s what justice in action looks like,” said Ribhu.

Taking Along Religious Leaders

One of the most powerful moves of CMFI was reaching out to religious leaders.

The reason was simple: whatever the religion is, it is the religious leader who conducts a marriage.

“If religious leaders refuse to marry children, the practice will stop,” says Ribhu.

The movement began visiting thousands of villages. They met Hindu priests, Muslim clerics, Christian pastors, and others. They asked them to take a simple pledge: “I will not marry a child, and I will report child marriage if I see it.”

The results have been astonishing: on festivals like Akshaya Tritiya—considered auspicious for weddings—many child marriages used to happen until recently. But temples now refuse to perform them.

“Faith can be a big force for justice,” Ribhu says. “And religious texts support education and protection for children.”

Going Global with a Universal Goal

But the campaign is no longer just India’s story. In January of this year, Nepal, inspired by the campaign, launched its own Child Marriage-Free Nepal initiative with the support of Prime Minister K. P. Sharma Oli. All the seven provinces of the country have joined it, vowing to take steps to stop child marriage

The campaign has also spread to 39 other countries, including Kenya and the Democratic Republic of Congo, where calls for a global child protection legal network are gaining momentum.

“The legal systems of different countries and regions may differ, but justice should be the same everywhere,” says Ribhu, who has also authored two books—Just Rights and When Children Have Children—where he has laid out a legal, institutional, and moral framework to end child exploitation called PICKET. “It’s not just about shouting for change. It’s about building systems that protect children every day,” Ribhu says.

Sacrifices and Hope

Ribhu gave up a promising career in law practice. Many people didn’t understand why.

“People said I was wasting my time,” he remembers. “But one day my son said, ‘Even if you save just one child, it’s worth it.’ That meant everything to me.”

A believer in the idea of Gandhian trusteeship—the belief that we should use our talents and privileges to serve others, especially those who need help the most.

“I may not be the one to fight child marriage in Iraq or Congo. But someone will. And we’ll stand beside them.”

A Powerful Award and a Bigger Mission

The World Jurist Association Medal isn’t just a trophy. For Ribhu, it’s a platform. “It tells the world: This is possible. Change is happening. Let’s join in.”

He also hopes that the award will help his team connect with new partners and expand their work to new regions.

“In 2024 alone, over 2.6 lakhs Child Marriages were prevented and stopped and over 56,000 children were rescued from trafficking and exploitation in India. These numbers show that change is not just a dream—it’s real,” he says.

By 2030, Ribhu hopes to see the number of child marriages in India falling below 5 percent.

But there’s more to do. In some countries, like Iraq, girls can still be married as young as 10, and in the United States, 35 states still allow child marriage under certain conditions.

“Justice can’t be occasional,” Ribhu says. “It must be a part of the system everywhere. We must make sure justice isn’t just a word—it’s a way of life.”

IPS UN Bureau Report

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African Countries Still Underfunding Health by as Much as 50 Percent

Africa, Aid, Civil Society, Development & Aid, Editors’ Choice, Featured, Financial Crisis, Gender, Health, Humanitarian Emergencies, Sustainable Development Goals, TerraViva United Nations, Women’s Health

Health

Health workers getting ready for duty at an mpox treatment center in Lwiro in DR Congo, a hotspot for the pandemic that CD Africa handled in 2024. Credit: WHO

Health workers getting ready for duty at an mpox treatment center in Lwiro in the Democratic Republic of Congo’, a hotspot for the pandemic that CD Africa handled in 2024. Credit: WHO

NAIROBI, Apr 24 2025 (IPS) – The majority of African countries are yet to commit 15 percent of their GDP to funding the health sector, despite the growing disease burden weighing down the continent and two decades after the coming into force of the Abuja declaration on health sector funding.


Only a few countries, including Rwanda, Botswana, and Cabo Verde, have consistently met the 15 percent target, with some countries allocating less than 10 percent of their budget to the crucial sector.

Under the Abuja Declaration of 2001, African Union (AU) member states made a commitment to end the continent’s health financing crisis, pledging to allocate at least 15 percent of national budgets to the sector. However, more than two decades later, only three countries—Rwanda, Botswana, and Cabo Verde—have consistently met or exceeded this target (WHO, 2023). In contrast, over 30 AU member states remain well below the 10 percent benchmark, with some allocating as little as 5–7 percent of their national budgets to health.

Countries including Nigeria, Chad, and the Central African Republic are allocating as little as 5–7 percent to the sector, thanks to a myriad of political and economic challenges, including a high debt burden and narrow tax base, according to Director General of Africa Centres for Disease Control (Africa CDC), Dr. Jean Kaseya.

Competing demands for security and infrastructure financing and limited coordination between ministries of health and finance, plus the fact that the COVID-19 pandemic “hit national budgets hard,” worsened by global economic instability, haven’t helped matters, he said, while commenting on the latest annual report of the continental health body and the 2025 concept paper on Africa’s Health Financing in a New Era, both released in April.

Wivine M'puranyi, a 30-year-old mother of six,from village of Karanda in D.R Congo's South Kivu reflects on the distressing days when her two daughters were diagnosed with mpox, one of the pandemics that hit Africa in 2024.

Wivine M’puranyi, a 30-year-old mother of six from the village of Karanda in the Democratic Republic of Congo’s South Kivu, reflects on the distressing days when her two daughters were diagnosed with mpox, one of the pandemics that hit Africa in 2024. Credit: WHO

“It also exposes just how costly underinvesting in health can be. The real story here is political will, where leaders prioritize health, and budgets follow,” he noted.

The report finds that only 16-29 percent of African countries currently have updated versions of the National Health Development Plan (NHDP) supported by a National Health Financing Plan (NHFP), the two documents being critical in driving internal resource mobilization.

“Updating National Health Development Plans (NHDPs) and National Health Financing Plans (NHFPs) is not just a matter of paperwork—it’s a heavy lift. Countries need robust data, skilled teams, funding, and strong inter-ministerial coordination,” he said.

Low funding has a consequence: it has led to many health departments being understaffed and overstretched, partly because some governments ‘deprioritize’ updating the two documents because they fear the plans won’t be implemented or be funded. “But without current, credible plans, it’s nearly impossible to make a case for more domestic or external investment. These documents are not bureaucratic checkboxes—they’re investment blueprints,” the DG told IPS.

He noted that countries that have updated and actively used their NHDPs and NHFPs have seen tangible benefits, one such country being Burkina Faso, where an updated NHFP had helped streamline funding and implementation for free healthcare policy.

In Senegal, incorporating macroeconomic forecasting into the NHFP improved budget predictability and donor alignment. “These tools are powerful when they are costly, realistic, and regularly monitored. But let’s be clear; plans must be funded and used—not just filed away—to make a real difference,” Kaseya added.

According to the documents, Africa continues to carry a disproportionate share of the global disease burden—25 percent—but with only 3 percent of the global health workforce, resulting in a “dangerously overstretched workforce,” according to the documents. Should this shortage be prioritized over all other health needs and deficiencies, or what should be addressed first?

The shortage of health workers remains a fundamental challenge, with Africa carrying 25 percent of the global disease burden but a disproportionate 3 percent of the global health workforce—a challenge that cannot be addressed “in isolation.”

Likobiso Posholi, 35, from Ha Sechele village in Mohale's Hoek in Lesotho who is recovering from a recent caesarean section. Many countries in Africa are yet to commit 15% of the national budgets so that women like Posholi can access affordable maternity services.

Likobiso Posholi, 35, from Ha Sechele village in Mohale’s Hoek in Lesotho, recovering from a recent cesarean section. Many countries in Africa are yet to commit 15 percent of the national budgets so that women like Posholi can access affordable maternity services. Credit: WHO

However, recruiting en masse without sustainable financing or strategic deployment can strain the system, and in some countries, trained professionals remain unemployed due to fiscal constraints or wage bill ceilings. “Kenya, for example, is piloting co-financing mechanisms between national and local governments to overcome this. The key is to tackle workforce gaps through integrated, context-specific reforms that link financing, recruitment, and health system needs,” Kaseya said.

The Africa CDC has drafted a three-pronged strategy and placed it at the forefront of a health financing revolution that could potentially represent a paradigm shift from dependency to self-determination. Some aspects of the strategy can be implemented immediately without being subjected to a lot of bureaucracy in view of the emergency brought about by cuts in Overseas Development Assistance (ODA), he added.

Reductions in ODA went down by 70 percent between 2021 and 2025, exposing health systems to deep-rooted structural vulnerabilities and placing immense pressure on Africa’s already fragile health systems, with overseas financing being seen as the backbone of critical health programmes.

These include pandemic preparedness, maternal and child health services, and disease control initiatives, all of which are at risk, threatening Sustainable Development Goal 3 and Universal Health Coverage.

“Some components of our strategy can be rapidly deployed. Health taxes on products like tobacco, sugar, and alcohol are politically sensitive but technically straightforward and yield dual benefits, generating revenue and promoting healthier populations. Strengthening health financing units within ministries is a high-impact, low-cost intervention that can dramatically improve budget execution and efficiency,” Kaseya suggested.

Likewise, deploying digital tools—such as real-time dashboards to track financing flows—can happen quickly and with limited bureaucracy. Countries like Benin, South Africa, and Ethiopia are already implementing such reforms with measurable progress.

He pitched that digitization of the health sector is no longer a luxury, as it is foundational to the much-needed resilient, transparent, and efficient health systems.

On the other hand, the platforms improve decision-making, enable better resource tracking, and enhance service delivery. However, fragmentation of digital solutions remains a challenge, with many platforms developed in ‘silos,’ often “donor-driven and poorly integrated,” he commented.

He singled out Ghana, which offered a strong example of progress, having developed a national platform that integrates health and financing data. “The true value of digitization is realized when countries lead the process, ensure interoperability, and embed digital solutions into broader system reforms,” Kaseya said.

On the positive side, CDC Africa for the first time led an emergency response, putting in place a Joint Continental Incidence Management Support Team (IMST) co-led with the World Health Organization and bringing together over 28 partners to collaborate on the Mpox response. This work was done under the “One team with a One unified plan, One budget, and One monitoring framework.”

“This is a historic first that marked a significant milestone in Africa’s leadership of public health emergencies of continental significance,” the report observed.

It further supported national responses to “multiple major public health emergencies,” including the mpox outbreak in 20 AU member states and the Marburg virus disease outbreak in Rwanda. This was in declaring the former a Public Health Emergency of Continental Security (PHECS) on August 13, 2024, in consultation with the affected countries and relevant stakeholders.

Also on the positive side, the continental health body was advancing a comprehensive three-pillar strategy centered on domestic resource mobilization, innovative financing, and blended finance.

IPS UN Bureau Report

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How to Turn the Tide: Resisting the Global Assault on Gender Rights

Civil Society, Crime & Justice, Education, Featured, Gender, Gender Identity, Global, Headlines, Human Rights, LGBTQ, TerraViva United Nations, Women’s Health

Opinion

Credit: Amanda Perobelli/Reuters via Gallo Images

MONTEVIDEO, Uruguay, Mar 27 2025 (IPS) – This year’s session of the United Nations Commission on the Status of Women (CSW69), the world’s leading forum for advancing gender equality, confronted unprecedented challenges. With Saudi Arabia in the chair and anti-rights voices growing increasingly influential in the forum, the struggle to hold onto international commitments on gender equality intensified dramatically. On 8 March, International Women’s Day mobilisations also took on added urgency, with demonstrations from Istanbul to Buenos Aires focusing on resisting the multiple manifestations of gender rights regression being felt in communities worldwide.


CIVICUS’s 2025 State of Civil Society Report shows that hard-won women’s and LGBTQI+ rights are at risk, challenged by coordinated anti-rights movements that use gender as a political wedge issue. But it also provides abundant evidence that civil society is rising to the challenge.

Global regression

They call it ‘child protection’ in Russia, ‘family values’ in several Eastern European countries, ‘religious freedom’ in the USA, and ‘African traditions’ across the continent. The terminology shifts, but the objective is the same: halting progress towards gender equality and dismantling rights. Of course, it isn’t about differences in cultural values – it’s an orchestrated political strategy.

In Afghanistan, the Taliban’s system of gender apartheid has reached its brutal endpoint: women are effectively imprisoned in their homes, barred from education, work and public life, their voices literally silenced by prohibitions on singing or talking in public. Iranian authorities have gone to extreme lengths to maintain control over women’s bodies. In Iraq, lawmakers are considering lowering the minimum marriage age to just nine years old.

These extreme examples exist along a spectrum that includes Ghana’s parliament criminalising same-sex relations, Russia expanding ‘propaganda’ laws to prohibit any positive portrayal of LGBTQI+ identities, and Georgia – a country that says it wants to join the European Union – adopting Russian-style legislation restricting LGBTQI+ organisations under the cynical framing of ‘protecting minors’.

In the USA, Trump-appointed justices overturned constitutional abortion protections, triggering restrictions across numerous states. The second Trump administration has now reinstated the global gag rule, restricting international funding for organisations providing reproductive healthcare. The Guttmacher Institute projects this will deny 11.7 million women access to contraception, potentially causing 4.2 million unintended pregnancies and over 8,300 maternal deaths.

A coordinated transnational movement

Across Africa, there’s an intensifying wave of anti-LGBTQI+ legislation, often driven by political opportunism. Mali’s military junta passed a law criminalising homosexuality as part of its broader crackdown on rights. Ghana’s parliament passed a draconian ‘anti-LGBTQI+ bill’, while Uganda’s Constitutional Court upheld the country’s harsh Anti-Homosexuality Act. In Kenya, a Family Protection Bill that would outlaw LGBTQI+ advocacy remains before parliament.

As recently seen at CSW, the ongoing backlash is transnational in nature. Anti-rights forces share tactics, funding and messaging across borders, with conservative foundations from the USA promoting restrictive legislation in Africa and Russian ideologues exporting their playbook to former Soviet states and beyond. US evangelical organisations and conservative think-tanks are a particularly influential source of anti-rights narratives and funding: they’ve funnelled millions of dollars into campaigns against reproductive rights and LGBTQI+ equality worldwide, while providing intellectual frameworks and legal strategies for adaption to local contexts from Poland to Uganda.

Victories against the odds

Against this daunting backdrop, civil society continues achieving remarkable victories through strategic resistance and persistence. In 2024, Thailand became Southeast Asia’s first country to legalise same-sex marriage, while Greece broke new ground as the first majority Orthodox Christian country to do so. France enshrined abortion rights in its constitution, creating a powerful bulwark against future threats.

A regional trend continued in the Caribbean, with civil society litigation successfully overturning colonial-era laws that criminalised homosexuality in Dominica. Colombia and Sierra Leone banned child marriage, while women’s rights groups in The Gambia defeated a bill that would have decriminalised female genital mutilation.

These successes share common elements: they’re the result of sustained, multi-year advocacy campaigns combining legal challenges, community mobilisation, strategic communications and international solidarity.

Take Thailand’s marriage equality victory. Success came partly through the campaign’s intersection with the youth-led democracy movement, which connected LGBTQI+ rights to broader aspirations for a fairer society. In Kenya, despite harsh anti-LGBTQI+ rhetoric from political leaders, strategic litigation by civil society secured a court ruling preventing incitement to violence against LGBTQI+ people.

Even in the most repressive contexts, activists find ways to resist. Afghan women, denied basic rights to education and movement, have developed underground schools and created subtle forms of civil disobedience that maintain pressure without risking their lives. Along with their Iranian sisters, they continue to campaign for gender apartheid to be recognised as a crime under international law.

The path forward: intersectionality and solidarity

Progress in realising rights is neither linear nor inevitable. Each advance triggers opposition, so every victory needs defence. To solidify and last, legal changes must be accompanied by social transformation – which is why civil society complements policy advocacy with public education, community organising and cultural engagement.

Advocacy is most effective when it embraces intersectionality, recognising how gender, sexuality, class, race, disability and migration status create overlapping forms of exclusion that need integrated responses. Feminist movements are increasingly centring the experiences of Black women, Indigenous women, women with disabilities and trans women.

Even where progress can feel elusive, civil society is playing a crucial role in keeping hope alive. Organisations defending women’s and LGBTQI+ rights are maintaining spaces where people are allowed to be their true selves, providing support services that nobody else will provide, documenting violations that would otherwise go unrecorded, keeping up the pressure on the authorities and building solidarity networks that sustain activists through difficult times.

International support for these efforts has never been more important. The USAID funding freeze highlights a troubling trend of shrinking resources for gender rights defenders at precisely the moment they’re needed most. This makes diversifying funding sources an urgent priority, with feminist philanthropists, progressive foundations and governments committed to gender equality needing to step up. More innovative funding mechanisms are required to rapidly respond to emergencies while sustaining the long-term work of movement building. Individuals have power: anyone can contribute directly to frontline organisations, amplify their voices on social media, challenge regressive narratives in their communities and demand that elected representatives prioritise gender equality domestically and in foreign policy. In the global struggle for fundamental rights, no one should be a spectator. The time for solidarity is now.

Inés M. Pousadela is CIVICUS Senior Research Specialist, co-director and writer for CIVICUS Lens and co-author of the State of Civil Society Report.

For interviews or more information, please contact research@civicus.org.

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Afghan Refugees, Among Others, Feel the Impact of USAID Funding Freeze

Aid, Asia-Pacific, Civil Society, Democracy, Development & Aid, Featured, Headlines, Human Rights, Humanitarian Emergencies, Migration & Refugees, Sustainable Development Goals, TerraViva United Nations, Women’s Health

Aid

Flashback to the opening of a USAID project. Credit: Ashfaq Yusufzai/IPS

PESHAWAR, Pakistan, Feb 16 2025 (IPS) – “I was shocked when told by a security guard that the clinic has been closed down. I, along with my relatives, used to visit the clinic for free checkups,” Jamila Begum, 22, an Afghan woman, told IPS.


The clinic has been established by an NGO with the financial assistance of the USAID to reduce maternal complications on the outskirts of Peshawar, the capital of Khyber Pakhtunkhwa, one of Pakistan’s four provinces. Begum, who is near to delivering a baby, says she couldn’t afford the high fee of blood tests and ultrasound examinations in private hospitals and is concerned about her delivery. Fareeda Bibi, an Afghan refugee, is concerned too.

“We have been receiving more than a dozen Afghan women for pre- and post-natal checkups through a clinic funded by the U.S., which has now been shut down,” Bibi, a female health worker, said at a clinic on the outskirts of Peshawar.

Pakistan is home to 1.9 million Afghan refugees and most of the women seek health services in NGO-run health facilities funded by the United States.

“The Afghan women cannot visit remote hospitals and came here conveniently because we have all female staff but all of a sudden, the small clinics have been closed, leaving the population high and dry,” Bibi says. “In the past year, we have received 700 women for free check-ups and medicines, due to which they were able to stay safe from delivery-related complications.”

Jamila Khan, who runs an NGO helping women in rural settings of the Khyber Pakhtunkhwa, one of Pakistan’s four provinces, is also upset by the funding freeze.

“Most of the USAID’s funds were used by NGOs, who will now either be completely closed down or will look for new sources of funds. For the time being, they are struggling to continue operations after the withdrawal of promised funds,” she says.

The suspension of funds by the USAID has hit all sectors in Pakistan, a former employee of USAID, Akram Shah, told IPS.

“The 39 projects funded by the United States included energy, economic development, agriculture, democracy, human rights and governance, education, health, and humanitarian assistance. The suspension order has impacted all,” he says.

President Donald Trump’s directives of suspending USAID funding worldwide after assuming his office also brought to a standstill several projects worth over USD 845 million in Pakistan.

Shah says the abrupt funding cut will badly harm the small landowners who looked towards the USAID but now we are immensely concerned about how to go ahead with our annual plan of going crops without financial assistance.

Our farming has been worst hit as farmers banked on the financial and technical assistance provided by the U.S. to enhance agricultural productivity.

“Most farmers in rural areas have been benefitting from the USAID for a long time, as we got high-quality seeds, tools, fertilizers, etc., which helped us to grow more crops and earn for our sustenance,” Muhammad Shah, a farmer, says.

The health sector is also badly hit, as USAID’s money kept running the Integrated Health Systems Strengthening and Service Delivery Integrated Health System Program, says Dr. Raees Ahmed at the Ministry of National Health Services Regulations and Coordination.

The promised funds of USD 86 million aimed at strengthening Pakistan’s healthcare infrastructure would leave the program half finished, he says. Additionally, Pakistan was supposed to receive USD 52 million under the Global Health Supply Chain Program to ensure the availability of essential medical supplies, but it will be closed down for want of funds.

Education officer Akbar Ali says they had pinned hopes on USAID’s assistance of USD 30.7 million for the Merit and Needs-Based Scholarship Program for the poor students to continue their studies but it has become a dream now.

Ali says the inclusive democratic processes and governance projects, of which USD 15 million was promised, have been halted. The program, in which teachers were also included, was intended to enhance democratic governance and transparency.

Funds for improving governance and the administrative system in the violence-stricken tribal areas along Afghanistan’s border will also stop. The USAID had pledged USD 40.7 million.

Muhammad Wakil, a social activist, says his organization, which is working for a U.S.-funded Building Peace in Pakistan, is also suffering. The program, worth USD 9 million, aimed at fostering religious, ethnic, and political harmony, has had to close.

“We have asked our workers to stay home and have suspended at least 20 workshops scheduled this year,” Wakil says.

He wondered why the United States, a staunch supporter of peace and religious harmony, has stopped funds.

The Mangla Dam Rehabilitation Project, a USD 150 million initiative essential for Pakistan’s energy and water security, has also suffered.

The decision to suspend these aid programs comes as part of a broader restructuring of US foreign assistance under Trump’s “America First” policy.

USAID, established in 1961 under President John F. Kennedy, has long been a cornerstone of US foreign policy, administering approximately 60 percent of the country’s aid budget. In the 2023 fiscal year alone, USAID disbursed USD 43.79 billion in global assistance, supporting development efforts in over 130 countries, media reported.

IPS UN Bureau Report

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