UN Chief Hails Turkmenistan’s Quiet Diplomacy as Launchpad for Landlocked Solidarity

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Volunteers at the Third United Nations Conference on Landlocked Developing Countries (LLDCs). Credit: Kizito Makoye/IPS

Volunteers at the Third United Nations Conference on Landlocked Developing Countries (LLDCs). Credit: Kizito Makoye/IPS

AWAZA, Turkmenistan , Aug 6 2025 (IPS) – In the glass-panelled hallway straddling Buildings 2 and 3 at the Awaza Congress Centre, two smartly dressed young Turkmens stood behind an ornate national pavilion—anxious, alert, and surprisingly eloquent.

Their broad smiles visibly grabbed wide-eyed delegates attending the Third United Nations Conference on Landlocked Developing Countries (LLDCs). With a confidence far beyond their age, the volunteers clearly explained to visitors the kernel of Turkmenistan’s national identity—entangled by culture as politics.

“This is a dutar,” said one, gesturing toward a glass-encased replica of a traditional two-stringed musical instrument. “It is played during weddings and celebrations. It carries the stories of our people.”

His colleague pointed to a smaller display nearby, where a miniature replica of the monumental Neutrality Monument stood—the golden effigy of Saparmurat Niyazov, the country’s founding president, glinting under gallery lights. “This represents our neutrality,” she said proudly. “We are a peaceful nation. We do not choose sides.”

As visitors flocked to the pavilion, the two young guides continued their patient explanations—this time describing a replica of Akhal-Teke horses, symbols of national pride, bred for endurance and elegance.

“Just like the horses,” one said with a grin, “Our country is strong, swift, and steady. But we also don’t race just because others are running.”

In this resort city, hospitality is a powerful expression of national pride.

As you move around the streets, women in long traditional gowns greet you with a graceful nod and a soft “Hoş geldiňiz”—welcome.” Dressed in embroidered velvet dresses that sweep the floor and crowned with intricate headscarves, these women are the gentle face of Turkmenistan’s long-held tradition of welcoming strangers with dignity and warmth.

“It is in our blood to treat foreigners with great care and concern.”

In a world increasingly divided, the warmth of Turkmenistan’s people, cloaked in simple gestures of kindness, stands as a symbol of diplomacy—one that speaks not through declarations, but through hospitality that lingers long after the meetings are over.

A Doctrine of Distance

Since 1995, when the UN General Assembly unanimously recognized Turkmenistan’s neutrality, the Central Asian nation has embraced a foreign policy of non-alignment, eschewing military alliances, foreign bases, and entanglements in regional conflicts. The policy, enshrined in the national constitution, is described by government officials as a model of “positive neutrality”—a means of building peace through equidistance and sovereignty.

A Fortress Amid Fires

Bordered by Iran, Afghanistan, Uzbekistan, Kazakhstan, and the Caspian Sea, Turkmenistan occupies a strategically sensitive patch of Eurasia. Yet it has remained almost impervious to the turmoil around it. When war engulfed Afghanistan, Turkmenistan kept its embassies open. It offered humanitarian aid—but not political commentary.

Unlike other Central Asian states, it refrained from joining Moscow-led security blocs like the Collective Security Treaty Organization (CSTO) and even kept Beijing at a careful diplomatic bay despite deepening energy ties.

Turkmenistan’s hosting of the LLDC conference carried both symbolic and practical significance. It is one of the few LLDCs that has successfully leveraged its location by investing heavily in cross-border energy and transport infrastructure.

“Your hosting of this important global gathering is a testament to the country’s commitment to international cooperation and sustainable development,” said UN Secretary-General António Guterres.

A Landmark Moment for Landlocked Nations

On the shores of the Caspian Sea, in the resort town of Awaza, limousines ferried dignitaries past pine-lined boulevards and marble buildings as world leaders gathered for the momentous talk.

The Awaza gathering brought together representatives from 32 landlocked developing countries—home to nearly 600 million people across Africa, Asia, Europe, and South America—to chart a new course under the Awaza Programme of Action, a 10-year strategy aimed at reversing structural disadvantages stemming from geographical isolation.

Awaza’s gleaming hotels and high-tech halls stood in contrast to Burundi’s rugged highlands thousands of kilometers away—but in both, a digital transformation is underway.

The stakes could not be higher. LLDCs account for just over 1 percent of global trade and economic output, despite housing 7 percent of the global population. They face steep transport costs, limited access to global markets, unreliable infrastructure, and acute climate vulnerabilities.

A Moment for Multilateralism

As the 3rd LLDC conference convened in the windswept coastal town of Awaza, all eyes turned to Turkmenistan—not for bold pronouncements, but for the quiet power of its example. With its longstanding policy of neutrality, the Central Asian nation has carved a distinct identity rooted in non-alignment and peaceful engagement, making it an ideal host for a summit aimed at fostering regional solidarity and global support for countries isolated by geography.

Secretary-General António Guterres, in a rousing address, held up Turkmenistan’s model of diplomacy and inclusion as a guiding light for other landlocked nations struggling with marginalization. Against a backdrop of rising global fragmentation, Awaza became more than a meeting ground—it emerged as a bridge between continents and between aspiration and action.

Speaking at a high-level press conference Tuesday, Guterres issued a passionate appeal for justice, equity, and renewed international solidarity, reminding the world that “geography should never define destiny.”

“This conference reflects a new era of cooperation taking shape across Central Asia,” said Guterres, “grounded in mutual trust, shared priorities, and growing regional solidarity. At a time when multilateralism is being tested, this spirit of partnership is more essential than ever.”

A Plea for Dignity and Inclusion

Guterres’s remarks were peppered with humanistic language rarely heard at geopolitical conferences. “This is not only a matter of development,” he told journalists. “It’s a matter of dignity and justice.”

Responding to a question from Euronews, he drew a distinction between landlocked developed nations like Switzerland or Austria and their developing counterparts. “They have free access to harbors and integrated markets. But for landlocked developing countries, being far from ports and trade hubs is a real disadvantage,” he said.

He praised Turkmenistan’s multilateral diplomacy and recalled the country’s remarkable feat of granting citizenship to all stateless persons left behind after the collapse of the Soviet Union. “This was almost unique in the world—a symbol of generosity I never forgot,” he said.

Four Pillars of Action

The Awaza Programme of Action is a comprehensive development framework aligned with the UN 2030 Agenda. It charts an ambitious, multi-sectoral path forward, structured around four priorities:

1. Unlocking Economic Potential

Guterres called for bold investment in infrastructure, education, digital connectivity, and innovation.

“The countries represented here have the talent and the ideas,” he said. “They need the tools and support.”

2. Connecting to the World

“Trade corridors, transit systems, and regional integration are not technical issues—they are lifelines,” Guterres said.

He urged countries and institutions to invest in both the “hardware” and “software” of trade—resilient transport infrastructure, harmonized customs procedures, and smart logistics platforms.

3. Confronting the Climate Crisis

Though LLDCs contribute less than 3 percent to global emissions, they are among the hardest hit by climate disasters.

Guterres called on rich nations to fulfill their pledges to double adaptation finance, support green industries in LLDCs, and provide early warning systems.

4. Reforming Global Finance

Guterres described the global financial system as “unfit for the realities of today.” He called for tripling the lending capacity of development banks, expanding concessional finance, and reforming sovereign debt architecture.

Global Responsibility and Shared Future

Though the conference was set against a backdrop of regional cooperation in Central Asia, its implications reverberate far beyond.

“When LLDCs thrive, entire regions benefit.” Guterres said

Global Call for Justice, Not Charity

Though spread across four continents—from the Sahel to the Himalayas, and from Central Asia to South America—LLDCs face a strikingly similar plight: crippling transport costs, technological isolation, and rising debt burdens.

“Landlocked developing countries don’t want charity. They want justice,” Guterres told reporters. “They want equitable access.”

Digital Lifelines for a Disconnected World

One of the most pressing themes in Awaza was the digital divide that has left millions in LLDCs without access to online education, health services, or global markets.

“Digital transformation must be central to our effort,” Guterres said.

He pledged to present a report on innovative financing to support AI capacity-building and called for robust public-private partnerships.

Connecting Landlocked Economies to the World

Guterres also emphasized infrastructure investment and seamless cross-border trade as keys to transformation.

“We must cut red tape, digitize border operations, and modernize transport networks,” he said.

Building Bridges Across Borders

In an interview with IPS, Aygul Rahimova, a resident of Turkmenistan, underlined the importance of the LLDC conference for regional connectivity.

“Although we are technically landlocked, Turkmenistan borders the Caspian Sea, which offers us a unique opportunity to serve as a transport and logistics bridge between Asia and Europe,” she said.

“I hope this conference becomes a catalyst for deeper cooperation… Turkmenistan is ready to play a key role in building bridges—through the Caspian, through trade, through diplomacy.”

IPS UN Bureau Report

 

Spotlight on Landlocked Developing Countries Ahead of Third UN Conference

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Sustainable Development Goals

Uganda's Malaba town borders Kenya to the east and is a major entry point for goods destined for landlocked Uganda, Rwanda, and South Sudan from Kenya's Mombasa Port. Credit: Joyce Chimbi/IPS

Uganda’s Malaba town borders Kenya to the east and is a major entry point for goods destined for landlocked Uganda, Rwanda, and South Sudan from Kenya’s Mombasa Port. Credit: Joyce Chimbi/IPS

NAIROBI, Aug 1 2025 (IPS) – Landlocked developing countries face a unique set of challenges. Without coastal ports, they rely on transit nations, causing higher trade costs and delays.

To explore solutions to these complex hurdles, the Third UN Conference on Landlocked Developing Countries (LLDCs) or LLDC3, will take place in Awaza, Turkmenistan, 5–8 August 2025.

May Yaacoub, LLDC3 spokesperson and head of Advocacy and Outreach at the United Nations Office of the High Representative for the Least Developed Countries, Landlocked Developing Countries and the Small Island Developing States (UNOHRLLS), told IPS that the conference is “an opportunity to unlock the full potential of landlocked countries and address the challenges faced by some of the world’s most marginalized countries.”

“In every LLDC the map itself shapes the economy. Without a coastline, even the simplest export, whether cotton lint, copper cathode or cloud‑based software, must first cross at least one foreign border and frequently an entire transit corridor before it reaches a port,” Tomás Manuel González Álvarez, Senior Programme Management Officer and LLDC Team Lead at UNOHRLLS told IPS.

“The UN estimates that this physical detour means average transport costs in LLDCs are about 1.4 times higher than in comparable coastal economies. Those added costs depress profit margins, narrow the range of viable products and deter investors who value just‑in‑time delivery.”

Against this backdrop and while lacking direct sea access causes and exacerbates hurdles in trade, connectivity, and development, Yaacoub says LLDCs host vibrant communities with untapped potential and that these countries “have the ideas and know what they need to prosper. By supporting them at LLDC3 with partnerships, innovations and cooperation, we can help to build a more equitable and prosperous future for all.”

“This conference comes at the heels of the expiration of the Vienna Programme of Actions, which was adopted in Vienna, Austria, in November 2014, during LLDC2. LLDC3 will continue the work of LLDC2 and serve as a platform to explore innovative solutions, build meaningful and strategic partnerships, and increase the investment in LLDCs,” she observed.

The theme of the conference is ‘Driving Progress through Partnerships’, which she says underscores a shift from donor-recipient dynamics to mutual accountability and co-investment. And, that this includes a stronger role for transit countries, enhanced multilateral cooperation, and alignment with the SDGs, Paris Agreement and the Pact of the Future.

Álvarez emphasizes that this key, landlockedness, is experienced very differently and that the conference agenda reflects an understanding of these complexities. In Africa, “for countries such as Niger or Zambia, the critical pain point is the sheer length and fragility of overland routes—1,800 km from Niamey to Cotonou; 1,900 km from Lusaka to Durban.”

“Road and rail bottlenecks meet frequent customs stops and, in parts of the Sahel, insecurity. The result is chronic delays and freight rates that can exceed the f.o.b. (a term that defines who pays for the transportation costs) value of low‑margin agricultural commodities.”

He says in Asia, Kazakhstan or Uzbekistan possess better road and rail grids yet face. At the same time, these economies are accelerating an energy transition, moving from hydrocarbons to renewables and green hydrogen so they now need corridors that can carry high‑voltage electricity and fiber as well as bulk ore.

“Bolivia and Paraguay rely on the 3,300‑km Paraguay–Paraná waterway for almost four‑fifths of their trade. Low river levels during recent droughts have stranded barges and cost Paraguay an estimated USD 300 million in 2024 alone. Moreover, new tolls levied by Argentina highlight the vulnerability that comes with dependence on a single transit state,” he says.

Within this context, Yaacoub says LLDC3 represents a major change in both scope and ambition compared to its predecessors—LLDC1 held in Almaty in 2003, which was a ministerial meeting, and LLDC2 in Vienna in 2014. The first conference of this nature, or LLDC1 focused primarily on transit policy, infrastructure development, international trade, and technical and financial assistance.

LLDC2 expanded to include structural economic transformation, regional integration, and means of implementation. Notably, she says, LLDC3 “introduces a more holistic and forward-looking agenda, emphasizing climate resilience and adaptation, digital transformation and technology access, sustainable industrialization, reforming the global financial architecture, shock-resilience and disaster risk reduction.”

Yaacoub says the LLDC3 agenda reflects the unprecedented global complexities of the current era—climate change, pandemics, geopolitical tensions, and economic shocks. Key thematic areas include climate vulnerability and financing, with an emphasis on operationalizing the Loss and Damage Fund, doubling adaptation finance, and ensuring access to concessional resources.

Álvarez says the conference is particularly focused on converting the narrative from landlocked to land‑linked and that unlocking these countries potential relies on a strategy built on mutually reinforcing pillars that include “how Multibillion‑dollar investments in regional corridors, the Central and Northern Corridors in East Africa, the Trans‑Caspian route into Europe, and new dry‑ports on the Paraguay‑Paraná system can cut door‑to‑port time by 30 percent within the decade.”

He says building climate resilience is critical due to a “heavy reliance of LLDCs on agriculture, especially rain-fed agriculture, as a primary source of income, employment, and sustenance. Climate variability has already begun to disrupt agricultural cycles, reduce crop yields, and threaten food security. These effects ripple across rural economies, deepening poverty and forcing difficult choices for households.”

Álvarez says these issues are critical, as the same remoteness that inflates freight costs also hampers relief when drought, flood or storm strikes. Many LLDCs suffer disproportionately from climate‑related disasters because they lack redundant road and telecom links, and that “as extreme weather intensifies, production shocks travel quickly through thinly diversified economies and can wipe out years of growth.”

Overall, he says, “collectively these headwinds jeopardize progress on at least six Sustainable Development Goals—most visibly Goals 1 (No Poverty), 9 (Industry and Infrastructure) and 13 (Climate Action). Unless structural constraints are eased, many LLDCs risk missing the 2030 milestones by a full generation.”

Álvarez says the “developmental drag created by geography is not merely inconvenient; it is systemic.”

Stressing that high logistics costs shrink the set of competitive exports and that “many LLDCs remain reliant on two or three unprocessed commodities, leaving them vulnerable to price swings and limiting the spill‑overs that normally accompany industrial clustering.”

He says limited fiscal space means that governments struggle to finance education, health and social protection at scale. LLDCs as a group record poverty rates 50–60 percent higher than the global developing‑country average and score lower on the World Bank’s human‑capital index, 0.36 versus 0.48 in 2024.

Yaacoub confirms that all these issues will be explored in depth across key thematic areas that also include the private sector, civil society and youth engagement to foster inclusive partnerships and South-South and Triangular Cooperation with an emphasis on regional and interregional collaboration.

“This inclusive process ensures that the new Awaza Programme of Action is grounded in the lived realities of LLDCs and their partners,” she observes.

After all is said and done, Yaacoub says the most desirable outcome from the Third UN Conference on Landlocked Developing Countries would be the global endorsement and operationalization of the Awaza Programme of Action, which is a transformative and actionable framework that empowers LLDCs to overcome their structural challenges and thrive in a rapidly evolving global landscape.

Stressing that LLDC3 will serve as “a high-level platform to present, promote, and mobilize support for the implementation of the Awaza PoA that was adopted in December 2024. The second outcome would be the mobilization of resources and investment commitments from development partners to support infrastructure, climate resilience, and digital transformation.”

Ultimately, she is optimistic that the conference will lead to strengthened partnerships and regional cooperation to renew and expand transit agreements and regional integration initiatives, including enhanced South-South and Triangular Cooperation frameworks and commitments to multilateral collaboration aligned with the SDGs, the Paris Agreement and the pact of the Future.

IPS UN Bureau Report

 

Price and Power of Freedom: Celebrating Nelson Mandela International Day

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Human Rights

For to be free is not merely to cast off one’s chains, but to live in a way that respects and enhances the freedom of others. – Nelson Mandela

The General Assembly’s Plenary meeting on Nelson Mandela International Day. Credit: Jennifer Xin-Tsu Lin Levine/IPS

The General Assembly’s Plenary meeting on Nelson Mandela International Day. Credit: Jennifer Xin-Tsu Lin Levine/IPS

UNITED NATIONS, Jul 18 2025 (IPS) – The United Nations celebrated Nelson Mandela International Day in honor of the activist and politician’s lifelong commitment to peace and democracy.

At the 16th celebration of Nelson Mandela International Day, delegates, representatives and visitors alike reflected on the impact of South Africa’s first black president and leader in a fully representative democratic election.

The activist and politician, who spent 27 years in prison, was a staunch freedom fighter—arguing that freedom was not only an individual mission but also a collective responsibility and communal effort.

These principles were enshrined in the Nelson Mandela Rules, officially called the United Nations Standard Minimum Rules for the Treatment of Prisoners, a document protecting humane treatment of individuals without liberty. The document emphasizes respect for human dignity, prohibits torture and promotes fair and just conditions.

Although the Nelson Mandela Rules are “soft law” and not legally binding, the General Assembly has adopted them as universally agreed minimum standards. Many countries have incorporated the rules into domestic law, but many others have violated conditions of healthcare, solitary confinement and ethical working rights. Delegates and various speakers agreed that there was still much work to be done.

Nelson Mandela International Day, established in 2009 by the United Nations General Assembly and officially celebrated in 2010 on July 18th (President Mandela’s birthday), is a holiday encouraging all citizens around the world to engage positively in their communities.

Dr. Naledi Pandor, chair of the Nelson Mandela Foundation, addresses the UN General Assembly Plenary on Nelson Mandela International Day. Credit: Jennifer Xin-Tsu Lin Levin/IPS

Dr. Naledi Pandor, chair of the Nelson Mandela Foundation, addresses the UN General Assembly Plenary on Nelson Mandela International Day. Credit: Jennifer Xin-Tsu Lin Levin/IPS

From annual volunteer events to the annual Mandela Prize, awarded to two laureates each year who have profoundly impacted their communities by serving humanity, speakers, including the award recipients, the Secretary-General and the chair of the Nelson Mandela Foundation, all reflected on Mandela’s legacy on their own lives and on the UN.

In Secretary-General António Guterres’ remarks to the General Assembly at their plenary meeting, he said, “Power is not a personal possession to be harbored. Power is about lifting others up; it’s about what we can achieve with one another and for one another. Power is about people.” He echoed Mandela’s belief in collective grassroots action to deliver power to the powerless, encouraging member states to bring these principles into practice.

Dr. Naledi Pandor, chair of the Nelson Mandela Foundation, similarly called for action against injustice and inequality. She recalled how the United Nations aided South Africa in ending apartheid as it “stood against apartheid domination, not through arms but through bringing its undeniable moral weight into combat against injustice. That boldness, that courage is needed more and more today.”

Nelson Mandela, then Deputy President of the African National Congress of South Africa, raises his fist in the air while addressing the Special Committee Against Apartheid in the General Assembly Hall, June 22, 1990. Global alliance CIVICUS commemorated Mandela Day with a reminder that many rights defenders are jailed and intimidated. Credit: UN Photo/Pernaca Sudhakaran

Nelson Mandela, then Deputy President of the African National Congress of South Africa, raises his fist in the air while addressing the Special Committee Against Apartheid in the General Assembly Hall, June 22, 1990. Credit: UN Photo/Pernaca Sudhakaran

Pandor went on to recall Mandela’s political views beyond South Africa—his demand for global equity extended to all, and reflecting on how he might feel about the current state of the world, she quoted his 1990 speech to the UN Special Committee Against Apartheid.

Mandela said, “We also take this opportunity to extend warm greetings to all others who fight for their liberation and their human rights, including the peoples of Palestine and Western Sahara. We commend their struggles to you, convinced that we are all moved by the fact that freedom is indivisible, convinced that the denial of the rights of one diminishes the freedom of others.”

Mandela was a strong supporter of Palestine, often comparing its struggle with South Africa’s. South Africa, even after his death, maintained close ties to Palestine and brought the case of genocide against Israel to the International Court of Justice (ICJ) in 2024.

The 2025 Nelson Mandela laureates, Brenda Reynolds of Saulteaux First Nation and Canada and Kennedy Odede of Kenya, both spoke about how Mandela inspired their respective work. Reynolds, a social worker by trade, led the establishment of a national, culturally grounded mental health initiative for survivors of Indian residential schools.

Reynolds described her work with survivors as an example of Mandela’s notion of moving forward from resentment towards progress—as people found peace with their experiences, they were able to recover and lift up their communities from oppression. She described this as a process of peacebuilding within people, saying, “peace begins with individuals, and from there, you can find peace within your family and within your communities.”

Odede, who founded Kenya’s largest grassroots movement, Shining Hope For Communities (SHOFCO), to empower struggling urban communities, shared how Mandela’s words and experience with struggle inspired him to build within his own life. He found creative ways to organize communities around simple things like soccer, providing hope to people in dire situations.

The representative for The Gambia, who spoke on behalf of the African states, called upon the UN to adhere to Mandela’s principles, particularly on poverty as a man-made horror that can and must be removed by actions of human beings. The representative warned of extreme poverty on the rise, centering the “developing countries and middle-income countries” suffering the most “with unemployment rates beyond records.”

He said, “It is time for solidarity, partnerships and genuine actions where they are most needed,” asserting that poverty and underdevelopment were huge perpetuators of racism, therefore continuing a vicious cycle that oppressed people.

The representative argued, “rising inequity and progressive discrimination are not inevitable; they are a result of decades of policies and dynamics emanating from colonialism, appetite, and discrimination.” Criticizing these practices as misaligned with the UN charter, he pushed the UN to renew their commitment to progressing social development by redistributing wealth.

As the world commemorates Nelson Mandela’s enduring legacy, the message resonating from this year’s observance is clear: his vision of freedom—rooted in dignity, justice and collective responsibility—demands more than remembrance; it requires action. From prison reform to poverty alleviation to indigenous healing to grassroots empowerment, Mandela’s ideals continue to challenge the global community to uphold humanity over power and compassion over indifference. In honoring his life, the UN and its member states are reminded that freedom is not static—it is a continual struggle, a shared pursuit and a moral obligation.

IPS UN Bureau Report

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Sweet Hope to End Bitter Pills for Multidrug-Resistant Tuberculosis

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Health

Rallying call to end TB by 2030. Credit: Busani Bafana/IPS

BULAWAYO, Jul 15 2025 (IPS) – Every day, Yondela Kolweni has to hold down her son, who screams and fights when it is time for his daily life-saving TB tablets—a painful reminder of her battle with the world’s top infectious killer disease.

“It is a fight I win feeling awful about what I have to do,” says Kolweni (30), a Cape Town resident and a TB survivor. “The tablets are bitter, and he spits them out most of the time, and that reminds me of the time I had to take the same pills.”

Kolweni’s five-year-old son is battling Multidrug Resistant TB (MDR TB), a vicious form of TB that is rising among children globally.

The global burden of MDR-TB among children and adolescents has increased from 1990 to 2019, particularly in regions with lower social and economic development levels, according to a recent study. In addition, the top three highest incidence rates of MDR TB in 2019 were recorded in Southern sub-Saharan Africa, Eastern Europe, and South Asia, while the top three highest rates of deaths in the same period were recorded in Southern, Central, and Eastern sub-Saharan Africa.

South Africa is one of 30 countries that account for 80 percent of all TB cases in the world and has the most cases of drug-resistant TB.

A Bitter Pill to Swallow

Kolweni’s son was diagnosed with MDR-TB five years ago, having tested positive for TB which has affected his grandmother and his mother. He was immediately on treatment, a drug cocktail that included moxifloxacin—a pill not for the yellow-livered.

“There were two medications he had to take, and there was one specifically, the yellow one, that he did not like, and with the color he knew what it was,” Kolweni told IPS in an interview, explaining a daily battle to get her son to take his meds.

It was down to a fight. She crushed the tablets, mixed them with a bit of water, and fed them through a syringe.

“We would sometimes hold him or wrap a towel around him so that we could feed him the medication, but he would still spit it out, which meant he was not taking the dosage he was meant to take,” said Kolweni. “We then came up with the idea to put his tablets in his yogurt, but that technique did not work because, being a smart kid, he took the bait but would soon spit out the medication.”

Moxifloxacin, an exceptionally bitter medicine, is one of the key drugs in the new all-oral treatment for multidrug-resistant tuberculosis (MDR TB). The treatment is a combination of the drugs Bedaquiline, Pretomanid, Linezolid and Moxifloxacin, known as BPaLM. The BPaLM regimen is specially formulated for children but is a bitter pill to swallow.

Sweet Medicine

But there is sweet hope. A new study, by Stellenbosch University and the TB Alliance, found that sweet, bitter-masked versions of Moxifloxacin significantly improve kids’ willingness to take the drug—easing the burden on parents and boosting treatment adherence.

Two formulations of moxifloxacin have been identified by children as tasting better than new generic versions of products currently on the market.

The results from the ChilPref ML study—a Unitaid-funded effort sponsored and led by Stellenbosch University in collaboration with TB Alliance—will help improve MDR TB treatment and adherence in children.

Dr. Graeme Hoddinott, of Stellenbosch University and the principal investigator of the study, notes that children cannot be treated in a humane manner for drug-resistant TB if the medicines taste so terrible that children refuse them or must be forced to take them.

Children diagnosed with drug-sensitive TB have good outcomes even within the four months because there is usually one tablet given, and there is a child-friendly formulation that dissolves easily to be given on a spoon or in a syringe, Hoddinott said. However, for drug-resistant TB, the situation is complicated. Most drugs for MDR TB are no longer used because of their toxicity and have been replaced by new drugs.

MDR-TB drugs are not child-friendly, Hoddinott admits. The active ingredient that kills TB in Moxifloxacin makes the pills incredibly bad tasting for children who have to take the medication daily for between six and nine months in cases of MDR TB.

“These drugs are incredibly bad tasting; they are genuinely awful to a point where adults who have been on extended TB treatment have been unable to administer the same drugs to their children because the smell evokes the time when they were sick,” Hoddinott told IPS. “It is a trauma to administer such bad-tasting drugs to a child, both for the parent and the child, particularly for the young children.”

The ChilPref study recruited just under 100 healthy children, ages 5–17, from two diverse settings in South Africa. The children evaluated flavor blends using a ‘swish and spit’ taste panel—tasting the medicine, which was dissolved in water, and then spitting it out without ingesting any of it.

Each child participant ranked the flavor blends among the three from each manufacturer and also rated the taste, smell and other characteristics of each. For moxifloxacin, there was a clear, strong preference for the new flavor blends (“bitter masker” and orange for Macleods, and strawberry and raspberry and tutti frutti for Micro Labs) over the existing commercially available flavors for both manufacturers. For Linezolid, there was no preference between the flavor blends.

“Ensuring children have access to effective and palatable TB treatments is a crucial step in improving adherence and treatment outcomes,” said Koteswara Rao Inabathina, one of the study’s authors and CMC Project Manager at TB Alliance.

“Through close collaboration with manufacturers, we have addressed critical unmet needs by developing practical solutions that make available and effective drug-resistant TB treatments not only accessible but also palatable and acceptable for children.”

The results of the ChilPref study showed that children preferred two new flavor blends of moxifloxacin, produced by Macleods Pharmaceuticals, India, and Micro Labs Pharmaceuticals, India. The results were communicated to the manufacturers, who are already updating their products.

“We are not surprised that a lot of kids did not like any of the tastings because we knew that they were horrible taste-wise, but we got a very clear signal for both manufacturers that the flavor blends we recommended were more preferred,” Hoddinott said. “We changed which flavor was going to market with relatively simple research.”

Dr. Cherise Scott, Senior Technical Manager at Unitaid, said the easier it was for children to take their medicines regularly, the more likely they were to complete their treatment successfully.

“We will not allow children to be neglected in global health responses simply because their needs are more complex.”

A Promising Treatment for MDR TB

As multi-drug-resistant TB transmission increases among children and adolescents, the development of new treatments is imperative, Hoddinott explained.

Moxifloxacin may also be increasingly used in the future for the treatment of drug-susceptible TB, which affects an estimated 1.2 million children globally each year.

Drug-resistant TB, has previously been one of the most difficult diseases to manage because of limited child-friendly treatment options, but scientists have made strides in developing new treatments for children, explains Dr. Anthony Garcia-Prats, one of the study authors and an associate professor at the University of Wisconsin-Madison.

“Now we are making sure that these medicines are appropriate for children, starting with an aspect that children and parents say is critical: taste,” Garcia-Prats said in a statement.

The new treatment is given when TB is either resistant to rifampicin, a critical first-line drug, or rifampicin and isoniazid, another first-line drug combination. These resistant strains are collectively referred to as RR/MDR-TB.

Annually there are an estimated 32,000 new cases of RR/MDR-TB among children 14 years and under—a population that is extremely sensitive to the taste of medicine, according to researchers.

This discovery could help improve adherence to TB medication and move a step closer towards the United Nations Sustainable Development Goal 3 to end TB by 2030.

“It is not a silver bullet,” Hoddinott cautions. “It does not solve everything, as people affected by TB still face many other challenges, and even the preferred flavor blends still do not taste nice. But, as part of the overall fight against TB in children, it’s an important step.”

Kolweni welcomes the development of masked TB medication.

“My experience with TB medication was not nice, and for children it is worse, and I think flavored tablets would make it easy for children to take, like  Gummies,” she said. “Every child loves flavors; even a suspension would be nice. My son would love it, and I will have no trouble getting him to take his medicine.”

Note: This article is brought to you by IPS Noram, in collaboration with INPS Japan and Soka Gakkai International, in consultative status with the UN’s Economic and Social Council (ECOSOC).

IPS UN Bureau Report

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Conflict, Climate Change Push Migrants in Yemen to Return to Their Home Countries

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Humanitarian Emergencies

People in Yemen impacted by war and climate shocks receive aid from the IOM. Photo credit: Majed Mohammed/IOM Yemen

People in Yemen impacted by war and climate shocks receive aid from the IOM. Photo credit: Majed Mohammed/IOM Yemen

UNITED NATIONS, Jul 13 2025 (IPS) – Yemen’s humanitarian crisis, driven by conflict, economic collapse and climate shocks, leaves migrants desperate to return to their home countries.

In March 2025, the Global Data Institute Displacement Tracking Matrix recorded that 1,234 non-Yemeni migrants left the country.

Once a critical transit and destination point, Yemen is unable to support incoming asylum seekers. Yemenis are struggling to survive amidst a decade-long conflict and worsening climate change impacts. Over 4.8 million people are internally displaced, and 20 million rely on aid.

Most migrants come from Ethiopia and Somalia, searching for safety or work in the Gulf countries. However, many become stranded in Yemen due to the harsh conditions and abuse.

The International Organization for Migration (IOM) found that in 2024, around 60,900 migrants arrived in Yemen with no means to survive. Subsequently, they are exposed to severe protection risks, including physical and sexual violence, exploitation, abduction, detention, and debt bondage.

“With limited humanitarian resources and few service providers on the ground, migrants often suffer from hunger, untreated medical conditions, and lack of shelter. Many are stranded without access to even the most basic services,” said the IOM to IPS.

“Meanwhile, public hostility toward migrants has increased, as they are increasingly viewed as competing with vulnerable Yemeni populations for scarce assistance. The ongoing conflict in Yemen further compounds these vulnerabilities, with migrants caught in airstrikes, exposed to explosive ordnance, and lacking access to safety.”

Women and girls are the most vulnerable group of migrants traveling through Yemen. They are disproportionately threatened with gender-based and sexual abuse.

“I’ve been beaten, detained, and exploited in Yemen,” said a 24-year-old Ethiopian woman to IOM. “Most nights, I went hungry. After everything that happened to me, I am happy to go back to my home and family.”

Severe climate impacts also make it increasingly difficult for both migrants and Yemenis to access food and water. Around 17.1 million Yemenis are struggling with food insecurity, and climate-related issues are only exacerbating this crisis.

The June 2025 Migration, Environment, and Climate Change (MECC) Country Report on Yemen by the IOM says that Yemen is the 12th most water-scarce country in the world. This significantly influences food insecurity, as rising temperatures caused by climate change create unpredictable rainfall.

In some areas, severe droughts are turning fertile farmland into arid deserts, forcing farmers to plant new crops or move in search of better conditions. Meanwhile, in other communities, heavy rain is sparking extreme flooding. Impacted areas are decimated by soil erosion and disease from contaminated water.

“Areas that used to experience heavy rainfall have now suffered from drought, and farmers have to adapt to this drought by either planting drought-resistant crops, changing their livelihoods, or migrating to another location. And some areas used to suffer from drought but now experience heavy rainfall, where the intensity of rainfall has led to the emergence of new diseases brought by floods,” said an official in the General Authority for Environmental Protection responsible for planning and information to the IOM.

Together, brutal conflict and a lack of access to vital necessities significantly limit migrants’ ability to return to their home countries. The IOM reported that in 2020, around 18,200 people risked their lives traveling by sea. Overcrowded vessels traversing rough waters often capsize, killing dozens on board.

For others, their journey back home leads them through heavily war-inflicted areas. Without proper assistance, migrants are left to navigate through dangerous frontlines, risking death from armed violence and landmines.

However, programs like the IOM’s Voluntary Humanitarian Return (VHR) aim to facilitate migrants’ safe return home. VHR is one of the only solutions for stranded migrants to voluntarily return in a safe and dignified manner.

So far, the IOM has helped 66 migrants safely return this year. This is a significant drop compared to the 5,200 individuals returned in 2024.

“IOM provides lifesaving protection and health service through Migrant Response Points (MRPs) in Aden, Sanaa and Marib and Community-based Care centers in Aden and Sanaa, as well as through mobile teams along the migratory routes funded by ECHO and UK FCDO,” said the IOM to IPS. “Since 2015, IOM has been facilitating Voluntary Humanitarian Return (VHR) as the only viable solution for stranded migrants who wish to return home voluntarily, safely, and with dignity.”

The IOM is backed by numerous groups such as the European Union, the King Salman Humanitarian Aid and Relief Centre (KSrelief), the US State Department’s Bureau of Population, Refugees and Migration, and the governments of Germany, France, Norway, and Finland. Unfortunately, despite widespread support for the program, more donations are urgently needed. The IOM is struggling to help migrants due to significant funding cuts.

“As migration flows continue to surge, the demand for safe and dignified return options for migrants has reached critical levels,” said Matt Huber, IOM’s former Chief of Mission in Yemen. “Without immediate funding support, the continuity of this vital programme is at risk, leaving thousands of vulnerable migrants stranded in precarious conditions with many experiencing serious protection violations.”

IPS UN Bureau Report

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UN Funding Crisis Threatens Work of Human Rights Council

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Opinion

The Human Rights Council is an intergovernmental body within the UN system responsible for strengthening the promotion and protection of human rights around the globe, and for addressing situations of human rights violations, and making recommendations on them, according to the UN. It has the ability to discuss all thematic human rights issues and situations that require its attention throughout the year. It meets at the United Nations Office at Geneva (UNOG).

NEW YORK / GENEVA, Jul 11 2025 (IPS) – The United Nations Human Rights Council (HRC) has expressed concern at the UN High Commissioner for Human Rights’ announcement that certain activities mandated by the council cannot be delivered due to a lack of funding. The council has sought clarity on why certain activities had been singled out.

Among the activities the commissioner says can’t be delivered is the commission of inquiry on grave abuses in Eastern Congo, an important initiative created—at least on paper—at an emergency session of the HRC in February in response to an appeal by Congolese, regional, and international rights groups.

The establishment of the commission offered a glimmer of hope in the face of grave and ongoing atrocities in the region, and it was hoped it might be an important step toward ending the cycle of abuse and impunity and delivering justice and reparations for victims and survivors.

It is not only the activities highlighted by the commissioner that are impacted by the funding crisis, however. Virtually all the HRC’s work has been affected, with investigations into rights abuses—for example in Sudan, Palestine, and Ukraine—reportedly operating at approximately 30-60 percent of capacity.

In discussions about the proposed cuts, several states—notably those credibly accused of rights abuses—have sought to use the financial crisis as cover to attack the council’s country-focused investigative mandates or undermine the Office of the High Commissioner’s broader work and independence. For example, Eritrea invoked the crisis in its ultimately unsuccessful effort to end council scrutiny of its own dismal rights record.

Amid discussions on the current crisis, there has been little reflection among states on how the UN got into this mess. States failing to pay their membership contributions, or failing to pay on time, has compounded the chronic underfunding of the UN’s human rights pillar over decades.

The United States’ failure to pay virtually anything at the moment, followed by China’s late payments, bear the greatest responsibility for the current financial shortfall given their contributions account for nearly half of the UN’s budget.

But they are not alone: 79 countries reportedly still haven’t paid their fees for 2025 (expected in February). Among those that haven’t yet paid this year are Eritrea, Iran, Cuba, Russia, and others that have used the crisis to take aim at the council’s country mandates or to undermine the work or independence of the high commissioner’s office.

Rather than seeking to meddle in the office’s work or reduce the HRC’s scrutiny of crises, states should work with the UN to ensure funds are available for at least partial delivery of all activities they mandate through the council, particularly in emergencies.

Urgent investigations into situations of mass atrocities are key tools for prevention, protection, and supporting access to justice. They cannot wait until the financial crisis blows over.

Lucy McKernan is United Nations Deputy Director, Advocacy, Human Rights Watch (HRW), and Hilary Power is UN Geneva Director, HRW

IPS UN Bureau

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