India’s Citizenship Law Triggered by Rising Right-Wing Ideology

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Credit: Foreign Policy

UNITED NATIONS, Jan 6 2020 (IPS) – “Fire bullets at the traitors of the country,” chanted mobs of Bharatiya Janata Party, or BJP, supporters wrapped in Indian flags in Delhi last week.


It’s been less than a month since protests emerged against the BJP’s Citizenship Amendment Act (CAA), a new law to redefine and restrict who is considered an Indian citizen. In a violent crackdown, 27 peaceful protesters have been killed and police have detained 1500 others. BJP vigilante mobs continue to threaten and beat people protesting this controversial bill.

The CAA became law on December 11th, 2019 to provide a path to citizenship for minorities that fled from Afghanistan, Bangladesh, and Pakistan prior to 2014, but its most controversial point is that it specifically excludes Muslims. Critics call it discriminatory and say it threatens the secular nature of India’s constitution by trying to establish a Hindu religious state, or a “Hindu Rashtra,” akin to other religious states like Saudi Arabia or Israel’s attempt for a Jewish nation state.

In addition to the CAA, the Indian government is also planning to implement a National Register of Citizens, also known as the NRC, across the whole nation by 2021. The most recent NRC was implemented by the Indian government in the state of Assam in 2015 forcing Indians to provide documented proof of their citizenship to be considered Indian citizens. The result was the disenfranchisement of 1.9 million mostly Muslim residents who now risk being sent to illegal detention camps as they do not have what the government considers sufficient documentation or “legacy documents” which must date back to the 1970s. People fear that its extension to the rest of the country will not only affect Muslims who are not safeguarded by the CAA, but also the poorest, unlettered parts of society.

According to Indian historian and executive-director of the Tricontinental Institute for Social Research, Vijay Prashad, the BJP has couched the CAA as a progressive refugee policy which is redundant given that India is already a signatory of the Global Compact for Migration as well as other international treaties on migration and refugees.

“Why not bring these treaties to be ratified by India, why bother to create your own bizarre thing if there’s already an international framework to say that we accept refugees and migration?” he asked rhetorically. “Well it’s because they’ve used the question of migration not for migration itself but to define what is an Indian citizen, which is a very chilling thing because now they are making the claim that Muslims are not citizens in India,” Prashad told IPS News.

Prashad says this is a core part of the BJP’s right-wing ideology. India’s home minister Amit Shah even referred to undocumented Muslim migrants coming from Bangladesh to India as “termites” and “infiltrators” and threatened to throw them into the Bay of Bengal.

India is currently the world’s largest democracy which historically has not used religion as a prerequisite for citizenship. According to Ramya Reddy, human rights lawyer from Georgetown University Law Center, the CAA puts India’s democracy at risk by violating Articles 14 and 21 of the Indian constitution, which deal with equality and liberty.

Protests

Daily protests have been met with extreme violence by the police who have fired stun grenades, smoke bombs, tear gas, and even used live ammunition to shoot and kill protestors. Police have attempted to stop protests by imposing Section 144 of the Penal Code, a draconian law from the British Raj historically used to crush freedom fighters by prohibiting the assembly of more than 4 people. The section of this law, however, is being applied selectively.

“When the radical Hindutva supporters gather, this is not considered an unlawful gathering according to the police because they’re pro-government. The police even escort them,” said Aatir Arshad a Bachelor’s student from Jamia Millia University who’s been involved in recent protests.

Jamia Millia Islamia University, a public college in New Delhi with a majority-Muslim student body, became the center of the protest movement in Delhi after police stormed the university campus, dragged out several students, beat them up and arrested them, including those who were not participating in the demonstrations.

“They rushed into the library, where students were not even protesting, they were just studying for their exams and the police beat them up,” Arshad told IPS News. “That moment was apocalyptic for Jamia Milia Islamia. They also harassed students and then claimed they did nothing.”

Arshad adds that police also entered the mosque on the university campus, beat up the Imam, as well as the guards of the university. Protests are still going on because of the events from that day.

Ahla Khan, an alumnus from Jamia Millia and resident of the Jamia Nagar area, explained to IPS News how on the first day of protests her and her sister were just walking to Jamia University when they got caught in the middle of a confrontation between police and protesters. They ran to the sidewalk and watched as police hit students with batons.

“I was watching a guy standing there, just looking at his phone doing nothing. The police ask him ‘where are you going’ and he doesn’t say anything. And just like that the police start beating him up,” says Khan.

She explains how the protesters have been highly organized and peaceful in Delhi. Many have volunteered to distribute tea in the biting cold weather, organized assemblies and facilitated plays and book readings. Chants and slogans have called for repealing the CAA as well as for Azaadi, or freedom. Police have been more restrained than in Uttar Pradesh (UP) where police violence has been lethal. The Chief Minister of UP called a meeting in late December threatening to seize property of those involved in protests “to compensate damage to public property.”

“In UP police and RSS goons have been barging into people’s houses, hitting them, beating people up, thrashing their entire houses, looting them, TVs and fridges broken,” said Khan.

The government has also made several attempts to prevent media outlets from covering police violence and has blocked the internet is several parts of India where there are massive protests. Internet shutdowns have become commonplace, with the shutdown in Kashmir being the longest ever in a democracy.

International Response

While many protesters are still languishing in jail, the United Nations has voiced concern over the CAA with Secretary-General Antonio Guterres’ spokesperson, Stephane Dujarric, calling for “restraint and urg[ing] full respect for the rights of freedom of opinion and expression and peaceful assembly.” UN Human Rights Commissioner Michelle Bachelet’s spokesperson stated that the law “would appear to undermine the commitment to equality before the law enshrined in India’s Constitution.”

Despite this, Reddy says that this doesn’t have any enforcement as domestic law always takes precedence over international law. Even though the UN has criticized the CAA, “[changes have] to happen domestically or with pressure,” she said. And right now, no other major international powers like the UK, the US, and Canada have come out against this because they’re strong allies [of India],” Reddy told IPS News.

In fact, on a recent visit to Washington, D.C. India’s External Affairs Minister Subrahmanyam Jaishankar cancelled a meeting with the House Foreign Affairs Committee after the other members of Congress refused to exclude Rep. Pramila Jayapal (D-Wash.), a critic of the CAA, NRC, and India’s actions in Kashmir.

South Asian students in the United States are expressing their dismay with the Indian government by launching a campaign demanding their House of Representatives “express their disapproval through targeted sanctions against Modi government officials until both laws are repealed.” So far, the letter has been signed by the Yale South Asian Society, Harvard College U.S.-India Initiative, Columbia University South Asian Organization, University of Pennsylvania South Asia Society Board, Cornell University South Asian Law Students Association, Brown University South Asian Students Association and Dartmouth University Muslim Students Association Al-Nur, and many other student groups.

Democratic Deficit

Implementing a nationwide National Register of Citizens will cause massive economic disruption, according to a recent report by the Wire. The article states that the NRC in the state of Assam alone, which makes up just 3% of the population, “took almost a decade, required the involvement of over 50,000 government employees and cost more than Rs. 1,200 crore,” or just over 168 million US dollars. While the Indian development dream is flailing with its ranking in hunger slipping annually and unemployment rising, the implications of implementing these exclusionary laws go beyond the marginalization of Muslims to also draining resources from some of the world’s poorest residents.

“This is not about a policy you can really implement,” said Prashad. “You can’t actually, practically expatriate 200 million Muslims.” Prashad also pointed out in his recent article that India’s Muslims form the eighth-largest country in the world.

The point, he adds, is that “this is a marker saying we are redefining citizenship and emboldening the hard-right and mobs on the street to make it clear to Muslims that they are not welcome here and that India is a Hindu country,” Prashad told IPS.

Despite the hard attempt by the government quell any resistance to the CAA, protests have been occurring daily with Muslims, Dalits, Buddhists, Christians, Sikhs, farmers, lawyers, workers, writers, and journalists joining together to prevent what could leave millions stateless in “the largest disenfranchisement in human history.”

When asking Aatir Ashad, who’s been protesting daily, about his experience he tells IPS News that whenever there’s a call for a protest, the police just close all of the metro stations so that no one can reach the protest site.

“Great democratic country we’re living in,” he says sarcastically, distressingly, as he prepares for another day of joining the protests.

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Arab Region’s Largest Youth Gathering Focuses on New Tech

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Population

At the Global Youth Forum in Egypt thousands of youth attend a session on Artificial Intelligence and to hear Sophia — a humanoid robot capable of displaying humanlike expressions and interacting with people. Credit: Stella Paul/IPS

SHARM-EL-SHEIKH, Egypt, Dec 18 2019 (IPS) – On late Monday morning, a motley group of more than a thousand youth gathered in a hall in Sharm el-Sheikh, Egypt, to listen to Sophia — a humanoid robot capable of displaying humanlike expressions and interacting with people. Yahya Elghobashy, a computer science engineering student from Cairo, sat excitedly in the audience. A few meters away from him, also in the audience, was Abdel Fattah el-Sisi — the President of Egypt.


As Sophia and a panel of scientists on the stage spoke about Artificial Intelligence (AI), El-Sisi was seen listening attentively and taking notes while the young crowd around him squealed and took photos.

“It was very exciting that I was going to see and hear the world’s best humanoid robot and that the president himself was there,” Elghobashy revealed, a big smile on his face.

Since 2017, Egyptian president El-Sisi has been seen here at the World Youth Forum each year. The event is now the Arab world’s largest youth gathering, focusing on peace, culture and development.

The 3-day forum, which ended yesterday, Dec.17, drew nearly 8,000 people including 64 speakers and several hundred youth leaders from Africa, Asia, Europe, and the Americas. There was also a large contingent of government officials and ministers in attendance, which has been happening under the direct patronage of the president. The core theme of the event is “Egypt: where civilisations meet” – an effort to highlight the cultural diversity of the country to the world.

Technology and innovation in the spotlight

But the dominating subject of discussions at the forum this year was technology and innovation. Of the 20 sessions, half were centred around technology and artificial intelligence (AI), cyber security, industrial innovation and blockchain technologies and applications.

On Monday, Dec. 16, at the session on AI, youths were seen loudly cheering as Sophia the robot spoke. Designed by Hanson Robotics of Hong Kong, Sophia described herself as a robot who is here to assist in the fields of research, education, and entertainment, and help promote public discussion about AI.  At the session, a panel of youth experts also talked passionately about ethics and the future of robotics. “You can build robots that are energy-efficient and also run on renewable energy,” said the humanoid robot to the cheering young crowd.

“This is very progressive that we are discussing advanced technology like AI here. As an engineering student, I think it especially encourages us to talk about what is most relevant to our life, our country and our future,” Elghobashy told IPS.

At a press conference later, El-Sisi assured people that the government was indeed paying attention to the developments at World Youth Forum and planned to bring cutting-edge technologies to the country’s youth for a better future.

“We will be launching a series of new universities teaching all relevant digital age sciences. We will also seek partnerships with international institutions to guarantee a high level of quality education,” El-Sisi said.

New technologies, risks and challenges

Besides the excitement of ground-breaking technologies, the forum also threw light on the risks and challenges of new technologies such as  blockchain – a decentralised, distributed ledger that records the provenance of a digital asset. Cryptocurrency, like Bitcoin, is a perfect example of blockchain technology.

Challenges faced by various countries regarding blockchain due to the lack of national legislation in countries other than China and the United States was also a prominent talking point. This includes possible threats like blockchain being misused by terrorist organisations to sell oil, purchase weapons, and exchange digital currencies.

The missing technologies

Samia Khamis is a student of international relations in Amman, Jordan who traveled to the forum for the first time. “I came via Cairo, which is only an hour away from Jordan, but the moment I stepped out of the airport I could feel that the air pollution level is much higher than my country,” she told IPS.

Cairo is one of the world’s most polluted cities.  According to NUMBEO – an air quality data monitor, residents of Cairo breathe in polluted air, with levels reaching as high as 85 percent.

According to Khamis, Egypt needs to develop technologies that could clear its sky which is “dark” because of pollution. “It is good that we are brining so many technologies on display here, but we need technologies that can make our environment better and our air clearer,” she said.

The forum’s closing ceremony took place on Tuesday night.

 

Call to Action as Thousands Breathe New Life to the Cairo Promise at ICPD 25 Summit in Nairobi This Week

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Gender equality and women empowerment at the heart of ICPD25. Credit: Joyce Chimbi / IPS

NAIROBI, Kenya, Nov 11 2019 (IPS) – Every day 830 women die while giving life. At least 33,000 girls are forced into child marriage with 11,000 girls undergoing female genital mutilation. These are some of the cruel realities young women face every day. However, there is renewed hope that delegates expected to attend the International Conference on Population and Development (ICPD) in Nairobi this week will re-energise and breathe new life to the Cairo Promise.


“The Summit is a call to action to accelerate progress towards the world we imagined in 1994,” Arthur Erken, one of the three co-chairs of the International Steering Committee of the Nairobi Summit, tells IPS. He emphasises that the magic of the first ICPD conference is in the paradigm shift from “a numbers-driven approach to development to placing people, their needs and aspirations, at the heart of sustainable development”.

Erken says this summit is, therefore, a call to action to countries and partners to fulfil the Cairo Promise by making concrete commitments towards achieving the ICPD goals.

Unfulfilled promises and Re-energising the global community

Co-hosted by the governments of Kenya, Denmark and the United Nations Population Fund (UNFPA), the Nairobi Summit takes place on the 25th anniversary of the ground-breaking 1994 International Conference on Population and Development (ICPD).

Arthur Erken says that ICPD25 is a call for action to accelerate the Cairo promise. Credit: Joyce Chimbi / IPS

Unfortunately, says Erken, this promise has for millions of women and girls around the world not been fulfilled. “The world we imagined in Cairo is not a reality,” says Erken. He says the Cairo Promise was about ensuring that all people have access to sexual and reproductive healthcare, including safe pregnancy, childbirth and family planning services, and are free from all forms of violence and harmful practices.

Other experts such as Beatrice Okundi, assistant director of the National Council for Population and Development (NCPD), affirms that at the heart of the promise is gender equality, and the emphasis placed on equality and empowerment of women and girls.

Raising awareness

Okundi says that accelerating the Cairo Promise will require raising awareness on the relationship between population growth and sustainable development. “For Kenya to absorb an additional one million people every year as it has done for the past 10 years, our economy must grow at a double-digit figure up from the current 5.7 percent,” she tells IPS.

Five themes to a call for Action

Erken explains that the summit is focused around five themes: universal access to sexual and reproductive health and rights, financing the ICPD agenda, drawing on the demographic dividends, ending gender-based violence and harmful practices and upholding the right to sexual and reproductive healthcare, even in humanitarian and fragile contexts.

He says the summit is also about achieving three critical zeroes: zero unmet need for family planning, zero maternal deaths and zero violence and harmful practices against women and girls, including child marriages and female genital mutilation. “ICPD25 is also about assessing how much these three zeroes will cost governments as well as partners, and emphasises the need for innovative financial models,” Okundi adds.

She says that “ICPD sets in place a far-sighted plan that advances human well-being and their rights, well ahead of numerical numbers”.

Erken points out the Nairobi Statement “is not a negotiated document”. However, it is nonetheless the overall global framework formulated and based on wide consultations with diverse stakeholders, including governments and CSOs, among others. “This statement is an embodiment of areas that need prioritisings. It is a reflection of the state of implementation of the ICPD Programme of Action and the areas where concrete commitments are required in order to move the ICPD agenda forward.”

Finish what we started….

But not every expert or delegate is as hopeful, as expressed by Angela Nguku, the executive director of White Ribbon Alliance, an international coalition on safe motherhood. She argues there is no need for new promises or commitments.
“We need to finish what we started in Cairo by removing obstacles, especially corruption from our path,” she says. Nguku says that misappropriation of public funds continues to stand between populations and Cairo promise.

“On this continent, the ICPD agenda remains unfulfilled, not because of a resource gap, but a leadership and governance gap. We need to put the resources we have where they are needed,” she tells IPS.

Nonetheless, delegates expect that the new commitments made in the next three days will lead to completion of the unfinished business of ICPD.

Let’s not wait another 25 years

ICPD25 runs from November 12-14, bringing together more than 6,000 delegates from around the world, with at least 164 countries and delegates drawn from civil society organisations, grassroots organisations, young people, business and community leaders, faith-based organisations, indigenous peoples, international financial institutions, people with disabilities, academics and many others working towards the pursuit of sexual and reproductive health and rights.

“The summit is not a platform to prescribe solutions to convening countries and convening delegates. It is an opportunity for governments and other partners to make commitments, and own the process,” says Erken.

Experts acknowledge that tremendous progress has been made over the last 25 years, but emphasize that a lot more will need to be achieved in a shorter period of time, to fulfil the promise by 2030.

“We cannot have another 25 years of ICPD. This is hopefully the last ICPD conference,” Erken observes.

 

The Nairobi Summit Is about the Future of Humanity and Human Prosperity

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Opinion

Kenyan President Uhuru Kenyatta hailed the strong partnership between his government and UNFPA during a meeting with UNFPA’s Executive Director, Dr. Natalia Kanem in March 2019, which will jointly convene the ICPD 25 from 12 to 14 November 2019 along with the Government of Denmark. Credit: PSCU

NAIROBI, Kenya, Nov 8 2019 (IPS) – As we count down the remaining days to the opening of the Nairobi Summit or the International Conference for Population and Development(ICPD), I am confounded by how much humanity has managed to simultaneously empower more women than at any other time in history, while at the same time failing to see that ‘women’s issues’ are actually ‘everyone’s issues’.


That countdown evokes memories of my own grandmother, who followed a common trend in India at the time, dropping out of school to get married and give birth to her first child at age 11. In many parts of the world, girls have over the years faced unthinkable obstacles while trying just to get an education, often jeopardizing their personal safety and risking being ostracized by their families and communities.

It wasn’t until a mere 25 years ago at the ICPD in Cairo that the world agreed that population and economic development issues must go hand in hand, and that women must be at the heart of our efforts for development.

Back then, governments, donors, civil society, and other partners made commitments to reduce infant and child mortality, reduce maternal mortality, ensure universal education, and increase access to sexual and reproductive health and rights, amongst many others. These commitments were a massive step forward for the rights of women and girls.

At the Conference in Nairobi, we all have an opportunity to repeat the message that women’s empowerment will move at snail-pace unless we bolster reproductive health and rights across the world. This is no longer a fleeting concern, but a 21st century socio-economic reality.

We can choose to take a range of actions, such as empowering women and girls by providing access to good health, education and job training. Or we can choose paths such as domestic abuse, female genital mutilation and child marriages, which, according to a 2016 Africa Human Development Report by UNDP, costs sub-Saharan Africa $95 billion per year on average due to gender inequality and lack of women’s empowerment.

Fortunately, the world has made real progress in the fight to take the right path. There is no lack of women trailblazers in all aspects of human endeavour. It has taken courage to make those choices, with current milestones being the result of decades of often frustrating work by unheralded people, politics and agencies.

Leaders like the indefatigable Dr. Natalia Kanem the Executive Director of UNFPA and her predecessors, supported especially by the Nordic countries, are pushing the global change of paradigm to ensure we demolish the silo of “women’s issues” and begin to see the linkages between reproductive rights and human prosperity.

Numerous studies have shown the multi-generation impact of the formative years of women. A woman’s reproductive years directly overlap with her time in school and the workforce, she must be able to prevent unintended pregnancy in order to complete her education, maintain employment, and achieve economic security.

Denial of reproductive health information and services places a women at risk of an unintended pregnancy, which in turn is one of the most likely routes for upending the financial security of a woman and her family.

A lot has been achieved since the years of my grandmother, when girls were expected to be demure and remain in the background. In many places the current teenage girl believes that every door is open to them; they can rise to any heights.

Yet in a lot of other countries, girls are up against a system that seems rigged against them for the long-term. These are countries where greater leadership and the right policies are sorely missing; where women and girls are robbed of the education they deserve and the jobs they need to lift themselves and their families out of poverty; where they are victims of sexual and physical abuse in their own homes or sold into child marriage.

As the UN Resident Coordinator to Kenya, I am privileged to serve in a country, which is hosting this very important conference. It has shown leadership to advance the cause of women’s right-from criminalizing female genital mutilation to stepping up the fight to end child marriage and pushing hard on improving reproductive, maternal and child health.

When the ICPD opens in Nairobi on 12 November 2019, I wonder how my grandmother’s life might have been different if she had been able to learn how to read and write and achieve her full human potential, but also appealing to all Governments to work towards giving half the world population the final and absolute control over their own bodies.

Siddharth Chatterjee is the United Nations resident coordinator to Kenya.

 

The Most Important Meeting You’ve Never Heard Of — & the Grand Challenge on Inequality

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Opinion

Ben Phillips is an author and activist on inequality.

Credit: United Nations

MEXICO CITY, Oct 9 2019 (IPS) – Last month 195 world leaders once again met in New York for big speeches and grand events. But on inequality, when all is said and done, more has been said than done.


Four years after governments across the world committed to fight inequality as part of the UN Sustainable Development Goals, far too little has been seen in the way of government action. That’s not the verdict of critical NGOs – that’s the official assessment of UN Secretary-General António Guterres himself.

As Guterres told countries, adding only the thinnest diplomatic coating, “the shift in development pathways to generate the transformation required to meet the Sustainable Development Goals by 2030 is not yet advancing at the speed or scale required.”

Indeed, he noted, “the global landscape for Sustainable Development Goal implementation has generally deteriorated since 2015”. It is in this context that the UN has called for a “decade of delivery” following five years in which we the people have been able to feast on words whilst fasting on action.

For years, grassroots organisations have been sounding the alarm about the damage being caused by widening inequality. More recently, the formal debate on inequality shifted and the accepted mainstream normative position has become that inequality is dangerous and needs to be reduced.

The UN has also stepped up in providing coordination and advice. But governments have not shifted in recognition of the new consensus. Cynicism about whether anything will be done has taken root amongst even the most hopeful observers.

And the big headlines from this year’s UN General Assembly did very little to counter that cynicism, dominated as they were by the world’s loudest leaders, who seem to make up for an absence of substance with a surfeit of bombast.

Quietly, on the sidelines, however, another group met to plan not a communique on the stage but a series of actions at home. It was not a huge group of countries, just a dozen, but it included countries from every region of the world and every income level.

They met not because they think they have the answers, but because they are keen to learn from each other and to act. From Indonesia to Sierra Leone to Sweden to Mexico, they and others gathered in the first heads of state and government meeting of the Grand Challenge on Inequality, a new multi-stakeholder initiative to support vanguard governments, committed to tackling inequality, in finding the path by walking it.

Then, even more crucially, these same leaders mandated senior leaders and officials – the doers – to gather just after the New York meetings in Mexico City, and then in a few months in Jakarta, and onwards, to plan the implementation of a series of practical country-specific policies to narrow the gap between the runaway few and the many pushed behind.

You haven’t heard about this meeting because the leaders don’t believe that they have yet earned the right to declare themselves the leaders. Saint Francis of Assisi said “Preach the Gospel, and if you must, use words.”

In a similar spirit, the country leaders in the Grand Challenge on Inequality recognized, in the New York and in Mexico City meetings, that the power of their commitment to tackling inequality will be shown not in what they say but in what they do.

They recognized that there is no single policy that on its own can beat inequality, and so a series of complementary policies year on year is needed. They recognized that tackling inequality means taking on vested interests: that it means progressive tax and universal public services, it means protected workers and regulated corporations, it means designing policy from the bottom-up not the top-down, and it means tackling the wealth and power of the very wealthy.

As part of that, they opened themselves up to forthright challenge from grassroots social movements and trade unions, and shared what they as leaders were finding most challenging and the lessons they had learnt from their mistakes. It was, I’ll confess, something of a shock to hear leaders start off not with justifications but with self-criticism.

It was a world away from the (in)famous “Big Men Who Strode New York”. In a world saturated by the fake, to witness sincerity was disorientating.

It is early days for the pioneer governments Grand Challenge on Inequality, but, as a witness and as someone who has spent years bluntly challenging governments for their failures, here’s why it matters: social transformation doesn’t happen when people recognize that ther society is unfair – it happens when people also recognize that it can be fairer.

And that depends on people witnessing change, somewhere. Cynicism and despair are ultimately tools of the status quo. There is nothing more dangerous to those who would keep things as they are than the threat of a good example.

And, quietly, this group of countries, of leaders who do not call themselves leaders, are starting to build that good example. Oxfam have started to call this group of governments the “axis of hope”. Perhaps these governments could be more prosaically named the “axis of action”.

Grassroots organising will remain essential to help foster leaders’ determination, and to push back against the pressures that will continue to be exerted by economic elites. There is no certainty that change is coming. But there is no longer certainty that it isn’t. And the sound that accompanies this change is not the bang of fireworks. It is a quiet whirring of hard work.

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Awareness Should be the Priority in Public Health Efforts against Leprosy

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Health

Dexter, a 25-year-old fisherman from Pohnpei in the Federated States of Micronesia, received treatment for Hansen’s disease, also known as leprosy, for over a year. He has been cured of the disease. Credit: Stella Paul/IPS

MANILA, Sep 9 2019 (IPS) – Increasing awareness of the continuing existence of Hansen’s Disease (leprosy) is critical to sustaining effective public health efforts against the disease, eliminating the social stigma associated with it, and halting its transmission.


That was the consensus reached by participants at the Global Forum of People’s Organisations on Hansen’s Disease in Manila on Sept. 9, following a lecture by Dr. Arturo Cunanan, the Chief Medical Officer of the Culion Sanitarium and General Hospital in the Philippines.The forum was organised by Japan’s Sasakawa Health Foundation (SHF) and The Nippon Foundation. 

Cunanan noted that for several years, the number of new cases has plateaued at about 200,000 per year, a troubling statistic that he attributed in part to a lack of awareness among public health bodies as well as people affected by the disease.

The social stigma attached to leprosy is a barrier to early detection of the disease, which is the key to slowing its rate of transmission. Cunanan said that the average length of time between the onset of the disease and the beginning of treatment is about two years.

This happens because on the one hand, patients are unaware of medical help available to them, unwilling, or otherwise unable to seek treatment due to stigma; and on the other, a lack of expertise and resources on the part of public health departments due to a misunderstanding of the persistence of the disease.

Not a priority

“Many public health and government officials confuse elimination and eradication,” Cunanan told the forum participants. “They think that leprosy being eliminated as a public health problem means it has been eradicated, so they are surprised when they learn it still exists.”

What this has resulted in is a decline in the material and human resources available for combatting leprosy. “Leprosy will never be a priority” for government health programmes, Cunanan said. “There are more pressing problems, bigger emergencies.”

The Philippines is a good example. The disease is considered a minor problem, and the number of new cases each year is relatively low – there were 2,108 new cases in 2017, out of a national population of about 107 million – but has been relatively consistent year after year, “between 2,000 and about 3,000”.

Because of the mistaken belief that leprosy has either disappeared entirely or has become rare, medical expertise and programmes have disappeared from public health institutions. That in turn has degraded the supervision and monitoring needed to identify new cases and prevent the transmission of the disease, Cunanan explained.

Lucy Massao, a member of the Tanzania Leprosy Association (TLA), noted that the stigma and lack of understanding of leprosy among the public in her country was also reflected in the shortcomings of the public health framework.

“We at TLA really spend a lot of time trying to educate people, including the officials,” she said. “Many patients, the health officials refer to us, because they cannot offer much support except for the medications. But they are improving, through working with us.”

Role of people’s organisations

Public health authorities elsewhere are also gradually recognising the value of the organisations of people who have been affected by leprosy. “You are the best experts,” Cunanan told the forum participants, “Because you have first-hand experience.”

Organisation members can assist in early detection and outreach, Cunanan explained, and help public health authorities improve their services to leprosy patients.

In the Philippines, collaboration with people’s organisations such as Coalition of Leprosy Advocates of the Philippines has actually been included in official policy. Philippine Assistant Secretary of Health Dr. Maria Laxamana, who delivered the keynote address on the forum’s first day, noted that “intensified collaborative efforts among [government] agencies and with private partners” is a key objective of the government’s National Leprosy Control Programme.

Dr. V.R. Pemmaraju of the World Health Organisation’s (WHO) Global Leprosy Programme said that there has been a marked growth in talent and inclusiveness among people’s organisations, which is increasing their effectiveness in supporting and extending public health efforts towards leprosy.

“What we’re seeing, and you can see it at this forum, is that the groups are more global, include more women, and are more educated about the disease and the support needed,” Pemmaraju told IPS.

“This has been very good from the point of view of the WHO, because of the added social aspect of the Global Leprosy Partnership,” he explained. Where people’s organisations still need to develop is in working effectively with governments.

“They [the organisations] have the experience and knowledge about leprosy, but what I’ve seen is that most need more skills in negotiating and engaging with government officials,” Pemmaraju said. “There is still some gap in inclusion of people’s organisations in forming public health policy [related to leprosy], and developing those skills would help to reduce that.”

Pemmaraju is upbeat about the prospects of people’s organisations gaining a bigger voice in public health policy towards leprosy.

“In each of these meetings, I see the groups growing globally and gaining more influence,” Pemmaraju said. “With the engagement of the people’s organisations, we [the WHO] are optimistic that we can achieve our goal of ‘zero leprosy.’”