Gaza: Physicians Call For Unimpeded Aid To Restore Reproductive Healthcare

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Armed Conflicts

Cardiologist Dr. Marwan Sultan, then Director of the Indonesian Hospital in north Gaza, in February 2025 showing damage to hospital equipment following an Israeli attack on the facility a few months prior. In July 2025, Dr. Sultan was killed in an Israeli strike on the apartment where he was sheltering with his family. Credit: PHR/GHRC

Cardiologist Dr. Marwan Sultan, then Director of the Indonesian Hospital in north Gaza, in February 2025 showing damage to hospital equipment following an Israeli attack on the facility a few months prior. In July 2025, Dr. Sultan was killed in an Israeli strike on the apartment where he was sheltering with his family. Credit: PHR/GHRC

BRATISLAVA, Jan 14 2026 (IPS) – Israel must lift all restrictions on medicine, food and aid coming into Gaza, rights groups have demanded, as two reports released today (Jan 14) document how maternal and reproductive healthcare have been all but destroyed in the country.

In two separate reports released jointly, Physicians for Human Rights (with the Global Human Rights Clinic at the University of Chicago Law School) and Physicians for Human Rights–Israel (PHR-I) show how the war in Gaza has led to rising maternal and neonatal mortality, births under dangerous conditions, and the systematic destruction of health services for women in Gaza.

The reports from the two groups, which are independent organizations, provide both detailed clinical analysis of the collapse of Gaza’s health system and its medical consequences as well as firsthand testimonies from clinicians and pregnant and breastfeeding women in Gaza forced to live and care for their newborns in extreme conditions.

And the organizations say that with conditions improving only marginally for many women despite the current ceasefire, Israel must roll back restrictions placed on aid and immediately help ensure people in Gaza get access to the healthcare they need.

“Israel’s destruction of Gaza’s health infrastructure, combined with untreated malnutrition resulting from restrictions on food and medical supplies, including baby formula, has created an environment in which the fundamental biological processes of reproduction and survival have been systematically destroyed, resulting in known and foreseeable harm, pain, suffering, and death,” Sam Zarifi, Physicians for Human Rights (PHR) Executive Director, said.

“Israel must immediately allow food and essential medical material to enter Gaza with a proper medical plan for helping the besieged population,” he added.

Israeli military operations following Hamas’s attack on Israel on October 7, 2023, have left massive destruction across Gaza, including to healthcare facilities. According to UNICEF, 94 percent of hospitals have been damaged or destroyed.

1.Destroyed incubators and equipment at the Kamal Adwan Hospital Neonatal Intensive Care Unit in north Gaza, following the targeting and raid of the facility by the Israeli forces in December 2024. Credit: PHR/GHRC

Destroyed incubators and equipment at the Kamal Adwan Hospital Neonatal Intensive Care Unit in north Gaza, following the targeting and raid of the facility by the Israeli forces in December 2024. Credit: PHR/GHRC

Maternal and reproductive healthcare has suffered. Before the war, Gaza had eight neonatal intensive care units with 178 incubators. Today, the number of incubators has dropped by 70 percent. In the north, there were 105 incubators across three NICUs, now there are barely any functional units remaining, UNICEF told IPS.

It says that the numbers of low birth weight babies have nearly tripled compared to pre-war levels and the number of first-day deaths of babies increased by 75 percent.

The PHR and PHR-I reports paint a similar picture.

The PHR report, which focuses on the period between January 2025 and October 2025 when a ceasefire was agreed, details how between May and June last year, the Palestinian Ministry of Health reported a 41 percent decrease in the birth rate in Gaza compared to the same time period in 2022; there was a significant increase in miscarriages that affected more than 2,600 women, and 220 pregnancy-related deaths that occurred before delivery.

The ministry also reported a sharp increase in premature births and low birth weight cases; over 1,460 babies were reported to be born prematurely, while more than 2,500 were admitted to neonatal intensive care. Newborn deaths also increased, with at least 21 babies reported to have died on their first day of life.

Meanwhile, the PHR-I report includes personal testimonies illustrating the severe problems pregnant women and women with newborns have faced in Gaza during the war, from lacking safe routes to care and being forced to give birth in unsanitary, dangerous conditions to battling hunger and severe food shortages as they try to breastfeed their children.

One woman, Samah Muhammad Abu Mustafa, a 30-year-old mother of two from Khuza’a, Khan Youni, described how when her contractions began in the middle of the night, because there were no vehicles and very few ambulances, which are reserved for shelling or other critical emergencies, she had to walk a long distance through rain. When she eventually reached the hospital, she said it was “horrifying.”

“I swear, one woman gave birth in the corridor, and her baby died. It was very crowded, and the doctors worked nonstop. I felt as though I could give birth at any moment. After giving birth to my eldest daughter, I was told I should not deliver naturally again because my pelvis was too narrow. Despite this, the doctors said I would have to deliver naturally because a cesarean section required anesthesia, and there was not enough available. I stood for three hours until it was finally my turn, without sitting even for a moment,” she said.

But despite the October 2025 ceasefire, massive problems remain with women’s access to and the provision of, maternal and reproductive healthcare in Gaza.

“Maternal health units in Gaza are largely non-functional and face critical shortages of essential medicines, consumables, and equipment,” Lama Bakri, project coordinator in the Occupied Territories Department at PHR-I, told IPS.

“Neonatal and diagnostic equipment remains scarce or blocked, including portable incubators for premature and low-birth-weight newborns. Although some aid has entered since the ceasefire, these gaps are not being addressed at the scale required, and meaningful improvement in the immediate future remains unlikely.”

Malnutrition also remains a serious problem.

“The ceasefire has allowed us to significantly scale up our nutrition response, but we are still treating pregnant and breastfeeding women for acute malnutrition in alarmingly high numbers,” Ricardo Pires, Communication Manager, Division of Global Communications & Advocacy at UNICEF, told IPS.

He said that between July and September 2025 about 38 percent of pregnant women screened were diagnosed with acute malnutrition.

“In October alone, we admitted 8,300 pregnant and breastfeeding women for treatment, about 270 a day, in a place where there was no discernible malnutrition among this group before October 2023,” he added.

UNICEF has documented almost 6,800 children admitted for acute malnutrition treatment in November 2025 compared to 4,700 cases in November 2024. So far, the number of admitted cases more than doubled in 2025 compared to 2024: almost 89,000 admissions of children to date in 2025, compared to 40,000 cases in 2024, and almost none before 2023.

“What we’re seeing is that no child meets minimum dietary diversity standards, and two-thirds of children are surviving on just two food groups or less. Around 90 percent of caregivers reported their children had been sick in the previous two weeks, which compounds the malnutrition crisis,” Pires said.

And there are fears for the longer-term demographic future of Gaza given the damage to maternal and reproductive healthcare.

“For Gaza’s demographic future, the implications are serious. Even with reconstruction, we will be dealing with a generation of children who were scarred before they took their first breath, children who may face lifelong health complications, developmental challenges, and the effects of stunting. The rebuilding must start now, but we should be clear-eyed: the damage to maternal and newborn health will echo for years, potentially decades,” said Pires.

But others say that with cooperation between international actors and the right political will, the situation need not remain so dire.

“To rehabilitate the population after everything that has happened is going to be a real issue, [but] now there is a Board of Peace, the needs of pregnant women and maternal and reproductive healthcare can be prioritized,” Zarifi told IPS.

“The capacity and the will exist among Gazans and Gazan healthcare workers to rebuild the healthcare system, including maternal and reproductive health services,” added Bakri. “The primary obstacle is not technical or professional but political: Israel’s control over Gaza’s borders and the restrictions on the entry of essential equipment, medical supplies, and reconstruction materials. With unrestricted access to what is needed to rehabilitate hospitals, rebuild destroyed units, and restock essential medicines, recovery is entirely feasible. Whether maternal and reproductive healthcare can return to pre-war levels depends on sustained international pressure to allow that access.”

Although some aid has entered since the ceasefire, these gaps are not being addressed at the scale required, and meaningful improvement in the immediate future remains unlikely.

However, while both NGOs like PHR and PHR-I and others, alongside international bodies like the UN, stress that any recovery and reconstruction in Gaza requires the ceasefire to hold and consolidate, repeated violations underline its fragility, and the effect that has on women.

Meanwhile, PHR and PHR-I point out that extreme weather and ongoing Israeli restrictions on medicine and food getting to Gaza to this day continue to severely affect pregnant women, new mothers, and babies. On top of this, Israel has also announced it will bar 37 international aid groups from working in Gaza, potentially compounding the problems.

Bakri said such measures were jeopardizing what small gains had been made since the ceasefire and “raise serious concerns about whether the situation can improve.”

“Even after the ceasefire, while bombardment has decreased, the reality these women face remains catastrophic – not only for their bodies and well-being but for the survival of the entire society,” said Bakri.

Zarifi added, “We are worried that the restrictions placed by Israel on some of the major actors in the humanitarian response will hamper access to assistance for those that need it. We have raised questions with the Israeli government as to why specific medicines are not allowed to be brought into Gaza and they say that they are not stopping them from being brought in but they can be brought in by commercial means. That is hard for people who can barely put any money together. These medicines should definitely be coming in through humanitarian channels.”

He also highlighted how important the issue of accountability is in ensuring any progress is made in rebuilding healthcare in Gaza and also limiting the probability of similar devastation in the future.

Both reports concluded that the harms caused by Israeli attacks are not isolated incidents but part of an ongoing pattern of systematic damage to the health of women and their children in Gaza, amounting to reproductive violence.

Israel has denied this and said that attacks on hospitals in Gaza have been because the medical facilities are being used by Hamas, and it has maintained that its forces adhere to international law.

While under international law healthcare facilities have special protection even in war, and attacks on them are prohibited, that protection is lost if they are deemed to fulfill criteria to be considered military objectives, such as housing militaries and arms.

However, any attack on them must still comply with the fundamental principles of distinction, proportionality and precautions in attack and failure to respect any of these principles constitutes a breach of international humanitarian law, according to the UN.

“These attacks are part of a deliberate policy designed to create a domino effect of suffering. From starvation and militarized aid distribution by the GHF, to lack of access to clean water, repeated displacement orders, living in shelters under continuous bombardment, and exposure to infections, disease, and harsh weather, the attacks on maternal and reproductive healthcare are another piece of this puzzle. Together, these conditions were created to systematically destroy the fabric of life in Gaza and reduce the population’s ability to survive,” said Bakri.

“The Israeli government has justified attacks on healthcare facilities by saying this was a problem caused by Hamas. We haven’t had an indication of this but it might be true. But in any case there has to be an investigation of these incidents and we hope the Israeli government will carry out such an investigation,” said Zarifi.

“But what is really alarming to us is that the norms prohibiting attacks on healthcare have been repeatedly violated, and there are also laws governing the protection of women and children that appear to have been violated. The only thing that makes these norms work is accountability. There has to be accountability for what happened, as it is the only way we can ensure that what has happened won’t happen in other conflicts. Impunity is watched by other actors around the world,” he added.

IPS UN Bureau Report

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Beijing+30: A Culmination of International, Intergenerational Dialogue

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IPS UN: Inside the Glasshouse

Participants at the Non-Governmental Organizations Forum meeting held in Huairou, China, as part of the United Nations Fourth World Conference on Women held in Beijing, China, on 4-15 september 1995. Credit: UN Photo/Milton Grant

Participants at the Non-Governmental Organizations Forum meeting held in Huairou, China, as part of the United Nations Fourth World Conference on Women held in Beijing, China, on 4-15 september 1995. Credit: UN Photo/Milton Grant

UNITED NATIONS, Sep 30 2025 (IPS) – Thirty years since the UN Fourth World Conference on Women in Beijing, the resolve that defined and united the world toward a global agenda for gender equality make it just as relevant in 2025.

The Beijing Conference represents a turning point for the global movement in gender equality. It is marked by the adoption of the Beijing Declaration and Platform for Action, which is still held up as a landmark document in presenting a comprehensive blueprint to achieve gender equality.

The Beijing Conference was just “one stop in a long and continuing journey of feminist advocacy,” said Sia Nowrojee, a Kenyan women’s rights advocate with more than thirty years’ experience.

“Even though it’s thirty years later, it’s absolutely relevant. It was the culmination of twenty years of advocacy and gender equality.” Nowrojee is the UN Foundation’s Associate Vice President of their Girls and Women Strategy division.

The Beijing Conference was the first time that the international community integrated gender equality into the global development and rights agenda. It was recognition that securing the rights and dignities for all women and girls would be integral to achieving widespread development. This was key for the countries that had emerged in the post-colonial era.

Sia Nowrojee, UN Foundation’s Associate Vice President of Girls and Women Strategy. Credit: UN Foundation

Sia Nowrojee, UN Foundation’s Associate Vice President of Girls and Women Strategy. Credit: UN Foundation

The leadership of advocates from the Global South was instrumental to the Beijing PoA. Representatives from Africa, Asia, and Latin America pushed for the measures that make the framework as inclusive as it is. Nowrojee gave the example of girls’ rights being recognized thanks to the efforts of African feminists in the lead-up to Beijing.

Hibaaq Osman, a Somali human rights activist and founder of El-Karama, considers that the Global South activists had been uniquely prepared to participate as they had lived through their countries’ great political upheavals against colonialism and racism.

Osman attended Beijing 1995 as part of the Center of Strategic Initiatives of Women, a civil society network.

Hibaaq Osman, a Somali human rights activist and founder of El-Karama. Credit: UN Foundation

Hibaaq Osman, a Somali human rights activist and founder of El-Karama. Credit: UN Foundation

“For me, as a young woman, I was shocked by the things that I heard. I was raised to believe that everything was a privacy. But to hear a woman speaking for herself and sharing things that I never thought you could share with others, including violence against women… It absolutely opened my eyes and made me see, ‘Oh my god, I can actually share things with other women,’” Osman told IPS.

For Osman, the Beijing conference represented the possibilities of what could be achieved through a shared agenda and a shared sense of hope. The unique energy from that conference drove her advocacy work through groups like the Strategic Initiative for Women in the Horn of Africa (SIHA) and then El-Karama, which is working to end violence against women in the Arab region and South Sudan.

General view of the opening session of the Fourth World Conference on Women in Beijing. Credit: UN Photo/Milton Grant

General view of the opening session of the Fourth World Conference on Women in Beijing. Credit: UN Photo/Milton Grant

Beijing 1995 also provided the expectation of accountability from governments and policy makers if they did not implement the PoA. “That had never happened before. There was a mechanism for the first time…,” said Osman. “You can hold governments and policymakers accountable. But you also have the connection with grassroots. That it was no longer the individual woman that could claim that she was the leader, but having accountability to your own people, I think that whole thing was fantastic.”

“I think the legacy of Beijing 1995 honestly, it gave us a legacy of getting out of our corners and just wide open to the rest of the women. And I think that vision, that framework is still working.”

Delegates working late into the night to draft the Beijing Declaration and Platform for Action. Credit: UNDP/Milton Grant

Delegates working late into the night to draft the Beijing Declaration and Platform for Action. Credit: UNDP/Milton Grant

The success of the Women’s Conferences also demonstrated the UN’s role as a space to build up the gender equality movement, Nowrojee remarked. The UN has also served as a platform for emerging countries to raise their issues to the international community and to shape global agendas on their terms.

Prior to Beijing, the UN World Conference on Women had previously been held in Nairobi (1985), Copenhagen (1980) and Mexico City (1975). These were also key forums for people from all parts of the world to build relationships and for there to be a “cross-pollination of ideas and experiences”, laying down the groundwork for what was later achieved in Beijing.

Nowrojee was 18 years old when she attended the Nairobi 1985 Conference as part of a school/youth delegation. The experience was formative in listening to women’s activists from the region impart their wisdom and insights.

“To see the world’s women come to my home and talk about the fact that we mattered was life-changing for me,” Nowrojee said. “I made friends who I still work with and love and see today. And I think there is that sort of personal part, which is both personally sustaining, but it’s a critical part of feminist movement building.”

Each conference built up momentum that saw no sign of slowing down. Osman and Nowrojee explained that as gains were being made at local, national and global levels, this encouraged those in the movement to act with urgency and go further. This provided them the spaces to learn how to refine the messages for local contexts.

Delegates at the Fourth UN World Conference on Women in Beijing 1995.' Credit: UNDPI /UN Women

Delegates at the Fourth UN World Conference on Women in Beijing 1995. Credit: UNDPI /UN Women

The gains towards gender equality should be noted: the codification of women’s rights around the world, their increased participation in politics and in peace negotiations. Evidence has shown that investing in women’s participation in society through health, education and employment leads to economic growth and prosperity. More women in the workforce mean greater economic gains and stability. Increased social protections for women lead to more stability in communities.

And yet, there was backlash to the momentum. Recent years have seen the rise of anti-rights and anti-gender movements gain greater traction, combined with increasing attempts to strip women of their rights. UN Women has warned that one in four countries are reporting a backlash to women’s rights.

Nowrojee remarked that the autocratic leaders that champion these movements target women’s rights because it threatens their own agenda. “If you are silencing half the human family, and you are hampering their ability to make decisions about their bodies, to participate in political process… these are very, very effective ways of undermining democracy, development, peace and the achievement of all the goals and values that we hold dear.”

“They understand that if you bring women down, you are bringing society down, because women are the core of society,” Osman added.

The modern movements are also well-funded and well-organized. But there is an irony to it in that they use the same tactics that feminist movements have been using for decades by organizing at the grassroots level before moving their influence up to the national level and beyond. But this should not be where activists fall to despair. Instead they should understand, Osman and Nowrojee remarked, that women in this space already know what actions need to be taken to regain lost momentum.

“I’m sure that Sia and I and many, many others who were part of that are also thinking about today and what’s happening, and we know the space for civil society is shrinking,” Osman said. “The space for democracy, human rights, justice, reproductive rights, for all of that, there is absolutely a rollback, But it’s not going to delay us. We are just going to be more sophisticated and ask ourselves “Where are the blocks, how do we build… diverse constituencies?”… So it is hard, but we are not slowing down whatsoever.”

Today, it may seem the pursuit of gender equality is an ongoing struggle that faces the threat of autocratic movements that sow distrust and division. For the people who championed the women’s rights movement and can recall a time before the Beijing PoA, they are all too aware of what is at stake. The leaders in modern movements today need to look back to the past to take lessons, and to take courage.

IPS UN Bureau Report

 

New Report Investigates Violence Against Women and Girls Through Surrogacy, Sparks Global Dialogue

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United Nations Special Rapporteur Reem Alsalem recently released her report on violence against women and girls with a focus on surrogacy, one of the most controversial topics in the medical field.

United Nations Special Rapporteur Reem Alsalem. Credit: UN Photo/Loey Felipe

United Nations Special Rapporteur Reem Alsalem. Credit: UN Photo/Loey Felipe

UNITED NATIONS, Sep 19 2025 (IPS) – A United Nations report calling for the global abolition of surrogacy has sparked intense debate among experts, with critics arguing that blanket bans could harm the very women the policy aims to protect.

Reem Alsalem, the United Nations Special Rapporteur on violence against women and girls, issued a report on violence against women and girls with a specific focus on surrogacy as a form of exploitation. The report, officially titled “The different manifestations of violence against women and girls in the context of surrogacy,” was published on July 14, 2025, and is slated for discussion at the upcoming UN General Assembly session in October.

The report calls surrogacy “direct and exploitative use of a woman’s bodily and reproductive functions for the benefit of others, often resulting in long-lasting harm and in exploitative circumstances.”

It further delves into the danger of surrogacy business models, in particular, which embrace the ambiguity of international law to churn a profit, often at the expense of both the surrogate and the prospective family. Alsalem recommends the abolition of surrogacy and asks member states to “work towards adopting an international legally binding instrument prohibiting all forms of surrogacy.”

One of the largest problems with surrogacy today, according to Senior Lecturer at Swinburne University Jutharat Attawet, is a lack of comprehensive education and legal standards around the practice. This results in social alienation and false conceptions, which worsen exploitation of people who participate in surrogacy—they are not provided adequate resources

Attawet, who specializes in surrogacy healthcare and domestic policy, considers surrogacy itself a beneficial tool for nontraditional family building. However, she acknowledges the steps it has to take to ensure autonomy and respect for surrogates.

Attawet’s research, cited in Alsalem’s report, shows that approximately 1 percent of babies born in Australia are from surrogates, so although the number has doubled over the past decade, doctors are not familiar with the process. Furthermore, legislation is primarily top-down rather than region- or area-specific. Since doctors in places like Australia are “intimidated by the language” surrounding surrogacy due to minimal education, they are less willing to openly engage with the procedures. This pushes families to seek surrogates elsewhere, where laws are less stringent and doctors more comfortable with the procedures.

Another incentive for overseas surrogacy, Attawet says, is lack of national support for surrogacy. Since it does not fulfill the criteria of most healthcare insurance plans, prospective parents often seek a more affordable surrogacy birth internationally. This further contributes to the exploitation both she and Alsalem note in their respective research—international surrogacy is much more difficult to regulate between different countries’ laws and often primarily harms the surrogate and the child, who is less likely to know their birth mother from an international surrogacy.

Alsalem criticized the practice of international surrogacy as an exploitative technique to perpetuate wealth inequality between different countries, but many experts argue that the job is one of the few accessible, well-paying jobs for child-bearing people who need to care for their family full-time. Polina Vlasenko, a researcher whose work was also cited in Alsalem’s report, explained to IPS that international surrogacy in Ukraine and the Republic of Georgia “is the type of job you can combine with having a kid and being a full-time caretaker of your kid… it still benefits women.”

Vlasenko elaborated, saying that most workers in the surrogacy industry, including intermediaries and clinicians, were women who had some sort of pre-existing connection to the process—often being former surrogates. To ban surrogacy entirely, Vlasenko argues, would merely harm women in all facets of the industry rather than resolving wealth gaps. She said, “this inequality is much deeper than services of surrogacy.”

Social worker and professor at Ohio State University Sharvari Karandikar similarly opposes the Special Rapporteur’s recommendation of abolition. In an interview with IPS, Karandikar explained that “in countries like India, it’s really hard to implement policies in a uniform way, and I think that one needs to have proper oversight of medical professionals and how they’re engaging in surrogate arrangements and medical tourism. Blanket bans do not work.”

She emphasized the dangers of surrogacy without regulation, saying it would only do more harm.

Instead, Karandikar advocates for “the safety, the better communication, more education, more informed choice and decision, more safeguards, better treatment options, and long-term health coverage for women who engage in surrogacy” as “a wonderful way to speak about women’s choices, decisions and their health instead of penalizing anyone.”

However, in order for the global conversation surrounding surrogacy to center around female agency, experts like Vlasenko say the perception of surrogates needs to change. She said, “sex work is not seen as violence or exploitation when it’s done for free… it’s the same with childbirth… surrogate mothers are taking the only work that, in their situation, allows them to fulfill certain responsibilities like childcare and income generation. They think that they’re agents in this process, but society sees them as victims.”

Ultimately, the surrogacy debate reflects broader questions about women’s autonomy, economic inequality and reproductive rights. As Vlasenko noted, addressing the “much deeper inequality” that pushes women to surrogacy may prove more effective than focusing solely on limiting the practice itself.

IPS UN Bureau Report

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Hypertension and Diabetes Grows Among India’s Poor Communities

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Health

A patient being checked for BP at Mann PHC. Credit: Rina Mukherji/IPS

A patient being checked for BP at Mann PHC. Credit: Rina Mukherji/IPS

MANN, India, Aug 26 2025 (IPS) – Generally thought to be diseases of the wealthier classes, non-communicable diseases (NCDs) like hypertension and diabetes are on the rise among India’s underprivileged working classes in semi-urban and rural sprawls.

Take the case of Mohan Ahire. A middle-aged gardener in Pune, Mohan never realized that the heaviness in his head was a symptom of hypertension. Last summer, a mid-morning visit to the market saw him fall unconscious on return. Upon regaining consciousness, his wife and sons discovered the paralysis on the right side of his body, leading doctors to diagnose it as a stroke.

Bahinabai Gaekwad, a 56-year-old sweeper in Mann village, was at work when she suddenly collapsed and died. Doctors from the Primary Health Centre (PHC) next door found that she had been suffering from undiagnosed hypertension for a long time. The ailment ultimately led to a fatal cardiac arrest.

The worst problem is that most patients from underprivileged sections are not aware of their health condition.

Praful Mahato, a migrant laborer from Balasore in Odisha, who is currently employed in a dhaba (roadside eatery) in Mann, a fast-industrializing rural outpost of Pune city, had been suffering from heaviness and dizzy spells for some time. But he attributed his symptons to long hours at work and resulting fatigue. A chance visit to a medical camp confirmed high blood pressure and diabetes. Since the last four months, medication has controlled his blood pressure and brought down his sugar level.

Jagdish Mondol, in his 50s, did not realize he had hypertension and diabetes until he needed to undergo a hernia operation at a government hospital in Bhadrak, Odisha. This was despite blurred vision and difficulty in walking. Thankfully, the operation got him to wake up to his health condition. Regular medication has now improved his blood pressure and sugar level.

Fortunately, some patients may seek help on their own. Lalita Parshuram Jadhav, a 40-year-old migrant construction worker from Yavatmal, is one such. “Since the last two years, I have been experiencing pain in my legs; it became quite acute over the past year,” she tells IPS. A medical check-up confirmed hypertension and high sugar levels.

India’s Hypertension and Diabetes Epidemic

The cases cited above exemplify the rising burden of India’s non-communicable disease (NCD) of Hypertension and Diabetes. Ranked among the top ten NCDs responsible for untimely deaths worldwide, these two diseases are interlinked. This means those with hypertension are also vulnerable to developing prediabetes and diabetes.

According to the World Health Organization (WHO), an estimated 1.28 billion adults in the 30-79 age group suffer from hypertension, with two-thirds of them living in low- and middle-income countries. Yet, only 21 percent of those affected have their hypertension under control, while around 46 percent of these remain unaware of their condition and remain undiagnosed and untreated.

Diabetes, notably, can be of two varieties. Type 1 Diabetes is a congenital condition, while Type 2 diabetes is a lifestyle disease that develops later in life. South Asians, Pacific Islanders, and Native Americans have a significantly higher risk of developing the disorder.

The International Diabetes Federation (IDF) recorded a dramatic increase in the number of people affected by Type 2 Diabetes globally since the 1990s, and since 2000, the rise has been dramatic. In India, there are an estimated 77 million people above the age of 18 years suffering from diabetes (type 2), while nearly 25 million are prediabetic (at a higher risk of developing diabetes in the future). Yet, more than 50 percent of these are unaware of their diabetic status.

In India, the prevalence of Diabetes rose from 7.1 percent in 2009 to 8.9 percent in 2019. Meanwhile, 25.2 million adults are estimated to have Impaired Glucose Tolerance (IGT), a prediabetic condition that is estimated to increase to 35.7 million in the year 2045. It is also estimated that approximately 43.9 million people suffering from diabetes remain undiagnosed and untreated in India, posing a major public health risk.

It is a matter of concern that most deaths from these diseases occur in the 30- to 70-year-old age group, posing a major economic loss.

In Mann, doctors at primary health centers (PHCs) are battling this scourge, with hypertension affecting around 28 percent of the population and 12 percent being diabetic. The scenario is similar to that at Mullaheera, in rural Haryana, located just outside the national capital region of Delhi.

Dr. Sona Deshmukh, from the People-to-People Foundation, which is collaborating with the Government of India on its Viksit Bharat @2047 initiative and the in-charge for the Pranaa Project, tells me, “Diabetes is common among the older population, but hypertension is rising among the youth.”

Dangers Posed by Hypertension and Diabetes

The problem with both Hypertension and Diabetes is socio-cultural, with most people viewing these diseases as benign. Yet, ignoring them can lead to paralytic strokes and ultimately, death.

Characterized by headaches, blurred vision, nosebleeds, buzzing in the ears, and chest pain,  uncontrolled and untreated hypertension can lead to—

  • chest pain (also termed angina);
  • heart attack, which occurs when the blood supply to the heart is blocked and heart muscle cells die from lack of oxygen.
  • heart failure, which occurs when the heart cannot pump enough blood and oxygen to other vital body organs; and
  • sudden death due to irregular heartbeat.

This is because excessive blood pressure can harden arteries, decreasing the flow of blood and oxygen to the heart. This elevated pressure and reduced blood flow can result in the complications listed above, besides bursting or blocking arteries that supply blood and oxygen to the brain, causing a stroke. It can also cause kidney damage, resulting in kidney failure.

In the case of Diabetes, the body is unable to either produce or use insulin effectively. While individuals with Type I diabetes have a congenital condition wherein the insulin-producing cells in the pancreas are attacked and destroyed, patients with Type II diabetes—which is a preventable lifestyle-related disease—either do not produce enough insulin or are unable to use insulin effectively for the body’s needs. Uncontrolled diabetes can lead to blindness and organ failures that affect the kidneys, heart, and nerves, ultimately leading to diabetic strokes and death.

Reasons Behind the Spurt

So, what are the reasons behind the spurt? Government Medical Officers Dr. Mayadevi Gujar and Dr. Vaishali Patil say, “The transition of many rural outposts into semi-urban industrialized zones has brought in lifestyle changes. Locals, who once partook of healthy home-cooked millets or cereals, now eat cheap, oily snacks from wayside kiosks cooked in reused palm oil. With more disposable income, workers lean towards sugary soft drinks and fast food, making them prone to diabetes. Addictions like tobacco and alcohol are on the rise. Tobacco-chewing remains common to both men and women in rural India.”

Additionally, with climate change affecting agricultural incomes in rural India, the younger generation is stressed with employment issues. These make a potent recipe for hypertension and diabetes.

Dr. Sundeep Salvi, a noted specialist in cardiovascular diseases, who heads the Pulmocare Research and Education (PURE) Foundation and has chaired the respiratory group for the Global Burden of Disease Study, adds, “Unlike in the past, people eat and sleep late, watch late-night television, drink endless cups of tea and coffee, and work late hours. Skipping meals is common, with little time for exercise. Sleep deprivation is a fallout of this. Stress and inadequate sleep are a deadly combination, feeding hypertension and diabetes.”

Salvi calls for hydration and good nutrition to stave off hypertension and diabetes. “Excess tea and coffee are harmful. Caffeine-present in tea and coffee-is a diuretic; it prevents hydration. A dehydrated constitution results in hypertension and diabetes, which, in turn, cause heart disease, stroke, kidney diseases, and eventually, death.”

He also views air pollution as a major risk.

“By air pollution, I am referring to both indoor and outdoor pollution. In rural areas, the burning of crop waste causes outdoor pollution. But indoor pollution in rural homes and urban slums is 5–10 times greater than outdoor pollution. High levels of particulate matter contribute to 20 percent of the global burden of diabetes, as well as hypertension.

Diabetologist and Director of the Diabetes Unit at Pune’s KEM Hospital Prof. Chittaranjan Yajnik, who has been working on this issue for over two decades, has an interesting take on the matter based on his findings.

Yajnik sees a direct correlation between vulnerability to diabetes and poor intrauterine growth.

“Poor intrauterine growth reflects in poor organ growth, especially of the infra-diaphragmatic organs (liver, pancreas, kidneys, and legs), reducing their capacity to perform adequately in later years. Such individuals, when faced with overnutrition and calories later in life, end up with prediabetes and diabetes.”

Yajnik’s research found that two-thirds of prediabetic girls and a third of the prediabetic boys were underweight at birth.

“These findings are suggestive of a ‘dual teratogenesis’ concept, which envisages a combination of undernutrition and overnutrition over a life course due to rapid socio-economic and nutritional transition…” This means intrauterine programming of diabetes needs to be supported in growth-retarded babies since metabolic abnormalities develop very early in life.

Yajnik certainly has a point, since anemia in expectant mothers and low birthweight babies is a major problem all over India. The National Family Health Surveys conducted over the years by the Government have shown a persistently high prevalence of fetal growth restriction in Indian babies. This phenomenon is linked to low birth weight in newborns, which is as high as 18.24 percent, according to the latest data.

The Solution

Recently, the Ministry of Health and Family Welfare (MOHFW) of the Government of India has implemented several schemes nationwide at the primary health level, starting with nutrition, medical care, and immunization for pregnant mothers while ensuring institutional delivery. Offspring are also extended comprehensive help for the 4 D’s (defects at birth, diseases, deficiencies, and developmental delays), immunization, supplementary nutrition, and WASH interventions. These continue through adolescence to prepare a healthy population for reproductive age.

Meanwhile, weekly wellness sessions have been introduced all over India. Deshmukh adds, “Regular screenings for hypertension and diabetes are done every few months for early detection and follow-up. Counselling sessions encourage people to adopt healthier lifestyles, while Yoga is being popularized through events like the International Yoga Day.”

These initiatives, one hopes, will arrest the epidemic.

IPS UN Bureau Report

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Aid Funding Crisis Means Parliamentarians’ Visionary Leadership Even More Crucial

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Africa, Asia-Pacific, Civil Society, Climate Change, Conferences, Development & Aid, Economy & Trade, Editors’ Choice, Featured, Gender, Headlines, Health, Humanitarian Emergencies, Middle East & North Africa, Population, Sustainable Development Goals, TerraViva United Nations, Women’s Health, Youth

Population

Dr. Alvaro Bermejo, Director General of the International Planned Parenthood Federation (IPPF) addresses the Let's Discuss the Future of Africa Together seminar that took place last week (August 21) on the sidelines of TICAD9 in Yokohama City, Japan. Credit: APDA

Dr. Alvaro Bermejo, Director General of the International Planned Parenthood Federation (IPPF) addresses the Let’s Discuss the Future of Africa Together seminar that took place last week (August 21) on the sidelines of TICAD9 in Yokohama City, Japan. Credit: APDA

YOKOHAMA CITY, Japan & JOHANNESBURG, South Africa, Aug 25 2025 (IPS) – As funding for sexual and reproductive health rights was on a “cliff edge,” parliamentarians now needed to play a “visionary” leadership role because “financing strong, resilient health systems for all their people rests with governments,” said Dr. Alvaro Bermejo, Director General of the International Planned Parenthood Federation (IPPF).

He was speaking at the Let’s Discuss the Future of Africa Together seminar that took place last week (August 21) on the sidelines of TICAD9 in Yokohama City, Japan.

The session was organized by the Asian Population and Development Association (APDA), in collaboration with the Forum of Arab Parliamentarians for Population and Development (FAPPD) and the African Parliamentary Forum on Population and Development (FPA).

He told parliamentarians that their role is most critical.

“Africa’s health faces a serious challenge: According to WHO’s latest analysis, health aid is projected to decline by up to 40% this year compared to just two years ago. This is not a gradual shift—it is a cliff edge,” Bermejo said. “You know as well as I do that lifesaving medicines are sitting in warehouses, health workers are losing jobs, clinics are closing, and millions are missing care.”

While this reality was outrageous, it needed to be adapted to.

“And in this crisis lies an opportunity—an opportunity to shake off the yoke of aid dependency and embrace a new era of sovereignty, self-reliance, and solidarity,” with a clear mission to protect the health and lives of women and vulnerable populations through delivering high-quality sexual and reproductive health services.

Parliamentarians engaged in debates during a policy dialogue seminar organised by the Asian Population and Development Association (APDA), in collaboration with the Forum of Arab Parliamentarians for Population and Development (FAPPD) and the African Parliamentary Forum on Population and Development (FPA). Credit: APDA

Parliamentarians engaged in debates during a policy dialogue seminar organized by the Asian Population and Development Association (APDA), in collaboration with the Forum of Arab Parliamentarians for Population and Development (FAPPD) and the African Parliamentary Forum on Population and Development (FPA). Credit: APDA

This seminar and another in the series, Policy Dialogue on the Africa-Japan Partnership for Population and Development, were both supported by the UN Population Fund (UNFPA) Arab States Regional Office (ASRO), the Japan Trust Fund (JTF) and IPPF.

During the discussions, a wide range of topics about population dynamics in Africa and Africa-Japan cooperation were discussed.

In his opening remarks, Ichiro Aisawa, a member of the House of Representatives of Japan, told the seminar it was necessary to take joint action across borders and generations.

“Youth holds the key to unlocking Africa’s future. By 2050, it is predicted that approximately 70 percent of Africa’s population will be under the age of 30. As African countries enter a demographic dividend period, the role played by parliamentarians in each country will be extremely important.

Aisawa said it was necessary to listen to the voices of the community in addressing issues related to youth empowerment, gender equality, and sexual and reproductive health (SRH).

Parliamentarians should take “concrete action through legislation and policies; it is essential to harnessing the potential of young people, directly linking them to social and economic growth, and creating a society in which no one is left behind.”

Yoko Kamikawa, Chairperson of Japan Parliamentarians for Population (JPFP), addresses a seminar for African and Asian parliamentarians on the sidelines of the TICAD9 in Yokohama City, Japan. Credit: APDA

Yoko Kamikawa, Chairperson of Japan Parliamentarians for Population (JPFP), addresses a seminar for African and Asian parliamentarians on the sidelines of the TICAD9 in Yokohama City, Japan. Credit: APDA

During the discussions, representatives from Africa gave examples of how Japan had supported their health initiatives, especially important in a climate of decreasing aid.

Maneno Zumura, an MP from Uganda, said what compounded the issues in her country and in Africa was “the changes in climate. The unpredicted climate has affected agricultural activities by 40 percent, especially in drought-prone areas of the country.” This had resulted in nearly a quarter (24 percent) of children experiencing malnutrition.

However, she noted that Japan had made considerable contributions to education and health.

“As we assess Uganda’s development and Japan’s impact, it’s clear that sustainable progress thrives on global solidarity and local governance. Key achievements include a 62 percent rise in women’s incomes through cooperatives, a 50 percent drop in maternal mortality in refugee settlements, and supporting the road infrastructure and education, illustrating how policy-driven interventions can break cycles of poverty and inequality.”

There were several specific projects she alluded to, including education experts from Japan who contributed to an improvement of the quality of primary education in districts of Wakiso, Mbale, and Arua through the Quality Improvement in Primary Education Project (2021-2023). They also trained 1,500 teachers in participatory teaching methods.

“The Government of Japan supported the vulnerable communities like refugees and host communities by strengthening the social services like health in refugee camps like Rhino Camp,” Zumura continued, including construction of a health center with antenatal facilities serving over 300,000 people in camps of Bidibidi and Rhino Camp. They also trained 200 health workers in the management of childhood illnesses and maternal health care.

Mwene Luhamba, MP, Zambia, said his country was looking forward to partnering with Japan in expanding One-Stop Reproductive Health Services, enhancing parliamentary engagement, and investing in youth programs.

Bermejo said part of the solution to the development issues is to confront constraints.

“Some countries in Africa do need global solidarity, but what Africa needs from the world, more than anything else, is fair terms. We must also confront the structural constraints. Debt service burdens are crowding out social investments. Let us seize this moment, not just to repair but to transform,” he said. “Sexual and reproductive health services save lives. They empower individuals, promote dignity, and drive national development.”

In her closing remarks, Yoko Kamikawa, Chairperson of Japan Parliamentarians for Population (JPFP), said that it was through dialogue across borders and sectors that “we build consensus, strengthen legal frameworks, and ensure that national strategies reflect the voices of all people and empower them—especially women and youth.”

IPS UN Bureau Report

 

HIV/AIDS Funding Crisis Risks Reversing Decades of Global Progress

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Health

About 9.2 million people across the world living with HIV were not receiving treatment in 2024, according to the UNAIDS report. At the launch of the report was Rev. Mbulelo Dyasi, Executive Director of SANARELA. Winnie Byanyima, UNAIDS Executive Director, Aaron Motsoaledi, Minister of Health of South Africa. Juwan Betty Wani, Programme Coordinator, Adolescents Girls and young women Network South Sudan. Helen Rees, Executive Director, Wits RHI. Credit: UNAIDS

About 9.2 million people across the world living with HIV were not receiving treatment in 2024, according to the UNAIDS report. At the launch of the report was Rev. Mbulelo Dyasi, Executive Director of SANARELA. Winnie Byanyima, UNAIDS Executive Director, Aaron Motsoaledi, Minister of Health of South Africa. Juwan Betty Wani, Programme Coordinator, Adolescents Girls and young women Network South Sudan. Helen Rees, Executive Director, Wits RHI. Credit: UNAIDS

UNITED NATIONS, Jul 10 2025 (IPS) – UNAIDS called the funding crisis a ticking time bomb, saying the impact of the US cuts to the President’s Emergency Plan for AIDS Relief (PEPFAR) could result in 4 million unnecessary AIDS-related deaths by 2029.

A historic withdrawal of global HIV/AIDS funding threatens to derail decades of hard-won progress in the fight against AIDS, according to UNAIDS’ annual report, entitled Aids, Crisis and the Power to Transform. This funding shortage – caused by sudden and massive cuts from international donors – is already dismantling frontline services, disrupting lifesaving treatments for millions and endangering countless lives in the world’s most vulnerable communities.

“This is not just a funding gap—it’s a ticking time bomb,” said UNAIDS Executive Director Winnie Byanyima.

Despite major strides in 2024, including a decrease in new HIV infections by 40 percent and a decrease in AIDS-related deaths by 56% since 2010, the onset of restricted international assistance, which makes up 80 percent of prevention in low- and middle-income countries, could have disastrous effects. The report, mostly researched at the end of 2024, concluded that the end of AIDS as a public health threat by 2030 was in sight.

However, in early 2025 the United States government announced “shifting foreign assistance strategies,” causing them to withdraw aid from organizations like the President’s Emergency Plan for AIDS Relief (PEPFAR), which had earlier promised 4.3 billion USD in 2025. PEPFAR is one of the primary HIV testing and treatment services in countries most affected. Such a drastic decision could have ripple effects, including pushing other major donor countries to revoke their aid. The report projected that if international funding permanently disappears, they expect an additional 6 million HIV infections and 4 million AIDS-related deaths by 2029.

At a Press Briefing, Assistant Secretary-General for UNAIDS Angeli Achrekar noted the importance of PEPFAR since its inception in 2003, calling it one of the most successful public health endeavors. She expressed hope that as the US lessens its support, other organizations and countries are able to take up the global promise of ending AIDS without eroding the gains already made.

Achrekar noted “acute shifts” in a weakening of commitment from countries less directly affected by HIV/AIDS since the US has pulled funding.

UNAIDS also reports a rising number of countries criminalizing populations most at risk of HIV – raising stigma and worsening gender-based violence and non-consensual sex, two of the highest HIV risk-enhancing behaviors. The report showed the primary groups who lacked care were child HIV infections and young women, which is likely related to government campaigns  “attacking HIV-related human rights, including for public health, with girls, women and people from key populations.”

These punitive laws include criminalization or prosecution based on general criminal laws of HIV exposure, criminalization of sex work, transgender people and same-sex sexual activity and possession of small amounts of drugs. These laws have been on the rise for the past few years, and in conjunction with limited funding, the results for HIV/AIDS-positive patients could be fatal.

Recently, scientific breakthroughs have been made regarding long-acting medicine to prevent HIV infection. Health workers have seen tremendous success, both with new technologies like annual injections and the potential for more growth in the form of monthly preventative tablets and in old prevention techniques like condom procurement and distribution and access to clean, safe needles for drug users. However, due to various global conflicts and wars, supply chains have been disrupted, often harming countries not in the thick of the altercation but reliant on products like PrEP, an HIV prevention medication.

Although many countries most afflicted with the AIDS crisis have stepped up, promising more national funding for the issue, and many community networks have doubled down on their efforts, the disruption of supply chains and the lack of international frontline health workers cannot be solved overnight. To entirely restructure how healthcare is provided takes time – something those with HIV do not always have.

Areas like sub-Saharan Africa, which in 2024 housed half of the 9.2 million people not receiving HIV treatment, have been particularly affected by the recent changes. The majority of child infections still occur there, and combinations of “debt distress, slow economic growth and underperforming tax systems” provide countries in sub-Saharan Africa with limited fiscal room to increase domestic funding for HIV.

Despite the loss of funding, significant progress has been made to protect essential HIV treatment gains. South Africa currently funds 77% of its AIDS response, and its 2025 budget review includes a 3.3% annual increase for HIV and tuberculosis programs over the next three years. As of December 2024, seven countries in sub-Saharan Africa have achieved the 95-95-95 targets established by UNAIDS: 95% of people living with HIV know their status, 95% of those are on treatment, and 95% of those on treatment are virally suppressed. UNAIDS emphasized the importance of this being scaled up to a global level.

Achrekar observed, referring to countries whose domestic funds towards AIDS have increased, that “prevention is the last thing that is prioritized, but we will never be able to turn off the tap of the new infections without focusing on prevention as well.”

She reiterated the importance of countries most affected by the HIV/AIDS crisis establishing self-sustaining health practices to ensure longevity in both prevention and treatment.

Achrekar praised the global South for their work in taking ownership of treatment while still calling upon the rest of the world to join.

She said, “The HIV response was forged in crisis, and it was built to be resilient. We need, and are calling for, global solidarity once again, to rebuild a nationally owned and led, sustainable and inclusive multi-sectoral HIV response.”

IPS UN Bureau Report

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