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WHO: ‘Long COVID’ may obstruct return to normal life for 36 million Europeans

This summer will be “the first in more than three years that many of us will enjoy without the looming threat of COVID-19”, but the life-threatening virus has not gone away completely, said WHO’s regional director for Europe, Hans Kluge, told reporters at a virtual press conference from Copenhagen.

Each week, the coronavirus causes at least 1,000 new deaths across the region every week, he said, outlining other health concerns at the start of the holiday season.

Coping with “long COVID”

Over the first three years of the global health emergency, 36 million people across the region may have experienced “long COVID”, a complex condition that scientists still know very little about, according to data from WHO’s partner, the Institute for Health Metrics and Evaluation at the University of Washington in the United States.

“That’s approximately one in 30 Europeans over the past three years,” explained Dr. Kluge, underscoring that those affected may still be finding it hard to return to “normal life”.

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Besides harming people in its protracted form, “COVID-19 exploited an epidemic of diseases, including cancers, cardiovascular disease, diabetes, and chronic lung illnesses, which account for 75 per cent of mortality in our region today,” he said, reiterating WHO’s call for more research to develop comprehensive diagnostics and treatment for long COVID.

Response to the threat

Dr. Kluge encouraged all eligible, especially those of vulnerable groups, to get vaccinated against COVID-19.

“We should ensure at least 70 per cent vaccine coverage for these groups, including both primary and additional booster doses,” he said.

He also advocated for more physical activity and a healthier lifestyle. Undertaking, if possible, 25 minutes of moderate exercise a day, quitting smoking, reducing alcohol consumption, and limiting salt intake could significantly increase one’s resilience to both infectious and non-communicable diseases, he added.

Extreme heat warnings

Readying Europeans for the summer, Dr. Kluge warned about months of possible extremely hot weather ahead which, according to the European Union and the World Meteorological Organization, is becoming the norm, not the exception.

“Last year in our region, extreme heat claimed 20,000 lives between June and August,” he said.

Limiting outdoor activity, staying hydrated, keeping homes cool, and having more time to rest are some of the ways to survive the heat, he said, asking people to “look out for each other” and to check in on elderly relatives and neighbours.

Containing mpox

A recent resurgence of mpox infections appeared in the United States and then in Belgium, Netherlands, Spain, and the United Kingdom, Dr. Kluge said .

While only 22 new mpox cases were recorded in the European region during the month of May, he suggested that people in high-risk groups get vaccinated, limit contact with others in the case of symptoms, and avoid close physical contact, including sexual, with someone who has mpox. 

Welcoming the United Kingdom’s efforts to continue its vaccination programme, he urged other countries to further reduce barriers to testing, vaccination, and care for persons in high-risk groups.

Sudan: Displacement soars amid shrinking humanitarian access

“We’ve already seen over 560,000 people crossing into neighbouring countries…[and] nearly two million people displaced internally,” said Raouf Mazou, UNHCR’s Assistant High Commissioner for Operations, following a visit to Sudan.

Since conflict erupted there on 15 April when rival militaries clashed, more than half a million people have reached neighbouring countries in a bid to escape the fighting, with Egypt receiving the most refugees followed by Chad, South Sudan, Ethiopia, and the Central African Republic. 

Reaching one million marker

Based on the continuing violence, the UN agency now expects that its previous estimate of one million refugees will be surpassed.

In response to the crisis, UNHCR and other UN agencies, humanitarian partners, and host communities have increased efforts to provide emergency shelter, clean water, health care services, psychosocial support, and other vital assistance to help displaced populations inside and outside Sudan. 

Host communities unaffected by the conflict until now are also “seeing the consequences”, Mr. Mazou said.

“All are in need of protection and assistance,” he added. “What is also quite striking, and which needs to be underlined, is how welcoming the host populations are.”

West Darfur horror

Although violence has erupted across multiple fronts, UNHCR raised particular concerns about West Darfur. Aid access is “limited” amid reports of “wanton killings” by militia that the UN human rights office, OHCHR, has condemned.

Bordering West Darfur, Chad has seen 170,000 people crossing its borders to flee the conflict, according to the UN refugee agency. Many, including women and children, have arrived needing treatment for their injuries, the agency said. 

At the same time, the rainy season has thwarted aid workers from reaching those crossing the border and transporting them to refugee camps, the agency said.

Tents have been set up at the Gorom refugee camp in South Sudan to host new arrivals from Sudan.
© UNHCR/Charlotte Hallqvist

Tents have been set up at the Gorom refugee camp in South Sudan to host new arrivals from Sudan.

South Sudan returnees

More than 120,000 people crossed the border into South Sudan, where sparse infrastructure and security concerns represent significant challenges that are preventing new arrivals from moving on, the agency warned. Much of the assistance they need will have to be airlifted, which is both costly and complex. 

Meanwhile, UNHCR teams are registering new arrivals, providing them with emergency relief, and helping them to reach different locations as quickly as possible.

Most of the arrivals are South Sudanese, returning to their country, Mr. Mazou said.

“They are part of the 800,000 South Sudanese refugees who were in Sudan, but they are now going back,” he said.

Strained resources

Capacity at border reception and transit facilities in neighbouring countries have been strained by the sheer numbers of people arriving, leading to overcrowding and further stretching of already limited resources, the UN refugee agency said.

Those fleeing Sudan arrive exhausted after days or sometimes weeks on the road, shocked by the violence they have witnessed and in need of food, medical care, and relief items, UNCHR reported.

During a donor conference for Sudan in Geneva on 19 June, $1.52 billion in pledges were received against an appeal for $3 billion to address the current situation.

Learn more about how UNHCR is helping the people of Sudan and those fleeing the violence here.

Legal protection essential for people displaced by climate change: UN expert

“The effects of climate change are becoming more severe, and the number of people displaced across international borders is rapidly increasing,” said Ian Fry, independent human rights expert on climate change, who took up the new post last year. 

“In 2020 alone, 30.7 million people were displaced from their homes due to weather-related events. Droughts were the main factor,” Mr. Fry said in his latest thematic report to the Human Rights Council in Geneva. “We must take immediate steps to give legal protection to these people.”

Multiple rights violations 

The independent expert said that people displaced by climate change face multiple human rights violations including of their rights to food, water, sanitation, housing, health, education and, for some, their basic right to life.

“The human rights implications of climate change displacement, in particular across international borders, are significant and truly disturbing,” the expert said.

He called it “profoundly worrying” that large numbers of people displaced across borders, die or go missing every year on both land and sea. 

More than 50,000 lost their lives during migratory movements between 2014 and 2022. “It is equally shocking to note that more than half of those deaths occurred on routes to and within Europe, including in the Mediterranean Sea,” he said.

Displacement and natural disasters 

According to the independent expert, displacement due to climate change can take many different forms.

It can involve sudden events or more slow acting factors such sea level rise or drought. Most people affected by these events feel they have no choice but to move. Women and children are the most impacted by disasters and the effects of climate change, and also account for the majority of displaced people.

“The international community must realise its responsibility to protect people displaced across borders by climate change impacts,” the expert said.

Legal protection

Mr. Fry explained that the world was not operating in a total vacuum in terms of legal protection safeguards, with several options already in place.

“The Human Rights Council should prepare a resolution for submission to the UN General Assembly urging the body to develop an optional protocol under the Convention relating to the Status of Refugees to address displacement and legal protection for people all over the world affected by the climate crisis,” the expert said.

“Until then, I urge all nations to develop national legislation to provide humanitarian visas for persons displaced across international borders due to climate change, as an interim measure,” he said.

Independent experts and other UN Human Rights Council-appointed rights experts, work on a voluntary and unpaid basis, are not UN staff, and work independently from any government or organisation.

Torture as a weapon of war must cease, rights experts demand

Today, more than 100 armed conflicts are raging worldwide, devastating communities, winding back development, and leading to grave violations of human rights. 

Ranging from severe beatings to sexual humiliation and rape, torture is widely used as a means of war. And often, torture involves the use of tools or instruments, mock executions, and forcing victims to watch family members also being tortured, said the UN human rights chief Volker Türk.

Torture happens in both official detention centres as well as secret sites, away from any scrutiny.

In a video address Mr. Türk, UN High Commissioner for Human Rights, recalled meeting a victim of torture whose harrowing story left an indelible mark: “It revealed the horror of what human beings are capable of inflicting on one another. He will carry that deep trauma for the rest of his life.”

Zero-tolerance to torture

Torture is a serious crime, unequivocally prohibited under international law, and never justified under any circumstances.

Under the UN Convention against Torture all States must investigate and prosecute allegations of torture, as well as cruel, inhuman, or degrading treatment. They are obligated to prevent torture through every possible means

“Yet in almost all cases, the people who ordered and commit the crime of torture escape justice”, said the OHCHR chief. 

The Committee against Torture, a body of 10 independent human rights experts that monitors implementation of the Convention, regularly reminds States of their obligations to educate and inform all military personnel, especially those charged with duties related to detention, about the prohibition.

“States must take a zero-tolerance approach in investigating and prosecuting acts of torture committed by their regular armed forces, and those forces under their effective control,” said Claude Heller, the Committee’s chair, “A vital first step in this is the explicit criminalization of torture at the domestic level.”

Help to the victims

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The scale of torture is alarming, with hundreds of thousands of victims spanning prisoners of war, human rights activists, and innocent civilians who can be caught up in random sweeps. Such acts of brutality occur in thousands of locations across countries on every continent, the UN rights chief reminded. 

He said it was especially important to ensure that “torture – wherever it takes place – is documented, investigated, prosecuted and punished.” 

By establishing the facts and seeking accountability, much needed help can be extended to victims of torture.

“Every torture victim has a right to acknowledgement, justice and redress”, said Mr. Türk.

Over four decades ago, the UN Voluntary Fund for Victims of Torture was established to provide social assistance, medical care, psychological support, and to help victims secure justice and deter future acts of torture.

It works with civil society groups in more than 120 countries and has reached over one million survivors. Today, however, the demand for the Fund’s assistance is so high, that thousands of requests for aid have had to be turned down

“We need more funds to match rising demand,” said the rights chief in a tweet. 

Taking away torture tools

The High Commissioner said that another effective way of preventing future cases of torture away from the battlefield, was to go after the trade in instruments of torture.

“I am fully supportive of all efforts to limit trade in items that could be used for torture, including through a new international torture-free trade treaty”, he said. 

Special Rapporteurs and other independent rights experts who serve on commissions or panels, are appointed by the UN Human Rights Council. They are mandated to monitor and report on specific thematic issues or country situations, are not UN staff and do not receive a salary for their work.

Security in eastern DR Congo continues to worsen, Security Council hears

“So far, the ceasefire between the M23 and the FARDC has held up relatively well and has contributed to some security gains”, said UN Assistant Secretary-General for Africa Martha Pobee.

“The relative calm in Rutshuru territory, for example, allowed more than 45,000 people from the Bishusha group to return home”, she said. 

She noted, however, that M23’s withdrawal from territory has been “piecemeal, tactical, and political”, while the armed group still controls much of Masisi and Rutshuru, together with the movement of people and goods in these areas. 

Moreover, its “offensive repositioning in recent weeks” raises fears that hostilities could resume at any time.

Disarming M23

She applauded the efforts of regional leaders to engage the parties concerned in implementing the decisions of the Luanda Road Map and the Nairobi process. She reiterated the readiness of the UN mission in DRC, MONUSCO, to back up Congolese authorities with the “pre-cantonment and disarmament” of the powerful rebel force. 

Ms. Pobee said she was pleased to note that last week, MONUSCO, the East African Community Regional Force and the expanded Joint Verification Mechanism had undertaken a reconnaissance mission to the Rumangabo base, to assess the conditions for beginning the disarmament and demobilization process of M23 in earnest.

“For these efforts to bear fruit, it is urgent that the M23 withdraw completely from the occupied territories, lay down its arms unconditionally and join the Demobilization, Disarmament, Recovery and Community Stabilization Programme,” she added.

She noted the security gains in North Kivu are fragile and overshadowed by the deteriorating situation in Ituri province, which has suffered from the security vacuum created by the redeployment of FARDC to North Kivu.

More than 600 people have been killed by armed groups in the past three months, with CODECO, the Zairean militia and the ADF, being the main perpetrators of these atrocities.

The senior UN official urged all armed groups to “cease hostilities” and called for the redeployment of national security forces, particularly in Ituri, to restore State authority.

In response to the ongoing insecurity in eastern DRC, MONUSCO continues  to “do everything possible to fulfill its mandate to protect civilians.” In Beni, Bunia, Bukavu and Goma, Mission-supported workshops eased tensions and strengthened local capacity to better respond to security challenges, including disinformation. At the same time, the Mission provided direct physical protection for civilians.

To date, between 50.000 and 70.000 displaced people are being protected by MONUSCO forces in the Roe site, located in Djugu territory, Ituri.

Martha Ama Akyaa Pobee, Assistant Secretary-General for Africa in the Departments of Political and Peacebuilding Affairs and Peace Operations, briefs members of the UN Security Council.
UN Photo/Eskinder Debebe

Martha Ama Akyaa Pobee, Assistant Secretary-General for Africa in the Departments of Political and Peacebuilding Affairs and Peace Operations, briefs members of the UN Security Council.

Often ignored crisis

Insecurity in eastern DRC continued to fuel a long-standing humanitarian crisis often ignored by the international community, said Ms. Pobee.

An estimated 6.3 million people have been displaced within the country and since March 2022, more than 2.8 million have fled their homes in Ituri, North Kivu and South Kivu provinces due to insecurity. 

Currently, around 28 per cent of the population of North Kivu and 39 per cent of Ituri’s regular population are displaced.

This situation has been further aggravated by inflation, epidemics and natural disasters, including last month’s floods in Kahele territory in South Kivu, which killed more than 470 people and left thousands missing. At the same time, nearly 26 million people, more than a quarter of the population, face food insecurity in the DRC.

The top Africa official expressed particular concern about the increasing number of women and girls who are becoming victims of gender-based violence and sexual exploitation. Gender-based violence increased by 2.3 per cent across the country and by 73 per cent in North Kivu province alone, compared to the same period last year.

She said the humanitarian response falls far short of the unprecedented level of need, welcoming the start of a system-wide scale-up response in eastern DRC for an initial period of three months. 

Pockets of instability

In addition to security and humanitarian challenges in the east, pockets of instability have resurfaced in the west and south of the country. Violence persisted in Mai-Ndombe, Kwilu and Kwango provinces, and has spread to Maluku in Kinshasa province, Ms. Pobee said. Tensions and violence were also reported in Kindu, Tshopo and Katanga. 

She urged authorities to hold perpetrators to account and take steps to strengthen social cohesion in order to preserve stability in these areas.

Hate speech continues

She said she was particularly alarmed by “the restriction of civic space and the increase in hate speech” and expressed concern at reports of an increase in violence against women political leaders and activists. 

Regarding the scheduled departure of the peacekeeping mission MONUSCO, she said it was necessary to “stay the course for an orderly, gradual and responsible transition“.

“MONUSCO’s departure is planned and initial steps are being taken in several areas. However, MONUSCO’s withdrawal must not compromise the protection of civilians. We must avoid creating security vacuums,” she said.

“An orderly and responsible transition depends on the ability of national security forces to deploy and respond effectively wherever the security situation requires it,” she insisted.

UN refugee agency predicts spike in resettlement needs next year

 According to the Projected Global Resettlement Needs Assessment for 2024, over 2.4 million refugees will be in need of resettlement, marking a 20 per cent increase compared to 2023.

A woman leaves a refugee camp in Rwanda on her way to resettlement in Norway.
© UNHCR/Lilly Carlisle

A woman leaves a refugee camp in Rwanda on her way to resettlement in Norway.

Escalating challenges 

With a deepening refugee crisis, security breakdowns and conflicts, urgent action is required to address the escalating challenges faced by millions forced on the run worldwide.

“We are witnessing a concerning increase in the number of refugees in need of resettlement in 2024. Resettlement remains a critical lifeline for those most at risk and with specific needs,” said Filippo Grandi, UN High Commissioner for Refugees. 

The Asia region tops the list, with nearly 730,000 refugees likely requiring resettlement support, representing around 30 per cent of the total. 

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Urgent assistance 

With the Syrian war extending into its 13th year and remaining the world’s largest refugee situation, refugees there continue to need the most resettlement support for the eighth consecutive year, with around 754,000 requiring urgent assistance.

Refugees from Afghanistan are estimated to have the second-highest level of needs, followed by refugees from South Sudan, Myanmar, and the Democratic Republic of the Congo (DRC).

“I ask all States with the means to step up and provide sustainable and multi-year resettlement commitments to offer safety and protection to those in need and to share the international community’s responsibility for refugees”, urged Mr. Grandi.

Resettlement provides a lifeline of hope and protection to those facing extreme risks by offering a durable solution while at the same time playing a pivotal role in relieving the pressure on host countries and strengthening the broader protection framework.

Horn of Africa: Around 60 million in urgent humanitarian need

“About five million children under the age of five are estimated to be facing acute malnutrition in 2023 in the Horn region, in the Greater Horn. That is about 10.4 million, that is just a staggering figure,” said Liesbeth Aelbrecht, the World Health Organization’s (WHO) incident manager for the greater Horn of Africa emergency.

Three year high

“What our colleagues are seeing in clinics and in hospitals, since the beginning of this year, are the highest level of severely malnourished children who are now coming to these facilities with medical complications since the crisis began three years ago.”

Echoing that alert, World Food Programme (WFP) Senior Emergency Officer Dominique Ferretti said that almost three years of drought had given way to rains and devastating flash floods: “While we just concluded a rainy season which performed better than predicted, one rainy season is not enough to bring an end to the crisis.”

Women collect water in drought-stricken Marsabit in northern Kenya.
© WFP/Alessandro Abbonizio

Women collect water in drought-stricken Marsabit in northern Kenya.

Although long-awaited rains arrived in March across the eight-member Intergovernmental Authority on Development (IGAD) region – encompassing Djibouti, Eritrea, Ethiopia, Kenya, Somalia, South Sudan, Sudan and Uganda – and with it the hope of relief, flash-flooding inundated homes and farmland, washed away livestock and closed schools and health facilities.

The result was the highest number of reported disease outbreaks in the greater Horn of Africa so far this century. Their frequency can be linked directly to extreme climate events, according to the UN health agency.

Ms. Aelbrecht noted ongoing outbreaks of cholera and measles, together with “very high numbers” last year and this year, including malaria cases.

“So, with the impact of flooding, we see these diseases worsening. Malaria, I would like to remind you, is one of the biggest killers in the region.”

Climate complications

Climate concerns are key to food security in the coming months, the UN Food and Agriculture Agency (FAO) noted at a press conference in Geneva.

Global forecasts indicate that El Niño weather pattern conditions are already present and will strengthen through the rest of the year, which could bring above-average rains during the October to December rainy season across eastern parts of the region, including much of Kenya, the Somali region of Ethiopia and Somalia.

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El Niño may somewhat reduce the risk of flooding in flood-prone areas such as South Sudan,” said Brenda Lazarus, Food Security and Early Warning Economist at FAO’s Subregional Office for Eastern Africa.

Nevertheless, she indicated that “on the risk’ side, below-average rains and dry spells, along with other drivers of food insecurity would likely negatively impact agricultural production and increase already alarming levels.

Investing is key

FAO emphasized the need to shift from a system focused mainly on emergency response, to anticipating and mitigating crises through investments such as in rainwater harvesting, soil and water conservation, or the use of more drought tolerant crops – and ensuring seeds are locally available.

Involving young people in building silos could also boost community resilience, the UN agency noted.

The 60 million severely food insecure include more than 15 million women of reproductive age, 5.6 million adolescent girls and close to 1.1 million pregnant women.

Close to 360,000 of them are expected to give birth in the next three months, according to the United Nations Population Fund (UNFPA).

Women who are forced to look for food just to survive “do so on the expense of their own health,” said Michael Ebele, UNFPA Regional Humanitarian Adviser for East and Southern Africa.

Increased risk of deaths

“So, we are seeing pregnant women not being able to go for antenatal care, not attending to other illnesses they may be having. And then, that comes with risks of complications…then the risks of maternal deaths increase.”

Malnutrition among pregnant and lactating mothers puts their unborn and breast-feeding children at risk of malnutrition and propagates malnutrition through entire life cycles in communities.

Malnourished mothers are also less able to withstand complications in pregnancy which put them at greater risk of losing their child.

“Because of the limited amount of resources, we have seen an increase in the risks of survival sex”, said Ms. Ebele, “increasing the risk of sexual exploitation and abuse, particularly of women and girls”.

Grain initiative threat

Asked by journalists how badly the Horn of Africa would be affected if the UN-brokered Black Sea Initiative to facilitate Ukrainian grain exports to the world’s markets is not renewed next month, WFP’s Mr. Ferretti replied that “the reality is that Ukraine is the breadbasket, it is a major supplier and it would hit us hard if this Black Sea initiative was not renewed”.

Thailand: Moving from punishment to treatment of people who use drugs

“I first started taking drugs when I was 15,” says 49-year-old Prapat Sukkeaw. “I smoked marijuana, but it was laced with heroin. I felt like I was floating, and it meant that I could forget about all the problems that I faced as a teenager. It was a beautiful feeling.”

Prapat Sukkeaw is one of an estimated 57,000 people who currently injects drugs in Thailand. His drugs of choice, marijuana and heroin, reflect a period in Thailand’s recent history when both illegal narcotics were the main stimulants being trafficked out of the storied Golden Triangle, a remote and somewhat inaccessible region which includes northern Thailand as well as Myanmar and Laos.

49-year-old Prapat Sukkeaw has used drugs since the age of 15.
UN News/Daniel Dickinson

49-year-old Prapat Sukkeaw has used drugs since the age of 15.

Employed by a non-governmental organization (NGO), he has on occasion wanted to give up heroin due to pressure from family and friends. Now, he has recognized that, even if he admits to being addicted, taking drugs “is my preference and my right”. He has now started taking the synthetic drug methamphetamine, as heroin has become progressively more expensive.

His focus has moved from abstaining from drugs to living with the side effects and managing the potential harm of their prolonged use, for example by not sharing needles.  

Like all Thai citizens, Mr. Sukkeaw has access to universal health care, but he found that as a person who uses drugs, he was stigmatized and discriminated against by health care workers. He was referred to Ozone, an NGO based in a suburb of the Thai capital, Bangkok. 

Ozone’s goal is to reduce the health and social impacts of drug addiction, promoting abstinence, but also supporting clients who want to carry on using and ensuring that they have access to the health services they require.

A hepatitis C test is prepared for a client at Ozone.
UN News/Daniel Dickinson

A hepatitis C test is prepared for a client at Ozone.

“Our clients who travel from around Thailand to Ozone welcome our non-judgmental approach,” said Ngammee Verapun, the centre’s director, himself a person who uses multiple drugs on a regular basis. “We are a community which values all people. We are client-centred and offer peer support treating everyone equally, no matter their background.”

Ozone offers a variety of services including needle exchanges and HIV testing as well as PrEP (pre-exposure prophylaxis) which reduces the risk of getting HIV from sex or injecting drugs. It also partners with Dreamlopments, a hepatitis C service provider which offers integrated healthcare free of charge. Hepatitis C is a viral liver infection spread by sharing needles. Its activities are supported by UNODC, although a funding shortfall has meant that the centre has had to close many of its outreach services in other parts of Thailand.

Karen Peters, UNODC.
UN News/Daniel Dickinson

Karen Peters, UNODC.

From punitive to progressive drug laws

Historically, Thailand has severely punished people who have broken strict drug laws. However, since a change in the law in 2021, the legal system has shifted towards rehabilitation for people who use drugs.

Speaking ahead of the International Day Against Drug Abuse and Illicit Trafficking, marked annually 26 June, Karen Peters, UNODC’s Bangkok-based regional drugs and health focal point, said: “Now people are allowed alternatives. It is not an ideal choice, but they are given the choice to attend a treatment facility or go to prison.”

The law is progressive in other ways, as harm reduction is specifically highlighted as an objective, which, according to Karen Peters, allows organizations like Ozone “to function within the confines of the legal and justice system”.

It is also helping to shift “the narrative around people who use drugs in Thailand from being socially marginalized”, she said.

Tackling stigmatization

The stigmatization of people who take drugs nevertheless continues, but according to Dr. Phattarapol Jungsomjatepaisal, the director of the National Addiction Treatment and Rehabilitation Committee in the Ministry of Public Health, the new legislation means that more “health service providers are being trained to act in a non-stigmatizing manner”.

He says that the reaction from people who use drugs has been “good” as there is a recognition that ultimately, they should receive better care in hospitals and health centres under Thailand’s universal health coverage system, while continuing to have the option to access services in community-led centres like Ozone. 

HIV and hepatitis C

One major concern remains the high prevalence of HIV and hepatitis C amongst people who inject drugs in a country where HIV rates are otherwise decreasing. In Thailand, an estimated eight per cent of drug users have HIV, approximately 3,800 people. 

The rate of hepatitis C, at 42 per cent, is “very frightening”, according to Dr. Patchara Benjarattanaporn, the country director of UNAIDS, the UN agency leading the global effort to end AIDS as a public health threat by 2030.

An Ozone Foundation client receives hepatitis C counseling.
UN News/Daniel Dickinson

Despite ongoing concerns about the health outcomes for people who use drugs, Dr. Benjarattanaporn believes that Thailand could become a model for the region’s countries facing similar challenges.

“The new narcotic law and the community-led aspect of treatment for drug users gives hope that Thailand can control cases, and this is a development that other countries are watching,” he said.

Back at Ozone, one client is receiving counseling about PrEP and HIV prevention, and another is undergoing a hepatitis test. The peer support remains a key element in attracting people to use its services, and it is now hoped that the new legislation will lead to less discrimination and will enable others to access similar services through more government health facilities.

A knowledge-based approach to tackling Afghanistan’s drug abuse crisis

Afghanistan, one of the world’s largest producers of heroin and methamphetamine – most of it smuggled abroad – is home to an estimated 3.5 million drugs users, according to the UN.

The worsening crisis has left most of the country’s drug treatment and rehabilitation centers struggling to cope.

A walk through what is considered in Kabul to be a ‘gold standard’ drug treatment centre is heart-breaking. The conditions in the 1,000-bed facility are dire. Since the Taliban came to power in 2021, international funding has dried up, leaving underpaid, poorly trained staff to deal with patients.

Food is scarce, and what little is available provides scant nutrition. Pharmacy cabinets are practically empty, so recovering patients’ bodies are shocked into detoxification.

My children have no-one to feed them

Residents of this facility, like those throughout the country, are expected to go through a 45-day programme, where they are provided medical services and counselling, according to authorities, after which they undergo an assessment. This is done to determine whether they can return to their families.

The de facto Taliban authorities have ‘motivated’ these people, most of whom are malnourished and homeless, to live here ‘voluntarily’ after they are brought in by outreach teams.

One man told UN News that he’s been living here for 6 months. “My children have no-one to feed them,” he said.

Conditions outside the prison-like walls of the treatment centre can be equally grim. Along with grinding poverty and ongoing insecurity, the region’s climate-driven weather extremes can be punishing for those living on the streets facing bitterly cold winters and scorching hot summers.

There would seem to be no end in sight to their suffering.

Entrance to the UNODC Information Centre in Tashkent, Uzbekistan
UN News / Ezzat El-Ferri

Entrance to the UNODC Information Centre in Tashkent, Uzbekistan

Centre for knowledge

Yet, across the border, in Uzbekistan, there is a beacon of hope.

In the country’s historic capital city, Tashkent, the United Nations Office on Drugs and Crime (UNODC) Regional Office for Central Asia has brought together a group of dedicated professionals to form its ‘Information Centre for Researching and Analyzing Transnational Threats Related to Drugs and Crime.’

The head of the Centre Salome Flores says her team’s mission is clear: “to produce knowledge that is objective, impartial, and well-integrated for the right people at the right time.”

This, she told UN News, allows decision-makers to do just that: take informed decisions. It also helps in developing an understanding of the scope of the drug problem in the region, particularly in Afghanistan, where in 2022 opium production represented nine to 14 per cent of the GDP and synthetic drug production is rising rapidly.

The Centre receives data from various sources, including from governments, open sources, social media, academic research, statistics, and of course from counterparts on the ground in Afghanistan.

However, the most instrumental tool the team uses in its work is the methodology built by UNODC over the past three decades to remotely identify crops.

Crop ‘signatures’

By combining ground surveys with advanced technology and satellite imagery, the agency has been able to create what are called ‘signatures’ to distinguish one crop from another. This allows UNODC to pinpoint with laser accuracy where opium poppy is being produced and cultivated.

The signatures were developed over many years by comparing satellite imagery with what is known as ground truths. The experts at the UN agency were able to develop hundreds of signatures using this method which required surveyors to visit specific GPS locations to verify the initial analysis.

Today, UNODC has the capability to identify various crops with an extremely high degree of accuracy, including wheat, melons, alfalfa, cotton, among others, and of course opium poppies. The signatures developed can even inform the team of the quality of the poppy fields and the expected yields.

Alex Nobajas Ganau, a geographic information officer at the centre, explained that the satellite imagery currently being used does not only provide pictures as such but includes “extra information which can be used to identify the quantity of chlorophyl and the type of crop that grows in each agricultural plot of land.”

The team’s work is extremely technical and sensitive. Protecting the data is vitally important to avoid catastrophic repercussions for farmers, particularly given the current political situation in Afghanistan.

Mr. Ganau said the raw data is never shared over the internet or connected to servers so it “cannot be hacked”. He said aggregated data is shared, “so rather than individual fields, we do it by district or by province.”

UNODC’s Ahmed Esmati analysing satellite imagery of Afghanistan from his office in Tashkent.
UN News / David Mottershead

The ‘A Team’

At the heart of the Information Centre are four resourceful Afghans with decades of on-the-ground experience. As part of the UNODC team in Afghanistan, they had conducted field visits and surveys until the agency decided to end these operations after the Taliban came to power. They are in regular contact with their colleagues who remain in the country and are providing key data, particularly on drug pricing.

As field surveyors and analysts, the Afghan experts have played a pivotal in the creation of the crop signatures that help monitor opium cultivation.

Ms. Flores told UN News: “The staff working at the UNODC Information Centre are extremely committed to their work. Our Afghan colleagues have been working on this for quite some time. So, we benefit from their experience; we benefit from their passion.

Working in this field is a dangerous business, particularly for Afghan nationals.

Saddiqi (a pseudonym) is one of the staff members who deemed it necessary to protect his identity.

Noting the technical nature of his work and the protections granted to him as a UN staff member, he stressed that the “situation in Afghanistan is… different”.

He said that he is proud of the work he does for UNODC, which is extremely beneficial to his country, and he hopes that “slowly, everything will be better inshallah.”

Like Saddiqi, Ahmed Esmati has been working at UNODC for over 16 years and started as a surveyor. He was able to get his family out of Afghanistan.

While lamenting that several of his colleagues lost their lives in the line of duty while the surveys were being conducted, Mr. Esmati stressed that the work in verifying satellite data and providing the evidence on the ground, was instrumental in building the capacity to conduct UNODC’s remote unique sensing activities today.

“Before doing this work, we relied on what the farmers and village elders were saying about poppy cultivation. But with this remote sensing and poppy identification through the satellite imagery, there is no room for manipulating data or [providing] for fake data, Mr. Esmati tells UN News.

Opium poppy field in Kapisa Province, Afghanistan (file)
UNODC

Opium poppy field in Kapisa Province, Afghanistan (file)

The neutrality of data

Afghanistan is the world’s largest supplier of opium, accounting for some 80 per cent of the global market. Drug abuse is rampant in the country. The Centre has therefore focused primarily on monitoring the production and cultivation of the extremely profitable plant-based substance used to produce heroin.

Following the political transition in Afghanistan in August 2021, UNODC ended its ground surveys and the evolution of the Information Centre began, said Central Asia Regional Representative Asita Mittal.

“As the UN, we believe in the neutrality of the data and our space, because it’s our responsibility that if you want evidence to inform policies and practices, you need to have quality data that is verifiable.”

UNODC field surveyor verifying opium yield in Sukhrud, Afghanistan (file)
UNODC

UNODC field surveyor verifying opium yield in Sukhrud, Afghanistan (file)

A shifting market?

After years of intensified opium production and cultivation, evidence shows that opium cultivation will decline sharply in 2023 due to a ban strictly enforced by the Taliban.

In the 2023 World Drug Report, UNODC cites record illicit drug supply and increasingly agile trafficking networks worldwide.

And while the benefits of a possible significant reduction in illicit opium cultivation in Afghanistan this year would be global, it would be at the expense of many farmers with no alternative means to generate income.

In that light, Ms. Mittal emphasized the importance of the Centre not only to the United Nations, the region and the international community, but also for the de facto authorities themselves.

How will we prove that the [Taliban ban] on poppy cultivation is effective? Only through objective evidence will we be able to present the truth to the international community,” Ms. Mittal tells UN News.

Early days

The Regional Representative stressed that it is still too early to know whether the results of the poppy ban will hold, as that would require analysis by the Information Centre over the coming years.

But with the de facto authorities clamping down, there are indications that the market is changing. Synthetics and methamphetamines seizures are skyrocketing across the region, quadrupling in Tajikistan and increasing a whopping 11-fold in Kyrgyzstan.

Ms. Mittal says: “The situation in Afghanistan is such that because of the ban on poppy cultivation, it’s quite possible that the traffickers will try to use that market for increasing the production of methamphetamines.”

There are some concerns that the production of methamphetamines could be driven by the ephedra plant which grows in the wild in this region of the world.

“But that’s just one possibility,” adds the Head of the Information Centre, Ms. Flores. “It can also come from chemicals. It can come from cold medications or from bulk ephedrine. So, we are trying to understand how people or traffickers are producing methamphetamines. And of course, if we can understand that, then we will be able to inform the authorities so they can act”.

Former opium poppy farmer cultivating tomatoes in Nangarhar Province, Afghanistan.
UN News / David Mottershead

Former opium poppy farmer cultivating tomatoes in Nangarhar Province, Afghanistan.

Alternative development solution

Since the Taliban returned to power in August 2021, the UN has been operating in the country under a “Transitional Engagement Framework”. With its operations largely limited to basic humanitarian the Organization has been identifying innovative ways to carry out its development activities through implementing partners, without directly supporting the de facto authorities.

UNODC works to build the capacity of farmers and vulnerable communities in Afghanistan through its implementing partners.

In this poverty-stricken country, opium cultivation remains very attractive and lucrative, as farmers can earn about 30 cents for 7 kg of tomatoes while the current price of 1 kg of opium is about $360.

The Information Centre is playing an important role in determining the need for alternative development programmes.

Crop change

Ms. Flores highlighted the importance of providing farmers with a proper income and replacing “an illicit crop with a licit crop.”

“If we know the geographic location, we can target resources and efforts. We are also able to understand the characteristics of the territory, the geography, and propose viable alternatives to poppy cultivation,” she explains to UN News.

Ms. Mittal adds that the most important investment the international community could make is in “reducing the vulnerabilities at both ends of the spectrum.” She noted that traffickers are “always looking for the weakest spots and the most vulnerable people”, and as such, more needs to be done to prevent cultivation and use.

Without this type of investment, illicit economies will continue to thrive.

If you stop one illicit activity, it may be replaced by another because people have to make sure there is food on the table,” she says.

Homes line a hill on the edge of Kabul city.
UN News / David Mottershead

Homes line a hill on the edge of Kabul city.

Profit-driven criminals

For decades, opium has travelled from Afghanistan through Central Asia and the northern route to other markets, including Europe, even reaching Southeast Asia, the Middle East and Africa.

Monitoring the drug trade in this region remains extremely important, as traffickers find new ways to smuggle their products and the rise of synthetic drugs presents a problem with potential global implications.

Ms. Mittal underscored that profits are what drive illicit activities, and the biggest profits are made outside of the producing countries like Afghanistan.

For example, even after the ban, a kilo of heroin can exceed $48,000 on the streets of London.

“So, while we may blame and put the onus on Afghanistan, which doesn’t even produce the precursor chemicals, we need to have a shared responsibility on dealing with this issue,” she says.

Confronting evolving threats

Ms. Flores said her team aims to monitor and analyse all the transnational threats in the region, including human trafficking – which is a growing risk with the migratory flow of people from Afghanistan, as well as the smuggling of firearms, illicit mining, wildlife trafficking, and falsified medicines as a growing trend in the region.

According to the head of the Information Centre, “Transnational threats evolve, and organized crime adapts. As authorities tackle issues, the illicit markets can change.”

The prospects of a diplomatic solution between the international community and the de facto authorities in Afghanistan continue to be grim, as human rights issues remain a major sticking point.

In the absence of true sustainable development in Afghanistan, illicit activities will likely persist as a plague in the country and in turn infect the world, making the work of the Information Centre instrumental in addressing these challenges.

Sudan: OHCHR calls for ‘urgent action’ to end militia attacks on people fleeing El Geneina

The explosion of ethnic violence in Darfur largely by nomadic “Arab” groups in alliance with the RSF who have been battling national army forces for control of the country since mid-April, has led tens of thousands to flee into neighbouring Chad.

‘Horrifying accounts’

In a statement, OHCHR Spokesperson Ravina Shamdasani said interviews with people fleeing the decimated city of El Geneina have revealed “horrifying accounts” of people being killed on foot by the RSF-supported militia.

“All those interviewed also spoke of seeing dead bodies scattered along the road – and the stench of decomposition”, she said. “Several people spoke off seeing dozens of bodies in an area referred to as Shukri, around 10km from the border, where one or more of the Arab militias reportedly has a base.”

She said immediate action to halt the killings was essential.

The High Commissioner for Human Rights calls on the RSF leadership to immediately, unequivocally condemn and stop the killing of people fleeing El-Geneina, and other violence and hate speech against them on the basis of their ethnicity. Those responsible for the killings and other violence must be held accountable.”

Safe passage

She added that people fleeing El Geneina must be guaranteed safe passage and humanitarian agencies allowed access to the area so they can collect the bodies of the dead.

“Out of 16 people we have so far been able to interview, 14 testified that they witnessed summary executions and the targeting of groups of civilians on the road between El-Geneina and the border – either the shooting at close range of people ordered to lie on the ground or the opening of fire into crowds.”

The civilian exodus from the city intensified following the killing of the state governor on 14 June just hours after he accused the RSF and militias of “genocide” – raising the spectre of the hundreds of thousands killed between 2003-2005 during a Government-orchestrated campaign of violence.

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Ms. Shamdasani said the testimonies recounted killings that took place on 15 and 16 June, but also during the past week.

Deadly hate speech

“We understand the killings and other violence are continuing and being accompanied by persistent hate speech against the Masalit community, including calls to kill and expel them from Sudan.”

One 37-year-old told the UN that from his group of 30 people fleeing to the Chad border, only 17 made it across, the Spokesperson recounted.

“Some were killed after coming under fire from vehicles belonging to the RSF and ‘Arab’ militia near the Chad border, while others were summarily executed, he said. Those who survived had their phones and money looted from them by armed men shouting: ‘You are slaves, you are Nuba’”.

A 22-year-old woman gave similar accounts of killings. She told how one badly wounded young man had to be left on the ground: “We had to leave him because we had only one donkey with us”.

El Geneina has become uninhabitable”, said Ms. Shamdasani with essential infrastructure destroyed and movement of humanitarian aid to the city, blocked.

We urge the immediate establishment of a humanitarian corridor between Chad and El-Geneina, and safe passage for civilians out of areas affected by the hostilities.”

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