United Nations, NEW YORK – What would the world look like if it was designed by and for women? 

For one thing, it would be safer. Cars would be equipped with crash systems tested to protect all types of bodies, and personal protective equipment would be sized to fit female health-care workers as well as their male counterparts.

It would also be more equitable. There would be more women working across science and technology, and new innovations would combat, rather than reinforce, old gender stereotypes.

Unfortunately, this is not yet the world we live in. But it is one imagined possible by the members united under the Equity 2030 Alliance, a global initiative from UNFPA, the United Nations sexual and reproductive health agency, to realize gender equity in science, technology and financing before the decade’s end. 

“Women walk through a world that was not built for them,” said UNFPA Executive Director Dr. Natalia Kanem at the programme’s launch. “Yet we can redesign the world. We can resolve this challenge if we unite and commit to equity by design, whether in tech, science or finance. The impact will last for generations to come.”

Below, read about several actions that the Alliance’s experts and members are taking to close gender gaps in their fields. 

Gendered innovations

“Ten years ago, five years ago, it wasn’t widely understood that women were left out of important safety and medical designs,” Equity 2030 expert Londa Schiebinger told UNFPA. “We’ve made a lot of headway, and we need to make a lot more.” 

Professor Schiebinger directs the EU/US Gendered Innovations in Science, Health & Medicine, Engineering, and Environment Lab at Stanford University. She has introduced a framework for advancing gender equity that hinges on three “fixes”: Fixing the number of women and members of underrepresented groups producing science and technology, fixing the institutions that have historically excluded them, and fixing the knowledge that researchers produce. 

According to Professor Schiebinger, one answer is to integrate sex, gender and intersectional analysis into the research process. Applying a gendered lens to investigating topics ranging from chronic pain and COVID-19 to assistive robots and virtual assistants has proved to yield better results.

“We educate the workforce of the future,” she said. “If we do our job right, we can have a huge impact on equity and inclusion.”

Better research, better health care in Argentina

Becoming a health-care professional requires building habits that eventually become second nature. Think about how often health-care workers wash their hands.

Dr. Alejandro Kohn, the medical director at Hospital Británico, a leading health-care institution in Buenos Aires, Argentina, wants to add another habit to health workers’ repertoire: Thinking about the social determinants of health. “Whatever we do, we understand fully that the social determinants of health have a huge impact,” he told UNFPA. 

Social determinants of health are non-medical factors  – such as age, race, ethnicity  and gender – that influence people’s well-being. And though these characteristics do so much to shape humans’ lived experiences, they’re often overlooked in scientific and medical research. 

Hospital Británico has taken several initiatives to expose and correct these blind spots. Inspired in part by Equity 2030 Alliance, the institution took a retrospective look at its studies and found that too few examined sex and gender as variables. In response, according to Scientific Review Committee coordinator Dr. Glenda Ernst, it was decided that residents should integrate Stanford’s Health and Medicine checklist on Gendered Innovations into their research work.

“I think we have a very good opportunity to improve,” Dr. Ernst said. “Residents are the future.” 

Checklists on Gendered Innovations such as the one developed by Professor Schiebinger’s project represent helpful tools for practitioners. But perhaps even more important, according to Dr. Kohn, is ensuring that social determinants of health are part of everyday consideration and conversation. 

“You cannot have excellence of care if you don’t have proper education and proper research,” he said. “We see, here, the opportunity to grow into equity.” 

From systemic inequities to inclusion 

Around the globe, patriarchal systems often drive women and girls out of schools, into caretaking roles, and away from pursuing certain careers.

”The main obstacle faced by girls and women in Cameroon lies in social norms and stereotypes prevailing in a patriarchal society,” sociologist, researcher and University of Yaoundé 1 Associate lecturer Irène Kuetche Djembissi told UNFPA.

“Women are often assigned to take care of their homes, husbands, and raise children,” she said. “Inequalities manifest in the education system and the job market.” 

To combat these disparities, the University of Yaoundé 1 is partnering with civil society organization the Association des Acteurs de Développement (ADEV) to promote the development of gender-inclusive solutions and innovations in STEM. The organizations are also working to ensure grant-making bodies across Sub-Saharan Africa pursue gender equity in their activities and the research they support. 

Dr. Kuetche Djembissi is ADEV’s technical director, and has committed through her work there and at the University of Yaoundé 1 to exposing gender inequity through her research and to combating sexism across society.

“More and more women are willing to challenge traditional beliefs despite the patriarchal society in which we live,” she said. “One area that particularly excites me is the continuous increase in young girls' access to mathematical, technology and scientific studies.” 

“Change is underway.” 

Mentors and mothers in Uganda 

“Women are expected to be the ones to cook, serve the food, wash the dishes, clean the house – while the husband is in the library or the laboratory,” Pauline Byakika-Kibwika, head of the Medicine Department at Makerere University in Kampala, Uganda, told UNFPA.

For many Ugandan women, the road to – or back into – higher education is not an easy one. As in many countries, gender norms in Uganda exert pressure on women to get married and have children; many will take significant time off from studies to deliver and raise kids.

“Societal norms have a great influence on people's career progression,” Professor Byakika-Kibwika said. 

To combat this challenge, Makerere University established a Gender Mainstreaming Programme in 2000 to integrate gender-equitable approaches into its research and innovation practices. The programme also promotes women’s empowerment and sexual and reproductive health and rights while working against sexual harassment and violence against women and girls.

Gender equity in design also hinges on finding and retaining female talent. Early on, according to Professor Byakika-Kibwika, the university realized fewer women were pursuing higher education and working in leadership roles at the institution. 

“This led to intensification of mentorship activities for women,” she said. “Over the years, we’ve had more women coming back for postgraduate, master’s and PhD programmes and for technical careers – and women getting into leadership positions.” 

The university has also introduced a zero-tolerance sexual harassment policy, and Professor Byakika-Kibwika said she’s noticed an increased awareness of the issue around campus.  

“Things change over time, but there's still a lot more work to be done,” she said. Source: UNFPA

MPs are considering the termination of a multi-million-dollar contract between MultiChoice Africa and the Kenya Broadcasting Corporation, citing it as an unfavourable agreement.

According to documents presented before Parliament, the two parties entered into a contract in 1994, allowing the national broadcaster to air international channels, while MultiChoice was responsible for providing content.

The detailed terms revealed that KBC held a 40 per cent stake in the agreement, while MultiChoice held the remaining 60 per cent. This initial agreement underwent a review in 1996.

As part of the contract, the national broadcaster was obligated to furnish equipment and infrastructure to facilitate Kenya's transition from analogue to digital broadcasting.

However, last week, members of the Public Investments Committee on Social Services, Administration, and Agriculture expressed concerns about the contract, saying the national broadcaster was receiving an unfair deal.

The House team, led by Navakholo MP Emmanuel Wangwe, pressed the management of MultiChoice Kenya to explain why millions owed to KBC in dividends had not been fully remitted and questioned why the national broadcaster was excluded from the day-to-day operations of the organisation.

The committee also scrutinised the company's senior executives and requested an explanation for a dividend funds variance of Sh20 million.

"As of 2011, the dividends owed to KBC amount to Sh116 million, but according to audited books, the national broadcaster received only Sh96 million. 

"Explain to this committee the glaring anomaly and clarify the purpose for diverting the funds intended for dividends," said committee vice chair Caleb Amisi.

"…based on our engagement with MultiChoice, we believe KBC is not receiving adequate value for money, and that is the reason for our presence here. We believe this agreement should be terminated unless MultiChoice considers a review to restore confidence on the part of KBC," added the vice chair.

However, MultiChoice finance director Ruth Omondi said all funds were indeed paid to KBC.

"I was not present at the time the deal was negotiated, and my responses are based on the records I have. Documents in our possession indicate that all the dividends were paid to KBC," she said.

The MPs, however, swiftly engaged in another confrontation with the firm's management, questioning why despite KBC holding a 40 per cent stake in the deal, it only had two out of five board members and lacked representation at the management level, hindering its ability to monitor day-to-day operations.

They also heard that during the actualisation of analogue to digital TV transition, KBC was to provide on-ground equipment and frequency whereas Multi-Choice was to provide content.

Multi-choice legal representative Clare Ruto defended the firm, saying the change in content had been done in agreement with KBC after certain channels proved not commercially viable.

“We were a content provider and it was KBC’s work to provide equipment. We have not moved out of the contract,” said Ruto.

The management of Multi-choice is set to appear before the committee again with key contract documents. By Josphat Thiong'o, The Standard

The World Health Organization (WHO) on Friday announced the inclusion of noma disease in its official list of neglected tropical diseases (NTDs).

The decision was recommended by the 17th meeting of the Strategic and Technical Advisory Group for Neglected Tropical Diseases. The decision has been welcomed because it is likely to expand health services to the world's most vulnerable populations. 

Noma or cancrum oris affects the face, eating the soft tissues and often destroying the bones completely. Sometimes it destroys the nose or even the eyes. This complication has been mainly common in West Africa. No wonder the Nigerian government and some activists from Nigeria and Côte d'Ivoire among others have been campaigning to have it listed among the World’s Neglected Diseases.

Studies in countries where it is prevalent, indicate that it affects mainly children under the age of seven. Malnutrition, a lack of vaccinations, poor oral hygiene, and poverty have been listed among the many contributing factors to noma. 

WHO director-general, Dr. Tedros Adhanom Ghebreyesus said noma is more than a disease, it is a social marker of extreme poverty and malnutrition, affecting the most vulnerable populations.

“By classifying noma as a neglected tropical disease, we are shining a light on a condition that has afflicted marginalized communities for centuries. We are committed to working with affected countries and communities to address the drivers of noma, and alleviate the suffering it causes,” said Ghebreyesus.

According to WHO, noma is a severe gangrenous disease of the mouth and face, that primarily affects malnourished young children (aged between 2 and 6 years) in regions of extreme poverty. It starts as an inflammation of the gums, which, if not treated early, spreads quickly to destroy facial tissues and bones.

It frequently leads to death, with survivors suffering severe disfigurement. Accurate estimation of the number of noma cases is challenging due to the rapid progression of the disease and the associated stigma, which contributes to leaving many cases undiagnosed. Cases of noma are mostly found in sub-Saharan Africa, although cases have also been reported in the Americas and Asia. In Uganda, studies have linked this complication to false teeth (ebiino/ebinyo) extraction. 

A study published in 2017 in the Journals of Case Reports said: "False teeth” (ebiino/ebinyo) refers to gingival swelling that occurs during the eruption of the primary canine teeth in infants and consists of the extraction of deciduous canine tooth buds. This practice, which is part of infant oral mutilation, is relatively common in African countries with an incidence that varies from place to place, ranging between 15 per cent and 80 per cent, especially in Angola, Tanzania, Somalia, Kenya, Sudan, Nigeria, and Uganda. 

The study further states that the practice arises from the belief that these “killer” canines cause fever, diarrhea, and any other infant illness, thus necessitating their removal, usually by traditional herbalists using unclean instruments and fingernails. 

In Bushenyi district in western Uganda, a study showed that more than one in two of the households had a child younger than 5 years old who had had false teeth in the last 5 years as of 2007, with more than 80 per cent of the respondents using traditional medicine alone or in combination with modern medicine to treat “false teeth disease.

The National Oral Health Policy developed by the ministry of Health does not however mention noma. Evidence from WHO indicates that noma is caused by bacteria found in the mouth. There are multiple risk factors associated with this disease, including poor oral hygiene, malnutrition, weakened immune systems, infections, and extreme poverty. 

Noma isn't contagious but tends to strike when the body's defenses are down. Early detection is essential, as therapy is most effective at the early stages of disease when it causes severe swollen gums, known as acute necrotizing gingivitis. Treatment involves antibiotics, advice and support on practices to improve oral hygiene with disinfectant mouthwash (salt water or chlorhexidine could be used) and nutritional supplements. 

If diagnosed during the early stages of the disease, treatment can lead to proper wound healing without long-term consequences. In severe cases though, surgery may be necessary. Children who survive the gangrenous stage of the disease are likely to suffer severe facial disfigurement, have difficulty eating and speaking, face social stigma and isolation, and need reconstructive surgery.  

The recognition of noma as an NTD aims to amplify global awareness, catalyse research, stimulate funding, and boost efforts to control the disease through multisectoral and multi-pronged approaches. Interventions addressing the burden of this devastating disease will contribute to achieving universal health coverage, as they will specifically target pockets of underserved populations.

Noma is often managed by oral health programmes in endemic areas and collaboration with NTD programmes at the operational level can be strengthened, notably by integrating noma within the activities aimed at detecting and managing skin-related neglected tropical diseases (skin NTDs).

The Government of Nigeria spearheaded action to have noma included in the list of NTDs. In January 2023, an official request was submitted to WHO on behalf of 32 member states. The request was supported by a detailed dossier highlighting the burden and distribution of noma and providing evidence to demonstrate fulfillment of the criteria set by WHO.

Several partner institutions contributed by sharing information and conducting advocacy. With noma now on the list, the total number of NTDs listed by WHO are twenty-one.  By URN/The Observer