Health Brief: Leave no one behind

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As another Women’s Day has come and gone, the invasion of Ukraine has highlighted the precarious situation of the country’s women and put their health needs at the forefront of international discussions.

“They give birth in bomb shelters, supported and supervised by doctors online. Ukrainian doctors, meanwhile, have created Facebook pages, offering instructions on how women over 37 weeks pregnant might safely deliver children in bomb shelters,” Oksana Zabuzhko, a Ukrainian writer, told the European Parliament on International Women’s Day on Tuesday (March 8).

An almost biblical situation, she called it. “Babies born in bomb shelters die of sepsis caused by dust raining down on them during attacks. Mary’s stable was much more hygienic.”

With a noticeable difference from the gospel though: “Putin’s bombs will not be stopped by the strength of our spirit.”

The issue of pregnancy and the outcomes of pregnancy is rightly a major one. The United Nations Population Fund (UNFPA) estimates that 80,000 women will give birth in the next three months in Ukraine without access to critical maternal health care.

“Those women have moved from having a life-changing experience to a life-threatening experience,” Isabel Yordi Aguirre, World Health Organisation’s technical officer for gender and human rights, told a WHO/Europe press briefing on Tuesday.

Aguirre emphasised that maternal mortality in Ukraine was already relatively high in the past, but for women on the move, in a train or elsewhere these numbers could rise even more.

In general, Ukrainian women’s sexual and reproductive health rights (SRHR) are predicted to be put aside in the war. Gender-based violence is already a well-known problem for those Ukrainians living in conflict regions in Eastern Ukraine since 2014.

A 2019 UNFPA study shows that 75% of women in Ukraine reported experiencing some form of violence since age 15, and one-third reported experiencing physical or sexual violence. Crisis and displacement put them at increased risk of sexual and physical violence and abuse, the UNFPA said.

“Sexual and reproductive health services must not be an afterthought in emergencies. For the woman about to give birth or the adolescent girl subjected to sexual abuse, these services are as vital as food, water and shelter, and can mean the difference between life and death,” Natalia Kanem, UNFPA executive director, said in a statement.

Giving strong women more power

“We are a nation of strong women,” Zabuzhko told the MEPs and added: “My fellow countrywomen are now fighting alongside our men. They’ve joined the army and the federal territorial defence forces.”

Apart from joining the army, women dominate the health workforce in Ukraine. As the WHO regional director for Europe, Hans Kluge, highlighted, women make up 83% of the Ukrainian health workforce.

Kluge also warned that women face specific risks in the midst of conflicts, such as from people outside the home and by armed groups, as well as intimate partner violence and sexual abuse and exploitation. Trafficking of women may also increase in the region. The needs of women and girls must be prioritised, he said and added:

“Women are key players in reducing conflict and advancing stability, as their participation increases the chances of ensuring lasting conflict resolution and peace. Yet they almost always remain absent from negotiations,” he said.

Like Kluge, Ionela Ciolan, a research fellow at the European Policy Centre (EPC), urged the EU to keep a focus on supporting the inclusion of women.

They should be a part of “in peace negotiations, future planning and the implementation of the post-conflict resolution and peace-building strategies,” she wrote, arguing that their participation brings more security, safety and prosperity.

The same message is to be found in the own-initiative report, Gender Action Plan III (GAP III), debated in the European Parliament’s plenary on Tuesday and scheduled to be voted upon this evening.

The report lists the Parliament’s wishes for including gender in the EU’s external action, and calls for many initiatives including the “inclusion of local women’s rights organisations and women-led front line humanitarian responders in humanitarian coordination and decision-making structures.”

Considering gender in humanitarian action

In line with the warnings above, the GAP III also calls for ensuring access to healthcare and SRHR for women and giving high priority for it in the EU’s and member states’ humanitarian aid response, including access to justice for sexual and reproductive rights violations and gender-based violence.

The report also calls for access to information and care of female diseases, such as endometriosis and cervical cancer, and sexually transmitted diseases, such as HIV.

“GAP III is a significant tool for the EU. It makes clear once again our determination to pursue equality rights and policies,” the rapporteur for the report, French MEP Chrysoula Zacharopoulou (Renew), said in the debate on Tuesday evening.

With the report, they hope to urge the Commission to better address the gender perspective in humanitarian settings, referring to their most recent communication on the EU’s humanitarian action.

Jutta Urpilainen, the Commissioner for International Partnerships, told EU lawmakers in Strasbourg that “the Commission is working to support, protect and save lives. And this implies a gender-specific approach too”.

She added that the EU must ensure that women’s and girls’ needs are addressed – in Ukraine and all areas of violent conflict.

While the wish list for new actions in the GAP III report could take some time to be realised, research fellow Ciolan called for action now to help the women of Ukraine.

To better protect them, she recommended that views of Ukrainian feminist civil society organisations be included.

The aim is to ensure gender-responsive humanitarian action so that sexual violence is punished and rapes are judged as war crimes. Another aim is to ensure support for Ukrainian refugees against human trafficking, provide mechanisms that monitor the protection of Ukrainian women’s fundamental rights, and create safe evacuation and humanitarian corridors.

By Amalie Holmgaard Mersh

Subscribe to EURACTIV’s Health Brief, where you’ll find the latest roundup of news covering health from across Europe. The Health Brief is brought to you by EURACTIV’s Health Team Giedrė Peseckytė, Clara Bauer-Babef, Amalie Holmgaard Mersh, Gerardo Fortuna, and Natasha Foote.

SHORT NEWS

EU Summit draft. The informal gathering of EU heads of state and governments will be held on Thursday and Friday (10-11 March) in Versailles. According to a first draft of the conclusions, seen by EURACTIV, EU leaders will pledge to focus on supporting innovation and sustainable European production of affordable medicines and fast-tracking the registration of European suppliers, as well as making Europe a leader in biomedicines.

Orphan drugs call. Both the European Parliament and the World Health Organisation (WHO) have reiterated the need to update the regulations on medicines for children and orphan drugs, in order to better address unmet needs of children and adolescents in cancer care.

Disabilities. EU disability ministers are meeting in Paris on Wednesday (9 March) to take stock of the EU’s disability strategy and exchange best practices. EURACTIV France spoke to the French secretary of state in charge of people with disabilities who initiated the meeting within the French EU Council presidency framework.

Anti-microbial resistance. The European Medicines Agency has created a guide listing the antimicrobials which should be reserved exclusively for humans to combat antimicrobial resistance (AMR). But eyebrows were raised when one divisive antimicrobial, colistin, did not make the cut.

Cancer

Extending screening. The EU’s Group of Chief Scientific Advisers (GCSA) has issued scientific advice to the Commission to strengthen its plan to fight cancer in Europe. The priority, they say, is to extend screening to other different kinds of cancer.

Workers’ exposure to carcinogens. On Thursday (3 March) the Council gave the final green light to an update on the EU rules on reducing workers’ exposure to carcinogens, mutagens, or reprotoxic substances, addressing the first cause of work-related deaths in Europe.

COVID-19

Pandemic effects on women. Ahead of Women’s Day, the European Parliament started discussing the disproportionate effects that the pandemic had on women, who ultimately faced more unpaid care work, violence and worsened mental health as a consequence of lockdowns and curfews.

Member states cooperation. With citizens more concerned about health due to the pandemic, questions are raised as to whether the EU’s current instruments are enough, or whether it is time to discuss member states sharing more health competencies with the EU.

Healthcare disruptions. On Monday (7 March) WHO announced that two years into the pandemic, health systems are still facing significant challenges in providing essential health services. Ongoing disruptions have been reported in over 90% of countries surveyed in the third round of WHO’s Global pulse survey on continuity of essential health services during the COVID-19 pandemic.

mRNA vaccine side effects. A review of adverse events following vaccination against COVID-19 with mRNA vaccines in the USA confirms that most side effects were mild and decreased substantially after one day. The new study, published in The Lancet Infectious Diseases journal, suggests that for more than 298 million vaccine doses administered between December 2020 and June 2021, 92% of reported adverse events were not serious, and less than 1% of v-safe participants reported seeking any medical care following vaccination.

Face masks. Maintaining face mask use in public indoor spaces and in public transport for at least two weeks after COVID-19 vaccination targets (with a minimum of 70%) are met is cost-effective, typically cost-saving, and saves lives, according to a modelling study published in The Lancet Public Health journal. The lower the level of the final population vaccination coverage, the greater the economic and health benefits of maintaining face mask use.

Humanitarian aid for Ukraine

Call for medical supplies. An urgent call for medical oxygen and other critical medical supplies from the UN World Health Organisation (WHO) comes as supplies dwindle and difficulties in delivering WHO medical supplies to Ukrainian hospitals intensify.

UNICEF launched €400 million appeal.  The UN’s Children’s Fund UNICEF estimates that it will need €400 million over the next three months to help civilians, especially children, in Ukraine, though its teams continue to face logistical problems delivering aid to the field. EURACTIV France reports.

Temporary protection in EU. EU ministers unanimously agreed to offer temporary protection to refugees fleeing Ukraine during a meeting on Thursday (4 March), as a million have left the country.

UN raised $1.5 billion. Following seven days of the war in Ukraine, one million refugees have fled to neighbouring countries and to help those fleeing and staying, $1.5 billion was pledged for humanitarian support on Tuesday (1 March).

mRNA technology

Sanofi to invest 1.5 billion euros in messenger RNA in France. The French pharmaceutical company will invest 1.5 billion euros to develop messenger RNA vaccine technology, announced Prime Minister Jean Castex during a visit to Neuville-sur-Saône (Rhône) in a factory of the group Monday (7 March).

After the failure of its vaccine against COVID, the French pharmaceutical giant seems to want to forget the mistakes of the past and move forward. According to its new investment plan, the group will allocate 750 million euros just to fight against infectious and emerging diseases between 2022 and 2026.

The prime minister welcomed Sanofi’s ambition to develop six messenger RNA vaccine candidates by 2025, solely for these types of diseases. For its part, the Sanofi group has promised to “structure a real French industry along the entire mRNA value chain”.

The Capitals

BELGRADE 

Expert: Time to scrap COVID passes in Serbia. The director of a major COVID hospital in Belgrade’s suburb of Batajnica, Dr Tatjana Adžić Vukićević, said that it is time that COVID passes were scrapped. EURACTIV.rs | betabriefing.com

ZAGREB

Breast cancer mortality in Croatia falls for the fifth consecutive year. Breast cancer mortality has fallen in Croatia for the fifth consecutive year, the Croatian Public Health Institute (HZJZ) announced ahead of Daffodil Day, noting that the disease was no longer the leading cause of mortality in women. By Zeljko Trkanjec | EURACTIV.hr

BUCHAREST

Romania to lift most COVID-19 restrictions. The government will no longer extend the state of alert, enforced due to the COVID-19 pandemic, meaning most restrictions will be lifted as of Wednesday. By Bogdan Neagu | EURACTIV.ro

ROME

COVID-19 situation in Italy at a standstill. The number of COVID-19 cases, related deaths and admissions to intensive care units in Italy are decreasing although the incidence values in about half of the country’s provinces are at a standstill, the National Research Council (NRC) stated. By Simona Zecchi | EURACTIV.it

LISBON

Portuguese civil society mobilised in Ukraine humanitarian crisis. From Portugal to Eastern Europe, civil society has mobilised to take humanitarian aid to Ukraine and the borders, with improvised locations filling up daily with boxes and bags waiting to travel. By Mariana Caeiro | Lusa.pt

BUCHAREST

Romania treats first two wounded patients from Ukraine. Two Ukrainian citizens wounded in the war have been admitted to a hospital in eastern Romania. This comes after the country offered to help Ukraine in its war efforts by taking in wounded patients.

The defence ministry said the first transfer from Ukraine – a 44-year woman and her 19-year son, both wounded by shooting – were admitted at a military hospital in Galati, a few kilometres away from Ukraine. (Bogdan Neagu | EURACTIV.ro)

VIENNA

Austria burns another health minister, Mückstein steps down. The Austrian Health Minister Wolfgang Mückstein has announced his resignation less than a year after taking office, citing exhaustion due to managing the pandemic and death threats. By Nikolaus J. Kurmayer | EURACTIV.de

Upcoming events

10 March – The European health workforce and the digital skills gap: What is the EU’s role in closing the divide?

10 March – launch of the European health report 2021 and COVID-19 update in the WHO European Region

10-11 March –  Informal European Council

15-17 March – Health Valley Event 2022

16 March – European Parliament’s health committee (ENVI) meeting

17-18 March – Annual conference on EU law in the Pharmaceutical Sector 2022

22 March – Preventing Medication Errors to Protect Patient Safety

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