By Manipadma Jena
BHUBANESWAR, India, Aug 2 2024 – “Daily squabbles at the lone water point in Bhubaneswar’s slums, where hundreds of households depended on this single non-potable water source, have now receded into the past,” says Aparna Khuntia, a member of a large cohort of water volunteers who have played an important enabling role in ensuring households in the eastern India city now have their own on-premises potable running tap water available all 24 hours.

No mean feat this, considering that the capital city of India’s eastern state, Odisha, is flooding with much of the outbound rural to urban migrants. Of Odisha’s 8.86 million rural households, one in three has an out-migrant according to government data. Of this, 70% move within the State, a majority landing up in Odisha’s fast developing capital city.

For new migrants into a city, they may set up a shelter using discarded flex advertisement banners with a few bamboo poles but access to water, let alone potable water, remains a huge challenge.

“Even government-recognized slums like our colony in 2019 got just two hours of water supply in a day. Large families who could not store enough faced untold difficulties. Many had to pay for a water tanker every other day. Illegal water connections were rampant, resulting in huge revenue losses for the government,” 36-year-old Khuntia told IPS.

By 2030, 2 billion people will still live without safe drinking water

“The midpoint of our journey to 2030 has passed. The world is on track to achieve only 17 per cent of the targets under the Sustainable Development Goals (SDG),” reveals the recent 2024 United Nations SDG report card.

Goal 6 focusing on ensuring availability and sustainable management of water and sanitation for all, found between 2015 and 2022, the proportion of the global population using safely managed drinking water increased from 69 to 73 per cent according to report. Although more people now access safe drinking water, in 2022, 2.2 billion still went without this basic human right. Achieving universal coverage by 2030 will require a sixfold increase in current rates of progress for safely managed drinking water, it warns.

In 2022, the UN said, roughly half the world’s population experienced severe water scarcity for at least part of the year. One quarter faced “extremely high” levels of water stress.

Such situations were experienced this extreme summer 2024 in India’s largest economic hubs Bangaluru and Delhi.

Climate change worsens these issues. Rating agency Moody’s in June warned water shortage may hit India’s future economic growth.

Even so, according to the report 93.3% of India’s population are now using at least basic drinking water services which UN rates as “moderately improving.”

Women Benefit the Most From Women Water Managers

To further progress on SDG-6, in 2020 when Odisha launched the ‘Drink from Tap Mission’ to dispense certified quality drinking water 24X7 from piped supply installed at each urban household, it created a pool of the women water volunteers. Designated Jal Sathi or water partner, they were stringently selected from among local Self-Help Groups (SHGs), trained and raring to make a difference.

And a difference they did bring about. The government’s implementing Housing and Urban Development department “increased their water tariff collection by around 90 percent,” said Khuntia. Representing community partnership in urban water management, they are key stake-holders in a novel initiative.

A key government official G Mathi Vathanan, who once headed the State-owned non-profit company Water Corporation of Odisha (WATCO) that rolls out the water mission for the State government, even went on to write a book on the women volunteers giving them much of the credit for the initiative’s success.

“The women from SHGs are the ones who helped make reality the goal of bringing water to the doorstep of each household. The mission’s success was due to (their ability to) building people’s trust in the government,” he said.

The service these women volunteers provided to households turned the tide against diarrhea, jaundice, and poor gut health that plagued the poor, especially children.

The UN’s Sustainable Development Report 2024 ranks India on SDG progress at 109 out of 166 indicating a “score moderately improving” but “insufficient to attain goal.”

India’s federal government is mulling replicating Odisha’s Pure Water Scheme’s success in other States.

These women managers helped other householder women by bringing drinking and cooking water to their doorstep, eliminating the disproportionate burden of water on women in India.

Change-Makers’ Contribution: A Working Day in a Water Partner’s Life

Each woman volunteer works with 1,200 designated households, both in her own tenements and higher-end households. This familiarity with her gives her an edge with her clients—of trust, of openness in interactions helping her to achieve what government staff are unable to.

Every month she visits her households, reads the installed water meter, generates the bill and often gets paid too. But for those who are unable to pay, the water-partner will visit again and again urging, cajoling payments.

“We urge them not to waste such a precious commodity like water, and for those who lagged in taking new connection we convinced them to do so,” said Khuntia. With water meters installed and payments mandatory, households tend not to waste water. In slums, bills often were no more than 50 to 65 rupees (less than one dollar), affordable even for the poorest.

“So, this tap drinking water mission was a win-win for both government and consumers,” Khuntia, a mother of two told IPS. It also ensures Sustainable Cities and Communities under SDG-11. Revenue accruing to the government ensures water infrastructure maintenance.

On water-users’ request, Khuntia said they tested the tap water with kits they carried. They also reported water-related issues and information of pipe leaks that compromised water purity, to the government’s maintenance staff who attended immediately.
“Earlier, people would rarely call the staff if they noticed water pipe damages; sometimes it was deliberate, for water theft. But because we visit families often and they are comfortable with us, we get this information very quickly,” she added.

The SDG targets 6–1 of the 2030 Sustainable Development Goals call for universal and equitable access to safe and affordable drinking water for all. The drink from tap mission is a move to achieve this.

According to WATCO, by March 2023, 4.5 million urban residents in 29 Urban Local Bodies out of 115 ULBs in Odisha State have access to or be in line to drink from tap utilities.

Under the scheme, not only water equity is ensured, but sustainability is also ensured by fixing water meters for every household water pipeline. Since households pay for their water, they tend not to waste it.

However, after four years of service, these women volunteers have been demanding better pecuniary recognition for their services. What they get now is 5% of their total bill collection as an incentive, 100 rupees if she enrolls a new customer for a water connection, and a bicycle. Aparna Khuntia told IPS she gives 4 hours a day to this work while her monthly income approximates 5000–7000 rupees (60–84 USD). Much of it is spent supplementing her husband’s 15000 rupees (180 USD) income from plying a three-wheeler auto rickshaw for household expenses, including their one-room rent. What is left over is spent during festivals or when we visit relatives in the village.

“With a government change in the June election this year, Odisha’s new government is reorganizing the entire women’s self-help group set-up. The Jaal Sathis will possibly get a new designation but the programme which has been highly successful, will continue,” WATCO’s chief operating officer, Sarat Chandra Mishra, told IPS.
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By Ed Holt
MUNICH, Aug 2 2024 – Campaigners and experts have demanded a breakthrough HIV intervention hailed as “the closest thing to an HIV vaccine” must be made available as soon and as cheaply as possible to all who need it as its manufacturer faces protests over its pricing.

Activists led a massive protest during the 25th International AIDS Conference (AIDS2024) in Munich last week as a study was presented showing lenacapavir—a drug currently sold by pharmaceutical firm Gilead for more than USD 40,000 per year as an HIV treatment—could be sold for USD 40 per year as a form of pre-exposure prophylaxis (PrEP) to help prevent HIV infection.

Community groups working in prevention, as well as experts and senior figures at international organizations fighting HIV, called on the company to ensure it will be priced so it is affordable for low- and middle-income countries (LMICs), which account for 95 percent of HIV infections.

“It is no exaggeration to call lenacapavir a game changer. It could be life-changing for some populations. We need to see it produced generically and supplied to all low- and middle-income countries to the people who need it,” said Dr. Helen Bygrave, chronic disease advisor at Medecins sans Frontiere’s (MSF) Access Campaign.

During the event, data from a trial of lenacapavir, a twice-yearly injectable, were presented. The results of the trial were announced by pharmaceutical firm Gilead last month and showed the drug offered 100% protection to more than 5,000 women in South Africa and Uganda.

Many experts and community leaders helping deliver HIV interventions who spoke to IPS described the drug as a real “game changer,” offering not just spectacular efficacy but relative ease and discretion in delivery—the latter key in combating stigma connected with HIV prevention intervention in some societies—compared to other interventions, such as oral PrEP.

But they warned there were likely to be challenges to access, with cost expected to be the main barrier.

Lenacapavir is currently approved only as a form of HIV treatment at a price of USD 42,000 per person per year.

While as a PrEP intervention it would be expected to be sold at a much lower price, an abstract presented at the conference showed that it could cost just USD 40 a year for every patient.

In a statement put out following the protests, Gilead said it was developing “a strategy to enable broad, sustainable access globally” but that it was too early to give details on pricing.

Critics claimed Gilead was not being transparent in its statement—the company talked of being committed to access pricing for high-incidence, resource-limited countries rather than specifically low- and middle-income countries—and there are fears that the price at which it is eventually made available as PrEP will be so high as to put it out of reach of the countries that are struggling most with the HIV epidemic.

“Cabotegravir, a two-month injectable form of PrEP, is currently being procured by MSF for low-income countries for USD 210 per person per year. We would not expect [the price for lenacapavir] to be higher than that, and we would hope it would be more ‘in the ballpark’ of  USD 100 per person per year,” said Bygrave.

She added that “questions have been asked of Gilead about its pricing for lenacapavir, and the company has been pretty vague in its answers.”

“Civil society needs to put continued pressure on Gilead about this issue because, without that pressure, I do not trust Gilead to do the right thing,” Bygrave, who took part in protests at the conference against Gilead’s pricing, said.

Some speakers at the conference set out a series of demands for the firm.

Winnie Byanyima, Executive Director of UNAIDS, called on Gilead to license generic manufacturers to produce it more affordably through mechanisms such as the Medicines Patent Pool (MPP), a UN-backed programme negotiating generics agreements between originators and generic pharmaceutical companies.

Others, such as keynote speaker Helen Clark, Chair of the Global Commission on Drug Policy, said such interventions must be seen as “common global goods, and ways must be found to make them accessible to all.”

“The pharmaceutical industry has been the beneficiary of much public research investment. With respect to HIV/AIDS, it has benefited from the mobilization of scientists and engaged communities who have advocated for investment in R&D and treatments. Prima facie, the notion that the companies can then make great profits from and not share the intellectual property created is wrong,” she said.

Others went even further, accusing some pharmaceutical firms of being parties to the creation of a de facto global two-tier system for medicine supply.

“Companies must share their medicines. We cannot accept an apartheid in access to medicine in which the lives of those living in the Global South are not regarded as having the same value as the lives in the North,” Archbishop Dr Thabo Makgoba, Archbishop of the Anglican Church of Cape Town and HIV advocate, said at a UNAIDS press event during the conference.

Some of those who work with key populations stressed the need to push through all necessary approvals and set lenacapavir’s price at an accessible level as quickly as possible to save lives.

“It’s great to have innovation and get important new tools in the fight against HIV. But the question is: how long will it take to get them to the people who need them? Until then, they are just a great announcement—like a beautiful picture hanging up there that you can see but cannot actually touch. We need to give communities the funding and the tools they need to do their vital work,” Anton Basenko, Chair of the Board of the International Network of People who Use Drugs (INPUD), told IPS.

The calls came as campaigners stressed the exceptional potential of lenacapavir. It is not only its astonishing efficacy, but also its relative ease and discretion of delivery, which experts are excited about.

Stigma around HIV prevention, such as oral PrEP, which involves taking daily tablets, has been identified as a major barrier to the uptake of HIV interventions in some regions.

Some HIV healthcare specialists at the conference told IPS they had seen cases of women leaving clinics with bottles of tablets and, as soon as they heard them rattling in the bottle, threw them into the bin outside the clinic because the noise would tell others they were taking the tablets and leave them open to potential discrimination, or even gender-based violence.

“The lack of oral PrEP uptake and adherence among women and girls is due to a number of factors, such as stigma and worries about being seen with a huge bottle of pills. What about if you are in a relationship and your partner sees the bottle and starts asking whether you are cheating on them or something?

“A woman could go and get a lenacapavir injection a couple of times a year and no one would have to even know and she wouldn’t have to think about taking pills every day and just get on with her life. This drug could change lives completely. I would definitely take it if it was available,” Sinetlantla Gogela, an HIV prevention advocate from Cape Town, South Africa, told IPS.

The concerns around access to lenacapavir at an affordable price for low and middle income countries come against a background of record debt levels among poor countries, which experts say could have a severe negative impact on the HIV epidemic.

A recent report from the campaign group Debt Relief International showed that more than 100 countries are struggling to service their debts, resulting in them cutting back on investment in health, education, social protection and climate change measures.

Speakers at the conference repeatedly warned these debts had to be addressed to ensure HIV programmes, whether they include lenacapavir or not, continue. Many called for immediate debt relief in countries.

“African debt needs to be restructured to let countries get hold of the medicines they need,” said Byanyima.

“Drop the debt; it is choking global south countries, denying us what we need for health. Please let us breathe,” said Makgoba.

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By Bradley Busetto and Bjorn Andersson
MALE, Maldives, Aug 2 2024 – The ocean is our lifeline, covering 70 percent of the earth’s surface, it is the source of half of the oxygen we breathe, and it absorbs 26 percent of the carbon dioxide we produce. It is home to millions of marine species, contains 97 percent of all of the water on our planet and offers humankind immense resources. 

Maldives – 500,000 people living in ocean-side communities across an archipelago of 26 atolls and 1,192 islands – demonstrates both the challenges of living within an ocean world and its vast potential. Therefore, we must ensure that the ocean is not only our treasured history but part of our healthy and prosperous future as well.

The UN in Maldives together with Ocean Generation (an organization working to restore a healthy relationship between people and the ocean), is supporting the Maldives in meeting the increasing dangers of the climate crisis and preserving and protecting our threatened ocean.

At the recently concluded 4th Small Island Developing States (SIDS4) Conference in Antigua, Maldives President Mohamed Muizzu directly addressed these challenges, calling for international public and private sector finance to invest in Maldives – to provide urgently needed climate financing for new green energy sources and to fund climate protection for communities and islands threatened by rising sea levels.

Recognizing the precarious state of our oceans due to human consumption patterns and global heating, the President has recently ordered a pause to coastal development activities over concerns of high-water temperatures and coral bleaching in nearby waters.

Heeding the President’s call, the UN and Ocean Generation are looking forward to working with Maldives towards solutions for the challenges faced by one of the most climate-vulnerable states in the world.

Here are four key areas with the potential to make the biggest difference.

1) Green energy

A critical issue for Maldives is to reduce the use of expensive diesel fuel for energy production and transport between the many and distant atolls and island communities. Less diesel fuel use is a win-win: fewer carbon emissions and less foreign exchange spent on costly imported fuel.

International investment is urgently needed to scale-up commercial, private-sector supported solar and other renewable energy sources for the capital city Malé and other urban areas, for smaller island communities, and for resorts.

Meeting the Government’s goal of 33 per cent green energy supply by 2028 is a key priority where UN and World Bank initiatives can contribute.

2) Reducing plastic pollution

Safely disposing of waste and reducing the amount of waste that is generated are crucial goals for improving the lives of coastal communities. Reducing the import of single use, throwaway plastics into Maldives that ultimately end in our ocean and wash up on the shores of Maldives atolls, will be essential.

Global plastic production is currently around 420 million metric tonnes per year.  Half of this is destined for single-use. We cannot rely on recycling to address our plastic waste problem.  Only 13 percent of global plastic is recycled and of that 13 percent, only 1 percent is re-used through the system again meaning that even the plastic that does get recycled will eventually end up in landfill, being burned or in the environment.

Maldives Ministry of Environment, Climate Change and Technology’s efforts to increase fees on plastic bags is essential to the national goal of phasing out plastic usage. Working with the Government, the UN and Ocean Generation strive to raise awareness among stakeholders of the cost of inaction and the shift towards environmentally-friendly alternatives to single-use plastics.

The rich biodiversity of the Maldives is vital for the resilience of its island communities, supporting thriving fisheries, diverse vegetation, and various economic opportunities. Credit: UNDP Maldives / Ashwa Faheem

3) Biodiversity conservation

The broad biodiversity of Maldives coastal and marine life is the key to resilience of the interconnected communities of the islands, through fisheries and vegetation and economic livelihoods. Maldives can act as a global laboratory both for oceanic health and for the immediate and dynamic effects of climate change. Ongoing UN initiatives focused on conservation and sustainably managing coral reefs in fishing communities are already laying the ground for local lessons to shape national policy change.

4) Fighting climate change

The ocean is our biggest ally when it comes to climate change, especially with regards to absorbing heat. Average global temperatures today sit at 15 degrees C, (59 F) and without the ocean absorbing heat, that average is estimated to be 50 degrees C (122 F).  Maldives has already demonstrated its commitment to climate resilience, by becoming the first country in Asia and the first Small Island Developing State to embrace the UN Secretary-General’s Early Warnings for All (EW4All) initiative.

Globally, it is the first country to endorse a national EW4All road map, at the presidential level, to ensure multi-hazard early warnings for all by 2027. Continuing to conserve, protect and restore marine resources, as a clear nature-based solution to climate change, is of utmost priority.

Maldives’ climate initiatives offer valuable lessons for all island nations, and their successful implementation could serve as a model for global change. By scaling up efforts to reduce fossil fuel dependence and combat throwaway consumerism, we can protect our oceans and planet, creating a sustainable future for all.

This article was adapted from an Op-Ed written by the UN Resident Coordinator in the Maldives Bradley Busetto and the founder of Ocean Generation Jo Ruxton, MBE. The links follow: maldives.un.org oceangeneration.org.

Source: UN Development Coordination Office (UNDCO).

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