World
ASEAN leaders meet Myanmar coup leader amid killings
Southeast Asian leaders met Myanmar’s top general and coup leader in an emergency summit in Indonesia Saturday, and are expected to press calls for an end to violence by security forces that has left hundreds of protesters dead as well as the release of Aung San Suu Kyi and other political detainees.
There is little hope for an immediate breakthrough in the two-hour gathering in Jakarta between Senior Gen. Min Aung Hlaing and the six heads of state and three foreign ministers representing the Association of Southeast Asian Nations. But his decision to face them offers a rare chance for the 10-nation bloc to directly deal with the general who ousted one of its leaders in a Feb. 1 coup.
“The unfolding tragedy has serious consequences for Myanmar, ASEAN and the region,” Singapore’s Foreign Minister Vivian Balakrishnan said on the eve of the summit.
One proposal, which has been discussed in preliminary meetings, is for Brunei Prime Minister Hassanal Bolkiah, the current ASEAN chair, to travel to Myanmar to meet the military leadership and Suu Kyi’s camp to encourage dialogue. He would be accompanied by ASEAN Secretary General Lim Jock Hoi — also from Brunei — if the junta agreed, a Southeast Asian diplomat told The Associated Press on condition of anonymity because he is not authorized to speak to the media.
Also read 17th China-ASEAN Expo opens in south China
Another diplomat said humanitarian aid could be offered to Myanmar if conditions improved. The diplomat also spoke to AP on condition of anonymity for lack of authority to discuss such plans publicly.
Foreign Minister Retno Marsudi of Indonesia expressed hopes that “we can reach an agreement on the next steps that can help the people of Myanmar get out of this delicate situation.”
Following the coup, ASEAN, through Brunei, issued a statement that did not expectedly condemn the power grab but urged “the pursuance of dialogue, reconciliation and the return to normalcy in accordance with the will and interests of the people of Myanmar.” Amid Western pressure, however, the regional group has struggled to take a more forceful position on issues but has kept to its non-confrontational approach.
All ASEAN states agreed to meet Min Aung Hlaing but would not address him as Myanmar’s head of state in the summit, the Southeast Asian diplomat said. Critics have said ASEAN’s decision to meet him was unacceptable and amounted to legitimizing the overthrow and the deadly crackdown that followed. Daily shootings by police and soldiers have killed more than 700 protesters and bystanders, according to several independent tallies.
Amnesty International urged Indonesia and other ASEAN states to investigate Min Aung Hlaing over “credible allegations of responsibility for crimes against humanity in Myanmar.” As a state party to a U.N. convention against torture, Indonesia has a legal obligation to prosecute or extradite a suspected perpetrator on its territory, it said.
“The Myanmar crisis trigged by the military presents ASEAN with the biggest test in its history,” said Emerlynne Gil of the London-based rights group. “This is not an internal matter for Myanmar but a major human rights and humanitarian crisis which is impacting the entire region and beyond.”
Police dispersed dozens of protesters opposing the coup and the junta leader’s visit.
More than 4,300 police have fanned out across the Indonesian capital to secure the meetings, held under strict safeguards amid the pandemic. Indonesia has reported the highest number of COVID-19 infections and deaths in Southeast Asia.
Also read: ASEAN urged to engage Myanmar's National Unity Govt to end crisis, military rule
The leaders of Thailand and the Philippines skipped the summit to deal with coronavirus outbreaks back home. Laos, which has the least number of infections in the region but this week imposed a lockdown, also canceled at the last minute. The face-to-face summit is the first by ASEAN leaders in more than a year.
ASEAN’s diversity, including the divergent ties of many of its members to either China or the United States, along with a bedrock policy of non-interference in each other’s domestic affairs and deciding by consensus, has hobbled the bloc’s ability to rapidly deal with crises.
Aside from Myanmar, the regional bloc groups Brunei, Cambodia, Indonesia, Laos, Malaysia, the Philippines, Singapore, Thailand and Vietnam.
White House offers new tax credit to help spur vaccinations
President Joe Biden on Wednesday announced new employer tax credits and other steps to encourage people reluctant to be inoculated to get the COVID-19 vaccine as his administration tries to overcome diminishing demand for the shots. The moves came as Biden celebrated reaching his latest goal of administering 200 million coronavirus doses in his first 100 days in office.
With more than 50% of adults at least partially vaccinated and roughly 28 million vaccine doses being delivered each week, demand has eclipsed supply as the constraining factor to vaccinations in much of the country.
In a White House speech on Wednesday, Biden acknowledged entering a “new phase” in the federal vaccination effort that relies on increased outreach to Americans to get their shots, both to protect them and their communities.
“Vaccines can save your own life, but they can also save your grandmother’s life, your co-worker’s life, the grocery store clerk or the delivery person helping you and your neighbors get through the crisis,” Biden said. “That’s why you should get vaccinated.”
Also read: At ‘moment of peril,’ Biden opens global summit on climate
Over the past week, the pace of inoculation in the U.S. has slowed slightly. That is partly a reflection of disruptions from the “pause” in administration of the Johnson & Johnson shot for a safety review, but also of softening interest for vaccines in many places even as eligibility has been opened to all those older than 16.
As the vaccination program progresses, the administration believes it will only get more difficult to sustain the current pace of about 3 million shots per day. Roughly 130 million Americans have yet to receive one dose.
Surveys have shown that vaccine hesitancy has declined since the rollout of the shots, but administration officials believe they have to make getting vaccinated easier and more appealing, particularly for younger Americans who are less at risk from the virus and do not feel the same urgency to get a shot. That means providing incentives and encouragement to get vaccinated, as well as reducing the friction surrounding the vaccination process.
Biden announced a tax credit for small businesses to provide paid leave for those getting vaccinated or potentially needing to take time off to recover from side effects. Paid for through the $1.9 trillion virus relief package passed last month, the tax change would provide a credit of up to $511 per day, per employee for businesses with fewer than 500 workers to ensure that those workers or businesses don’t suffer a penalty by getting vaccinated.
The White House is urging larger employers, which have more resources, to provide the same benefits to their workers, and educate them about the shots and encourage them to get vaccinated.
“We’re calling on every employer, large and small, in every state, give employees the time off they need with pay to get vaccinated,” Biden said.
Also read: Hitting latest vaccine milestone, Biden pushes shots for all
According to the White House, just 43% of working adults have received at least one shot.
As Biden celebrated the vaccine milestone, there is a different reality in the states.
In Iowa, nearly half of the counties are not accepting new doses of the COVID-19 vaccine from the state’s allotment because demand has fallen off. In Florida, Palm Beach County plans to close mass vaccination clinics at the end of May with thousands of available vaccine slots unclaimed. In rural West Virginia, a vaccine clinic at a casino/race track parking garage is opening shots to out-of-state residents to address lagging demand. The hope is that people from Washington, D.C., make the hour’s drive to get vaccinated. In Arizona, a plan collapsed that would have opened a federally run vaccine site in Tucson; demand is slipping and county officials preferred more targeted, mobile locations.
Asked about the dip in vaccinations, Health and Human Services Secretary Xavier Becerra said “fluctuation is not uncommon” and that “what we want to do is continue to encourage Americans to continue to get vaccinated.”
“The pace of vaccination isn’t linear,” Becerra said, adding that “we are on a pretty good pace.”
Through its partnership with more than 40,000 retail pharmacies, the White House says more than 90% of Americans now live within 5 miles of a vaccination site. The administration is encouraging state and local efforts to bring vaccines directly to people, whether through initiatives reaching the homebound or clinics at large employment sites.
Many states have also begun to open up vaccination sites to walk-in appointments, reducing reliance on often-cumbersome reservation systems.
Maximizing the number of Americans vaccinated in the coming months is critical for the White House, which is aiming to restore a semblance of normalcy around the July Fourth holiday and even more so by the beginning of the next school year.
Administration officials have been careful to avoid predicting when the country will have vaccinated enough people to reach herd immunity — when enough people become immune to a disease to make its spread unlikely. The U.S. is on track to have enough vaccine supply for every adult by the end of May and for every American by July, but administering the shots will be another matter.
With its stockpile secure and demand dropping at home, the president spoke again of sharing excess doses with allies.
Biden said he talked with Canadian Prime Minister Justin Trudeau for about 30 minutes on Wednesday. “We helped a little bit there, we’re going to try to help some more,” Biden said, referring to his decision last month to share about 1.5 million doses of the AstraZeneca vaccine with Canada. “But there’s other countries as well that I’m confident we can help, including in Central America. But it’s in process.”
Also read: Biden to America after Floyd verdict: ‘We can’t stop here’
He added. “We don’t have enough to be confident to send it abroad now. But I expect we’re going to be able to do that.”
Biden set his goal of 200 million shots last month after meeting his 100 million-in-100 days goal just over a month ago. That original benchmark was announced Dec. 8, days before the U.S. had even one authorized vaccine, let alone the three that have now received emergency authorization. Still, it was generally seen within reach, if optimistic.
By the time Biden was inaugurated on Jan. 20, the U.S. had already administered 20 million shots at a rate of about 1 million per day, bringing complaints at the time that Biden’s goal was not ambitious enough. Biden quickly revised it upward to 150 million doses in his first 100 days.
8 killed after glacial burst triggers avalanche in India's Uttarakhand
At least eight people were killed and six others rescued in critical condition after part of a glacier collapsed, triggering an avalanche in the northern Indian state of Uttarakhand, officials said Saturday.
According to officials, 384 others, mostly belonging to India's Border Roads Organisation (BRO) and General Reserve Engineer Force (GREF), have been rescued safely.
The avalanche took place Friday late afternoon during heavy snowfall in Chamoli district of Uttarakhand.
"384 BRO persons moved to safety. Eight snow trapped bodies recovered from the two BRO Camps. Six critically injured being evacuated. Air sorties are being attempted to assist medical evacuation. Rescue operations by army continue unabated," reads a statement issued by Indian army.
Also read: Glacier breaks in India’s north; flood kills 9, 140 missing
Officials said though rescue operations were launched immediately on Friday, it had to be temporarily halted during night hours owing to bad weather conditions.
Also read: 140 are missing after glacier breaks in India’s Himalayas
On Saturday morning the rescue efforts were resumed.
In February, a similar disaster led to a massive avalanche followed by floods, killing at least 80 people in the area.
Jerusalem tension triggers Gaza-Israel fire exchange
Tensions in Jerusalem sparked the worst round of cross-border violence between Israel and the Gaza Strip in months on Saturday, with Palestinian militants firing at least 30 rockets and Israel striking back at targets operated by Gaza’s Hamas rulers.
Skirmishes have spiked in recent days in Jerusalem, which has long been a flashpoint in the Israeli-Palestinian conflict, and is home to holy sites sacred to Jews, Christians and Muslims. Residents braced for possible further unrest as police stepped up security and the U.S. Embassy appealed for calm.
On Friday, Israeli police said 44 people were arrested and 20 officers were wounded in a night of chaos in Jerusalem, where security forces separately clashed with Palestinians angry about Ramadan restrictions and Jewish extremists who held an anti-Arab march nearby.
The incidents in Jerusalem triggered a flare-up in Gaza. Hamas’ armed wing warned Israel “not to test” its patience and militants in the Palestinian enclave started firing rockets into southern Israel late Friday and continued through Saturday morning.
The Israeli military said its aircraft and tanks struck rocket launchers and unspecified underground infrastructure for Hamas. The militant group did not claim responsibility for the rocket attacks, but a small military formation affiliated with the leftist Popular Front for the Liberation of Palestine said it fired some of the missiles.
Sirens warning of incoming rockets from Gaza kept blaring in southern Israel. Air defenses intercepted some of the rockets. There were no reports of injuries on either side.
At dawn, hundreds of people in Gaza challenged nightly curfews imposed by Hamas to curb the coronavirus outbreak and took to the streets in an act of solidarity with fellow Palestinians in Jerusalem, burning tires.
There were concerns the violence could reignite following Friday noon prayers at a major holy site in Jerusalem, but thousands of worshippers dispersed peacefully after Muslim religious leaders called for restraint.
Also read: Palestinians torn as Israel seeks Gulf tourists in Jerusalem
But in the evening, dozens of Palestinians marched toward an entrance to the walled Old City of Jerusalem and clashed with Israeli police, which said the protesters had thrown stones and other items at officers. Six Palestinians were injured with two hospitalized.
Palestinians have clashed with Israeli police on a nightly basis since the start of the Muslim holy month of Ramadan. The tensions began when police placed barricades outside the Old City’s Damascus Gate, where Muslims traditionally gather to enjoy the evening after the daytime fast.
The clashes intensified Thursday evening when hundreds of Palestinians hurled stones and bottles at police, who fired a water cannon and stun grenades to disperse them. Dozens of Palestinians were wounded in the melee.
At the same time, a far-right Jewish group known as Lahava led a march of hundreds of protesters chanting “Arabs get out!” toward the Damascus Gate. The show of force came in response to videos circulated on TikTok showing Palestinians slapping religious Jews at random. Other videos made in response to them appear to show Jews assaulting Arabs. After keeping them a few hundred yards away from Damascus Gate, Police used water cannon, stun grenades and mounted police to push far-right protesters back toward mostly Jewish west Jerusalem.
The Palestinians want east Jerusalem to be the capital of their future state. Its fate has been one of the most divisive issues in the peace process, which ground to a halt more than a decade ago.
Early Saturday, Jordan strongly condemned “the racist attacks on Palestinians.” Foreign Minister Ayman Safadi tweeted: “As the occupying power under international law, Israel is responsible for stopping these attacks & for the dangerous consequences of failing to do so.”
The U.S. Embassy said it was “deeply concerned” about the violence in recent days. “We hope all responsible voices will promote an end to incitement, a return to calm, and respect for the safety and dignity of everyone in Jerusalem,” it said in a statement.
Tens of thousands of Palestinians attended weekly prayers at the Al-Aqsa mosque compound in Jerusalem’s Old City on Friday. The site is the third holiest in Islam and the holiest for Jews, who refer to it as the Temple Mount.
Also read Israel advances plans in sensitive east Jerusalem settlement
Sheikh Muhammad Hussein, the Grand Mufti of Jerusalem, condemned the “police and settlers’ attack on Palestinians in Jerusalem” in his sermon. But he called on worshippers to remain calm and not to give the other side an excuse to storm the compound. They dispersed peacefully after prayers and there were no immediate reports of unrest.
The sprawling hilltop compound has seen clashes on a number of occasions over the years and was the epicenter of the 2000 Palestinian intifada, or uprising.
Hamas meanwhile staged demonstrations across Gaza after Friday prayers, reiterating its support for armed struggle. “After a long series of protests and demonstrations, we have reached the conclusion that without weapons, we cannot liberate our land, protect our holy sites, bringing back our people to their land or maintain our dignity,” senior Hamas official Mahmoud Zahar said.
No sign of Indonesian sub as air dwindles, search resumes
The oxygen supply for the 53 crew members of an Indonesian submarine missing in waters off Bali is believed to have run out early Saturday with no sign of the vessel while the search resumed, bolstered by the arrival of a sonar-equipped Australian warship.
The KRI Nanggala 402 went missing after its last reported dive Wednesday off the resort island, and concern is mounting it may have sunk too deep to reach or recover in time. The navy chief said the submarine was expected to run out of oxygen early Saturday morning.
“We will maximize the effort today, until the time limit tomorrow at 3 a.m.,” military spokesperson Maj. Gen. Achmad Riad told reporters Friday. A news conference was scheduled for later Saturday morning.
There have been no signs of life from the submarine, but family members held out hope that the massive search effort would find the vessel in time.
“The family is in a good condition and keeps praying,” said Ratih Wardhani, the sister of 49-year-old crewman Wisnu Subiyantoro. “We are optimistic that the Nanggala can be rescued with all the crew.”
Twenty-four Indonesian ships and a patrol plane were mobilized for the search, focusing on the area where an oil slick was found after the submarine disappeared during an exercise. Rescuers made similar massive searches in the previous two days.
Also read: Search for Indonesia submarine focuses on oil slick off Bali
An American reconnaissance plane, P-8 Poseidon, was expected to join the search Saturday and a second Australian ship was due soon.
“These two Australian ships will help expand the search area and extend the duration of the search effort,” Australian Navy Rear Adm. Mark Hammond said.
Singaporean and Malaysian rescue ships were also expected in the coming days.
Indonesian President Joko Widodo canceled a visit to Banyuwangi port, where some rescue ships left earlier, to prepare for a weekend regional summit in Jakarta, officials said. He asked Indonesians to pray for the crew’s safe return, while ordering all-out efforts to locate the submarine.
“Our main priority is the safety of the 53 crew members,” Widodo said in a televised address on Thursday. “To the family of the crew members, I can understand your feelings and we are doing our best to save all crew members on board.”
Also read: Worries grow about Indonesian sub's crew as oxygen dwindles
There’s been no conclusive evidence the oil slick was from the sub. Navy Chief of Staff Adm. Yudo Margono said oil could have spilled from a crack in the submarine’s fuel tank or the crew could have released fuel and fluids to reduce the vessel’s weight so it could surface.
Margono said an unidentified object exhibiting high magnetism was located at a depth of 50 to 100 meters (165 to 330 feet) and officials held out hope it is the submarine.
The navy said it believes, however, that the submarine sank to a depth of 600-700 meters (2,000-2,300 feet), much deeper than its collapse depth, at which water pressure would be greater than the hull could withstand. The vessel’s collapse depth was estimated at 200 meters (655 feet) by a South Korean company that refitted the vessel in 2009-2012.
The cause of the disappearance is still uncertain. The navy has said an electrical failure could have left the submarine unable to execute emergency procedures to resurface.
Submarine accidents are often disastrous.
In 2000, the Russian nuclear submarine Kursk suffered internal explosions and sank during maneuvers in the Barents Sea. Most of its 118 crew died instantly, but 23 men fled to a rear compartment before they later died, mainly of suffocation. In November 2017, an Argentine submarine went missing with 44 crew members in the South Atlantic, almost a year before its wreckage was found at a depth of 800 meters (2,625 feet).
But in 2005, seven men aboard a Russian mini-sub were rescued nearly three days after their vessel was snagged by fishing nets and cables in the Pacific Ocean. They had only six hours of oxygen left before reaching the surface.
The German-built diesel-powered KRI Nanggala 402 has been in service in Indonesia since 1981 and was carrying 49 crew members and three gunners as well as its commander, the Indonesian Defense Ministry said.
Indonesia, the world’s largest archipelago nation with more than 17,000 islands, has faced growing challenges to its maritime claims in recent years, including numerous incidents involving Chinese vessels near the Natuna islands.
US to resume J&J COVID vaccinations despite rare clot risk
U.S. health officials lifted an 11-day pause on COVID-19 vaccinations using Johnson & Johnson’s single-dose shot on Friday, after scientific advisers decided its benefits outweigh a rare risk of blood clot.
The government uncovered 15 vaccine recipients who developed a highly unusual kind of blood clot out of nearly 8 million people given the J&J shot. All were women, most under age 50. Three died, and seven remain hospitalized.
But ultimately, federal health officials decided that J&J’s one-and-done vaccine is critical to fight the pandemic — and that the small clot risk could be handled with warnings to help younger women decide if they should use that shot or an alternative.
The Centers for Disease Control and Prevention said the J&J vaccine has important advantages for some people who were anxiously awaiting its return. And the Food and Drug Administration updated online vaccine information leaflets for would-be recipients and health workers, so that shots could resume as early as Saturday.
Also read: Several U.S. states shut down Johnson & Johnson vaccine sites after adverse reactions reported
“This is not a decision the agencies reached lightly,” FDA Acting Commissioner Janet Woodcock told reporters late Friday.
CDC Director Dr. Rochelle Walensky added that the pause should increase confidence in vaccine safety, showing “that we are taking every one of those needles in a haystack that we find seriously.”
The U.S. decision — similar to how European regulators are rolling out J&J’s shot — comes after advisers to the CDC debated in a daylong meeting just how serious the risk really is. Panelists voted 10-4 to resume vaccinations without outright age restrictions, but made clear that the shots must come with clear warnings about the clots.
Also read: Merck to help produce rival J&J’s COVID-19 vaccine
“I think we have a responsibility to be certain that they know this,” said Dr. Sarah Long of Drexel University College of Medicine, who voted against the proposal because she felt it did not go far enough in warning younger women.
The committee members all agreed the J&J vaccine “should be put back into circulation,” panel chairman Dr. Jose Romero, Arkansas’ health secretary, said in an interview after the vote. “The difference was how you convey the risk ... It does not absolve us from making sure that people who receive this vaccine, if they are in the risk group, that we inform them of that.”
European regulators earlier this week made a similar decision, deciding the clot risk was small enough to allow the rollout of J&J’s shot. But how Americans ultimately handle J&J’s vaccine will influence other countries that don’t have as much access to other vaccination options.
Dr. Paul Stoffels, J&J’s chief scientific officer, pledged that the company would work with U.S. and global authorities “to ensure this very rare event can be identified early and treated effectively.”
At issue is a weird kind of blood clot that forms in unusual places, such as veins that drain blood from the brain, and in patients with abnormally low levels of the platelets that form clots. Symptoms of the unusual clots, dubbed “thrombosis with thrombocytopenia syndrome,” include severe headaches a week or two after the J&J vaccination — not right away — as well as abdominal pain and nausea.
The government initially spotted six cases of the rare clots, with nine more cases coming to light in the last week or so. But even the first handful of reports raised alarm because European regulators already had uncovered similar rare clots among recipients of another COVID-19 vaccine, from AstraZeneca. The AstraZeneca and J&J shots, while not identical, are made with the same technology.
European scientists found clues that an abnormal platelet-harming immune response to AstraZeneca’s vaccine might be to blame -- and if so, then doctors should avoid the most common clot treatment, a blood thinner called heparin.
That added to U.S. authorities’ urgency in pausing J&J vaccinations so they could tell doctors how to diagnose and treat these rare clots. Six patients were treated with heparin before anyone realized that might harm instead of help.
Dr. Jesse Goodman of Georgetown University closely watched Friday’s deliberations and said people should be made aware of the clotting risk but that it shouldn’t overshadow the benefits of COVID-19 protection.
“We need to treat people as adults, tell them what the information is and give them these choices,” said Goodman, a former vaccine specialist at the FDA.
Two-dose vaccines from Pfizer and Moderna, which are made differently and haven’t been linked to clot risks, are the mainstay of the U.S. vaccination effort. But many states had been counting on the easier-to-store, one-dose option to also help protect hard-to-reach populations including people who are homeless or disabled.
The CDC’s advisers struggled to put the rare clot cases into perspective. COVID-19 itself can cause a different type of blood clots. So can everyday medications, such as birth control pills.
The side effect debate isn’t the only hurdle facing J&J. The FDA separately uncovered manufacturing violations at a Baltimore factory the company had hired to help brew the vaccine. No shots made by Emergent BioSciences have been used — J&J’s production so far has come from Europe. But it’s unclear how the idled factory will impact J&J’s pledge to provide 100 million U.S. vaccine doses by the end of May and 1 billion doses globally this year.
COVID-19 continues to disrupt essential health services in 90pc of countries: WHO
The second round of a World Health Organization “pulse survey“ reveals that over one year into the COVID-19 pandemic, substantial disruptions persist, with about 90% of countries still reporting one or more disruptions to essential health services, marking no substantial global change since the first survey conducted in the summer of 2020.
Within countries, however, the magnitude and extent of disruptions has generally decreased. In 2020, countries reported that, on average, about half of essential health services were disrupted.
In the first 3 months of 2021, however, they reported progress, with just over one third of services now being disrupted, said the WHO on Friday.
This survey looks at 63 core health services across delivery platforms and health areas. It was sent to 216 countries and territories across the six WHO regions.
Also Read: 90pc of countries report disruptions to essential health during coronavirus pandemic
135 responses were received (63% response rate) from senior ministry of health officials predominantly between January and March 2021.
The responses referred to the situation in the country during the 3 months prior to survey submission (in this case predominantly covering periods between October 2020-February 2021).
Overcoming disruptions
Countries have been working to mitigate disruptions. Many have now stepped up communications efforts to inform the public about changes to service delivery and provide advice about ways to safely seek health care. They are also triaging (the practice of allocating scarce medical resources among patients) to identify and better meet the most urgent patient needs.
More than half the countries consulted say they have recruited additional staff to boost the health workforce; redirected patients to other care facilities; and switched to alternative methods to delivering care, such as providing more home-based services, multi-month prescriptions for treatments, and increasing the use of telemedicine.
Read Alert over shortage of new drugs for ‘world’s most dangerous bacteria’
In addition, WHO and its partners have been helping countries to adapt their processes so they can better respond to the challenges being placed on their health systems; strengthen primary health care, and advance universal health coverage.
“It is encouraging to see that countries are beginning to build back their essential health services, but much remains to be done,” says Dr Tedros Adhanom Ghebreyesus, Director General, WHO.
“The survey highlights the need to intensify efforts and take additional steps to close gaps and strengthen services. It will be especially important to monitor the situation in countries that were struggling to provide health services before the pandemic.“
Persisting causes of disruptions
Countries are still having to make important decisions when responding to COVID-19 that may negatively affect access to care for other health issues. Redeployment of staff to provide COVID-19 relief and temporary closures of health facilities and services continue.
Read COVID-19: Health services for noncommunicable diseases significantly impacted
Although they may have taken on new staff, 66% of countries continue to report health workforce-related reasons as the most common causes of service disruptions. Supply chains are also still disrupted in nearly one third of countries, affecting the availability of essential medicines, diagnostics, and the PPE needed to safely and effectively provide care.
Communications efforts need to be further scaled up: more than half of countries report service disruptions due to patients not seeking care and because of community mistrust and fears of becoming infected.
Meanwhile, 43% of countries cite financial challenges as major causes for disruptions in service utilization.
As a result, millions of people are still missing out on vital health care. In terms of services, the biggest impact reported by nearly half of countries is on provision of day-to-day primary care to prevent and manage some of the most common health problems.
Read Shocking imbalance in Covid vaccine distribution: WHO
Long-term care for chronic conditions, rehabilitation, and palliative end-of-life care, is also still badly disrupted - severely affecting older people and people living with disabilities.
Potentially life-saving emergency, critical and surgical care interventions are still disrupted in about 20% of countries, reflecting the most immediate indirect consequences of the pandemic.
Two thirds of countries also report disruptions in elective surgeries, with accumulating consequences as the pandemic is prolonged.
Among the most extensively affected health services (i.e. those for which more than 40% of countries are reporting disruptions) are those for mental, neurological and substance use disorders; neglected tropical diseases; tuberculosis; HIV and hepatitis B and C; cancer screening, and services for other noncommunicable diseases including hypertension and diabetes; family planning and contraception; urgent dental care; and malnutrition.
Read WHO team urges patience after 1st look for origin of virus
Issued ahead of World Immunization Week (which starts 24 April) and World Malaria Day (25 April) the survey reveals that serious gaps also remain in addressing disruptions to services in both these areas.
More than one third of countries are still reporting disruptions to immunization services, despite progress in countries reducing disruptions to immunization services in health facilities and “outreach” immunization services by about 20% and 30% respectively compared to 2020.
This highlights the need for new and sustained approaches to improving immunization coverage and uptake.
“The COVID-19 pandemic continues to pose serious challenges to global health beyond the impact of the disease itself,” said Henrietta Fore, UNICEF Executive Director.
Read WHO report says animals likely source of COVID
“For children, disruptions to immunization services have serious consequences. As we scale up delivery of COVID-19 vaccines, we have to ensure that this does not come at the cost of essential childhood vaccinations. We cannot allow today’s fight against COVID-19 to undermine our fight against measles, polio or other vaccine preventable illnesses. Prolonged immunization disruptions will have long-term consequences for children’s health. The time to catch up is now.”
Meanwhile, nearly 40% of countries are also reporting disruptions to one or more malaria services. While progress compared to 2020 – with about 10% fewer countries reporting disruptions to malaria diagnosis and treatment and 25-33% fewer countries reporting disruptions to malaria prevention campaigns (including distribution of long-lasting insecticide impregnated bed nets, indoor spraying and seasonal malaria chemoprevention), the reported level of disruption is still significant and needs to be urgently addressed.
WHO will continue to support countries so they can respond to increased strains on health systems and rapidly evolving priorities and needs throughout the course of the pandemic, and to ensure that COVID-19 control strategies are in balance strategies to tackle other health priorities and secure continued access to comprehensive care for everyone, including the most vulnerable.
Key support mechanisms include the ACT-Accelerator, which works to speed up equitable access to COVID-19 vaccines, tests and treatments, and the Strategic Preparedness and Response Plan, which guides actions taken at national, regional, and global levels to tackle COVID-19.
Read COVID-19 infections approaching highest rates ever, WHO warns
The Organization also remains focused on the delivery of the work it has committed to before the COVID-19 pandemic started. Internally, through the “Boost initiative” and the UHC Partnership, which covers 115 countries, WHO has strengthened its capacity to provide additional support to countries so they can maintain essential health services during the pandemic, and advance progress towards universal health covera
Why the world should pay attention to Taiwan's drought
Taiwan is supposed to be one of the rainiest places in the world - its climate is subtropical in the northern and central regions, and tropical in the south. Typhoons are common in summer and autumn, and it also gets monsoons. It rains so often here that umbrellas are placed at subway stations and businesses for anyone to borrow.
But something unusual happened last year - no typhoon hit the island. And there has been little rain in the past year, reports BBC.
That has plunged Taiwan into its worst drought in 56 years. Many of its reservoirs are at less than 20% capacity, with water levels at some falling below 10%.
At the Baoshan No. 2 Reservoir in Hsinchu County, one of the primary water sources for Taiwan's $100bn semiconductor industry, the water level is at the lowest it's ever been - only 7% full.If this and other reservoirs in Taiwan dry up, it could be detrimental for the global electronics sector, because so many of the products people use are powered by semiconductors - computer chips - made by Taiwanese companies.
Also read: Taiwanese man involved in deadly train derailment released on bail
Around 90% of the most advanced microchips are manufactured in Taiwan.They're key to objects ranging from ventilators to smartphones, and the pandemic has left demand high and supply tight. The US is now worried about over-reliance on chips made overseas, including in Taiwan.The sector is a big contributor to the island's overall economy, but it requires a lot of water to clean the wafers that go into many tech devices. Struggling to ensure supplies, the government stopped irrigating more than 74,000 hectares of farmland last year.It has also turned off the tap for residents and businesses in three cities and counties, including one of its biggest municipalities, Taichung, two days a week.In dry areas, high-volume industrial users including semiconductor manufacturers have been asked to reduce water usage by 13%, and non-industrial users, such as hair salons and car wash businesses, by 20%.Farmers have been the hardest hit.Like thousands of crop planters cross Taiwan, Chuang Cheng-deng, a fourth generation rice farmer in Hsinchu, has been forced to leave his seven hectares of land fallow."We also think about our country's economy, but they shouldn't completely stop providing water. You can give us water for two days a week or one day. Farmers will find a way. But now they've completely cut our water, farmers can't find a way out. You're focusing entirely on semiconductors," Mr Chuang says.The government is compensating farmers, but Mr Chuang says a lot of landowners take the subsidies instead, and farmers can't object for fear they will not be able to lease the land. Even if they get the money, they risk hurting their brand and losing clientele they've worked hard to build by not growing their products.He points out the government has been encouraging young people to go into farming as Taiwan's farmers are ageing, but young farmers are now left with no way to farm after they've invested in equipment and land."Farmers feel really helpless," Mr Chuang says, looking sadly at the dry irrigation canal running through his fields.
Also read: Taiwan prosecutors probe train crash that killed 51Experts say Taiwan should have seen the warning signs."Taiwan has been suffering from a significant decrease in the number of rainy days each year since the 1960s," says Hsu Huang-hsiung, a climate change expert at government-funded think tank Academia Sinica.In parts of the island, the number of rainy days each year has fallen by about 50.And a warming trend in the Indian Ocean since 1950 may have brought about the Pacific Ocean's high pressure system last year, which prevented rain from falling in June and reduced the number of typhoons that were formed, according to experts."Climate change has never been a centre of discussion in our government or society. Although everybody talks about being afraid of climate change, it tends to be lip service. They express care, but don't take any action," Mr Hsu says.Taiwanese people's tendency to take water for granted - and some would say the government's neglect of how water resources are managed - are at the root of the shortage, according to people who have looked into the problem."If you look at Taiwan as a whole, it has sufficient rainfall. The problem is how we use water," said Kuo Yu-ling, a young farmer. "The first problem is our pipes leak water. Another problem is how we transfer water from one place to another. I don't know if the government is considering transferring water from the eastern part of Taiwan to the west, because the east enjoys several months of rain each year, but Hsinchu and north of it get almost no rain."Leaking pipes have caused Taiwan to lose nearly 14% of its water. Deforestation has also led to soil runoff when it does rain, leading to sediment build-up in the reservoirs, depriving them of their capacity to collect more water during rainy periods, for use in dry spells.The government has been tackling these problems: for example, the pipe leakage rate has dropped from 20% a decade ago.However, Taiwan's notoriously low water prices - blamed for giving consumers little incentive to conserve water - seem untouchable. Some say it's because it would be very unpopular to raise prices and politicians are afraid to do so because they don't want to lose votes.At NT$11 (US$0.39; £0.27) a ton, Taiwan's water rates are the second lowest among 35 countries and territories surveyed; half the cost of South Korea's rate, four times lower than that of the US and six times lower than costs in the UK.The Water Resources Agency says: "Due to the economic and social development and the fairness of social resources, it is still being carefully evaluated and there is no mature adjustment plan for the time-being."Instead, it's looking at Taiwan's surrounding waters for solutions, planning to build more seawater desalination plants. Most are located in outlying islands, with only three on Taiwan's main island. A new facility has been built in Hsinchu to deal with the current drought, but it can only treat 13,000 tons of water daily, a drop in the bucket compared to the 170,000 tons used each day just by Hsinchu Science Park, where many semiconductor makers are based.Desperate for rain, the government has tried to manipulate nature by carrying out cloud seeding numerous times, while officials from the Irrigation Agency held a rain worshipping ceremony in early March at which they prayed for help from Mazu, a sea goddess in Taoist and Buddhist traditions.It's hoping the annual rainy season, which normally lasts from mid-May to mid-June, will bring lots of showers.But it shouldn't get its hopes up. Last year, by May the rainy season was over and not enough rain had fallen.For now, people with no tap water fill up their buckets twice a week in advance, or fetch water from tanks set up on the street on the off days.TSMC and other chipmakers are planning for the worst. They are recycling more of the water they use - TSMC says it recycles more than 86%. The company is also buying truckloads of water from construction sites and other places. So far, it says, its operations have not been affected.Kuo Yao-cheng, a spokesman for the Water Resources Agency, says everyone will have to pitch in to resolve this issue."The government is taking measures to address these problems. … Everyone and every sector must think about how we can conserve water, especially because climate change will lead to insufficient rainfall," says Mr Kuo.For his part, Farmer Chuang has taken to growing watermelons and sunflowers, which require less water. He pumps ground water from the well he has dug in his farm to water his plants. But he believes sacrificing farming every time there's a drought will only worsen Taiwan's already low food self-sufficiency rate - the amount of food its people consume that is locally grown and not imported from overseas."We have to find a long-term solution to this problem," Mr Chuang says.If Taiwan doesn't rise to the challenge, both its farms and its prized semiconductor industry can expect to suffer in years to come.
Worries grow about Indonesian sub's crew as oxygen dwindles
Indonesian navy ships were scouring the waters off Bali on Friday as they raced against time to find a submarine that disappeared two days ago and has less than a day’s supply of oxygen left for its 53 crew.
The KRI Nanggala 402 went missing after its last reported dive Wednesday off the resort island, and concern is mounting the submarine may have sunk too deep to reach or recover. The navy chief said the submarine was expected to run out of oxygen by around 3 a.m. Saturday.
“We will maximize the effort today, until the time limit tomorrow 3 a.m.,” military spokesperson Maj. Gen. Achmad Riad told reporters.
There have been no signs of life from the submarine, but the spokesperson refused to speculate on its fate.
A total of 24 navy and other ships and a patrol plane were being mobilized for Friday’s search with a focus on the area where an oil slick was found after the submarine disappeared during an exercise. Rescuers made similar massive searches in the past two days.
An Australian warship equipped with a sonar device and a helicopter was set to arrive later Friday. A second Australian warship as well as Singaporean and Malaysian rescue ships were also expected in the coming days.
“These two Australian ships will help expand the search area and extend the duration of search effort,” Australian Navy Rear Adm. Mark Hammond said.
On Friday, Indonesian President Joko Widodo was heading to Banyuwangi port, where the rescue ships left earlier. He asked Indonesians to pray for the crew’s safe return, while ordering all-out efforts to locate the stricken submarine.
“Our main priority is the safety of 53 crew members,” Widodo said in a televised address on Thursday. “To the family of the crew members, I can understand your feelings and we are doing our best to save all crew members on board.”
There’s been no conclusive evidence the oil slick was from the sub. Navy Chief of Staff Adm. Yudo Margono said oil could have spilled from a crack in the submarine’s fuel tank or the crew could have released fuel and fluids to reduce the vessel’s weight so it could surface.
Margono said an unidentified object with high magnetism was located at a depth of 50 to 100 meters (165 to 330 feet) and officials held out hope it’s the submarine.
The navy also said it believes the submarine sank to a depth of 600-700 meters (2,000-2,300 feet), much deeper than its collapse depth at which water pressure would be greater than the hull could withstand. The vessel’s collapse depth was estimated at 200 meters (655 feet) by a South Korean company that refitted the vessel in 2009-2012.
The cause of the disappearance is still uncertain. The navy has said an electrical failure could have left the submarine unable to execute emergency procedures to resurface.
Pentagon press secretary John Kirby said the United States is sending airborne assets to assist in the search. “We are deeply saddened by the news of Indonesia’s lost submarine, and our thoughts are with the Indonesian sailors and their families,” Kirby said. Other countries have also offered assistance.
Submarine accidents are often disastrous.
In 2000, the Russian nuclear submarine Kursk suffered internal explosions and sank during maneuvers in the Barents Sea. Most of its 118 crew died instantly, but 23 men fled to a rear compartment before they later died, mainly of suffocation. In November 2017, an Argentine submarine went missing with 44 crew members in the South Atlantic, almost a year before its wreckage was found at a depth of 800 meters (2,625 feet).
But in 2005, seven men aboard a Russian mini-sub were rescued nearly three days after their vessel became snagged by fishing nets and cables in the Pacific Ocean. They had only six hours of oxygen left before reaching the surface.
The German-built diesel-powered KRI Nanggala 402 has been in service in Indonesia since 1981 and was carrying 49 crew members and three gunners as well as its commander, the Indonesian Defense Ministry said.
Indonesia, the world’s largest archipelago nation with more than 17,000 islands, has faced growing challenges to its maritime claims in recent years, including numerous incidents involving Chinese vessels near the Natuna islands.
25 die in Delhi hospital due to oxygen shortage
As many as 25 patients have died at a leading hospital in the Indian capital in the past 24 hours due to "low pressure oxygen".
The deaths were announced by Sir Ganga Ram Hospital on Friday morning, soon after it sent an SOS to the Indian government flagging acute shortage of oxygen at the national capital's premier medical facility.
Also read: Covid-19 turns India into vaccine importer from exporter
"25 sickest patients have died in last 24 hours. Oxygen will last another two hours. Ventilators and BiPAP (ventilators for invasive treatment) not working effectively. Resorting to manual ventilation in ICUs and Emergency" the hospital authorities said in a statement.
"Major crisis likely. Lives of another 60 sickest patients at risk, need urgent intervention," the statement added.
A top hospital official attributed the deaths to low pressure oxygen. "Low oxygen concentration likely contributed to deaths of critical patients. Critical patients need high pressure, stable oxygen supply," Satendra Katoch, the medical director, told the media.
Some 500 Covid patients are currently being treated at Ganga Ram. Of them, as many as 142 are on life support, according to the hospital.
On Wednesday also, 24 Covid-19 patients on ventilator at a government hospital in the western Indian state of Maharashtra died after their oxygen supply ran out following leakage of the life-supporting gas from a tanker.