the unjust candidacy of dr. tedros a. ghebreyesus for who ...€¦ · a. ghebreyesus for who...
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TheUnjustCandidacyofDr.TedrosA.GhebreyesusforWHODirectorGeneralPosition
APUResearchDepartment,April2017
Introduction
• Since1991,EthiopiahasbeenruledbyTigrayPeople’sLiberationFront(TPLF)thatpracticesethnicapartheidtostayinpower
• TheAmhara,30-40%ofEthiopia’spopulation,aresingledoutinthisatrocity
• TPLFcontrolsallaspectsofEthiopia– ThemilitaryisrunalmostexclusivelybyTPLFGenerals
– TPLFanditsaffiliatesownmajoreconomicsectorsofthecountry
Introductioncont’d…
• 2003- Dr.GhebreyesuswhowasalreadyamemberofTPLFbecamedeputyMinisterofFederalMinisterofHealth(FMOH).
• 2005-2012– hewasMinsteroftheFMOH.• 2012-2016– hewasMinisterofForeignAffairs.
• May24,2016- heannouncedhiscandidacyforWHODirectorGeneralposition.
Methods
• SecondarydatapublishedbytheFMOHofEthiopiawerereviewedincluding– DemographicandHealthSurvey(DHS1-5)– HealthSectorDevelopmentPlan(HSDPII-IV)– HealthSectorTransformationPlan(HSTP),and– HealthandHealthRelatedindicators(HHRI)
• Otherpublishedarticlesrelatedtothetopicwerealsoreviewed.
•ResultsoftheReview
1.Discrimination/Marginalization
• AmongregionsofEthiopia,itiseasytoobserve– Unequalimmunizationcoverage– Unequalpercapitaexpenditure– Unequaliodizedsaltdistribution– TigrayRegionhashighestAntenatalCareService(ANC)utilizationandhighestSkilledBirthAttendance
– “Khat”,astimulantdrug,isbannedin“Tigrayregion”butpromotedinotherregions
UnequalImmunizationCoverage
Figure1:Fullimmunizationcoverage2016Source:DemographicandHeathSurvey(DHS)2016
“Amhararegion”haslowestiodizedsaltdistribution
Figure2:IodizedsaltdistributionbyregionsandRural/Urban>25ppmfor2000and>15PPMin2005and2011Sources:DemographicandHeathSurvey(DHS)(2000,2005and2011)
“TigrayRegion”hashighestANCandskilledbirthattendance
0
10
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30
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60
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90
100
2000 2005 2011 2014 2016 2010 2014 2016
ANCcarebyskilledprovider Deliverybyskilledattendant
%ANCcare,D
elivered
byskilled
atten
dant
Amhara
Tigray
National
Figure3:ANCandDeliverybySkilledBirthAttendantfor“AmharaandTigrayregions”intheyear2000,2005&2011comparedwithNationalRatesSources:DemographicandHeathSurvey(DHS)(2000,2005&2011)
CorrelationofPercapitaexpenditureandIMR
Figure4:Demographic,percapitaexpenditureandInfantMortalityRate(IMR)(2009)Source:ReviewingEthiopia’sHealthSystemDevelopmentbyRichardG.2009
2.HealthPolicyutilizedasstrategytocontrolAmhara’spopulationgrowth
• “Amhararegion”hasthehighestContraceptivesAcceptanceRateandInjectableContraceptivesUseresultingintheleastfertilityrateinthecountry
• “AmharaRegion”lackslifesavingprogramslikeAntenatalcare,immunization,skilledbirthattendanceandiodizedsaltdistribution
• “Amhararegion”hasthehighestperinatal,neonatal,infant,andunderfivemortalityrate
• Intotal,2.5millionAmharahadvanishedfromthe2007census
Amharas havethehighestratesofcontraceptionuse
Figure5:Femalesuseofanycontraceptivesmethods(2000,2005,2011,2014and2016)Sources:DemographicandHeathSurvey(DHS)(2000,2005,2011,2014and2016)
Amharas havethehighestratesofInjectableContraceptivesuse
Figure6:Injectablecontraceptivesmethodsuse(2000,2005,2011,2014and2016)Sources:DemographicandHeathSurvey(DHS)(2000,2005,2011,2014and2016)
Amharas fertilityrateistheleastamongEthiopians
Figure7:Totalfertilityrate(TFR)(2000,2005,2011&2014)Sources:DemographicandHeathSurvey(DHS)(2000,2005,2011&2014)
“Amhararegion”hasthehighestPMR
Figure8:Perinatalmortalityrate(PMR)(2000,2005&2011)Sources:DemographicandHeathSurvey(DHS)(2000,2005&2011)
“Amhararegion”hasthehighestNMR
Figure9:Neonatalmortalityrate(NMR)(2000,2005&2011)Sources:DemographicandHeathSurvey(DHS)(2000,2005&2011)
“Amhararegion”hasthehighestIMR
Figure10:Infantmortalityrate(IMR)(2000,2005&2011)Sources:DemographicandHeathSurvey(DHS)(2000,2005&2011)
“Amhararegion”hasalsothehighestinU5MR
Figure11:Under5mortalityrate(U5MR)(2000,2005&2011)Sources:DemographicandHeathSurvey(DHS)(2000,2005&2011)
Observedversusexpectedpopulationbasedonpredictionfrompreviouscensusandestimatedpopulationgrowthrate
Ethnicgroupandnationalpopulationcensus
Actual1984* 1994basedon1984estimates
Actual1994
2007basedon1984estimates
2007basedon1994estimates
Actual2007
Amhara 12,055,250(28.288%)
16,170,175
16,007,933(30.1%)
22,126,832
23,687,258 19,867,817(26.9%)
Tigre** 2,415,871 3,240,502 3,284,568(6.2%)
4,746,924 4,540,067 4,483,776(6.1%)
Oromo 12,387,664(29.068%)
16,616,055
17,080,318(32.1%)
24,340,415
23,609,128 25,488,344(34.5%)
Nationalpopulation*
39,868,572 53,477,265
53,477,265
78,337,417
73,918,505 73,918,505
Table1:NationalandAmharapopulationdifferencesfromestimatesbasedon1984,1994and2007CSASources:EthiopianCentralStatisticsAuthority(CSA),EthiopiaFMOHHealthandhealthrelatedindicators(HHRI’s)2015andMoresh AmharaOrganizationstudyondepopulationofAmharas 2014
DecliningproportionoftheAmhara
Figure12:Percentage“regional”populationcomparedtocountrytotal.Source:EthiopianCentralStatisticsAuthority(CSA)
TheeffectofdecadesofAmharas depopulationbyTPLF
Figure13:Ethiopiaannualpopulationgrowthrateby“Region”2015Source:EthiopiaFMOHHealthandHealthRelatedIndicators(HHRI’s)2015
3.Biasedpolicies,inactionandimpartiality
• Amharas,comparedtootherethnicgroupswerelesslikelytoengageinriskysexualbehavior
• Ironically,Amharas arethemostaffectedbyHIV/AIDSbutaretheleastlikelytogettreatment
Sexualbehaviorinvariousregions
Figure14:Percentage15-49yearsoldwhohad2+sexualpartnersinthepast12monthsexcludingspouseorcohabitingsexualpartnerFemales(F),Males(M)(2000,2005,2011&2016)Sources:EthiopiaDemographicandHeathSurvey(DHS)(2000,2005,2011&2016)
Sexualbehaviorinvariousregions
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0.6
1.1
0.2
1.6
0.8
1.1
0
0.5
1
1.5
2
%M
enMenwhoPayedforSex
Figure15:Percentageofmenage15-49reportingpaymentforsexualintercourseinthepast12monthsby“Regions”2005Source:EthiopiaDemographicandHeathSurvey(DHS)2005
RuralAmharadevastatedbyHIV
Figure16:EstimatedandProjectedHIVPrevalence,AdultPopulation15- 49,RuralEthiopiaandRegions,1982– 2010Source:AIDSinEthiopia:Sixthreport2010
HAARTuseinvariousregions
Figure17:PeoplelivingwithHIV(PLHIV)onHAARTacross“Regions”2009/2010Source:HealthSectorStrategicPlan(HSDP)IV2010
4.CorruptionandmisuseofbudgetØ TheGlobalFundtoFightAIDSTuberculosisandMalaria
grantedEthiopia$1,306,035,989overtheyears.Ø However,accordingtothe2012auditreportoftheGlobal
Fund’sOfficeoftheInspectorGeneral,theofficeofDr.Ghebreyesusinappropriatelyusedthemoney.TheinappropriateactionsincludeØ MisappropriationoffundsØ UseofdonorfundsforunsoundprogramsandpoliticalpurposesandØ Constructionofsubstandardhealthfacilities
Ø TheEthiopiangovernmenthasbeenaskedtorefund$7,026,929.00.
5.Disregardforhumanlife
Ø TPLF/EPRDFledgovernmentabusesforeignaidsandusesitasaweapontorepressitscitizens
Ø AccordingtoHumanRightsWatchReporttitled“DevelopmentwithoutFreedom:HowAidUnderwritesRepressioninEthiopia",theTPLFledEthiopiangovernmentwasusingaidtosuppresspoliticaldissentbyconditioningaccesstoessentialgovernmentprogramsonsupportfortherulingpartywheremanyfamiliesofoppositionmemberswerebarredfromparticipationinthefood-for-workor"safetynet"program,whichsupports7millionofEthiopia'smostvulnerablecitizens.
6.Incompetency/Inaction
ØEthiopiawasaffectedbyCholeraepidemicalmosteveryyearduringDr.Ghebreyesus’stenureandhisrefusaltodeclaretheepidemicresultedinthedisseminationofthediseasethroughoutthecountry
ØDr.Ghebreyesusalsodidn’ttakeappropriateandtimelyactionwhenhewasMinisterofForeignAffairsofEthiopia.ØThousandsofimmigrantEthiopianswerekilledinSaudiArabia,SouthAfrica,LibyaandYemenasaresultofxenophobiaandhisfailuretoprotecthiscitizens.
7.LackofTransparency
ØDr.GhebreyesusintentionallycoveredupCholeraoutbreakstoprotecthisgovernment’simageinsteadofprioritizingpublicsafetytowhichhewasprimarilyaccountable
ØDr.Ghebreyesus’sgovernmentneverallowedinternationalorganizationstoinvestigatehumanitariancrisisinEthiopia
8.Maleficenceandriskingpublicsafety
ØMillionsofEthiopianchildrenareaffectedbyiodinedeficiencybecauseofDr.Ghebreyesus’sunjustdistributionofiodizedsalt
ØDr.Ghebreyesusfailedtosavethelivesofpeopleandtheenvironmentaffectedbytannerywastedisposal
9.Accountability
ØDr.Ghebreyesus,asthememberofTPLF’sExecutive,isresponsibleforalloftheatrocitiescommittedbyTPLFonEthiopians,especiallythesystematicethniccleansingandgenocideofAmharas.
ØSadly,WHOisunaffectedbythecriminalrecordsofDr.Ghebreyesus
10.Violationofbasichumanright
Ø “Healthisastateofcompletephysical,mentalandsocialwell-beingandnotmerelytheabsenceofdiseaseorinfirmity”
ØDr.Ghebreyesus’sgovernmentrestrictedfreedom,violatedHumanrightsandstifleddemocracy
ØDr.Ghebreyesus’sactionsareagainstWHOprinciplesthatareprofoundlyembeddedinadvancinghumanitybyvigorouslyaddressingcomplexhealthissuesandabidingbyinternationalhumanrightlaws
11.LackofIntegrity/Truthfulness/Honesty
ØDr.Ghebreyesuspromisestoaddresshealthinequalities,howeverhisrecordasMOHEspeaksloudlyagainsthimØHeusedfamilyplanningmethodstocontrolthepopulationgrowthoftheAmharas,whichhispartylabelsasnumberoneenemy.
ØThereisrampantinequalityofhealthandwealthbetweenthedifferentregionsofEthiopia.
ØDr.Ghebreyesusdiscriminatedagainsthisowncitizensbasedontheirethnicbackgrounds
