A stand-by drug used to prevent potentially-fatal bleeding after childbirth has some new competition – with improved benefits, according a United Nations health agency-led report.

Excessive bleeding after childbirth still kills around 70,000 mothers a year and currently, Oxytocin is the first-choice medication, but it must be kept cold, unlike the new drug, Carbetocin.

The study, partly led, among others, by the World Health Organization (WHO) and published on Wednesday, suggests that the new drug which can be stored at normal temperatures, could save the lives of thousands in low- and lower-middle-income countries.

“This is a truly encouraging new development that can revolutionize our ability to keep mothers and babies alive,” said WHO Director-General Tedros Adhanom Ghebreyesus.

Since Oxytocin must be stored and transported at a cool two to eight degrees Celsius – a difficult task in many countries – numerous women lack access to the medicine. And if they can obtain it, heat exposure may render the drug less effective.

The study, published in the New England Journal of Medicine, has shown the heat-stable Carbetocin is not only as safe and effective as Oxytocin, but even without refrigeration – when stored at below 30 degrees Celsius and 75 per cent relative humidity – it retains its efficacy for at least three years.

Clinical trial

WHO notes that approximately 70,000 women die annually from postpartum haemorrhage – increasing the risk that their babies will also die within a month.

In the largest clinical trial of its kind, close to 30,000 women who gave birth vaginally were studied in Argentina, Egypt, India, Kenya, Nigeria, Singapore, South Africa, Thailand, Uganda and the United Kingdom.

Immediately after child birth, each woman was randomly injected with a single dose of either heat-stable Carbetocin or Oxytocin – revealing that both were equally effective at preventing excessive bleeding.

 “The development of a drug to prevent postpartum hemorrhage that continues to remain effective in hot and humid conditions is very good news for the millions of women who give birth in parts of the world without access to reliable refrigeration,” said Metin Gülmezoglu of WHO’s Department of Reproductive Health and Research.

While Carbetocin has not yet been cleared for use beyond clinical trials, the next steps begin with a regulatory review, countries’ approval and then consideration by WHO’s Guideline Development Group.

However, the UN health agency said on Wednesday, that following the positive trial results, it will be working to advance affordable access to the potentially lifesaving drug in countries with a high maternal death rate.

In Burundi, opponents of constitutional reform supported by the Government have faced torture and execution amid a “continuing environment of threats and intimidation”, senior UN investigators said on Wednesday.

Reporting to the Human Rights Council, the Commission of Inquiry on Burundi delivered its findings based on more than 380 interviews, in addition to 500 testimonies collected last year.

The dossier compiled by the three-member panel encompasses events surrounding the national referendum last month on constitutional reform which could extend President Pierre Nkurunziza’s term in office well beyond 2020.

Noting a presidential declaration made in support of his successor after the referendum, the report reiterates the view of some observers that Mr. Nkurunziza’s comments were “by no means a clear and firm commitment not to run” in future elections himself.

It also notes “difficulties” faced by international media outlets in covering events in the country amid the suspension of broadcasters including the BBC and Voice of America, following reports that were deemed “biased” by Burundian authorities.

On the alleged rights violations committed in the country, the report highlights “numerous arrests” of people who called for a “no” vote in the referendum, including members of opposition parties who were then allegedly executed or abducted.

It states that “unidentified bodies” have continued to be found “in various parts of the country” after their arrest by “individuals in police uniform” or National Intelligence Service (SNR) agents.

Victims were also targeted by the Imbonerakure — the youth wing aligned to the ruling CNDD-FDD party — whose influence is said to have risen “in the repressive machinery which has developed since 2015”.

Describing how the Imbonerakure “cover the country”, the Commission of Inquiry’s findings detail how their members inform the authorities about “real or perceived opponents in each locality”, all the while “harassing, controlling or intimidating the population”, with the approval of State officials.

This collaboration extends to putting pressure on people to collect contributions for elections in 2020, the report states, before detailing how civil servants are required to pay the equivalent of 10 per cent “or more” of their salary to an election fund.

This levy extends to households and others above voting age on an “ad hoc basis at the local level”, the report continues, citing eyewitness reports of “roadblocks set up throughout the country” by the Imbonerakure to check whether people had receipts for the tax.

Such developments have contributed to the “continuing deterioration” of the Burundian economy that has left the country’s people among the very poorest in the world, according to per capita earnings, the report continues.

Referencing the UN Office for the Coordination of Humanitarian Affairs (OCHA), it states that 3.6 million people are in need of humanitarian assistance in Burundi today.

The deteriorating economic situation will be included in the Commission of Inquiry’s final report to the Human Rights Council in September.

Raising awareness of women’s contributions is critical to correcting historical imbalances that have undervalued their presence, the United Nations Secretary-General said on Wednesday.

António  Guterres was speaking at an event at UN Headquarters in New York to launch a book that pays tribute to women’s participation in the development of the global organization.

HERstory: Celebrating Women Leaders in the United Nations is an initiative by Colombia and Qatar, and builds on an exhibition held two years ago.

The initiative shines a spotlight on pioneers and trailblazers such as Lucille M. Mair, the first woman to serve at the rank of Under-Secretary-General: the title given to officials who oversee UN Departments; and Margaret Anstee, who was the first woman to head a peacekeeping operation.

“The history we learn at school, that is celebrated in public monuments and events, tends to be a very partial history. It is the history of men,” Mr. Guterres said.

“Raising awareness of women’s contributions is an essential part of correcting the imbalance in our culture that has historically undervalued women’s contributions and women’s work.”

Mr. Guterres reminded the audience of the “enormous progress” in women’s rights achieved during more than seven decades since the founding of the UN.

But he also recalled that women comprised just six of the 278 delegates at the 1945 conference that established the Organization: a story told in a recent UN News podcast, which you can listen to here.

And while such paltry participation could not happen today, the UN chief reported that practically every week he still encounters diplomatic delegations that do not include a single woman. 

The issue is also a concern in-house, Mr. Guterres said, adding that the UN has had to work at ensuring its own events do not feature “manels”—that is, all-male panels.

The Secretary-General has made gender parity a top priority, pushing for greater women’s representation at the UN, including at the senior management level.

“This is not simply about the fight for gender equality,” he stated.  “From peace and security to development to human rights, greater inclusion is the key to our success – bringing new perspectives, different leadership styles, greater innovation and, ultimately, a more effective organization.”

A “full-scale” ground and aerial offensive in southwest Syria could inflict an even heavier toll on civilians than the suffering caused by previous devastating battles in the war-ravaged country, the United Nations Special Envoy for Syria has warned.

“Let us be aware of what this would mean, if the southwest sees a full-scale battle-to-the-end: it could be like eastern Aleppo and eastern Ghouta combined together,” Special Envoy Staffan de Mistura, told the Security Council on Wednesday.

“We … cannot allow … this to become another Ghouta, another Douma, or another Aleppo, where so many civilians were sacrificed and died. And yet I see things moving in this direction,” he said.

Speaking via video link from Geneva, Mr. de Mistura also cautioned that such fighting could increase tensions across the region and risk compromising momentum in political talks to reach a lasting peace deal.

In his briefing, Mr. de Mistura told Council members that intensified efforts were on-going “to find a way ahead” for the implementation of a deal and for the establishment of a Syrian-led and Syrian-owned, UN-facilitated committee on a new constitution, within the framework of the Geneva process and in accordance with Security Council resolution 2254.

We … cannot allow … this to become another Ghouta, another Douma, or another Aleppo, where so many civilians were sacrificed and died – UN Special Envoy Staffan de Mistura

“I will continue on my side to facilitate further movement in this direction to seek the support, counsel and advice of many – which is why I anticipate inviting the Sochi co-convenors back to Geneva in the coming weeks … and then, of course, report to you, to the Security Council,” he said.

Concluding his briefing, the UN Special Envoy urged the Security Council as well as the Syrian Government to support efforts on the political front to put Syrians themselves in charge of their own future, because “no country or no organization can simply impose a fait accompli on the Syrian people.”

He also called on all parties to the conflict and on those who have influence over them to help find a solution that will “spare civilian suffering”, prevent more people from being displaced, and “reduce potential tensions.”

Worsening fighting could jeopardize aid efforts – UN relief official

Also briefing the 15-member Council, John Ging, the Director of Operations at the UN Office for the Coordination of Humanitarian Affairs (OCHA), detailed the humanitarian consequences of the fighting in the southwestern Governorate of Dara’a, saying that to date, an estimated 45,000 to 50,000 people have been displaced due to hostilities.

The number, he added “could nearly double” if fighting continues to escalate, and most hospitals and medical facilities there have already closed, he told Council Members.

UN cross-border relief operations from Jordan, bringing much needed aid to hundreds of thousands in need across southern Syria, could also be jeopardized if violence worsens, said Mr. Ging.

“I call on all stakeholders to ensure that cross-border humanitarian deliveries continue in a sustained, safe and unimpeded manner to reach all those in need, including the newly displaced people,” said the senior OCHA official.

More than 10,000 children were killed or maimed in conflict last year while more than 8,000 youngsters were recruited or used as combatants, the United Nations reported on Wednesday.

These violations contributed to the overall rise in the number of children globally affected by fighting in 2017, as documented in the annual report of the Secretary-General on Children and Armed Conflict (CAAC).

UN chief António Guterres has expressed outrage over the numbers, according to a statement issued by his spokesperson.

“Boys and girls have once again been overly impacted by protracted and new violent crisis.  Despite some progress, the level of violations remains unacceptable,” the statement said.

“The Secretary-General reiterates that the best way to address this horrific situation is to promote peaceful solutions to conflicts.  He calls on all parties to exert maximum efforts in this regard.”

The report covers 20 countries, including hotspots such as Syria, Yemen and Afghanistan, but also situations in countries such as India, the Philippines and Nigeria.

Virginia Gamba, the UN’s expert on Children and Armed Conflict, said 66 parties to conflict are listed this year – three more than in the 2016 report – with nine government forces and 57 armed groups named.

“Among the most significant violations registered in 2017 were killing and maiming, recruitment and use and attacks on schools and hospitals, all of which registered a rise in comparison to the previous year,” she told journalists at UN Headquarters.

Overall, the UN verified more than 21,000 grave violations of children’s rights between January and December 2017, compared with 15,500 the previous year.

Government forces committed at least 6,000 of these crimes while the majority involved various non-state armed groups.

Ms. Gamba said crises in the Central African Republic (CAR), the Democratic Republic of the Congo (DRC), Myanmar, South Sudan, Syria and Yemen were the main reason for the “serious increases” reported.

She provided examples, including what she described as the “despicable trend” of turning children in Nigeria into “human bombs”, where nearly half of the 881 verified child casualties resulted from suicide attacks.

Also worrying is the number of children detained for their alleged association with armed groups. For example, more than 1,000 children in Iraq were held due their suspected affiliation with the terrorist group ISIL, also known as Daesh.

Ms. Gamba also reported positive developments, such as the formal release of more than 10,000 child soldiers from armed groups and forces, while four armed groups in Myanmar have agreed to work with her Office.