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Women’s Economic Empowerment and Inclusive Global Economic Growth: COVID-19 and Beyond

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Keynote Speech by Chief Economist Gita Gopinath
At the Inaugural Dr. Hansa Mehta Lecture

It is a tremendous honor to deliver the inaugural lecture in memory of Dr. Hansa Mehta – an Indian freedom fighter, an educator, a policy maker, and above all, a champion of women’s rights. We have Dr. Mehta to thank for ensuring that the Indian constitution enshrines gender equality. We have Dr. Mehta to thank for correcting and replacing the phrase “All men are born free and equal” in the United Nation’s Universal Declaration of Human Rights with “All human beings are born free and equal.”

It therefore befits Dr. Mehta’s legacy that we are gathered virtually today at the United Nations on International Women’s Day. And as an Indian woman, I am especially grateful for the opportunity to honor Hansabehn, on whose strong shoulders I and many others stand.

We have Dr. Mehta to thank for ensuring that the Indian constitution enshrines gender equality. We have Dr. Mehta to thank for correcting and replacing the phrase “All men are born free and equal” in the United Nation’s Universal Declaration of Human Rights with “All human beings are born free and equal.”

It therefore befits Dr. Mehta’s legacy that we are gathered virtually today at the United Nations on International Women’s Day. And as an Indian woman, I am especially grateful for the opportunity to honor Hansabehn, on whose strong shoulders I and many others stand.

We are meeting amidst a global health and economic crisis which threatens to roll back years of hard-won economic and social gains for women. Women have been affected disproportionately by the pandemic because they work predominantly in sectors such as restaurants and hospitality that have been hit hardest by the lockdowns, and as the main caregivers at home they have had to drop out of the labor market as schools closed. In developing countries, women are over-represented in the informal sector where they face lower pay, less job security and lower social protection. In these countries, girls have dropped out more from school to help in households. And further, recent reports from the United Nations highlight a disturbing fact that violence against women and girls has intensified since the outbreak of the pandemic.

These disparities worsen already-large gender gaps that persisted before the crisis. While there have been successes over the past few decades as women pushed the boundaries on educational attainment, economic and political participation, and broke through the glass ceiling to lead countries, corporations, and international organizations, there is much more than needs to be done to achieve gender equality.

Globally, only 55 percent of women are engaged in the labor market as opposed to 78 percent of men. In 72 countries, women are barred from opening bank accounts or obtaining credit. Women continue to earn about 50 percent less than men for the same type of work, and they represent only 25 percent of parliamentarians.

The moral case for gender equity is very clear. Today I will emphasize that we at the IMF have strived to make the point that the economic case for gender equity is also very clear.

As you are aware the IMF has been promoting policies to support growth and stability for more than 70 years. We assess the economic health of our member countries, provide policy advice and essential financing as the global lender of last resort. In just this pandemic we have provided financial assistance to 85 countries, in addition to debt relief for our poorest members.

With all this on our plate, why do we as an institution also care so deeply about women’s empowerment and inclusive growth? We care about it not only because it is a moral imperative, but because gender empowerment is critical for the economic wellbeing of both men and women, and for societies as a whole. Empowering women, through improving access to health, education, earning opportunities, rights and political participation, can be an economic game changer for any country. A wealth of research at the IMF, at the United Nations, other international organizations and academic institutions supports this assertion.

As countries around the world struggle to grow their economies—grappling with ageing populations, and buffeted by trade shocks, social unrest, weather-related disasters and now, the worst peacetime crisis in a century–tapping into the huge potential of women is unambiguously a win-win for both women’s empowerment and inclusive global economic growth.

I will elaborate next on how gender equity can lead to inclusive and stronger global economic growth, and the role governments, the private sector and international organizations should play in empowering women.

Third, women’s empowerment enhances economic resilience. Recent IMF staff research has made a strong case that more women leaders in finance would not only reduce existing gender employment gaps in the corporate sector, but also strengthen bank stability. This work finds that higher share of women on banks’ board of directors and banking supervision boards are associated with greater financial sector resilience, lower probability of insolvency, and greater profitability.

As women globally account for less than 20 percent of board seats in banks and banking supervision agencies, and account for fewer than 2 percent of bank CEOs, this suggests tremendous room to achieve greater financial sector resilience while also increasing banking sector profitability.

There is rigorous evidence that when women are in leadership positions it enhances the lives of other women. For example, in 1993, India started reserving a fraction of village council leadership positions for women. As a consequence, in villages with a female leader there was a significant rise in parents’ aspirations for their daughters, the gender gap in adolescent educational attainment was erased, and girls spent less time on household chores. This policy also weakened stereotypes about gender roles in the public and domestic spheres.

To summarize, the empowerment of women is an important channel by which we can obtain stronger, more inclusive, and more resilient growth. This takes me to the next question: what needs to be done? To be clear, responsibility for this must be shared by governments, the private sector, and international organizations.

A natural place to start is with governments which can use fiscal policy to assist with the advancement of women in education, health, financial inclusion and economic empowerment. Gender budgeting can ensure that tax and spending policies transparently and adequately include provisions for women’s access to opportunity in education and the workplace. IMF research has found that higher spending on childcare has contributed positively to female employment in the Czech Republic, Poland and Norway. Flexible working arrangements, such as those established in Japan, have also been shown to reduce gender gaps in labor force participation.

Well-designed workplace regulations that protect women under the law—including parental leave policies that encourage greater parity between men and women, flexible work arrangements, access to affordable childcare and health services, as well as the equitable treatment of women in courts and protection against violence—have all been shown to significantly raise women’s participation in economic activity. Governments can also reform tax policies that penalize secondary earners—who is most often a woman—to encourage women to join the labor force. Studies have found that reforming secondary earner taxation and boosting tax incentives for part-time work has helped support female employment and raise labor force participation in countries from Korea to Norway to the United Kingdom.

Governments must also take concrete actions to level the playing field for women. In many regions of the world, a key obstacle to women’s empowerment are outdated legal, regulatory and institutional impediments—all of which are in the hands of governments to reform. In more than 100 countries, women encounter at least one legal impediment to their participating in the economy. In some countries, women do not have the legal right to open bank accountssign contracts, own property, or initiate legal proceedings without a husband’s consent. 75 percent of countries in Francophone Africa have regulations restricting women’s employment and 12 countries in the Spanish-speaking countries have decrees prohibiting female employment in some sectors. In half of the countries we studied, when legal impediments to women undertaking economic activities were reduced, their labor force participation rose by at least 5 percentage points in the following 5 years.

We know that it takes only a few strong but persistent voices to change these inequities – it happened in India, with Dr. Hansa Mehta, who helped pushed through the Sarda Act that forbade child marriage, championed better educational opportunities for girls, and put in place personal law reforms.

There is a role for the private sector as well. To start with, businesses can promote gender equity by ensuring equal pay for equal work. Even where governmental regulations do not mandate it, firms can take the initiative to put in place work-life policies that support women’s labor force attachment including through mentoring and leadership opportunities, flexible schedules, travel and childcare subsidies, and zero tolerance towards workplace harassment.

It is estimated that in developing countries, 70 percent of women-owned businesses are under-served by financial institutions, as a result of which women entrepreneurs run smaller enterprises, earn less than male peers and are more likely to fail. This is a financing gap—as well as a lost business opportunity—in which the financial industry can step up to aid women’s financial inclusion.

And finally, we at the international organizations also have a role in this endeavor. The United Nations has declared gender equality among the 17 Sustainable Development Goals (“SDGs”) to achieve inclusive growth by 2030. At the IMF, we have increased our emphasis on women’s empowerment through training, technical advice, and peer-learning workshops with country authorities. I am also proud to note that we at the IMF have worked hard to diversify our leadership, successfully raising female directorship to over 30 percent, appointing the IMF’s second consecutive female Managing Director, and its first female Chief Economist. Gender equality is an aspect of the job I take very seriously and during my tenure I have increased the number of women in leadership positions in my own Department.

Let me now conclude by saying that this crisis has demonstrated the excellent contributions of women as leaders, as health professionals, as first-responders, as care givers. Yet women have been hit disproportionately hard by this crisis, and we still have a distance to go to get to gender equality. While much remains to be done, I am confident we will continue to make important progress towards the empowerment of women everywhere in the world.

Some 100 years ago this was the dream of a woman from a small town in India who we are honoring today. I hope this generation’s leaders and policymakers will take every opportunity they get to honor Dr. Hansa Mehta’s legacy through urgent and determined action for greater gender equality.

Thank you.

IMF Communications Department

Reforms move Cyprus closer to universal health coverage

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New WHO analysis shows how access to health care and financial protection deteriorated in Cyprus following health budget cuts and coverage restrictions from 2012 to 2015. Policy responses to the financial and economic crisis exacerbated existing gaps in health coverage, but reforms introduced in 2019 are closing these gaps and addressing other long-standing health system problems. Informed by evidence, the reforms are expected to reduce unmet need and financial hardship. They represent a major step towards universal health coverage.

Gaps in coverage before the financial crisis

The health system in Cyprus has always relied heavily on out-of-pocket payments, which reflects a large gap in population coverage, low levels of public spending on health, persistent budget and capacity constraints in public facilities, fragmented service delivery, and a large and underregulated market for privately provided health services.

Austerity aggravated underlying problems

Before the crisis, Cyprus was one of only two or three countries in Europe to base entitlement to publicly financed health care on income. In 2013, in response to the financial crisis, the government restricted the basis for entitlement even further, linking it to payment of social security contributions as well as income. As a result, the share of the population without public coverage rose from 15% to 25%. The government also increased user charges (co-payments) and reduced public spending on health. These policies increased waiting times, encouraged health staff to move from public to private facilities, and shifted health care costs onto households at a time of rising unemployment, poverty and income inequality. Between 2009 and 2015, the share of people experiencing unmet need for health and dental care grew and the number of households with catastrophic health spending doubled.

Post-crisis reforms aim to transform the health system

After the crisis, in 2019, the government began to implement the long-debated General Health System (GHS). To shorten waiting times, improve care quality and reduce out-of-pocket payments, the GHS strengthens the role of the national purchasing agency (the Health Insurance Organization) in buying services from both public and contracted private providers.

The GHS has also introduced major improvements in coverage policy, changing the basis for entitlement from income and payment of contributions to residence, which allows all legal residents to be covered for the first time; simplifying and reducing user charges; and reinforcing protection mechanisms – there is now an annual cap on all co-payments for everyone, with a more protective cap for children, people receiving the guaranteed minimum income and pensioners with a low income.

“This is the biggest reform since independence, not only because it ensures the whole population is covered and will reduce waiting times for patients, but primarily because it minimizes out-of-pocket payments and offers significant financial protection to all beneficiaries,” said Marios Kouloumas, President of the Pancyprian Federation of Patients Associations and Friends, which represents all the patient organizations in Cyprus.

Greater public investment in health is needed to sustain progress towards universal health coverage

The 2019 reforms bolstered Cyprus’s ability to meet the health and economic challenges of COVID-19. A key test now, once again in difficult circumstances, is whether the government can continue to secure public investment in the health system and keep the reform agenda on track. Reducing fragmentation, lowering waiting times and improving access, quality and financial protection will require steady growth in public spending on health and continued effort to strengthen the purchasing of health services.

WHO supports countries to move towards universal health coverage – leaving no one behind

Financial protection is at the heart of universal health coverage, which means that everyone can use the quality health services they need without financial hardship. Linked to WHO’s General Programme of Work, the European Programme of Work places universal health coverage as one of the three priorities for the WHO Regional Office for Europe. Through the WHO Barcelona Office for Health Systems Financing, the Regional Office undertakes context-specific monitoring of financial protection in over 30 countries, including Cyprus.

The Barcelona Office also provides tailored technical assistance to countries to reduce unmet need and financial hardship by identifying and addressing gaps in coverage.

Buddhist Times News – To boost Buddhism, UGC plans ambitious database on courses, scholars and research

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Buddhist Times News – To boost Buddhism, UGC plans ambitious database on courses, scholars and research

Savitribai Phule Pune University (SPPU) offers courses in Pali at advanced levels, including research and doctoral studies. (File Photo)

The Department of Pali was established in July 2006, to mark the 2550th anniversary of the Mahaparinibbana of the Lord Buddha and the 50th anniversary of Modern Buddha Dr. Bhimrao Ramji Ambedkar’s historic embrace of Buddhism. Department of Pali is the only place under the jurisdiction of Savitribai Phule Pune University (SPPU) where facility for learning Buddhist Literature in Pali, Sanskrit and Tibetan is available from basic to advance level. In its short career the Department has achieved the status of being one of the leading institutions in the field.

We have taken a holistic approach in the study of Buddhist Studies by including a number of related subfields such as Comparative Linguistics, Buddhist Psychology, Comparative Philosophy: Indian and Western, Buddhist Art, Architecture and Inscriptions, Buddhist Culture and History of Buddhist Thought, Socially Engaged Buddhism in our new curriculum. The Department has developed a strong bondage with local Buddhist community and Vipassana practitioners and is also successful in attracting overseas students and scholars.

In an ambitious plan to promote India as a global hub for Buddhist heritage and tourism, the University Grants Commission (UGC) plans to create a database pertaining to Pali and Buddhist studies.

In a notification dated February 23, the UGC has sought information about current courses, research, scholars and experts, alumni along with important events, seminars and conferences organised in this field from all universities, research institutions and centres. The UGC has also asked for details on the number of courses offered, number of students pursuing studies at undergraduate, post-graduate level and above at universities.

Savitribai Phule Pune University (SPPU) offers courses in Pali at advanced levels, including research and doctoral studies. Besides, research in Buddhist studies has been offered at Deccan College Post Graduate and Research Institute for over four decades now.

The two institutions had recently inked an MoU to jointly roll out a PG diploma in Buddhist Heritage and Tourism from the next academic year.

While many Asian countries like Sri Lanka, Cambodia, Thailand, Korea and China offer select courses and have plethora of tourism-centered activities, a database with rich information on all available courses and research of this scale also aimed at long term plans, including promoting tourism, is a one-of-its-kind programme.

source  —  Indian Express,pune

Over 4 tonnes of medical supplies arrive in Kyrgyzstan to equip COVID-19 response

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With financial support from the United Kingdom and the United Nations COVID-19 Response and Recovery Multi-Partner Trust Fund, WHO delivered over 4 tonnes of medical supplies to Kyrgyzstan to support the Government’s COVID-19 response. The delivery included essential medicines and devices, such as blood glucose meters and machines to regulate air pressure during the use of breathing support.

The supplies will be distributed to all hospitals across the country, in line with priorities and needs. All the materials meet WHO quality and safety standards to keep frontline health care workers and patients safe, while preventing the spread of COVID-19. The cargo was shipped from the WHO regional logistics hub in Dubai, at a cost of more than US$ 260 000.

During the handover ceremony, Kyrgyzstan’s Minister of Health Alymkadyr Beishenaliev expressed his gratitude to the United Nations representatives and to the British Ambassador for supporting and strengthening the country’s COVID-19 response. The British Ambassador to Kyrgyzstan Charles Garrett noted that the pandemic demonstrated effective cooperation between the United Kingdom and the Ministry of Health and Social Development of the Kyrgyz Republic and other national partners involved in the response to COVID-19.

The United Nations Resident Coordinator in Kyrgyzstan Ozonnia Ojielo and WHO Representative to Kyrgyzstan Nazira Artykova emphasized that the United Nations remains committed to supporting the Government’s efforts to strengthen its preparedness for and response to COVID-19 and beyond.

The Democracy Forum and Lord Bruce will be hosting a live webinar entitled: ’Tibet: an environmental crisis in waiting’

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The Democracy Forum and Lord Bruce will be hosting a live webinar entitled: ’Tibet: an environmental crisis in waiting’ – Book Publishing Industry Today – EIN Presswire


















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Emergency Medical Teams: knowledge exchange and hands-on support strengthen COVID-19 response in Armenia

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Emergency Medical Teams: knowledge exchange and hands-on support strengthen COVID-19 response in Armenia

Doctors, nurses and paramedics from Germany, Italy, Poland and the United Kingdom of Great Britain and Northern Ireland have been arriving in Armenia since the summer of 2020 to join hands with their peers and curb the spread of COVID-19. Armenia has recently faced challenges from both the pandemic and the armed conflict and is in heightened need of hands-on support to strengthen its COVID-19 response.

Emergency Medical Teams (EMT) are groups of health professionals who deploy rapidly from one country to another to treat patients affected by an emergency or disaster. The WHO initiative also helps to build local capacity and strengthen health systems through international exchange.

Empowered by frontline colleagues

Dr Naira Stepanyan is an infectious disease doctor and the deputy director of the National Center of Infectious Disease in Armenia. She treated the first COVID-19-infected patient in Armenia, registered on 1 March 2020. Dr Stepanyan told us that, even though her family has always been her primary source of motivation, during the pandemic, health care workers inspired her to overcome the difficulties she faced.

EMT support was also a source of encouragement for her, since she could discuss the practices used in other COVID-19 responses in the WHO European Region. “I became more self-confident as a result of working with the EMTs,” she said. “When you learn that high-level professionals from other countries use the same methods as you do, or they appreciate the work done locally, it gives additional motivation to continue doing your job and to improve it.”

Such missions are beneficial for both hosting countries and for the members of EMTs, since the exchange during a health emergency provides an opportunity to learn and share experiences with fellow health care colleagues. This is critical to advancing COVID-19 response knowledge across borders. “This is a two-way process,” stated Paul Ransom, an EMT member from the United Kingdom. “We share our knowledge with the Armenian medical workers and learn from their experience as well. There are some methods that are better in the United Kingdom and other methods that are better implemented in Armenia.”

Life-saving equipment

WHO has also supported Armenia by delivering life-saving equipment, such as oxygen concentrators, electrocardiographs, polymerase chain reaction tests and ultrasound examination machines. They were purchased with the financial assistance of the European Union, the United States Agency for International Development (USAID) and other WHO partners.

Dr Naira Stepanyan noted the importance of oxygen concentrators, which their medical center received as a result of this joint initiative, saying that they “help patients even psychologically”. Egor Zaitsev, WHO Representative in Armenia, underlined that from the very beginning of the pandemic, the goal of WHO was to ensure that health care workers received the necessary support. Technical advice and practical assistance were provided based on the country’s major needs. “2020 was a hard year, and the Armenian health care system overcame many challenges, becoming stronger and better prepared for the future. WHO in Armenia will stand strong with the country to ensure their success,” he said.

About Emergency Medical Teams

EMTs, a WHO initiative, are a global network of pre-qualified teams of doctors, nurses and paramedics skilled to provide medical assistance during emergencies. WHO classification means that the team has been accredited as compliant with international WHO standards for being proficient in the direct treatment of patients. The arrival of EMTs to Armenia was organized in cooperation with the European Union and the governments of its respective countries.

Historically Yours : Thomas Jefferson on religion

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Historically Yours : Thomas Jefferson on religion

What religion was President Thomas Jefferson, the author of The Declaration of Independence, the Virginia Statute of Religious Liberty and a major figure in our separation of church and state? Historians listed him as either a Deist or “no specific denomination.”

Jefferson grew up Anglican but from early adulthood professed faith in a Creator uninvolved in the affairs of this world. He was a product of his time – the Age of Enlightenment – everything in life, including religion, had to have a scientific explanation. Jefferson advised a nephew, “Fix reason firmly in her seat and call to her tribunal every fact, every opinion.

Question with boldness even the existence of a god; because, if there be one, he must approve the homage of reason, than that of blindfolded fear.” Thomas Jefferson’s religious views did not become a major public issue until he ran for president in 1800 against incumbent Federalist John Adams. The Federalist, eager to retain control over the presidency, unleashed a frenzied personal attack upon Jefferson. They charged him as “an unbeliever who was unworthy to serve as chief magistrate of a Christian nation.” A Jefferson victory, the Federalist declared, would arouse the wrath of God, “destroy religion, introduce immorality…loosen all bonds of society and undermine the standing of the United States among the nations of the world.”

Eugene R. Sheridan, a leading authority on Jefferson’s religious beliefs, states that Jefferson believed in God but not organized religion. He revered Jesus as the greatest moral teacher in history but did not believe that he was the son of God. He rejected the Bible as a source of divine revelation and regarded it as a mere human history. He dismissed the possibility of miracles and the dogma of the Trinity as contrary to human reason and the laws of nature. What most concerned Jefferson was not the religious beliefs of people, but “how men acted in society.” “If acceptance of orthodox Christian doctrines produced virtuous lives, he welcomed the result without supporting the cause.” As much as he criticized orthodox Christianity in private, he rarely did so publicly, “not only out of a sense of political prudence, but also because of his deep commitment to religious freedom which led him to respect the right of others to hold religious opinions different from his.”

ywAAAAAAQABAAACAUwAOw== Historically Yours : Thomas Jefferson on religion

Jefferson steadfastly refused to reply in the election to the wave of criticism concerning his religious beliefs, believing that he was accountable to God alone for his convictions.

Jefferson swept to victory, however, the charge that he was an enemy of Christianity continued to plague him. The public disagreed. Jefferson was re-elected president in 1804 in a landslide victory, receiving 162 out of 176 electoral votes.

Sources: The Jefferson Monticello, courtesy of the Thomas Jefferson Encyclopedia.

“Jefferson’s Religious Beliefs,”: Wikipedia, “Religious views of Thomas Jefferson,”: Thomas Jefferson (Notes on Virginia, 1782), “Thomas Jefferson on Christianity & Religion,”: Virginia Museum of History & Culture, “Thomas Jefferson and the Virginia Statute for Religious Freedom.”



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Bugle Boy Historically Yours : Thomas Jefferson on religion


Carbon leakage: prevent firms from avoiding emissions rules | News | European Parliament

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Carbon leakage: prevent firms from avoiding emissions rules | News | European Parliament

, https://www.europarl.europa.eu/news/en/headlines/society/20210303STO99110/

Meet Three Scientologists Who Are Moving Forward Creating the Future Despite the Pandemic

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Meet Three Scientologists Who Are Moving Forward Creating the Future Despite the Pandemic

In Taipei, Taiwan, Scientologist and interior designer Ping Ting helps his clients grasp exactly what it will be like to live in one of the homes he designs. He also encourages them to contribute to the designing process by giving them access to his work as he goes along. 

Using a virtual reality headset, clients can see exactly how it would be walking into the new home Ping designs.
Using a virtual reality headset, clients can see exactly how it will be to walk into the new home Ping designs.

And when they tour their future homes, his clients can experience every detail before its construction begins. Ping Ting makes this possible by having them wear VR headsets, so they can be certain that the design is exactly what they want. Communication is an essential element in his creative process, which results in greater affinity and reality, as covered the book Scientology: The Fundamentals of Thought by L. Ron Hubbard. Watch Scientology: The Fundamentals of Thought book on film on the Scientology Network.

Also covered in Scientology: The Fundamentals of Thought is the central role creativity plays in every aspect of existence, something Ildikó Debreczeni of Szolnok, Hungary, incorporates into her work. 

Costume designer and Scientologist makes performers comfortable
Hungarian Scientologist and designer Ildikó Debreczeni puts performers at ease by designing comfortable costumes.

She owns a company that creates intricate custom-designed costumes for opera, ballet and theatrical productions. Ildikó demonstrates the extra care she takes in designing what she refers to as “work clothes” for performers. This allows them to be comfortable and at ease in their apparel. 

Charming photographs by a vivacious photographer.
A vivacious photographer shares her love of nature with the images she captures.

Creativity also informs the work of Stefania, a photographer from Padova, Italy, whose beautiful photographs feature nature at its best. She shares her passion with a selection of delightful photographs.

Scientologists@home is an original series featured on the Scientology Network. Created at the start of the pandemic as a worldwide platform for Scientologists to connect and share how they’re staying safe and making the most of their time at home during the lockdown, Scientologists @home gradually added stories of people getting back to work, and now going back to church. The videos are also available on the Scientology website at Scientology.org/daily-connect.

Since launching on the Scientology Network and the Daily Connect website, the Scientologists@home series has exploded in popularity, with people from over 400 cities and 50 countries around the world, ages 5 to 85, submitting their videos.

The upbeat and optimistic tone to each video is punctuated with Scientologists sharing how they’ve been studying and applying LRH Technology from a number of books and courses, at home or at work, to improve their lives.

The Scientology Network was launched by Mr. David Miscavige, ecclesiastical leader of the Scientology religion, on March 12, 2018. Since launching, it has been viewed in 240 countries and territories in 17 languages. Satisfying the curiosity of people about Scientology, the network takes viewers across six continents, spotlighting the everyday lives of Scientologists, showing the Church as a global organization, and presenting its social betterment programs that have touched the lives of millions worldwide. The network also showcases documentaries by independent filmmakers who represent a cross-section of cultures and faiths, but share a common purpose of uplifting communities.

Broadcast from Scientology Media Productions, the Church’s global media center in Los Angeles, the Scientology Network is available on DIRECTV Channel 320 and can be streamed at scientology.tv, on mobile apps and via the Roku, Amazon Fire and Apple TV platforms.

Better than screening: with WHO’s help Ukraine chose a cost-efficient policy to prevent breast cancer

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Emergency Medical Teams: knowledge exchange and hands-on support strengthen COVID-19 response in Armenia

State budget healthcare institution of Omsk region “City hospital No 3”

To fight breast cancer effectively, Ukraine chose to implement the early diagnosis programme
International Women’s Day (IWD), 8 March is an opportunity to highlight a health issue that affects women alone – an inspiring story of Ukraine’s search for the best tool to fight breast cancer. The country’s authorities used WHO/Europe’s expertise and advice to change their initial plans for nationwide mammography screening and started developing a more promising early diagnosis programme. The move will save Ukraine thousands of lives and millions of euros in loans.

Breast cancer prevention: finding best practices

A recent study conducted by IARC and EURO has shown that in Ukraine, more than 1 out of 4 breast cancers are diagnosed at late stage making cure out of reach, even with the best treatments. To break this worrying trend, Dr Arman Kacharian, the lead for cancer control at the Ministry of Health of Ukraine, reached out to WHO/Europe for their expertise in this field.

In 2019-2020 he discussed effective breast cancer prevention policies at the IARC/WHO workshop on cancer screening and the large WHO/Europe screening conferences, where he came to conclusion that a large scale mammography screening program would not be the best option for Ukraine to improve its situation with breast cancer.

According to the latest WHO guidelines, nationwide mammography cancer screening programmes tend to be expensive and only demonstrate positive results in countries where health systems get vast economic and human resources. Health systems of many countries of the WHO European Region are unable to test large numbers of healthy women and ensure rapid and accurate diagnosis and follow up for those tested positive.

After consultation with WHO/Europe experts, Ukraine’s authorities became interested in another WHO-recommended cancer prevention strategy – the early diagnosis programme. It is based on the rapid identification of cancer in patients who have symptoms of the disease and rapid full diagnosis follow up. Given the major improvements in breast cancer treatment in the past decades, in cases when breast cancer is diagnosed at early palpable stage, the rates of secure cure are very high.

Early diagnosis programme: what are the benefits?

Cancer, when identified early, is more likely to respond to effective treatment, resulting in a greater probability of surviving as well as less heavy and expensive treatment. The value of detecting cancer early is clear, and significant improvements can be made in the lives of cancer patients.

“In comparison to mammography screening programme, centralization of advanced centers providing high-quality early diagnosis of breast cancer is more efficient, economical and sustainable in a setting with limited resources ”, said Dr Olga Trusova, a leading Belarusian mammography expert who took part in the BELMED project aimed at implementation of breast cancer screening in Belarus. BELMED was funded by the EU and implemented by WHO/Europe and IARC since 2016.

WHO/Europe organized a series of online consultations between Dr Kacharian and Dr Trusova to share views and expertise on cancer prevention policies.

The early diagnosis approach for breast cancer was recognized as more appropriate for Ukraine than mammography screening. It is less resource intensive and allows Ukrainian health system to better prepare for future screening measures if needed.

Saving Ukraine’s resources

WHO/Europe has also helped Ukraine to assess its resources. The country has been collaborating with France on breast cancer prevention projects. In early 2020 France proposed a soft loan of 24 million euros to Ukraine to buy mammography machines for screening.

Following advice of WHO/Europe experts, Ukraine performed a rapid mapping of the mammographic facilities available in the country matching them with the national data on breast cancer detection stratified by regions, including the data from the Ukrainian breast cancer screening pilot programme.

It turned out the country had sufficient mammographic equipment to start an efficient early diagnosis breast cancer programme. It was only needed to ensure the existing mammography units worked in full capacity, dealing with more than 4 to 8 women a day as some does presently.

“The help from WHO saved a lot of money for Ukraine”, said Dr Kacharian, “The soft loan was intended for purchase of mammography units. If we don’t need this equipment, we won’t have to reimburse the loan. We`ll renew mammography equipment in oncological specialized hospitals for organizing one day diagnostic program”. WHO/Europe is involved in the discussions where Ukraine is now negotiating with France to see how to invest more efficiently in breast cancer control.