Trafficking and Human Rights in Nepal: Community Perceptions and Policy and Program Responses

This report from the Population Council's Horizons program summarizes the policy analysis, documentation of current intervention models, and community-based study of trafficking in the context of an emerging HIV/AIDS epidemic in Nepal

A comparative analysis of anti-trafficking intervention approaches in Nepal

This report on current intervention models is part of a larger research study entitled “Intervention Needs for the Prevention of Trafficking and the Care and Support of Trafficked Persons in the Context of an Emerging HIV/AIDS Epidemic in Nepal.” The United States Agency for International Development supported this comprehensive study under the Population Council’s Horizons Program. The Population Council subcontracted the Asia Foundation in Kathmandu to conduct the research. This report documents and analyzes current intervention models for the prevention of trafficking and the care and support of trafficked persons in Nepal. Between August and September 2000, two researchers interviewed four key informants, one donor agency, and two international and eight local NGOs based in Kathmandu. All of these individuals and organizations support or implement anti-trafficking programs or have extensive knowledge of trafficking-related issues in Nepal. This research aims to understand current perceptions of trafficking and identify the assumptions that explicitly or implicitly inform intervention approaches. A comparative analysis of different intervention approaches was made using a human rights framework

Trafficking and human rights in Nepal: Community perceptions and policy and program responses

In recent years, millions of women and girls have been trafficked across national borders and within countries. The trafficking problem is particularly acute in Nepal, one of the least developed countries in the world, with 42 percent of its citizens living below the poverty line. An estimated 5,000 to 7,000 girls are trafficked from Nepal to India and other neighboring countries every year, primarily for prostitution, and 200,000 Nepali girls and women are currently working in the sex industry in India. The occurrence of trafficking in Nepal is generally attributed to widespread poverty, low status of girls and women, and social disparities rooted in ethnic and caste groupings. Women living in an environment of restricted rights, limited personal freedom, and few employment opportunities may decide that out-migration is their only hope for achieving economic independence and a higher standard of living. Those who are victimized by traffickers instead experience abuse, exploitation, and greater vulnerability to HIV/AIDS. This brief describes a recently completed operations research project undertaken in Nepal that recommends strengthening anti-trafficking interventions in the region and providing effective care and support to trafficked women and girls

Global mortality associated with 33 bacterial pathogens in 2019: a systematic analysis for the Global Burden of Disease Study 2019

Summary Background Reducing the burden of death due to infection is an urgent global public health priority. Previous studies have estimated the number of deaths associated with drug-resistant infections and sepsis and found that infections remain a leading cause of death globally. Understanding the global burden of common bacterial pathogens (both susceptible and resistant to antimicrobials) is essential to identify the greatest threats to public health. To our knowledge, this is the first study to present global comprehensive estimates of deaths associated with 33 bacterial pathogens across 11 major infectious syndromes. Methods We estimated deaths associated with 33 bacterial genera or species across 11 infectious syndromes in 2019 using methods from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, in addition to a subset of the input data described in the Global Burden of Antimicrobial Resistance 2019 study. This study included 343 million individual records or isolates covering 11 361 study-location-years. We used three modelling steps to estimate the number of deaths associated with each pathogen: deaths in which infection had a role, the fraction of deaths due to infection that are attributable to a given infectious syndrome, and the fraction of deaths due to an infectious syndrome that are attributable to a given pathogen. Estimates were produced for all ages and for males and females across 204 countries and territories in 2019. 95% uncertainty intervals (UIs) were calculated for final estimates of deaths and infections associated with the 33 bacterial pathogens following standard GBD methods by taking the 2·5th and 97·5th percentiles across 1000 posterior draws for each quantity of interest. Findings From an estimated 13·7 million (95% UI 10·9–17·1) infection-related deaths in 2019, there were 7·7 million deaths (5·7–10·2) associated with the 33 bacterial pathogens (both resistant and susceptible to antimicrobials) across the 11 infectious syndromes estimated in this study. We estimated deaths associated with the 33 bacterial pathogens to comprise 13·6% (10·2–18·1) of all global deaths and 56·2% (52·1–60·1) of all sepsis-related deaths in 2019. Five leading pathogens—Staphylococcus aureus, Escherichia coli, Streptococcus pneumoniae, Klebsiella pneumoniae, and Pseudomonas aeruginosa—were responsible for 54·9% (52·9–56·9) of deaths among the investigated bacteria. The deadliest infectious syndromes and pathogens varied by location and age. The age-standardised mortality rate associated with these bacterial pathogens was highest in the sub-Saharan Africa super-region, with 230 deaths (185–285) per 100 000 population, and lowest in the high-income super-region, with 52·2 deaths (37·4–71·5) per 100 000 population. S aureus was the leading bacterial cause of death in 135 countries and was also associated with the most deaths in individuals older than 15 years, globally. Among children younger than 5 years, S pneumoniae was the pathogen associated with the most deaths. In 2019, more than 6 million deaths occurred as a result of three bacterial infectious syndromes, with lower respiratory infections and bloodstream infections each causing more than 2 million deaths and peritoneal and intra-abdominal infections causing more than 1 million deaths. Interpretation The 33 bacterial pathogens that we investigated in this study are a substantial source of health loss globally, with considerable variation in their distribution across infectious syndromes and locations. Compared with GBD Level 3 underlying causes of death, deaths associated with these bacteria would rank as the second leading cause of death globally in 2019; hence, they should be considered an urgent priority for intervention within the global health community. Strategies to address the burden of bacterial infections include infection prevention, optimised use of antibiotics, improved capacity for microbiological analysis, vaccine development, and improved and more pervasive use of available vaccines. These estimates can be used to help set priorities for vaccine need, demand, and development