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ENOUGH IS ENOUGH! Nearly a year into targeted, reproductive violence against Palestinian women and girls, and the bombing of our reproductive health site in Gaza; IPPF readies itself for a fresh wave of attacks against its health workers and clinics in Lebanon.  "Our healthcare workers in Lebanon are under attack. 70% of them are women. The facilities where women come and access life-saving reproductive services have already been destroyed in Gaza. Now the world is forced to watch another horrific spectacle of the same war crimes being committed in Lebanon.” “We demand all governments - including the U.S., Germany, UK and others - that are supplying these weapons that kill, maim and displace our fellow healthcare workers to stop. We demand an end to the killing of ALL civilians; we will not be silenced, we will continue to collect evidence and talk about these crimes against our collective humanity,” said Dr. Alvaro Bermejo, Director General, International Planned Parenthood Federation.  Israel's indiscriminate attacks on Gaza have had devastating consequences for women's reproductive health. The attacks on our own health site, on hospitals and maternal health sites significantly limited access to care. We are experiencing this in Sudan too; clinics destroyed, men’s use of violence against our health workers, and rape used as a weapon of war.   In Palestine, obstetric and reproductive violence have been evidenced as a feature of Israel’s violence; we are urgently ringing all alarm bells before these crimes are repeated against women and girls in Lebanon.  “Our staff are terrified; they are running for their lives. Contact with our team is limited - health care workers are too scared to use their phones. We fear not just for our colleagues; but for every single woman and girl. Once again, the very essence of humanity is at stake, as though women, children, and all human beings are merely numbers,” said Lina Sabra, Executive Director of IPPF Member Association in Lebanon, SALAMA. Lebanon is experiencing its deadliest days since the country’s civil war ended in 1990. The acceleration in killing over the past few days amid the escalation between Israel and Hezbollah is only made possible by powerful countries with a vested interest in the continuation of this war.  We remind all parties that acts of obstetric and reproductive violence have been prosecuted as crimes against humanity.

Eswatini (27 August 2024) - IPPF’s Member Association in Eswatini, the Family Life Association of Eswatini (FLAS), is soon to roll out the first women-controlled HIV prevention product, the dapivirine vaginal ring (DVR). FLAS will be among the first organisations to offer the DVR outside implementation or pilot studies anywhere in the world. Made of flexible silicone, the ring is inserted into the vagina by a woman and slowly releases the antiretroviral drug dapivirine in the vagina over a one-month period, helping to reduce a woman’s risk of acquiring HIV. In 2023, in sub-Saharan Africa, women and girls accounted for 62% of all new HIV infections and every week, 3,100 adolescent girls and young women aged 15–24 years became infected with HIV. Therefore, there continues to be an urgent need for HIV prevention methods that females can use to protect themselves. The DVR is a product women can control themselves and use without the knowledge or consent of their partners, unlike condoms, which men often refuse to use. The DVR is inserted into the vagina and left for a one-month period, where it can then be replaced each month for continued protection. Unlike daily oral PrEP, the DVR does not rely on remembering to take a pill each day and is also discreet as it stays inside the vagina throughout the month. The DVR does not prevent pregnancy or other sexually transmitted infections (STIs), so women choosing to use the ring may want to consider combining it with condoms and methods of contraception. The availability of the DVR is an exciting step in supporting women’s autonomy and choice in HIV prevention. This need for women-controlled HIV prevention products has long been advocated for, with the African Women Prevention Community Accountability Board launching the HIV Prevention Choice Manifesto in early 2023. The Choice Manifesto prioritises the principle of choice to ensure that women and girls have the right to choose which HIV prevention methods work for them. Currently the ring is available at selected facilities through implementation studies across six countries in East and Southern Africa; South Africa, Kenya, Zimbabwe, Lesotho, Eswatini, and Uganda.  Diantha Pillay, Associate Director for Product Access for IPM South Africa NPC (an affiliate of the Population Council), said:  “It is encouraging to see the efforts made by FLAS and IPPF to support the choice agenda for HIV prevention for women and make effective HIV prevention methods, like the DVR, more widely accessible in a real-world setting. We hope this can pave the way for introduction of future pipeline products that speak to the needs of women.” The Population Council is currently developing a longer duration DVR that women would use for three months versus one month to significantly lower annual product costs and offer women a more convenient option to protect themselves. Thabo Lizwe Masuku, Programs Manager for FLAS, said: “Women have been telling us for a long time that  there is a need for a variety of methods for HIV prevention, since they are highly exposed. For women and girls to truly have choice about what works for them as they navigate different stages and circumstances of their lives, policy makers, donors, governments and implementers must ensure the mix of HIV prevention methods are available, accessible, and affordable. Access to the ring through our clinics in Eswatini now gives women choice and options to protect themselves against HIV.” IPPF is committed to ensuring that choice in HIV prevention is a reality for women and girls and aims to roll out the dapivirine vaginal rings at as many Member Associations as possible, as well as offer other HIV-prevention choices, as we work alongside our partners towards a future free of HIV in Africa and beyond. For more information and to speak to staff in Eswatini, please email [email protected]   Notes: The dapivirine vaginal ring has been recommended by the WHO since January 2021. (25) In clinical trials, the  ring was shown to reduce HIV infection by 35% in The Ring Study (26,27) and 27% in the ASPIRE Study. (28,29) Recent open-label studies show greater adherence to the ring, and modelling data suggest that HIV risk could be reduced by about 50%. (30) The dapivirine ring has received regulatory approval from the European Medicines Agency (EMA), as well as from local medicines regulators in Namibia, South Africa, Kenya, Zimbabwe, Uganda, Zambia, Malawi, Rwanda, Eswatini, Lesotho, Botswana and is currently under regulatory review in a number of other countries Our Member Associations (MAs) that provide clinical services are required to provide comprehensive SRH services through our Integrated Package of Essential Services (IPES) which include services for sexual health and well-being, contraception, abortion care, sexually transmitted infections (STIs)/reproductive tract infections (RTIs), HIV, obstetrics and gynaecology, fertility support, and sexual and gender-based violence. IPPF’s new five-year strategy, Come Together, focuses on expanding choice. In support of this, we recently launched a special programme to expand our HIV prevention options, which aims to integrate the newest HIV prevention methods – the vaginal ring and injectable PrEP - into our comprehensive sexual and reproductive health services.  IPPF’s IMAP Statement on Biomedical HIV Prevention can be found here. About the Family Life Association of Eswatini (FLAS)  For over 30 years, the Family Life Association of Eswatini (FLAS) has provided sexual and reproductive health (SRH) services to the people of Eswatini (formally Swaziland). While family planning, antenatal, post-natal and post-abortion care form a key part of FLAS services, there’s a significant focus on HIV and AIDS programmes. Eswatini has some of the highest HIV and AIDS prevalence rates in the world. As a result, the prevention and management of HIV and AIDS, the provision of voluntary counselling and testing (VCT), and the prevention of mother to child transmission (PMTCT) are central to FLAS’s work. FLAS has 15 service points, including three permanent clinics and three mobile facilities, staffed by a permanent team of 40 staff backed by 230 volunteers, 180 Youth Action Movement members and 29 peer educators. About the International Planned Parenthood Federation (IPPF) IPPF is a global healthcare provider and a leading advocate of sexual and reproductive health and rights (SRHR) for all. Led by a courageous and determined group of women, IPPF was founded in 1952 at the Third International Planned Parenthood Conference. Today, we are a movement of 150 Member Associations and Collaborative Partners with a presence in over 146 countries.Our work is wide-ranging, including comprehensive sex education, provision of contraceptives, safe abortion, and maternal care and responding to humanitarian crises.  We pride ourselves on being local through our members and global through our network. At the heart of our mission is the provision of – and advocacy in support of – integrated healthcare to anyone who needs it regardless of race, gender, sex, income, and crucially no matter how remote. Our services are available to all, and reach the most marginalised groups in societies, including key and priority populations, youth, and people with disabilities. Most of our MAs have special programs to engage youth (10-24) inside and outside of school settings. Because our clinics offer comprehensive services, attending our clinics is non-stigmatizing and does not label people as having a particular disease or membership to a particular group. This model of services that are integrated and open to all, embedded in indigenous, locally owned organisations, is ideal for ensuring that the most vulnerable and marginalised groups can access the HIV prevention services they need. About the Population Council The Population Council is a leading research organization dedicated to building an equitable and sustainable world that enhances the health and well-being of current and future generations. The Council transforms global thinking on critical health and development issues through social science, public health, and biomedical research. We generate ideas, produce evidence, and design solutions to improve the lives of underserved populations around the world.  

Jerusalem, 9 July 2024: Nine months on since the start of the Israeli aggression in Gaza, maternal healthcare is almost decimated. Pregnant, postpartum, and breastfeeding women in Gaza are facing serious health consequences. Miscarriages have risen at least 300% since October last year. One of our own health workers from the Palestinian Family Planning and Protection Association (PFPPA) recently lost her pregnancy due to the stress of the attacks.   “I am a healthcare worker with PFPPA, and I have been forced to flee not once, not twice, but six times since the start of the violence, with my husband and three small children. Our home was destroyed by bombing. Whilst I was fleeing from one location to another, I started to unexpectedly bleed. I was able to find a doctor only after reaching Rafah, who confirmed I was miscarrying. I didn’t even realise I was pregnant,” Wafa, our healthcare worker in Gaza, told us.   With the starvation being faced by the people in Gaza in addition to the lack of drinking water, our service providers are reporting on daily basis of pregnant women suffering from anaemia, malnutrition and in desperate need of prenatal vitamins and supplements.   Our service providers in Gaza are also witnessing many women who are either having premature deliveries or miscarriages. Women of newborns are unable to breastfeed their babies due their own malnutrition and anxiety, while at the same time most families cannot afford milk formula as prices are becoming extremely high - and that is if they can find it in the market. When medical facilities are available, many women are unwilling to leave their shelters to obtain pre- and post-natal care, as they worry if they are separated from their families there will be military attacks and bombings and fear for their and their loved one's fate if they do so.   Ammal Awadallah, Executive Director of PFPPA, said:  “Nine months on, and a woman who conceived at the start of these hostilities will now be giving birth. But where, how, and what life is that baby entering? This will be a lost generation in Gaza, a generation born into genocide. We’re doing the best we can to offer support to women in Gaza, but the conditions to get aid into Gaza, let alone warehouse supplies, make our jobs extremely difficult. PFPPA has always been committed to women’s health and that doesn’t stop, now or ever.”   Over 37,900 people have now lost their lives in Gaza. Women and girls that survive are facing a myriad of challenges; deprived of sexual and reproductive health services, sanitary and hygiene products. We believe every single person and organisation needs to mobilise to end this, by calling on their governments to demand unhindered humanitarian aid access, to demand a permanent ceasefire, and divest from any organisations aiding and abetting Israel’s military campaign against Palestine.   We are working in close collaboration with colleagues in Palestine on how best to serve those caught up in the violence, to ensure health workers are safe and able to provide sexual and reproductive health care without threat to life.   For more information and to speak to our Executive Director in Palestine, please email [email protected]     About the Palestinian Family Planning and Protection Association  Established in Jerusalem in 1964, the Palestinian Family Planning and Protection Association (PFPPA) is locally registered as an independent, non-profit and non-governmental association with headquarters in Jerusalem. PFPPA has service delivery points located in the West Bank Areas of Ramallah, Bethlehem, Hebron and Halhoul, in addition to one in the Gaza Strip, which has yet to be relocated after it was destroyed following an Israeli airstrike on 8 October. Furthermore, and in cooperation with local partners, PFPPA is also responsible for three safe spaces to provide Gender Based Violence (GBV) related services in the Jerusalem area.  About the International Planned Parenthood Federation  IPPF is a global healthcare provider and a leading advocate of sexual and reproductive health and rights (SRHR) for all. Led by a courageous and determined group of women, IPPF was founded in 1952 at the Third International Planned Parenthood Conference. Today, we are a movement of 150 Member Associations and Collaborative Partners with a presence in over 146 countries.  Our work is wide-ranging, including comprehensive sex education, provision of contraceptive, safe abortion, and maternal care and responding to humanitarian crises. We pride ourselves on being local through our members and global through our network. At the heart of our mission is the provision of – and advocacy in support of – integrated healthcare to anyone who needs it regardless of race, gender, sex, income, and crucially no matter how remote.   

Another horrendous attack by Israel on displacement camps in Rafah, Gaza, has occurred this week, ignoring the orders of the UN’s top court, the International Court of Justice (ICJ), to halt its offensive. Thousands of innocent people are sheltering for their lives in this area, having been told to move there for their safety by Israeli authorities. Instead, they were attacked as they slept, with men, women and children facing nightmarish deaths.    The deaths, displacement and destruction in Gaza must stop. We stand in support of Palestinians who have endured decades of apartheid, land dispossession, and gross human rights violations. The injustices faced by Palestinians are deeply rooted in colonialisation and lack of accountability. Our international systems, which were created to ensure international rule of war, must apply evenly to all member states – including those in the Global North.    Over 37,000 people have now lost their lives. Women and girls that survive are facing a myriad of challenges, deprived of sexual and reproductive health services, sanitary and hygiene products. There must now finally be a critical mass of people of conscience saying enough is enough. Every single person needs to mobilise to end this, by calling on their governments to demand unhindered humanitarian aid access, and to call to trial any governments who have supplied weapons to Israel, aided in Israel’s impunity, and failed to call for a ceasefire.   We call for an immediate end to Israel’s military offensive in Rafah and the ongoing atrocities across the Gaza Strip.   Ammal Awadallah, Executive Director of the Palestinian Family Planning and Protection Association, said:   “Every second, every minute that passes a horrific and devastating situation becomes worse. More and more people are being killed and seriously injured. Pregnant women are fearing the worse for their own fate and that of their pregnancies, what should be a happy time for expecting mothers has become for thousands a living nightmare.   Women and girls are living in a state of anxiety and trauma of getting their period and not having access to menstrual pads, clean water or any sort of hygiene supplies. We need all people and governments to take a stand for what is right for humanity recognizing that the Palestinian people have a right to live with dignity and respect with full access to safe and sufficient health care. There is no justification, that this tragedy continues for millions of Palestinians in Gaza. An immediate and full ceasefire is the only option.”  Dr Alvaro Bermejo, Director-General of IPPF, said:    “In Rafah, nearly all hospitals in Rafah have been forcibly evacuated, and are either out of service or barely functioning, leaving no possibility for the provision of or access to medical care for pregnant women about to give birth.    We are inspired by our health workers in Gaza, who continue to provide sexual and repreoductive healthcare to those in need, but our concern for them, and all Palestinians, will not stop until a permanent ceasefire is reached.    All our humanity is on trial right now. Our organisation is committed to anti-colonialism, anti-racism, and liberation for all, we will speak out in defence of civilians facing peril every day. Silence is not an option.”   For media enquiries, or to speak to our staff member in Palestine, please contact [email protected] Click here to donate to IPPF's emergency appeal for Palestine. About PFPPA Established in Jerusalem in 1964, the Palestinian Family Planning and Protection Association (PFPPA) is locally registered as an independent, non-profit and non-governmental association with headquarters in Jerusalem. PFPPA has service delivery points located in the West Bank Areas of Ramallah, Bethlehem, Hebron and Halhoul, in addition to one in the Gaza Strip, which has yet to be relocated after it was destroyed following an Israeli airstrike on 8 October. Furthermore, and in cooperation with local partners, PFPPA is also responsible for 3 safe spaces to provide Gender Based Violence (GBV) related services in the Jerusalem area. About the International Planned Parenthood Federation IPPF, through its 149 Member Associations and collaborative partners, delivers high-quality sexual and reproductive healthcare and helps advance sexual and reproductive rights, especially for marginalized people with diverse needs that are currently unmet. IPPF's Member Associations and partners are locally owned, independent organisations, which means the support and care they provide are informed by local expertise and context. IPPF advocates for a world where people have the information they need to make informed decisions about their sexual and reproductive health and their bodies. We stand up and fight for sexual and reproductive rights and against those who seek to deny people their human right to bodily autonomy and sexual and reproductive freedom. We deliver care rooted in rights, respect, and dignity for all - no matter what.   Photo credit: IPPF/Samar Abu Elouf/Palestine