Sunday, July 31, 2022

Why dangerous content thrives on 

Facebook and TikTok in Kenya


NAIROBI — The shooter approaches from behind, raising a pistol to his victim’s head. He pulls the trigger and “pop,” a lifeless body slumps forward. The shot cuts to another execution, and another.

The video was posted on Facebook, in a large group of al-Shabab and Islamic State supporters, where different versions were viewed thousands of times before being taken down.

As Facebook and its competitor TikTok grow at breakneck speed in Kenya, and across Africa, researchers say the tech companies are failing to keep pace with a proliferation of terrorist content, hate speech and false information , taking advantage of poor regulatory frameworks to avoid stricter oversight.

“It’s a deliberate choice to maximize labor and profit extraction, because they view the societies in the Global South primarily as markets, not as societies,” said Nanjala Nyabola, a Kenyan technology and social researcher.

About 1 in 5 Kenyans use Facebook, which last year renamed itself Meta, and TikTok has become one of the country’s most downloaded apps. The prevalence of violent and inflammatory content on the platforms poses real risks in this East African nation, as it prepares for a bitterly contested presidential election next month and deals with the threat of terrorism posed by a resurgent al-Shabab.

“Our approach to content moderation in Africa is no different than anywhere else in the world,” Kojo Boakye, Meta’s director of public policy for Africa, the Middle East and Turkey, wrote in an email to The Washington Post. “We prioritize safety on our platforms and have taken aggressive steps to fight misinformation and harmful content.”

TikTok’s head of government relations and public policy in sub-Saharan Africa, Fortune Mgwili-Sibanda, also responded to The Post by email, writing: “We have thousands of people working on safety all around the world — and we’re continuing to expand this function in our African markets in line with the continued growth of our TikTok community on the continent.”

The companies’ content moderation strategy is two-pronged: Artificial intelligence (AI) algorithms provide a first line of defense. But Meta has admitted that it’s challenging to teach AI to recognize hate speech in multiple languages and contexts, and reports show that posts in languages other than English often slip through the cracks.

In June, researchers at the London-based Institute for Strategic Dialogue (ISD) released a report outlining how al-Shabab and the Islamic State use Facebook to spread extremist content, like the execution video.

The ISD’s two-year investigation revealed at least 30 public al-Shabab and Islamic State propaganda pages with nearly 40,000 combined followers. The groups posted videos depicting gruesome assassinations, suicide bombings, attacks on Kenyan military forces and Islamist militant training exercises. Some content had lived on the platform for more than six years.

Reliance on AI was a core problem, said the report’s co-author, Moustafa Ayad, because bad actors have learned how to game the system.

If the terrorists know the AI is looking for the word jihad, Ayad explained, they can “split up J.I.H.A.D with periods in between the letters, so now it’s not being read properly by [the] AI system.”

Ayad said most of the accounts flagged in the report have now been removed, but similar content has since popped up, such as a video posted in July featuring Fuad Mohamed Khalaf, an al-Shabab leader wanted by the U.S. government. It garnered 141,000 views and 1,800 shares before being removed after 10 days.

Terrorist groups can also bypass human moderation, the second line of defense for social media companies, by exploiting language and cultural expertise gaps, the report said. Kenya’s national languages are English and Swahili, but Kenyans speak dozens of other tribal languages, dialects and the local slang, sheng.

Meta said it has a 350-person multidisciplinary team, including native Arabic, Somali and Swahili speakers, who monitor and handle terrorist content. Between January and March, the company claims to have removed 15 million pieces of content that violated its terrorism policies, but did not say how much terrorist content it believes to still be on the platform.

In January 2019, al-Shabab attacked the DusitD2 complex in Nairobi, killing 21 people. A government investigation later revealed they planned the attack using a Facebook account that remained undetected for six months, according to local media.

During Kenya’s last election in 2017, journalists documented how Facebook struggled to rein in the spread of ethnically charged hate speech, an issue researchers say the company is still failing to address. Adding to their worries now is the growing popularity of TikTok, which is also being used to inflame tensions ahead of the presidential vote on August 9.

In June, the Mozilla Foundation released a report outlining how election-related disinformation has taken root on TikTok. The report examined more than 130 videos from 33 accounts that had been viewed more than 4 million times, finding ethnic-based hate speech, as well as manipulated and false content that violated TikTok’s own policies.

One video clip mimicked a detergent commercial in which the narrator told viewers that the “detergent” could eliminate “madoadoa,” including members of the Kikuyu, Luhya, Luo and Kamba tribes. Interpreted literally, “madoadoa” is an innocuous word meaning blemish or spot, but it can also be a coded ethnic slur and a call to violence. The video contained graphic images of post-election clashes from previous years.

After the report, TikTok removed the video and flagged the term “madoadoa,” but the episode showed how the nuances of language can elude human moderators. A TikTok whistleblower told report author Odanga Madung that she was asked to watch videos in languages she didn’t speak and determine, from images alone, whether they violated its guidelines.

TikTok did not directly respond to that allegation when asked by The Washington Post, but the company issued a statement recently about efforts to address problematic election-related content.

TikTok said it moderates content in more than 60 languages, including Swahili, but declined to give additional details about its moderators in Kenya or the number of languages it monitors. It has also launched a Kenya-specific operations center with experts who detect and remove posts that violate its policies. And on July 14, it rolled out an in-app user guide containing election and media literacy information.

“[We] have a dedicated team working to safeguard TikTok during the Kenyan elections,” Mgwili-Sibanda wrote. “We prohibit and remove election misinformation, promotions of violence and other violations of our policies.”

But researchers still worry that violent rhetoric online could lead to real violence.

“One will see these lies really turn into very tragic consequences for people attending rallies,” said Irungu Houghton, director of Amnesty International Kenya.

Researchers say TikTok and Meta can get away with lower content moderation standards in Kenya, in part because Kenyan law does not directly hold social media companies responsible for harmful content on their platforms. By contrast, Germany’s “Facebook Act” fines companies up to U.S. $50 million if they do not remove “clearly illegal” content within 24 hours after a user files a complaint.

“This is quite a gray area,” said Mugambi Laibuta, a Kenyan lawyer. “[W]hen you’re talking about hate speech, there’s no law in Kenya that states that these sites should enforce content moderation.”

If Meta and TikTok do not police themselves, experts warn, African governments will do it for them, possibly in anti-democratic and dangerous ways.

“If the platforms don’t get their act together, they become convenient excuses for authoritarians to clamp down on them across the continent … a convenient excuse for them to disappear,” Madung said. “And we all need these platforms to survive. We need them to thrive.”

Kenya election: The influencers paid to push hashtags

Jack Goodman - BBC World Service Disinformation team
Sat, July 30, 2022 

Illustration showing hand holding strings acting as puppeteer over three mobile phones, which contain a person using a speaker phone to symbolise influencers. Surrounded by thumbs up emoji icons


Social media influencing is a growing and potentially lucrative business for young people in Kenya and increasingly, politicians come calling.

"People will know that you are pushing a hashtag, everyone on Twitter knows you are being paid to do it for a politician," says Nick, a freelance writer and aspiring social media influencer from Nairobi.

"But politicians wouldn't acknowledge publicly that they have paid an influencer to spread campaign messages. They try to make it look like they have nothing to do with it."

With the fiercely contested presidential election on 9 August, many fear the system of paid-for influence can lead to manipulation and the spread of harmful narratives.


Videos questioning the integrity of the Kenya election have spread on TikTok

Nick, in his mid-20s, started marketing brands online to earn some extra cash while studying or looking for a job.

As he gained followers, betting companies, TV stations, people looking to launch a product approached him to promote them on Twitter. He was also offered some political work, where he can earn 1000ksh (about £7) for a few hours' work - a better daily wage than most casual jobs.

Nick says he prefers promoting brands he likes, rather than politicians, but would tweet support for a candidate for whom he wouldn't vote.

"Personally as long as they are not promoting anything negative or violent or tribal I don't mind. Who says no to extra money?"

However, for the parties and candidates it is a serious business.

"It's a huge activity. During the political season billions exchange hands," says Gordon Opiyo, a long-time political consultant, who is working with clients supporting deputy president and candidate William Ruto.

Gordon says for people hired by clients to plan the campaign, the first task is to recruit a group of so-called microinfluencers - anyone with between 10,000 and 500,000 followers. They then create a group chat and outline the strategy, where instructions for the hashtags, photos and talking points to be used are distributed.


Gordon Opiyo has worked in political consulting for years

The aim is to control the narrative around a particular candidate or topic, and bypass the mainstream media by going straight to social media.

Users working in groups of up to 200 often acquire dummy accounts to promote a particular hashtag, which tend to be used to generate traction around more divisive topics.

Deputy President Ruto fact-checked


The misinformation circulating over academic qualifications


The woman who rallies crowds - but won't vote


Kenyan influencers paid to take 'guerrilla warfare' online

Experts say that almost every attempt to get a political hashtag trending is probably paid for.

"If you see content with a hashtag you know the end game is to make the hashtag trend," says Brian Obilo, who has researched these networks for the Mozilla Foundation in Kenya.

"They may claim the tags are used to mobilise supporters, but if you look at accounts driving the tags, you'll see the accounts are complicit with spreading disinformation online. You'll know someone is bankrolling it."

Politicians tend to keep their distance throughout, Gordon says.

"The main sponsors are usually detached. You'll never get them having any formal contract... because they know that it is a very grey area."

According to Code for Africa's iLAB, a team conducting early warning detection of hate speech and co-ordinated disinformation campaigns, the hashtag #RutoMalizaUfungwe (in English: "[Deputy President] Ruto finish your term and go to jail") was the number one trend on Twitter after being promoted by a core of new seemingly fake accounts.

Many of them referenced the post-election violence of 2007, which led to Mr Ruto's trial at The Hague, and some posts contained hate speech.

Social media posts have accused the national elections body of supporting William Ruto

As in previous years, there have been concerted efforts to question the integrity of the main elections' governing body.

Isaac wants a career in politics. He has been promoting Mr Ruto's campaign and says he has been paid to post 30 tweets a day.

Last month he pushed a tag alleging the head of the national electoral body could not be trusted.

In June, Twitter suspended 41 accounts involved in promoting a similar hashtag suggesting Mr Wafula Chebukati, the head of the Independent Electoral and Boundaries Commission (IEBC), was supporting Mr Ruto, for violations of its manipulation and spam policy.

Twitter told the BBC it prohibits "attempts to use our services to manipulate or disrupt civic processes, including through the distribution of false or misleading information about the procedures or circumstances around participation in a civic process".

This is part of a wider campaign to discredit institutions, which has been on the rise, and has led to election violence in the past, says Code for Africa's Allan Cheboi. The organisation has observed efforts to discredit the IEBC on TikTok and in anonymous articles that have spread on WhatsApp.

The merging of the influencer economy and politics seems to be growing in Kenya. Influencer marketing agency Twiva, which appears to be using its platform to work with political campaigns, did not want to provide a comment about why it has not listed this service on its website.

Flooding social media with hashtags is just one of the strategies used.

Abraham Mutai, a digital strategist who has advised politicians on influencing projects, believes a more effective approach involves paying top political influencers to talk about certain topics over a week. Rather than a rapidly shared hashtag and pre-scripted talking points, it looks real.

"For politicians, they see that organic conversations are powerful because they look not paid for…but in fact they are. It's all about perception," says Abraham, who is on the campaign trail with the Raila Odinga camp.

A lot of money funds these social media operations. From three typical jobs every month, a macroinfluencer (followers nearing the one million mark) or strategist could receive five million ksh (£35,000), which is also shared between the smaller influencers.

Claims about the current president Uhuru Kenyatta and the head of the IEBC have also spread

But although there is money to be made, some influencers are not particularly happy about their employers.

"We can spread false information about a certain politician, and other days praise their opponents. Depends on who is paying for the task," says Alex, not his real name, via WhatsApp. After having his main account suspended on Twitter he is feeling frustrated at not being able to work.

"It's like a tree. We're just the leaves. Why do I say this? Because influencers can be replaced any time."

Like Alex, Nick is not enthusiastic about this line of work. He says political jobs are notoriously bad for one crucial reason.

"There's a huge chance you won't get paid. It's not the same as another marketing job," he says. "First of all you don't really believe in what you're doing. You just do it for the money and that money may not come. Personally I'm not a fan of it."

Additional reporting by Peter Mwai, graphics from Jacqueline Galvin and Olaniyi Adebimpe, and social media analysis by Shayan Sardarizadeh.

Kenya elections: Why farmers like William Ruto's big ambitions

Thu, July 28, 2022 


William Ruto at a campaign rally in June 2022

A great farmer - that is how people hanging around outside a small shopping centre in Kosachei town in western Kenya describe Deputy President William Ruto, who is running for the presidency in the 9 August election.

Mr Ruto is one of Kenya's biggest maize farmers. His expansive farm, which is next to the shopping centre, is evidence of his fortune.


Women buy vegetables, bananas and eggs from the farm and sell them in markets in nearby towns, while the men work as casual labourers on the farm.

Tucked away behind a black metal gate, it is heavily guarded by police.

Mr Ruto owns vast pieces of land across the country and concerns have been raised about how he acquired some of them.


In June 2013, the High Court ordered him to surrender a 100-acre (40-hectare) farm, and compensate a farmer who had accused him of grabbing the land during the 2007 post-election violence. He denied any wrongdoing.

In that election he had backed the presidential bid of Raila Odinga, who is now his main challenger - reflecting the constantly shifting political alliances in Kenya as leaders calculate how best to secure power.

Kenya's Daily Nation newspaper says Mr Ruto enjoys a cult-like following among his supporters. But the most recent nationwide opinion poll - which Mr Ruto has dismissed as "manufactured" - show he is trailing Mr Odinga by 37% to 43%.

Kosachei residents are hopeful that he will win, and help farmers increase their yields and make Kenya self-sufficient in food.

"He is a good neighbour who teaches us how to farm. Back when he was the minister for agriculture he subsidised fertiliser. The price of fertiliser at the moment is at its highest ever. He is the only one who understands the issues of farmers," says vegetable seller Mama Sasha.


Mama Sasha (L) and her friends showcase cabbages outside her stall in Kosachei

Mr Ruto's farm is in Uasin Gishu county, which - along with neighbouring counties - produce most of Kenya's maize.

Its supply to the national cereal board has had controversies over payments.

In 2018, a company registered under the names of Mr Ruto's wife and son was investigated over the supply of maize worth millions of Kenyan shillings, but the anti-corruption agency cleared it.

Mr Ruto's neighbours in Kosachei defend him, saying he was unfairly targeted.

They refuse to offer any criticism of him, blaming outgoing President Uhuru Kenyatta - who is backing Mr Odinga after he fell out with his deputy early in their second term - for government failures.

For them, Mr Ruto is the source of their livelihood and "a win for him will be a win for everyone".

"If a 'mama mboga' [vegetable vendor] doesn't have starting capital, they go and get produce from his farm to start their business," Mama Sasha tells us while showing off some cabbages and traditional vegetables from Mr Ruto's farm.

Her mud-walled stall is located metres away from Mr Ruto's farm.

He has promised cheaper loans to farmers to help them meet the costs of production and provide ready markets for their produce.

Farmer Edward Barngetuny wants all taxes on farm implements to be scrapped

A maize, dairy and sheep farmer, Edward Barngetuny, whose 40-acre farm is in the Salient area of neighbouring Nandi County, says the increased cost of fertiliser has made farmers reduce the acreage they farm.

"The biggest issue we are facing is the lack of guaranteed minimum returns. If the market is regulated then one is able to do the math and plan accordingly," the 33-year-old father of two says.

The price of maize is regulated by demand and supply forces making it unpredictable.

Currently, a bag of maize is selling at the highest price ever but some farmers in Mr Ruto's home area had already abandoned the crop for sugarcane whose price is regulated by the government.

"We'd like him [Ruto] to remove all taxes on farm implements. Implements have become very expensive yet we want to mechanise to increase yield," Mr Barngetuny says.

He dismisses the recently announced subsidy on maize flour - which is to last for the next month - as an election gimmick, saying it will not affect most growers as the next harvest is not until December.

"It's just to entice Kenyans to vote in the upcoming elections," he says.

Dairy farming is also huge in western Kenya and the Kalenjin community from which Mr Ruto hails has a traditional delicacy called "mursik".

It is milk fermented in a traditional gourd lined with soot from branches of specific trees for preservation and flavour.

Nelly Kulei has been in the mursik business for more than 20 years and says this year has been tough.

Mursik seller Nelly Kulei says she has been hit by milk shortages

"We were affected by milk shortages and the rising cost of living. We are hopeful that things will change after this election," says the mother of five as she demonstrates how mursik is made.

The Kalenjin community produced Kenya's longest-serving president, the late Daniel arap Moi, who ruled for 24 years.

In Eldoret town, a group of residents regularly meet to discuss politics in what is called "Bunge la Mwananchi", Swahili for People's Parliament.

A former aspiring MP Dan Langat speaks to them about the need for the Kalenjin community to give its full backing to Mr Ruto, who has replaced the late Mr Moi as the community's kingpin.

"We are hopeful that Mr Ruto will take the presidency and reinstate our position in the country," he tells the crowd.

Dan Langat has been ralling people to support William Ruto's presidential bid

Eldoret has grown to become Kenya's fourth largest town. It boasts a new skyscraper, built on its hilly terrain.

The town buzzes with traders mostly selling agricultural produce.

But it is also home to major textile firms that provide employment to thousands.

One of them, Zaritex, is owned by Daniel Odhiambo, who comes from the Luo community, like Mr Odinga.

He says while Eldoret is a violence hotspot during elections, he has no plans to travel back home to Kisumu as he does not fear being targeted because of his ethnic background.

He says about 50% of his employees are locals from the Kalenjin community and they have coexisted well.

"The security agencies here have really tried to preach peace and we are hopeful that it will be peaceful," Mr Odhiambo says as he shows an employee how to measure a fabric.

Eldoret also has a thriving second-hand clothes sector at West Market.

Known as "mtumba", second-hand clothes have featured in the manifestos of both leading candidates, each wanting to support the local textile industry and reduce reliance on imported clothes.

Mr Odinga caused controversy by stating that second-hand clothes were previously owned by dead people in Europe, but he later clarified that he would support traders who sold them even as he sought to grow the local textile industry.

"We've become a dumping ground. Some of the clothes we receive are of a poor quality"", Source: Violet Nyambokho, Source description: Second-hand clothes vendor, Image: Violet Nyambokho

Tabitha Mumbi, 40, says the sector offers a livelihood to millions of Kenyans.

"I'm a product of mtumba, my parents educated me until diploma level with this business and now I'm paying my children's school fees with this money," she says.

She and other the traders did not want to talk election politics, but agreed the market needed to be regulated to ensure that only second-hand clothes of a good quality were imported.

"We've become a dumping ground. Some of the clothes we receive are of a poor quality and it has now become difficult to make any profits," explains 50-year-old Violet Nyambokho, who has sold skirts for 15 years.

Miles away in the rolling hills of Iten, known as the home of champions for accommodating most of the country's celebrated athletes, runners are hopeful that a Ruto victory would benefit the sport.

Iten is famous for producing athletics stars

Kamariny stadium - which Mr Ruto promised in 2017 would be completed in six months - is still under renovation.

"There is lack of support for athletes who want to compete in track events. That is why we are seeing a preference for road races. There are no facilities for athletes to train in track events," coach Peter Bii says, blaming contractors for the delay in completing work on the stadium.

He says most athletes who come to Iten to train because of the terrain end up getting frustrated because of lack of support - and they want better organisation.

"Mr Ruto will need to disband Athletics Kenya as its current composition is full of retirees who lack creativity," he says.

The coach's comments underline the high expectations that Mr Ruto's supporters have - but he will first need to show them he is a winner by racing to victory.



Election branding

GAUGING THE MOOD: How a handshake changed Odinga's heartland


YOUTH VIEW: The woman rallying election crowds - but won't vote


A WOMAN'S BATTLE: Taking on sexist bullies to stand


RAILA ODINGA: The eternal candidate hoping it will be fifth-time lucky


WILLIAM RUTO: William Ruto: The former chicken seller with presidential ambitions


READ MORE: Full coverage

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What Is Freedom of Assembly and How Is the Situation in Europe?

Freedom of assembly is an essential component of every democracy. It gives citizens the opportunity to get information and to express their opinions. However, in recent years it has been facing increasing pressure.


by Franziska Otto
CIVIL LIBERTIES UNION OF EUROPE
June 24, 2022


What exactly does freedom of assembly mean?

Freedom of assembly is a fundamental civil liberty and is enshrined in Article 20 of the Universal Declaration of Human Rights and in Article 12 of the Charter of Fundamental Rights of the European Union. It states that people may assemble peacefully.

However, in this case "assembly" does not necessarily refer to any meeting of several people. Meeting up with friends at the weekend to go to a football match or to attend a rock concert with thousands of people is not an "assembly" in the same sense. Rather it refers to the right is that people have to meet other people to express an opinion or to get information, for example by attending a Fridays for Future demonstration. In this way, assemblies are an important part of the culture of public debate, doing far more than just giving citizens the opportunity to express their displeasure about, say, a new law - they actually help the government to understand what the people want.

What does the German Constitution say about freedom of assembly?

Article 8 of the German Grundgesetz guarantees the freedom of assembly. Paragraph 1 states that all Germans have the right to assemble peacefully and without weapons without registration or permission. Paragraph 2 restricts this somewhat, because open-air assemblies can be restricted by and on the basis of a law.

In addition to Article 8 GG, there is also a law on assemblies which prescribes certain regulations regarding the right of assembly. Some federal states (for example Bavaria and Lower Saxony) have their own Landesversammlungsgesetz ('state assembly law'), others follow the federal law.


What are legitimate restrictions?

As described above, "open-air" assemblies can be restricted. But what does this mean, or why might this be necessary? The law may require that such events be registered. Generally, this must be done at the appropriate assembly authority (Versammlungsbehörde) no later than 48 hours prior to the public announcement. This is mainly for practical reasons, as road traffic may need to be diverted for a demonstration marching through a city centre or to ensure that security can be guaranteed.

In addition, there may be certain requirements that an open-air assembly must observe, such as having to follow the instructions of the police regarding the route of a demonstration march.

This rule does not apply to so-called spontaneous gatherings, i.e. those where people come together unplanned and without an organiser.

If there is a danger to public safety or order, a gathering can either be broken up by the police or prohibited in advance. However, both options should always be the last resort and may only come into play if regulations for the specific assembly are not being followed. Such conditions can relate either to the conduct of the event, such as the aforementioned route that a demonstration is to take, or to the content. The latter means that a person could be banned from speaking or from carrying flags. This can happen, for example, if a right-wing extremist group carries flags with swastikas (a symbol banned in Germany), i. e. something that is also punishable outside of assemblies.

The right to hold an assembly does not apply if it aims to promote a party that has been declared unconstitutional.

If a meeting is banned in advance, the organisers can go to court. The court then decides whether the ban was lawful or whether the assembly may take place.
What are the duties of the state with regard to freedom of assembly?

The German state is obliged to guarantee freedom of assembly, regardless of the views expressed by the participants. A demonstration for more renewable energy should not be banned because the government is planning new nuclear power plants.

Freedom of assembly must also be promoted by the legislature by allowing the right to peaceful assembly to be exercised in a non-discriminatory manner. What does this mean in practice? When, for example, a right-wing group announces a demonstration, left-wing counter-demonstrations usually take place at the same time. Often there are also violent confrontations. However, concerns about such confrontations must not influence whether the demonstration is allowed to take place.

This means, for example, that the fact that it can be assumed that there will be violent counter-demonstrations at a demonstration is not reason enough to refuse permission for it from the start.

And what exactly is a "pacified district"?


A "pacified district" (“Befriedeter Bezirk”) is proclaimed around the three constitutional bodies in Germany - the German Bundestag, Bundesrat and the Federal Constitutional Court - as well as around the state parliaments in the individual federal states. In these areas, open-air assemblies are generally prohibited. This is justified by the need to ensure the working and functional capacity of these organs.

However, there may be exceptions in certain cases, namely if it can be assumed that the assembly will not restrict the work of the affected institution. This may be the case, for example, when the German Bundestag is in summer recess and no sessions are taking place.

Applying for an assembly in a pacified district is more difficult than elsewhere. The Federal Ministry of the Interior and the president of the constitutional body concerned decide whether an application can be accepted. The application must be submitted at least seven days before the start of the event. Spontaneous assemblies are not permitted.



Freedom of assembly in Germany: What is the current situation?


As with many other parts of public life, the coronavirus pandemic resulted in severe restrictions on freedom of assembly.

Especially at the beginning of the pandemic, when there was a great deal of uncertainty about the virus and its consequences, public health was often placed above the fundamental right of freedom of assembly. Many federal states also issued assembly bans along with legal ordinances to protect the population from Covid-19. These ranged from a complete prohibition of assemblies to exceptions in which assemblies had to be authorised. However, the German Constitution does not provide for such permission reservations, as it explicitly states that freedom of assembly applies without permission. Therefore, the German Constitutional Court also decided in a ruling in April 2020 that a blanket suspension of freedom of assembly is not legal.

In part, there are fears that new measures for restrictions were created during the pandemic that could also be pulled out of the drawer in other social crises.

However, our democracy thrives on social exchange and political opinion-forming. Freedom of assembly is essential to guarantee both. Bans must always be the last resort, a principle that should also apply in times of exception such as a pandemic.

Further reading on this topic:

EU Governments Use Pandemic Measures to Restrict Civic Space and Freedoms: Liberties & Greenpeace Report


Lithuanian Pride March Goes Ahead Despite Local Efforts To Restrict Freedom Of Assembly


Teenage Pro-Abortion Protesters Targeted For Participation; “Hungary Style Takeover" Of Media


Civicus: Orbán's Government Targets LGBTI Rights Amid the Pandemic and Bans Protests


Photo credits:

Mélodie Descoubes/Unsplash

#DemandingOnDemocracy, protests
 

India’s transgender population struggles with unhelpful hospitals and high costs


Issued on: 31/07/2022 -



















A group of transgender women attend an inauguration ceremony of a free dance school for transgender people in Chennai, India on 31 May, 2022. © AFP/Arun Sankar


India's transgender community faces many obstacles to accessing quality health care, especially when it comes to the costs of gender affirmation surgery

Manisha Khera, a transgender person from Mumbai, has been saving up for several years for a hormone replacement therapy (HRT) and at a later stage a sex reassignment surgery (SRS) but finds the entire procedure complex and at times, frustrating.

“The procedure is complex and moreover the cost is prohibitive. I have turned to government hospitals but it is so difficult there too. The biggest obstacle is that there is no enabling environment,” Manisha told RFI

A distant dream for transgenders

Manisha is among the thousands of transgender people in India who find it tough to go through SRS because government hospitals have been unhelpful while private hospitals are prohibitive in costs when it comes to such a procedure.

"Many of us are struggling. Government hospitals, though mandated to offer such facilities, fail to offer a sensitive approach to the process and give us the run around," she adds.

According to the population census of 2011, India has almost half a million transgender persons, though other estimates put them at nearly 3-million-strong.

In 2014, India's Supreme Court for the first time recognised a third gender, paving the way for millions of people to join the mainstream. The ruling aims to give transgender Indians a legal status, better protection and jobs.

Those in the community maintain there is still a long way before they get social acceptance especially from the medical community.

SRS costs €5000 to €7500 depending on which part of the country it is carried out in while some hospitals perform them for far less.

Metropolitan cities like Mumbai and Delhi are expensive while in smaller cities the costs for such a procedure are affordable.

“A lot of us undergo gender distress caused by not having our body match gender identity. But such surgeries are expensive,” said Rita Singh, an aspiring actor.

According to the Transgender Persons (Protection of Rights) Act, 2019, the government has been mandated to provide health facilities to transgender persons, including separate HIV surveillance centres, and gender affirmation surgery.

Little government help

The Act also says that the government must provide hormonal therapy, and counselling, both before and after the surgery. It mandated at least one hospital in each state to offer SRS along with hormonal therapy.

But many transgenders complained the whole process was awkward as it entailed registering with a portal for the allocation of a nationally recognised transgender certificate and identity card to allow for such surgeries.

Till date, just a few thousand have been provided proper certification.

“Government hospitals fail to offer a sensitive approach to the process. Many of my fellow transgenders have visited government hospitals to enquire about SRS but there are a lot of missing links. Most of the staff there are not aware of how to behave in a situation like this,” said Jyothi, a transgender.

India’s National Human Rights Commission mentions that many transgenders do not possess identity cards, voter cards or bank accounts because of “limited education, lack of awareness and poor exposure to the social political and legal system.”

Transgenders drop out of mainstream schools at a very early age because of the prejudice they face from the people around them. Being legally invisible, they have battled hard to gain acceptance and recognition but continue to be ‘othered’.

Even till date, the stigma associated with HIV/AIDS is a fundamental barrier in seeking healthcare for HIV-positive trans people.

During the height of the pandemic for instance transgender individuals faced several challenges while accessing health care that laid bare the inequality in access.

“We have a tough life and there is a battle at every stage. But we will raise our voice so that there is recognition. Healthcare is very important,” Navya Singh, a trans model and actor told RFI.

AMERIKA

The Spread of Book Banning

Explaining the increasing politicization of the book banning debate.

Books at a New Jersey high school library that were targeted for bans.
Credit...Bryan Anselm for The New York Times


By Claire Moses
July 31, 2022, 6:46 a.m. ET

You're reading the The Morning newsletter. Make sense of the day’s news and ideas. David Leonhardt and Times journalists guide you through what’s happening — and why it matters. Get it sent to your inbox.


Book-banning attempts have grown in the U.S. over the past few years from relatively isolated battles to a broader effort aimed at works about sexual and racial identity. Alexandra Alter and Elizabeth Harris cover the publishing industry. I spoke to them about what’s behind this trend.

Claire: How did book-banning efforts become so widespread?

Alexandra: We’ve seen this going from a school or community issue to a really polarizing political issue. Before, parents might hear about a book because their child brought a copy home; now, complaints on social media about inappropriate material go viral, and that leads to more complaints in schools and libraries across the country.

Elected officials are also turning book banning into another wedge issue in the culture wars. Last fall, a Republican representative in Texas put together a list of 850 books that he argued were inappropriate material in schools and included books about sexuality, racism and American history. In Virginia, Gov. Glenn Youngkin campaigned on the issue by arguing that parents, not schools, should control what their children read. Democrats have also seized on the issue through congressional hearings about rising book bans.

And, sometimes, the disputes have spilled into something more menacing. The Proud Boys, the far-right group with a history of street fighting, showed up at a drag-queen-hosted story hour for families in a library in San Lorenzo, Calif.

Why do parents and conservatives want these bans?

Alexandra: For some parents, it’s about preventing kids from reading certain things. Others want to introduce certain topics — like L.G.B.T. rights or race — to their children themselves.

A lot of the people I’ve spoken to say they don’t consider the bans they want to be racist or bigoted. They say the books contain specific content that they feel isn’t appropriate for children, and they’ll sometimes point to explicit passages. But librarians we speak to say that the most challenged books around the country are basically all about Black or brown or L.G.B.T. characters.

In Texas, residents sued a library after a library official took books off the shelves based on a list from an elected official. They weren’t all children’s books; the list included Ta-Nehisi Coates’s “Between the World and Me” and “How to Be an Antiracist” by Ibram X. Kendi.

It’s hard to disentangle the banning surge from other conservative efforts to use the government to limit expression, including what critics call Florida’s “Don’t Say Gay” law. Those are all movements that have overlapped and spurred book-banning debates.

Elizabeth: Book banning is part of a wider political context right now, of extreme polarization, of heightened political tensions and the amplification of certain messages by the kinds of media — social or otherwise — that people consume.

Has any banning effort stood out to you?

Elizabeth: In Virginia Beach, a local politician sued Barnes & Noble over two books, “Gender Queer,” a memoir by Maia Kobabe, and “A Court of Mist and Fury,” a fantasy novel. This lawmaker wants Barnes & Noble to stop selling these titles to minors. The suit probably won’t succeed. But it’s an escalation: The issue went from people thinking their children shouldn’t read certain books to trying to stop other people’s children from reading certain books.

I understand why some of the fights over school reading are so intense: By definition, teachers are making choices about which books children are — and are not — going to read, and parents may not always agree. The efforts to take books from libraries feels different, yes?

Elizabeth: When people are trying to push a book out of the library, they’re making a decision for everyone, that nobody has access to a particular book. But librarians are trained to present a range of viewpoints. For them, it’s a matter of professional ethics to make sure that the point of view of one person or one group isn’t dictating what everyone reads.

Elizabeth: Book banning can also be damaging to kids who identify with story lines in books that are banned in their communities. The question for the child becomes, “What’s wrong with me?”

How are librarians responding?

Alexandra: It’s heartbreaking for them. Librarians say they got into this field because of a love of reading and talking to people about books. Some have left their jobs; some have been fired for refusing to remove books. Others quit after being subject to a barrage of insults on social media.

A librarian in Texas quit after 18 years because she was harassed online. She moved out of state and took a job in tech.

What’s next?

Elizabeth: The movement is not going away as long as the midterms are ahead of us. And the school year will start just as election season is really heating up, so both could add fuel to this fire.

Alexandra Alter joined the Times in 2014 and Elizabeth Harris in 2005. Elizabeth’s first byline for The Times was on a first-person piece about camping in Central Park. Alexandra’s first byline ever was in 2002 for The Nepali Times, about traditional clay pottery in a village near Kathmandu.


For more

Librarians are at the center of the culture war.

How “Gender Queer” became the most banned book in the U.S.
SHOOTING THE MESSANGER
East Timor authorities investigate journalist Raimundos Oki over reporting on alleged police abuses

Committee to Protect Journalists (CPJ)
31 July 2022

Journalist Raimundos Oki (C) holds a placard during a rally organised by people supporting him, as he was facing a separate defamation case at the time, Dili, East Timor, 29 May 2017,
VALENTINO DARIEL SOUSA/AFP via Getty Images

Journalist Raimundos Oki is under investigation for violating judicial secrecy laws over his reporting on alleged police abuses.

This statement was originally published on cpj.org on 27 July 2022.

Authorities in East Timor should drop their investigation into journalist Raimundos Oki and stop using legal threats to curb independent reporting, the Committee to Protect Journalists said Wednesday.

On June 29, officers with the Scientific Police for Criminal Investigation, a forensic investigation body, summoned Oki for questioning, according to news reports and the journalist, who communicated with CPJ via email.

During an hour-long questioning session the following day in Dili, the capital, officers told Oki, editor-in-chief of the news website The Oekusi Post, that he was under investigation for violating judicial secrecy laws over his reporting on alleged police abuses, according to those sources.

That reporting, published on June 23, 2021, alleged that state prosecutors had ordered police to detain about 30 young girls who were suspected victims of sexual assault, and said that, in pursuit of evidence of assault, police officers had performed forced “virginity tests” on the girls that resulted in physical injuries.

“East Timor journalist Raimundos Oki was simply doing his job by reporting on allegations that police abused young girls in pursuit of criminal evidence; he should not be harassed for exercising his freedom of expression rights that are guaranteed under Timorese law,” said Shawn Crispin, CPJ’s senior Southeast Asia representative. “Authorities must drop their outrageous investigation into Oki immediately, and ensure that he can work without fear.”

If charged and convicted of violating judicial confidentiality, a criminal offense under Article 291 of the penal code, Oki could face up to six years in prison.

After his questioning on June 30, Oki received a letter from authorities notifying him that he was a defendant in a legal secrecy case, and saying he was required to report to authorities if he planned to travel abroad, he told CPJ.

No court date has been set in the case, Oki said.

CPJ submitted a request for comment to the East Timor public prosecutor’s office through its official website, but did not immediately receive any response.

In December 2021, American missionary Richard Daschbach, the subject of that police investigation, was sentenced to 12 years in prison for sexually abusing young girls, according to news reports.
Why the proposed prisoner swap may not quickly free detainees in Russia: Analysis

There are still hurdles ahead for Brittney Griner and Paul Whelan.

By Shannon K. Crawford
July 31, 2022,

WNBA star and two-time Olympic gold medalist Brittney Griner sits in a cage at a court room prior to a hearing, in Khimki, Russia, July 27, 2022.
Alexander Zemlianichenko/Pool via Reuters

US discusses prisoner swap with Russia

Secretary of State Antony Blinken spoke with Russian Foreign Minister Sergey Lavrov to push Lavrov to accept the offer the U.S. put forth to free detained Americans Brittney Griner and Paul Whelan.


Secretary of State Antony Blinken's announcement that the U.S. had put a "substantial offer" on the table for Russia aimed at bringing home two Americans imprisoned in Russia -- WNBA star Brittney Griner and former Marine Paul Whelan -- was an exceedingly rare disclosure in the world of hostage diplomacy, where almost nothing is revealed until a deal is done. The revelation that convicted arms dealer Viktor Bout had been offered up as part of a prisoner swap only intensified speculation that the detainees might soon be on their way home.

But despite these developments, and Blinken restarting direct discussions with his Russian counterpart on Friday -- their first interaction since the outbreak of war in Ukraine -- experts caution there is still likely a long way to go before Griner and Whelan are released.


Secretary of State Antony Blinken speaks during a news conference after meeting with top Japanese Ministers at the U.S. State Department, on July 29, 2022, in Washington, D.C.
Drew Angerer/Getty Images

Trial delay

While Griner has been in Russian detention since February on drug charges and pleaded guilty, she has yet to be convicted of a crime. Although a guilty verdict is all but assured, Russia has consistently signaled that it wants to see its legal process play out before brokering any kind of agreement.

MORE: Paul Whelan's twin brother speaks out on US proposal to secure his release with Brittney Griner


"That's what is required under Russian law," said William Pomeranz, the director of the Wilson Center's Kennan Institute for advanced research on Russia and Eurasia. "It's required that there has to be a final judgement."

Pomeranz cautions that there are "always loopholes" in the country's legal system, but says that Moscow wants to appear to have held out until after her sentencing before making a determination on a prisoner exchange or similar agreement.

Griner's trial began in early July, and Russian court watchers have predicted it could conclude before the end of summer. But there is no clearly set timeline and her preliminary detention has already been authorized through Dec. 20.

That's not the kind of control you want your adversary to have if you're a negotiator.

"If the Russians want to delay, they can do so. It will be up to the Russian court as to how fast and expedited a decision is made," Pomeranz said.

A numbers game

This spring, the Biden administration conducted its first prisoner swap, exchanging Russian citizen and convicted drug trafficker Konstantin Yaroshenko for another former U.S. Marine, Trevor Reed.

While Reed's return home was welcomed, he and many others questioned why Whelan -- who has already been locked away in Russia for over three years on espionage charges the U.S. government has called "trumped up" -- was left behind.

On Thursday, State Department Spokesperson Ned Price declined to say whether the U.S would take part in a deal that saw only Whelan or Griner freed, but it comes as no surprise that the offer put forward by the administration seeks a package deal.

However, even though the allegations against Griner wouldn't even amount to a misdemeanor in the U.S. and the government says the case against Whelan is fabricated, Russia will likely expect more than Bout -- or any individual prisoner -- in return.

"The Russians will want to have equivalency," said Pomeranz. "So if there are two Americans who are being proposed for a swap, the Russians will insist on two Russians in American custody."

MORE: Trevor Reed 'cautiously optimistic' about proposal to free Griner and Whelan from Russia


In this June 15, 2020, file photo, former U.S. Marine Paul Whelan, who was detained and accused of espionage, holds a sign as he stands inside a defendants' cage during his verdict hearing in Moscow.
Maxim Shemetov/Reuters, FILE

This means the Biden administration would have to sweeten the deal -- and open itself up to more criticism for letting Russian criminals walk free.

And while Moscow might say Bout is a high priority, former Defense and State Department official and ABC News contributor Col. Steve Ganyard says in reality, he isn't.

"He is not a spy who caused major damage to U.S. national security," Ganyard said. "They get more mileage out of poking a finger in the United States' eye, and more importantly, making the White House look desperate."

Publicity push?

The very revelation that the administration offered Moscow a deal may speak best to that desperation.

"A sensitive negotiation isn't made public before it's done if it's going well," said Ganyard. "Publicizing the offer is a way of deflecting U.S. domestic pressure, but it's actually hurting the White House negotiating position by admitting frustration and a weak hand."

Price admitted on Thursday it was evident that the deal had not been received as U.S. diplomats had hoped given the amount of time that had passed since the offer was first made.

"We believe that now that this message, this substantial proposal, has been conveyed directly and repeatedly through appropriate channels in recent weeks -- of course without resolution," he said.

"The fact that now, several weeks later, we are where we are, I think you can read into that as being a reflection of the fact that this has not moved to the extent we would like," Price added.

So far, the Russians have given no public indication that they are ready to seriously engage.

"Unless there is some behind-the-scenes movement we don't know about, Brittney Griner and Paul Whelan will continue to be pawns in a drawn-out negotiation," said Ganyard.
Other infant formula makers besides Abbott have faced Cronobacter contamination and operational deficiencies, documents show

"Rigorously managing the environment" is particularly important, experts say.

MEANS THEY ARE CLEANING UP THEIR MESS

BySasha Pezenik and Sony Salzman
July 30, 2022

Some of the operational deficiencies that helped trigger the massive shutdown of Abbott Nutrition's infant formula plant earlier this year have also been found at some other companies' factories, according to an ABC News investigation of some of the other formula makers that have stepped in to help fill empty American grocery shelves in the midst of the critical nationwide shortage.

The pathogen that prompted those concerns, Cronobacter sakazakii, can be widely found in the environment -- but in infants, it can be deadly.

Its discovery inside Abbott's Sturgis, Michigan, plant prompted a massive voluntary formula recall in February, after four babies who had consumed Abbott's formula contracted a Cronobacter infection. Two of the infants subsequently died, although Abbott maintains there has not been conclusive evidence that its formula caused the infant illnesses, since none of the Cronobacter strains found at their plant matched the two samples genetically sequenced from the sickened infants.

Ultimately, it was the combined findings of Cronobacter inside Abbott's plant -- along with a pattern of serious operational deficiencies and consumer complaints -- which led to its closure.

Abbott's shutdown ricocheted across the country, exacerbating the supply shortage and forcing families to scramble for alternatives in the hyper-concentrated formula market. In the wake of Abbott's recall, other companies jumped in to ramp up manufacturing to help mitigate the strain.

Yet within the last five years, those companies -- Reckitt's Mead Johnson, Gerber, and Perrigo's PBM -- have also not been immune to operational and even contamination-related concerns.

Nearly a decade's worth of FDA inspections obtained through the regulatory intelligence company Redica Systems and reviewed by ABC News have found the presence of Cronobacter in environmental sampling, in critical and high-hygiene areas, and even in finished product from some of these formula manufacturers' American plants.

In some cases, investigators found crucial equipment in a state that could nurture the spread of potentially dangerous pathogens, according to inspection reports.
'Rigorously managing the environment'

Cronobacter is exceptionally hardy, experts say. It is also "fairly common" in places like soil -- but that's exactly why "rigorously managing the environment" in formula factories and "taking proactive steps to prevent pathogens from creeping into our foods" are particularly important, food safety expert Scott Faber told ABC News.

Akin to a restaurant health inspector, the FDA performs no-notice inspections of U.S. manufacturing facilities to ensure companies are complying with manufacturing and cleanliness standards; they also perform inspections when alerted by a company that product contamination has been found -- or when consumer complaints prompt a for-cause probe into whether the company is upholding an acceptable standard.

Normally fully stocked shelves of baby forumala are empty in a Target store in Queens, New York, June 23, 2022.

Universal Images Group via Getty Images, FILE

ABC News has reviewed FDA inspection documents for the three other domestic companies which, along with Abbott, have been responsible for roughly 90% of the country's formula market.

The right set of circumstances can compound a perfect storm of risk factors for potentially dangerous pathogens to survive, experts say -- and that's especially worrisome when a contaminant like Cronobacter lurks where food is made for babies, who are among those most vulnerable to that germ.

"Especially for sensitive populations, that quality control is so important. You don't want contamination to rise to a level where it becomes a problem," Dr. Amy Edwards, a pediatrician and associate medical director for infection control at UH Rainbow Babies & Children's Hospital in Ohio, told ABC News. "That's why inspections are meant to be incredibly invasive -- we have to get close enough to zero contamination levels to be safe."

Mead Johnson


In August 2021, FDA investigators made a routine visit to Mead Johnson's plant in Evansville, Indiana, where it has operated for more than a century. An inspection report notifying the company's management of objectionable conditions, called a Form 483, was issued, after investigators found the plant's data wasn't recorded frequently enough to ensure proper sterility of their product.

FDA investigators said that company records indicated Cronobacter was found in one of the plant's rooms, and that the area was subsequently sanitized. A plant operator was observed not washing his hands between glove changes, and not changing his gloves between touching non-food and food contact surfaces.

The employee was subsequently retrained, Mead Johnson told the FDA, according to inspection documents. But it was not the first time investigators had flagged concerns at one of Mead Johnson's plants.

In late 2017, seven investigators visited Mead Johnson's plant in Zeeland, Michigan, after the company had alerted the FDA that two finished batches of Enfamil formula -- batches that had already been exported from the country -- tested positive for Cronobacter. An FDA inspection revealed that Cronobacter had been found "in critical and high hygiene areas of the processing environment on 26 occasions" between mid-January and late August of 2017, documents obtained by ABC News show.

FDA investigators also said they found Cronobacter specifically in areas that risked leading to "potential contamination" of "food contact surfaces."

The potential problems the FDA discovered at the plant were addressed in time for later inspections -- but food safety experts told ABC News these issues can become a serious problem if not immediately dealt with.

"Cronobacter is an environmental pathogen -- it's everywhere," food safety attorney Bill Marler said. "But it's really, really bad to have it in infant formula."

Mead Johnson's plant had "multiple wall leaks," nonconformity reports reviewed by the FDA said, as well as "equipment condensation" in areas where positive Cronobacter samples were later found.

"Leaks are the bane of infection control," Edwards said. "Water is life; if you're not controlling your water, then you are not controlling your bacteria."

The Zeeland facility submitted a corrective action plan, promising "increased frequency of cleaning the areas where positive results were identified, evaluation and inspection of equipment" and "repairs to equipment and the facility as needed."

FDA investigators followed up with the Zeeland plant in spring 2018. The facility had retooled its sanitization procedures, implemented dryer inspections, and made repairs to flooring, water infiltration, and caulking.


Returning in March 2019, investigators noted the plant's environmental monitoring program had identified and mitigated several instances of Cronobacter in various areas of the plant.

In a statement to ABC News, Reckitt, of which Mead Johnson is a division, maintained that the company manufactures their formula "using the highest standards for quality and safety," adding that whenever the FDA finds an issue they "immediately develop and implement an action plan to address the issue."

Reckitt said they "regularly review and enhance" their facilities' manufacturing processes "and invest in new technologies and equipment," adding that their "robust operating protocols meet or exceed the highest regulatory standards," which they employed while "safely" increasing infant formula amid the shortage.

An FDA spokesperson, when asked for comment regarding their investigators' findings of Cronobacter at multiple formula companies' facilities, said the agency "takes its responsibility seriously" to ensure the rigorous safety of American foods, and that the agency is reexamining whether more can be done.

First Lady Jill Biden, joined by Surgeon General Vivek Murthy, delivers remarks after a shipment of infant formula, sent in through Operation Fly Formula, arrived at Dulles International Airport in Dulles, Va., May 25, 2022.
Stefani Reynolds/AFP via Getty Images

Based on a "close look at recent and historical findings" from inspections, the FDA spokesperson said, "We will be looking at what additional strategies could be employed to better prevent microbial contamination during the production of powdered infant formula," adding the agency is "conducting an evaluation" of their response to the formula crisis "to determine what additional steps should be taken to ensure the maximum effectiveness of agency programs and policies related to infant formula and medical food."

Nevertheless, said the spokesperson, "It is important to note that it's a firm's responsibility to ensure the consistent quality and safety of the products they produce."

"We are most interested in how aggressively a firm addresses and responds to potential contamination," the FDA spokesperson said.

Steven Lynn, the former director of the FDA's pharmaceutical Office of Manufacturing and Product Quality, told ABC News that manufacturers' oversight "must be robust to assure no adulterated product reaches the vulnerable infant population they serve."


"It sounds easy, but it's not," said Lynn, an expert on good manufacturing practices. "Problems can and do occur. That's a fact of life."

Lynn, who reviewed the inspection documents obtained by ABC News, noted that there appear to be "problematic similarities" among some of the formula manufacturers' lapses in quality control, including "issues with inadequate process controls, including cleaning, sampling and ultimately controlling the production environment to assure there is no microbial contamination," he said.

Lynn said that FDA investigators did what they were supposed to do: identify deficiencies for the companies to fix.

"The key is making sure the issues are thoroughly investigated, and then implementing robust solutions to correct and prevent them from reoccurring in the future," in order to ensure that "safe formula is on the market," Lynn said.
Gerber

In August 2021, FDA investigators made a routine visit to Nestlé Nutrition's Gateway facility in Eau Claire, Wisconsin, which makes Gerber products. They found "dirty scoops used during the previous production day" lying on a stainless steel table in one of the raw material rooms, and "debris" on the floor.

It was determined that some cleaning activities were resulting in water getting "trapped in cracks in the floor" and "onto equipment located on lower decks."

In addition, Cronobacter was detected in an in-process powder sample of infant formula.

The finished lot of that product was immediately destroyed.

FDA investigators discussed their findings and suggested remedies with management, but did not issue a Form 483 at that time, according to inspection documents reviewed by ABC News.


A Gerber spokesperson told ABC News that their infant formulas go through up to 500 quality and safety checks, "many of which are above and beyond regulatory requirements."

"If we find Cronobactor or any other contaminant in the product, that is when we take the most extreme reaction," Scott Fitz, Vice President of Technical & Production for Gerber told ABC News.

"All the product in that batch is blocked, and all the batches around that product are blocked," he said, adding that the company thoroughly investigates the contaminant's origins and destroys any impacted product.

"Given the sensitive consumer we're dealing with, we can't take the chance of it getting to shelf," Fitz said. "This isn't about regulation, it's about doing what's right."
PBM Nutritionals

After a routine visit in August 2019, the FDA issued a Form 483 identifying a cold storage temperature regulation deficiency at the Milton, Vermont, plant of PBM Nutritionals, a subsidiary of Perrigo, which makes store-brand formulas for retailers like Walmart and Amazon.

Investigators found that some of the facility's data was not specific enough "to ensure there is no significant growth of microorganisms of public health significance" in their storage tanks. Documents provided by the company to the FDA noted a recent roof leak had overwhelmed the drainage system, and that, upon inspection, environmental sample swabs tested positive for Cronobacter before additional cleaning.

In a statement to ABC News, Perrigo said they are "proud" of their compliance track record, adding that the Cronobacter within the plant had been found by their own self-monitoring, rather than by FDA investigators.

"Our facilities in Vermont and Ohio are in good regulatory standing and remain compliant with all FDA processes and procedures," they said.

Perrigo said they had hired independent experts "a few years ago" to "enhance" their manufacturing processes and protective measures. The company said the experts found their "aging equipment could lead to concerns in the future," so they invested approximately $110 million in improving formula plant quality, and hired an additional 100 quality and sanitation personnel.


Perrigo said that they had addressed the FDA's observation regarding cold storage.

"Our quality control process is a continuous improvement process, and any concerns found are promptly addressed," the company said.

"Everybody knows what the persistent problems are that cause bacterial contamination in product," said Marler, the food safety attorney. "It's cracks, water, old equipment. It's when companies stop realizing they're producing food that is going into the bodies of babies and they start thinking about it as a widget, as a commodity."

Patrick Stone, a former FDA investigator, says factories that make infant formula should be held to a higher quality-control standard than other mass market food products. But too often, he said, "it actually takes an outbreak or something to happen before people wake up and say .... 'Why is this happening?'"
Abbott Nutrition

After inspecting Abbott's Sturgis facility earlier this year, FDA chief Dr. Robert Califf described the "shocking" and "egregiously unsanitary conditions" investigators had found.

"Standing water; cracks in the key equipment that present the potential for bacterial contamination to persist, particularly in the presence of moisture; leaks on the roof; a previous citation for inadequate hand washing," Califf testified before Congress in May. "Many signs of a disappointing lack of attention to the culture of safety, in this product that is so essential to the lives of our most precious people."

Investigators discovered five strains of Cronobacter from environmental sampling of Abbott's plant, and Abbott ultimately agreed to shutter the facility and recall the formula.

Food safety experts ABC spoke with emphasized the importance of establishing -- and adhering to -- a proactive protocol for rooting out risk factors, before they snowball.

"You don't wait for the accident to happen before you build a stoplight," said Faber, the food safety expert. "You probe your factory for where pathogens could be lurking, and then adopt critical controls to eradicate them.

The Abbott manufacturing facility in Sturgis, Mich., May 13, 2022.

Jeff Kowalsky/AFP via Getty Images

"If we're seeing any of the conditions found at Sturgis in other plants, we need to ask whether that philosophy has been sufficiently embraced," he said.

"Abbott has a zero-tolerance policy for Cronobacter in our plants, which is why we took the steps we did at Sturgis," an Abbott spokesperson said. "Our highest priority is getting babies safe, quality formula they need."

Further complicating the matter is that Cronobacter infection is listed as a reportable illness by only one U.S. state: Minnesota, where the first of the four infants was reported infected after consuming Abbott's formula last September.

Because there are no national requirements that Cronobacter be reported, doctors and labs are not required to report cases to their local health department -- which leaves the FDA to rely on consumer complaints and health care providers for on-the-ground data regarding infections.

"Until you increase that oversight, you're going to limp from mini-outbreak to mini-outbreak," Marler said.

A 'stringent enough' system?


In August 2017, a few months before the FDA found Cronobacter inside Mead Johnson's Zeeland plant, a two-week old infant from Illinois was declared brain dead after being diagnosed with a Cronobacter infection. The infant had consumed "multiple lots of Enfamil Newborn Premium ready-to-feed liquid milk product at the hospital, and some product was sent home with the parents," FDA inspection reports say.

But FDA sampling of the available formula was negative for Cronobacter.

Reckitt told ABC News they "cooperate fully with the FDA to investigate consumer complaints," underscoring that their formula had never conclusively been proven as the cause of an illness.

In the case of Abbott, too, no conclusive causation has been proven between the Cronobacter found at the Sturgis plant and infants' illness or death. Nevertheless, FDA chief Califf noted in congressional testimony that "we cannot rule it out either, as the confluence of events is highly unusual. There is no dispute that the facility was unacceptably unsanitary."


Food and Drug Administration Commissioner Robert Califf attends a hearing in Washington, April 18, 2022.

Xinhua News Agency via Getty Images, FILE

"There is some room for human error, but not for persistent human error," said Edwards. the pediatrician. "You have to have your process in place. And you have to have a process for monitoring your process to make sure it's always being followed."

When several controls fail at once, it risks prompting an unfortunate domino effect and "raises important questions about whether our current regulatory system is stringent enough," Faber said.

The FDA spokesperson told ABC News that the agency is assessing whether their annual surveillance inspections of formula facilities should include more environmental sampling going forward, albeit in a way that "minimizes any disruptions to the supply chain."

In June, ABC News was first to report that the Health and Human Services' Office of Inspector General had launched an audit into how the FDA responded leading up to the recall and closure of Abbott's Sturgis plant.

The CDC says Cronobacter infections are rare, but serious in infants -- noting that powdered formula can be contaminated at a processing facility, or at home. Because Cronobacter can survive so well -- on kitchen counters, on sinks, or in a manufacturing plant -- the CDC recommends that families using formula wash hands frequently around infants, thoroughly clean bottles, and safely store any powdered formula, or, if possible, use liquid formula.

"There are babies out there whose lives depend on formula. So what happens when the thing that you're giving your baby is actually the thing that makes them sick?" Edwards said. "That is incredibly scary. For parents, for all of us."

ABC News' Eric M. Strauss contributed to this report.