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What to know about the Taliban's new morality laws

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Three years after the Taliban's takeover, sweeping new laws are limiting the already restricted freedoms of women and girls in Afghanistan. The so-called "morality laws" were recently approved by the Taliban's supreme leader. Vanda Felbab-Brown, senior fellow at the Brookings Institution, joins CBS News to examine the impact of the laws.

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Will the war in Ukraine ever end? One year since Russia invaded | CBC Kids News

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Life in Wartime Ukraine, Through a Child’s Eyes

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Months underground, years of online school, sleepless nights during air attacks. The children of Ukraine share their stories. [VIDEO]

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Diabetes is a condition where your body is not able to turn the food you eat into energy. Your body needs insulin to unlock your body's cells and turn the food into energy. Your entire body is made up of these tiny cells, all different kinds depending on where they are in your body.

Insulin is something called a hormone, which is a chemical messenger inside your body. Without insulin, the food you eat cannot get into your cells, and instead that food gets stuck in your blood, making your blood sugar high.

There are several types of diabetes. Type 1 diabetes is a condition that happens when the immune system attacks the cells in your pancreas that make insulin. The immune system is supposed to help fight off colds, viruses, and things like that, but sometimes it attacks your own body by mistake. For people with type 1 diabetes, insulin is required every day to stay alive. About five to ten percent of people with diabetes have type 1.

For type 2 diabetes, the problem starts where the cells put up a wall and do not let the insulin in. Then the body starts working harder to make more insulin, and over time stops making it all together. Then people with type 2 diabetes need insulin, just like people with type 1. About 90 percent of people with diabetes have type 2.

There are also some other less common types of diabetes where you need different types of medicines, but type 1 and type 2 are the most common.
What is a pancreas?
The pancreas is a corn cob shaped organ that's about six inches long, and sits behind the stomach. The pancreas makes the hormones insulin and glucagon (which regulate blood sugars), and it also makes things called enzymes that help you break down the food you eat. The insulin allows you to turn food into energy, and the enzymes help you absorb other nutrients from the foods that your body needs.
How do you treat diabetes?
People with type 1 diabetes have to take insulin everyday, given by a shot or an insulin pump. People with diabetes also need to check their blood sugar at least a few times a day, and they can use a blood glucose meter (pricking their finger as needed), or wear a continuous glucose monitor to check their blood sugar levels.

There are a lot of other medicines to help the insulin get into the body's cells. Usually kids with type 2 diabetes start with something called metformin, which makes the cells more open to letting the insulin in. It also helps the liver keep the sugar it stores in the liver instead of being put out into the bloodstream.

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For Kids: What is Diabetes? What is diabetes? Diabetes is a condition where your body is not able to turn the food you eat into energy. Your body needs insulin to unlock your body's cells and turn the food into energy. Your entire body is made up of these tiny cells, all different kinds depending ...

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Malala's Magic Pencil by Malala Yousafzai

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How the Cost of Insulin Almost Cost Matt His Life | NowThis

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They discuss the war in Ukraine at the 1:35 marker until about  5:20.

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They discuss the war in Ukraine at the 1:35 marker until about  5:20.

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The Russia-Ukraine Conflict Explained | Nightly News: Kids Edition

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When the Taliban took control of the Swat Valley in Pakistan, one girl spoke out. Malala Yousafzai refused to be silenced and fought for her right to an education.

On Tuesday, October 9, 2012, when she was fifteen, she almost paid the ultimate price. She was shot in the head at point-blank range while riding the bus home from school, and few expected her to survive.

Instead, Malala's miraculous recovery has taken her on an extraordinary journey from a remote valley in northern Pakistan to the halls of the United Nations in New York. At sixteen, she has become a global symbol of peaceful protest and the youngest nominee ever for the Nobel Peace Prize.

is the remarkable tale of a family uprooted by global terrorism, of the fight for girls' education, of a father who, himself a school owner, championed and encouraged his daughter to write and attend school, and of brave parents who have a fierce love for their daughter in a society that prizes sons.

will make you believe in the power of one person's voice to inspire change in the world.

See more at: http://www.hachettebookgroup.com/titles/malala-yousafzai/i-am-malala/9780316322409/#desc

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Research & Subject Guides: I Am Malala: The Story of the Girl Who Stood Up for Education and was Shot by the Taliban: Home

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The 2014-2015 Text-in-Community campus read selection for North Carolina Agricultural & Technical State University

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Efforts to erase women and girls from everyday life in Afghanistan have only increased one year since the Taliban took over the government on Aug. 15, 2021.

Women and girls continue to face restrictions on their basic human rights imposed by the Sunni Islamist militant group for the first time since 2001. Traces of two decades of women's hard-earned rights hardly remain amid an economic crisis, drought, and oppressive mandates.

The Taliban believes educating women goes against Islam, wearing the hijab is now required and enforced, and women can't go to work or travel freely without a male guardian. Afghan women were promised the right to pursue education and employment under the Taliban's interpretation of Islamic law, but the group has failed to deliver.

Human rights groups are calling on the international community to take a firm stance against the Taliban to protect Afghanistan's women and girls.

"Girls are bearing the brunt of the deteriorating situation," Chris Nyamandi, Save the Children's country director in Afghanistan, said in a statement. "They're missing more meals, suffering from isolation and emotional distress, and are staying home while boys go to school. This is a humanitarian crisis, but also a child rights catastrophe."

Amnesty International and Human Rights Watch are demanding sanctions and travel bans to hold the Taliban accountable.

Here are seven facts about how life has changed for women and girls in Afghanistan that demonstrate why we need to continue to support gender equality in the country.

1. Afghan girls are twice as likely to go to bed hungry as boys.

Economic hardship in Afghanistan is causing 97% of families to struggle to feed their families and girls are eating less than boys, according to Save the Children's latest report, ​​" Breaking point: Life for children one year since the Taliban takeover."

Women and girls account for more than half the people in Afghanistan who are struggling to eat enough, the World Food Programme found, and 85% of female-headed households are resorting to drastic measures to feed their families.

Girls were twice as likely as boys to go to bed hungry often and 9 in 10 girls said their meals had reduced in the past year, according to Save the Children. Girls have also reported that they worry they're losing weight and lack the energy to study, play, and work.

2. More than 45% of Afghan girls are missing out on school.

Hundreds of thousands of girls and young women have missed out on school since the Taliban takeover.

In September 2021, the Taliban ordered the reopening of secondary schools, but only for male teachers and students without mentioning women and girls - seen as a de facto ban reversing years of gender equality process. Some schools reopened for girls in certain provinces due to public pressure, but the vast majority of schools in the country remained closed.

Earlier this year, the Taliban announced that all students, including girls, could return in March 2022 at the start of the new school year, but when girls returned to secondary school that week, they were sent home by the Taliban the same day due to dress code issues. The Education Ministry, in a statement later that day, said that education for girls beyond sixth grade was suspended indefinitely, prompting global outrage.

More than 45% of girls said they're not attending school compared with 20% of boys, according to Save the Children, due to barriers such as economic challenges and community attitudes toward girls' education. A small minority of girls and women are studying online and in illegal secret schools but many families don't have the necessary technology or funds to support additional school fees and costs.

Universities will also lack new women students if the ban on girls attending secondary school remains in place, according to the Guardian. Some colleges are open to women under strict gender segregation and even those who are allowed to continue their studies may be limited to the Taliban's approved areas of study, such as education and health care.

The behavior and dress code restrictions, plus the Taliban's harassment of women, have created unsafe learning environments that put women students at a disadvantage. Many women students have either stopped attending school or decided not to enroll in university at all.

3. 26% of Afghan girls are showing signs of depression.

Reports show that Afghan women and girls' mental health issues have increased. Caregivers reported to Save the Children that 26% of girls in Afghanistan are showing signs of depression compared with 16% of boys, and 27% of girls are showing signs of anxiety compared with 18% of boys.

Girls who participated in the organization's focus groups said worry and bad dreams contributed to sleep problems. They also said that since the Taliban takeover, they can no longer participate in activities that used to make them happy, like spending time with relatives and friends and going to parks and shops.

What's more, they expressed disappointment and anger over the fact they can no longer attend school and said they felt hopeless about their future because their previous rights and freedoms have been stripped away.

Meena's* (12) father arranged her marriage because his family had nothing to eat and they desperately needed the money.
Image: Sacha Myers / Save the Children

4. Girls comprised 88% of child marriages in Afghanistan since last year.

When families experience economic hardship, girls are often the first to pay the price because marrying them off is one less mouth to feed.

The economic situation in Afghanistan has left households without enough food or basic items and is increasing child marriage within communities, according to Save the Children. Lack of educational and professional opportunities for women and girls, families forcing women and girls to marry Taliban members, and Taliban members forcing women and girls to marry them are all contributing to the increase, according to Amnesty International.

Out of the children who said they'd been forced to marry to improve their family's financial situation in the past year, 88% were girls.

5. Women have lost the right to peacefully protest.

Police have stopped protests led by women activists in Kabul and other cities since the Taliban took power.

Women who have tried to stand up against the group by peacefully protesting have been threatened, arrested, detained, physically and psychologically tortured, and forcibly disappeared, according to Amnesty International. Protesters who have been detained were denied food, water ventilation, sanitary products, and health care.

To be freed, women protestors were forced to pledge that they and their families would never protest again or speak publicly about their detention experiences.

6. Women's freedom of movement is more restricted.

Women and girls can no longer travel far distances without the accompaniment of a male guardian, known as a mahram.

The Taliban announced in December 2021 that women couldn't travel more than 45 miles without a male relative escort. The mandate isn't consistently enforced but women remain in fear of repercussions especially poor and more vulnerable women who are more at risk.

The restriction has limited access to essential services like health care with nearly 10% of the population having to travel more than two hours to reach a medical facility and nearly half having to travel more than 30 minutes. There are also reports that Taliban officials have prevented doctors from treating women without a male guardian, but even women with an escort may not feel comfortable discussing issues like reproductive care in front of them.

In May 2022, the Ministry for the Promotion of Virtue and Prevention of Vice advised all women to wear a burqa or cover their faces in public and warned that they shouldn't leave home at all. The guidance isn't strictly enforced in cities like Kabul but rights groups have reported that the Taliban has carried out severe punishments, like lashings and stonings, for girls and women who elope, flee domestic violence, resist forced marriage or have illicit sex in rural areas.

There is also anecdotal evidence of the Taliban beating girls for smiling or wearing tight clothing.

7. Women left the workforce in droves.

Following the takeover, the Taliban's Prime Minister Mullah Mohammad Hassan Akhund claimed women would be allowed to keep working, but women government employees in Kabul had their salaries reduced and were ordered to stay home except for women whose jobs couldn't be performed by men. Government workers who violated the hijab dress code were threatened with being fired.

Women's participation in Afghanistan's workforce reached a high of about 22% right before the COVID-19 pandemic, but hundreds of thousands of more jobs have been lost since the Taliban takeover, disproportionately affecting women.

All industries have been impacted, but some were more affected than others. Over 3,500 small and medium women business owners had to cease operations because some feared punishment for not covering their faces, according to the Afghan Women's Chamber of Commerce.

It's been a year since the Taliban takeover of #Afghanistan.

Girls tell us their lives have been shattered.

▶️ 46% say they're not in school
▶️ 26% are showing signs of depression
▶️ 90% say they're missing meals

This is a humanitarian crisis - and a child rights catastrophe. pic.twitter.com/opa11abNL9
- Save the Children US (@SavetheChildren) August 10, 2022

Almost 40% of the teachers in the country were women before the takeover but now only a handful are still teaching. What's more, by the end of 2021, it was estimated that only 100 of Kabul's 700 women journalists were still working.

Many Afghan women doctors, especially those who worked in reproductive and sexual health, fled the country seeking safety. After initially discouraging them from going in, the Taliban urged women in health care to return to work in August 2021. But the health care sector continues to experience a major loss, with women who remain facing threats for not complying with rules.

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Women and girls in Afghanistan are going hungry, missing school, and at risk of violence one year after the Taliban takeover, according to reports from various organizations.

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Women and girls in Afghanistan are going hungry, missing school, and at risk of violence one year after the Taliban takeover, according to reports from various organizations.

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Raoul Wallenberg Institute of Human Rights and Humanitarian Law

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War in Ukraine explained (explainity® explainer video)

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Early Times

People in many early societies had no rights. They had only duties that they owed to their ruler.

The ancient Greeks and Romans were probably the first people to think much about rights. A Roman group called the Stoics believed in something that they called natural law. They said that natural law gave some rights to everyone, even people who were not citizens of Rome.

The Enlightenment and Afterward

The 1600s and 1700s were a time in European history that is called the Enlightenment. John Locke of England was an Enlightenment thinker who wrote that individual rights are older than governments. In France, Jean-Jacques Rousseau argued that the purpose of governments is to protect those rights. Other thinkers called such rights "the rights of man."

The American Revolution (1775-83) and the French Revolution of 1789 grew out of these ideas. The U.S. Declaration of Independence lists "Life, Liberty, and the pursuit of Happiness" as rights that "all men" get from God. French people wrote the Declaration of the Rights of Man and of the Citizen.

But even in the United States, many people did not enjoy full human rights. Slaves had almost no rights, and women had limited rights. Most slaves did not gain the basic human right of freedom until the 1800s. Women in most countries did not gain the same rights as men until the 1900s.

Human Rights Since World War II

After World War II (1939-45), the world learned that Nazi Germany had killed millions of Jews and other civilians (people not fighting the war). This crime is called the Holocaust. An international court at Nuremberg, Germany, put Nazi leaders on trial for "crimes against humanity." The Holocaust convinced many countries that it was necessary to protect the basic rights of people everywhere.

A number of these countries formed an organization called the United Nations (UN) in 1945. In 1948 the UN issued a document called the Universal Declaration of Human Rights. The declaration calls for "human rights" instead of "the rights of man" because it includes women's rights. The declaration has 30 articles, or sections. They mention many different rights. The United Nations also established Human Rights Day, to be celebrated on December 10 each year.

The Office of the United Nations High Commissioner for Human Rights investigates abuses of human rights throughout the world. The office works with several other UN groups to protect the rights of men, women, and children everywhere.

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A right that all people are born with is called a human right. Many people now agree that there are many human rights. Some of the most basic rights are the right to live and...

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Putin began building up troops along the border with Ukraine in late 2021. On February 24, 2022, Putin sent troops into Ukraine. They attacked many different sites as they moved into the country. The Ukrainian troops fought back as did the people of Ukraine. But many thousands of people fled to Poland and other countries to escape the fighting. The fighting caused a great deal of destruction.

The United States, the United Kingdom, and other countries tried to get Putin to stop the war. They sent weapons to help the Ukraine forces. They also imposed sanctions on Russia. Sanctions are economic punishments. They make it hard for Russia to sell their products and to get access to money. The fighting continued, however.

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In February 2022, Russian troops invaded the neighboring country of Ukraine. The Russians fired missiles at military targets as well as at homes in cities throughout Ukraine....

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On February 24, Russian forces launched an attack on Ukraine. The next day, Russian troops reached the edge of the country's capital, Kyiv. The move came after weeks of Russian troop buildup along Ukraine's borders.

Volodymyr Zelenskyy is Ukraine's president. He has called on world leaders to provide military assistance and sanctions against Russia. A sanction is a punishment, often one designed to hurt a country economically.

PRESIDENCY OF UKRAINE/HANDOUT/ANADOL AGENCY/GETTY IMAGES

World leaders have condemned Russian president Vladimir Putin for his actions. The United States and many other countries have sent military aid to Ukraine and put sanctions in place. U.S. president Joe Biden called the attacks "unprovoked and unjustified." He has said the sanctions will "impose a severe cost on the Russian economy."

SERGEI GUNEYEV-SPUTNIK/AFP/GETTY IMAGES

"This is a dangerous moment for all of Europe, for freedom around the world," President Biden said at a news conference on February 24.

Crisis in Context

Ukraine, a country in Eastern Europe, shares a long border with Russia, and is home to nearly 44 million people. Ukraine was once part of the Soviet Union. So was Russia. Ukraine and Russia became separate countries after the breakup of the Soviet Union, in 1991.

Putin claimed the attack was necessary to protect people in two parts of eastern Ukraine. These regions are controlled by separatist groups. The groups want their regions to break away from Ukraine. Before invading the country, Putin recognized the two regions as independent republics. Other countries have not.

Putin has also accused the U.S. and its allies of ignoring Russia's demand that Ukraine be stopped from aligning with them. Ukraine has hoped to join NATO, the North Atlantic Treaty × treaty MEDITERRANEAN-GETTY IMAGES an official agreement between countries or parties (noun) My sister and I signed a peace treaty and promised to quit fighting. Organization. NATO is made up of 28 European countries, plus the U.S. and Canada. And Ukraine has applied to join the European Union. It's made up of 27 European countries. If Ukraine were part of these groups, it would get more direct support.

The U.S. says Russia's claims are an excuse for a wider invasion of Ukraine. "This was never about genuine security concerns," Biden said. "It was always about . . . Putin's desire for empire × empire BETTMANN-GETTY IMAGES a group of countries and territories under the control of a single ruler or government (noun) The original 13 colonies were part of the British Empire. by any means necessary."

The World Responds

SEAN GALLUP-GETTY IMAGES

Large anti-war protests have taken place in cities around the world, including in Russia. Thousands of Russians have taken to the streets to protest their country's decision to invade Ukraine. On February 24 alone, more than 1,700 people across 53 Russian cities were detained by authorities. At press time, protests continue daily.

PIERRE CROM-GETTY IMAGES

As of March 3, more than a million people had fled Ukraine for safety in neighboring countries, according to the United Nations refugee agency. Aid groups are helping Ukrainians (see "Helping Hands"). One is the United Nations Children's Fund. Another, Nova Ukraine, is providing food and medical supplies. Both accept online donations.

KRYSTIAN DOBUSZYNSKI-NURPHOTO/GETTY IMAGES

World leaders continue to show support. As war broke out, NATO chief Jens Stoltenberg called on Russia to end its attacks. "We stand with . . . Ukraine during this terrible time," he said.

Helping Hands

WORLD CENTRAL KITCHEN

World Central Kitchen is providing hot meals to refugees at border crossings in Poland, like the one shown above. The group is also helping to feed people still in Ukraine.

World Central Kitchen was founded in 2010 by chef José Andrés. On February 27, he posted a video on social media, from the Poland-Ukraine border. "People are cold. . . . They carry with them whatever they can bring," he said. "They have a smile, with hope, when the situation is so dire."

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/ MoneyWatch

After years of rising prices, insulin costs in the U.S. are creating painful choices for diabetics and their families.

The problem is drawing the attention of lawmakers, with the Senate Committee on Aging examining insulin prices a hearing on Tuesday. One father testified that his 13-year-old son's insulin jumped from $300 for a 90-day supply in 2017 to more than $900 in early 2018.

"I immediately went into panic mode," Paul Grant, a project estimator for a building company in Maine, told the committee. "I tried to get answers from my insurance company but received little help or explanation. I don't think they even understand our health plan - I know I don't."

Grant, who said he ended up buying the same insulin from Canada, where it cost about $300, isn't alone. Insulin prices more than tripled from 2002 to 2013 and have continued to climb -- costs for the drug from two manufacturers rose almost 8 percent in 2017.

Diabetes, a disease in which the body fails to properly regulate blood sugar, affects 30 million -- or almost one in 10 -- Americans.

A deadly decision

One patient who was affected by the price spike was Alec Smith, who struggled to afford insulin after he aged out of his mother's health insurance plan. The then 26-year-old's employer didn't offer insurance, so he considered getting a health plan with a $7,600 deductible, his mother, Nicole Smith-Holt, told CBS MoneyWatch.

Instead, "He made the decision he would go without insurance" and pay out of pocket, she said. "We estimated [the insulin] would be $1,000, but when he went to the pharmacy, they told him it would be $1,300, so he went home without insulin."

Smith-Holt said she believed her son planned to buy the insulin, manufactured by Eli Lilly, when he received his next paycheck, and hoped he could ration his remaining supply. Instead, he died on June 27, 2017, of diabetic ketoacidosis, a complication resulting from diabetes that can be treated with insulin. It was a little over a month after he had left his mother's insurance plan.

"I thought it was a rare situation, like, 'This doesn't happen to anyone else,'" Smith-Holt said. But after her son's death, she heard from many others within the diabetes community, many of whom have had to make similar choices and risked adverse health consequences.

"We have people who are making life and death decision daily of, 'Do I buy groceries and or do I buy my insulin?'" she said. "We hear horror stories every day."

Smith-Holt, who traveled to the Eli Lilly shareholder meeting this month, said she was disappointed she wasn't able to read a statement at the meeting. Instead, she asked its CEO a few questions, such as whether he believes insulin is a human right. She said she didn't feel satisfied by the answers.

"Nicole traveled from Minnesota to our headquarters to tell Alec's story, and we took her visit very seriously," an Eli Lilly spokesman said in an email. "She's a woman with strong convictions who wants to make sure no one else falls through the cracks."

He added, "Nicole asked three questions, each of which was answered in the public meeting. The head of our U.S. diabetes team met privately with Nicole after the shareholders meeting, during which Nicole read her full statement and engaged in a productive and impactful dialogue about Alec."

One question posed by the Senate Committee on Aging is why insulin costs so much. After all, it's a nearly 100-year-old medication. Its inventors sold the patent for about $3 to help get the drug to as many diabetics as possible, and manufacturers were given the right to manufacture the drug without paying royalties.

An opaque system

But no generic version of the drug exists, and three manufacturers -- Eli Lilly, Sanofi and Novo Nordisk -- control 99 percent of the market. Adding to the complication is the tangled relationship between insurance companies, pharmacy benefit managers and drugmakers.

"There is a lack of transparency throughout the insulin supply chain. It is unclear precisely how the dollars flow and how much each intermediary profits," said William Cefalu, chief scientific, medical and mission officer at the American Diabetes Association, at the hearing.

Part of the issue are so-called "rebates" negotiated by pharmacy benefit managers and other players in the insulin market, which is a fee calculated as a percentage of the list price. But patients don't get the discounts and rebates negotiated between pharmacy benefit managers and drugmakers, nor are the rebates typically passed on to the patients.

Asked if Eli Lilly would considering lowering the price of insulin, the company spokesman said the issue "will require leadership and cooperation across many stakeholders, including manufacturers, payers, and policymakers."

"That's because the answer itself isn't simple. For instance, while the list price for Humalog has gone up, Lilly's average net realized price (the amount received after discounts and rebates are paid) has gone down since 2009," he said.

"I want to deconstruct that complicated web of transactions to figure out who is making so much money and why aren't discounts negotiated with manufactures reaching the patient, particularly the uninsured patients, but also the insured patient who has a high deductible," said Sen. Susan Collins, R-Maine, in the hearing.

To be sure, insulin isn't the only drug that's witnessed skyrocketing costs and a convoluted pricing system. A drug called Acthar surged more than 100,000 percent from 2001 to today, rising from $40 a vial to more than $40,000, according to "60 Minutes."

"There's an absolute opaque system of pricing for drugs in our country," Larry Morrissey, the mayor of Rockford, Illinois, told the news program. His city was hit with increased health care costs because of the drug. "That's part of the problem."

Need for transparency

In the meantime, efforts are underway in some parts of the country to shed light on insulin pricing. Nevada passed a law last year that will require insulin makers to disclose information on pricing, profits and discounts to pharmacy benefit managers. Two pharmaceutical groups are challenging the law, alleging it interferes with federal patent law.

Federal lawmakers may need to step in to ensure drugmakers provide more transparency on pricing, Jeremy Greene, professor of medicine at the Johns Hopkins University School of Medicine, said in the hearing.

"It's to everyone's advantage to point to each other while prices remain high," Greene said. "It's the uninsured patient and the taxpayer ultimately who is harmed by such a system."

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The rising cost of insulin: "Horror stories every day"

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As insulin prices surge, a mother recounts the financial squeeze that led to her son's death and that imperils other diabetics

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/ MoneyWatch

The cost of insulin has sparked Congressional hearings and calls for change from diabetics and patient advocates. Yet for many Americans who rely on the medication, it remains out of reach - and that is contributing to human rights abuses, according to a new report from Human Rights Watch, an organization that is better known for investigating war crimes and atrocities like genocide.

The issue is specific to the United States, given the nation's lack of controls on drug prices and complex insurance system that can leave people under- or uninsured, according to the watchdog group.

Other nations pay far less for the life-saving medication, with a congressional report finding that Americans pay about triple the cost for a dose of insulin compared with 11 other developed countries.

The three big drug companies that control the insulin market - Eli Lilly, Novo Nordisk and Sanofi - have raised prices for their analog insulins considerably since introducing their products more than two decades ago. Analogs, which are synthetic versions of insulin, control blood sugar better than so-called human insulin, and now represent more than 90% of the market, according to the center-right American Action Forum.

Eli Lilly's list price for Humalog, its analog insulin product, jumped 680% to $275 per vial in 2018 from its introduction in 1996, Human Rights Watch said.

The cost of Novo Nordisk's Novolog has jumped about 400% to roughly $289 per vial since it was introduced in 2000, while Sanofi's list price has increased 420% to $276 per vial since it hit the market, also in 2000, the report said. All numbers are adjusted for inflation.

"Almost every insulin-dependent person Human Rights Watch interviewed said they had rationed analog insulin because of out-of-pocket costs, taking it in ways not recommended by their physician in order to stretch their supply," the report noted.

The result can be illness and even death, such as in the case of Alec Smith, who struggled to afford insulin after he aged out of his mother's health insurance plan.

The 26-year-old couldn't afford the out-of-pocket cost of his insulin, produced by Eli Lilly, and died of diabetic ketoacidosis, a complication resulting from diabetes that can be treated with insulin. He died a month after leaving his mother's insurance plan.

Insulin manufacturers "know that people are dying, that people can't afford this," Sa'Ra Skipper, a diabetic, told Human Rights Watch. Her sister, also a diabetic, was hospitalized for diabetic ketoacidosis after splitting her insulin with her due to cost.

"Abhorrent, wrong and won't help patients"

The trade group Pharmaceutical Research and Manufacturers of America, or PhRMA, said that it objected to the report's characterization.

"We agree the status quo isn't working and needs to change, but to suggest those who develop life-saving medicines are complicit in human rights violations is abhorrent, wrong and won't help patients," said Debra DeShong, head of public affairs for PhRMA, in a statement to CBS MoneyWatch.

DeShong noted that pharmaceutical companies "provide patient assistance to help those who can't afford their medicines, including to those who rely on insulin, and it's why we're urging lawmakers to reform an insurance system that too often forces sick patients to subsidize the insurance costs of healthy individuals."

Novo Nordisk said in a statement to CBS MoneyWatch that it has several programs aimed at the "accessibility and affordability of the therapies," such as a patient assistance program that provides free insulin to some low- and middle-income people. It added that reform "will take time so we will continue to do what we can to help people who need us now."

In a statement, Eli Lilly said that the "average monthly out-of-pocket cost for Lilly insulin has decreased 44%, to $21.80, over the past five years." It added that it also provides programs for people facing higher out-of-pocket costs.

"We welcome new public policies, such as co-pay caps on insulins, which could bring much-needed relief to people who face higher out-of-pocket costs for their medications," Eli Lilly said in the statement. "Until actual reforms fill gaps, Lilly remains firmly committed to providing affordability solutions to people who need them."

"A privilege that many cannot afford"

To be sure, insulin isn't the only drug that has experienced sharp price increases, and Human Rights Watch noted that access to lifesaving medications is often a "a privilege that many cannot afford."

But the people who are most impacted by high drug prices are "socially and economically marginalized, reinforcing existing forms of structural discrimination."

For instance, lower-limb amputations are a risk of diabetes, but Black adults are more than twice as likely to undergo a diabetes-related amputation than White adults, the report noted. Hispanic and Black diabetics are also more likely to ration insulin than White patients, it added.

The U.S. doesn't regulate drug prices, which has allowed pharmaceutical companies to "set very high prices," the report noted. But it said some of the blame sits with pharmacy benefit managers (PBM) - powerful middlemen in the health care market that manage which drugs are covered by insurance companies.

Drug companies compete to get included in PBMs' formularies, or list of covered drugs, by offering so-called "rebates," or cash payment provided by drug makers to the PBMs. But pharmaceutical companies then lift their list prices higher to ensure that they aren't sacrificing the bottom line, the report noted.

"Violation of domestic and international law"

So how is that contributing to human rights abuses? Human Rights Watch says that insulin is so expensive in the U.S. that it undermines "equal and affordable access [to essential medicines], a cornerstone of the human right to health."

The impact on disadvantaged groups is "in violation of domestic and international law prohibiting discrimination," it added.

Several human rights agreements that have been signed or ratified by the U.S. are also being violated by the high cost of insulin, the group said. It singled out the U.S. government for its "continued failure" to put in place policies that would limit the skyrocketing cost of insulin. But it also has words for drugmakers.

"Companies also have a responsibility under the United Nations Guiding Principles on Business and Human Rights to respect human rights and ensure that their practices do not cause or contribute to human rights abuses," Human Rights Watch said.

But the biggest step could be taken by lawmakers, the group noted: "Congress should consider legislation to provide insulin to all insulin-dependent individuals in the country free of cost."

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Insulin isn't affordable for many Americans. That may be a human rights abuse, report says.

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Drug companies "know that people are dying, that people can't afford this," said one diabetic.

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KABUL, Afghanistan - In a morning of tears and anger, the Taliban on Wednesday reneged on a promise to allow Afghan girls to attend secondary school, as thousands of them turned up at their old school gates in tidy uniforms and carrying their school bags.

The abrupt about-face revived worries that the Taliban might keep teenage girls away from education indefinitely. When the militant religious movement first ruled Afghanistan from 1996 to 2001, girls were not allowed to study.

"Some of my classmates began weeping," said Sakina Jafari, an 18-year-old who hoped to resume her year 11 classes. "We were so excited to return. And now we don't know what will happen to us."

Another young woman who spoke to Afghan news outlet TOLO burst into tears as she described being turned away after waiting 186 days - she had counted - for school to resume. "What is our crime? That we are girls?" she raged.

Amid widespread condemnation, the Taliban gave no indication of when these classrooms might reopen. Most girls and young women have been prevented from attending secondary school since the Taliban swept to power in August.

Afghanistan's new rulers reopened schools for boys, and for girls up to the 6th grade.They subsequently allowed women to attend college under strict segregation from male students and a rigidly-enforced dress code. But secondary school remained off limits.

However, Taliban officials said Monday that they would allow all students - including girls at the secondary education level - to attend classes beginning Wednesday, the start of the Afghan new year. But just as the girls turned up to their school gates, they were sent home by Taliban officials who told them to wait for an official announcement.

One senior official insisted the Taliban had not reneged but needed more time to decide on a school uniform for teenage girls.

"There is no issue of banning girls from schools," said Suhail Shaheen, the Taliban's permanent ambassador-designate to the United Nations in response to a question by NPR. "It is only a technical issue of deciding on form of school uniform for girls. We hope the uniform issue is resolved and finalized as soon as possible."

That was echoed by one Kabul school teacher, who requested anonymity because she didn't want to anger Taliban officials. She said that as girls entered her classroom, the principal immediately headed them off, saying, "'Don't come in here until we've got official permission. And when you come back, you have to wear a black face veil, a black chador and a black scarf.'"

The teacher says her students were distressed. They argued that they were wearing modest clothes already - loose shirts and pants and headscarves. "One of them said, 'we are ready to wear burkas but please let us stay,'" she recalled one young woman pleading. "But we told them they had to leave."

An article on the pro-Taliban Bakhtar News Agency which celebrated the return of students to school reported that the spokesman for the Education Ministry, Mawlawi Aziz Ahmad Ryan, said that "schools for women from the sixth grade above are closed until further notice."

Ryan said a plan would be formulated "in accordance with Islamic law and Afghan culture and traditions, as well as the ruling of the Islamic Emirate."

The phrase "culture and traditions" is often shorthand in the Muslim world for imposing rules that deny women their rights under Islam on the basis that local culture does not permit it. Islamic teaching and practice encourages men and women to study and learn.

Western countries have made girls returning to school a key condition for restarting aid to the cash-strapped Afghan government. These donors largely cut off aid after the U.S. withdrew from Afghanistan and the Taliban seized power. For others, allowing Afghan girls to receive an education is a prerequisite for recognizing the Taliban's rule.

"I deeply regret today's announcement by Taliban authorities in Afghanistan that girls' education from the sixth grade has been suspended until further notice," said the U.N. Secretary-General António Guterres in a statement. "I urge the Taliban de facto authorities to open schools for all students without any further delay."

The U.S. Chargé d'Affaires Ian McCary tweeted that he was "deeply troubled" by the policy reversal.

Nobel Peace Prize laureate Malala Yousafzai, who was shot in the face by a Taliban fighter in Pakistan for her advocacy over girl's education, said she was disappointed. "I had one hope for today: that Afghan girls walking to school would not be sent back home. But the Taliban did not keep their promise. They will keep finding excuses to stop girls from learning - because they are afraid of educated girls and empowered women," she said in a statement.

The decision reflects reported splits in the Taliban's leadership

The Taliban's abrupt reversal highlights what analysts say is an internal debate over whether girls should attend high school at all.

Those divisions are exemplified by a tweet from Ahmad Yasir, the deputy head from the office of the first deputy prime minister. He wrote that he saw no religious justification for girls not to attend school, but subsequently deleted the tweet.

Heather Barr of Human Rights Watch, who focuses on women's rights in Afghanistan, says the latest news "is absolutely devastating."

She said she feared it may signal a repeat of when the Taliban did not allow girls to attend school when they ruled Afghanistan from 1996 to 2001.

It was then that the Taliban said closing schools for girls was "a temporary situation," Barr said.

"And they would allow girls to study ... once conditions were right," she said.

But that moment never arrived," Barr said. "And today it feels like it will never arrive this time either."
Hadid reported from Islamabad; Qazizai reported from Kabul.

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Taliban reverses decision, barring Afghan girls from attending school beyond 6th grade

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The rulers' decision - reneging on a previous promise - came at the start of the new school year in Afghanistan and risks further alienating the international community.

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Simplified Version
This simplified version of the 30 Articles of the Universal Declaration of Human Rights has been created especially for young people.

Nobody has any right to make us a slave. We cannot make anyone our slave.

Do you know your rights? This free interactive course will introduce you to your human rights so you will know them and defend them for yourself and others.

Do you know your rights? This free interactive course will introduce you to your human rights so you will know them and defend them for yourself and others.

An illustrated guide for children that explains human rights, with each of the 30 articles of the Universal Declaration of Human Rights, written in easy-to-understand language.

An illustrated guide for children that explains human rights, with each of the 30 articles of the Universal Declaration of Human Rights, written in easy-to-understand language.

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Read a Simplified Version of The United Nations Universal Declaration of Human Rights for Teens and Young Adults. Watch Videos and Learn More About the Fundamental Rights and Privileges That Everyone Has For Being Human.

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Simplified Version
This simplified version of the 30 Articles of the Universal Declaration of Human Rights has been created especially for young people.

Nobody has any right to make us a slave. We cannot make anyone our slave.

Do you know your rights? This free interactive course will introduce you to your human rights so you will know them and defend them for yourself and others.

Do you know your rights? This free interactive course will introduce you to your human rights so you will know them and defend them for yourself and others.

An illustrated guide for children that explains human rights, with each of the 30 articles of the Universal Declaration of Human Rights, written in easy-to-understand language.

An illustrated guide for children that explains human rights, with each of the 30 articles of the Universal Declaration of Human Rights, written in easy-to-understand language.

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United Nations Universal Declaration of Human Rights Summary: Youth For Human Rights Video

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Read a Simplified Version of The United Nations Universal Declaration of Human Rights for Teens and Young Adults. Watch Videos and Learn More About the Fundamental Rights and Privileges That Everyone Has For Being Human.

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United Nations
Universal Declaration of Human Rights

Do you know your rights? This free interactive course will introduce you to your human rights so you will know them and defend them for yourself and others.

Do you know your rights? This free interactive course will introduce you to your human rights so you will know them and defend them for yourself and others.

An illustrated guide for children that explains human rights, with each of the 30 articles of the Universal Declaration of Human Rights, written in easy-to-understand language.

An illustrated guide for children that explains human rights, with each of the 30 articles of the Universal Declaration of Human Rights, written in easy-to-understand language.

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Read A Simplified And Suitable For Children Version For Teens And Young Adults Of The Articles Of The United Nations Universal Declaration Of Human Rights. Watch Public Service Announcement Videos And Learn More About The Fundamental Rights And Privileges That Everyone Has For Being Human.

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An explanation of why people need insulin

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An explanation of why people need insulin

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What Is Type 1 Diabetes?

People who have type 1 diabetes can't use

glucose(the body's main type of sugar) for energy. That's because their body stopped making the hormone insulin. Normally, after we eat, the amount of glucose in the blood (blood sugar) goes up. When it does, the pancreas sends insulin into the blood. Insulin works like a key that opens the doors of the body's cells to let the glucose in, giving the cells the energy they need.

In type 1 diabetes, the pancreas doesn't make insulin. Without insulin, glucose can't get into the cells. It stays in the blood, which leads to high blood sugar. Having too much sugar in the blood isn't healthy and can cause problems. Some problems happen quickly and need treatment right away, while others develop over time and show up later in life.

90-Second Summary: Type 1 Diabetes

Learn the basics in 90 seconds.

What Happens in Type 1 Diabetes?

In type 1 diabetes, the body's immune system attacks and destroys the cells in the pancreas that make insulin. So the body can't make

insulin anymore.

This is different from type 2 diabetes, where the body still makes insulin, but the insulin doesn't work as it should.

Why Do Some People Get Type 1 Diabetes?

No one knows for sure why some people get type 1 diabetes. Doctors and scientists think a person's genes make them more likely to get it. But just having the genes for diabetes probably isn't enough. It's likely that something else needs to happen. Scientists are studying if other things - like some viral infections, a person's birth weight, or their diet - might make someone who already has the genes for type 1 diabetes more likely to get it.

Type 1 diabetes can't be prevented, and can happen in people of any age.

What Are the Signs & Symptoms of Type 1 Diabetes?

People can have diabetes without knowing it because the symptoms aren't always obvious and they can take a long time to develop. Type 1 diabetes may come on gradually or suddenly.

When a person first has type 1 diabetes, they may:

pee a lot because the body tries to get rid of the extra blood sugar by passing it out of the body in the urine

drink a lot to make up for all that peeing

eat a lot because the body is hungry for the energy it can't get from sugar

lose weight because the body starts to use fat and muscle for fuel

feel tired a lot

If these early symptoms of diabetes aren't recognized and treatment isn't started, chemicals can build up in the blood and cause stomach pain, nausea, vomiting, breathing problems, and even loss of consciousness. Doctors call this diabetic ketoacidosis, or DKA.

There's good news, though - getting treatment can control or stop these diabetes symptoms from happening and reduce the risk of long-term problems.

How Is Type 1 Diabetes Diagnosed?

Doctors use a blood test that measures the amount of sugar (glucose) in the blood. High blood sugars show that a person has diabetes. Then, the doctor will do more blood tests to find out what type it is.

Teens with type 1 diabetes often go to a pediatric endocrinologist. This is a doctor who specializes in diagnosing and treating kids and teens living with diseases of the endocrine system, such as diabetes and growth problems.

How Is Type 1 Diabetes Treated?

People with type 1 diabetes have to pay a little more attention to what they eat and do than people who don't have diabetes.

They need to:

check blood sugar levels as prescribed

give themselves insulin injections or use an insulin pump as prescribed

eat a healthy, balanced diet with accurate carbohydrate counts

get regular exercise

have regular checkups with doctors and other people on their diabetes health care team so they can stay healthy and get treatment for any diabetes problems

What Can Help Me Manage Type 1 Diabetes?

Sometimes people who have diabetes feel different from their friends because they need to take insulin, think about how they eat, and control their blood sugar levels every day. They may feel angry or depressed, or think that their parents are constantly worrying about their diabetes management.

Diabetes brings challenges, but people who have it play sports, travel, date, go to school, and work just like their friends.

Managing your diabetes might feel overwhelming at times, but you're not alone. Reach out to your diabetes health care team. They can answer questions and help with all kinds of issues. Don't hesitate to ask your doctors, dietitian, and others on the team for advice and tips. You might want to find a support group where you can talk about your feelings and find out how other people cope.

You also can get more information and support online at:

Date reviewed: September 2021

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Diabetes affects how the body uses glucose, a sugar that is the body's main source of fuel. In type 1 diabetes, glucose can't get into the body's cells where it's needed.

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The Malala Yousafzai Story | History Made Easy

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Nicole Smith-Holt's son, Alec, died in 2017 from diabetic ketoacidosis, a condition that occurs when the body doesn't have enough insulin.

Alec had Type 1 diabetes. The 26-year-old had been recently removed from his parents' health insurance plan and was about $300 short of the $1,300 he needed to pay for his insulin medication, his mother said.

In a bid to wait until his next payday to purchase the medication, he rationed the insulin he had left.

"Unfortunately, his body was found three days prior to payday," said Smith-Holt, of Richfield, Minnesota.

In the five years since Alec's death, not much has changed: The high cost of insulin remains a significant barrier to care for many Americans.

A study published this month in the journal Health Affairs found that 14% of people who use insulin in the United States face what is described as a "catastrophic" level of spending on the medication, meaning that after paying for other essentials, such as food and housing, they spend at least 40% of their remaining income on insulin.

The study's estimate, which covered 2017 and 2018, didn't include other costs related to diabetes care, such as glucose monitors, insulin pumps or other medications.

Though drugmakers often offer programs that can lower the out-of-pocket cost of insulin for both insured and uninsured patients, the financial burden can still be devastating for some.

People without insurance can shell out hundreds of dollars a month or more for the medication, which usually requires multiple vialsper month, said Dr. Robert Gabbay, chief scientist for the American Diabetes Association, an advocacy group for patients with diabetes.

To save money, some patients will ration or skip doses of their medication, said Krutika Amin, associate director of the Affordable Care Act program at the nonprofit KFF, also known as the Kaiser Family Foundation. But this approach eventually leads to higher costs, she said, when they are hospitalized or sent to the emergency room.

Why insulin remains unaffordable

But why does insulin - a medication that's been around for more than 100 years - remain unaffordable for many people in the U.S.?

The high cost can be attributed in part to "evergreening," a process in which drug companies make incremental improvements to their products that can extend the life of their patents, said Dr. Kevin Riggs, a physician at the University of Alabama at Birmingham Heersink School of Medicine. He co-wrote a study published in the New England Journal of Medicine in 2015 that described the century-long history of the drug.

The improvements may include tinkering with a molecule or changing the delivery system, such as using insulin pens instead of vials.

Extending patentscan discouragegeneric drugs from being developed, Riggs said, allowing drugmakers with exclusive rights to their insulin to charge whatever the market will bear. And as supply chains have become more complicated over the years, costs have ballooned.

"And so that means those prices have gone up crazy," he said.

And even when the patents do expire - as many have - Riggs said that the large investment it takes to get insulin manufactured and approved by U.S. regulators may make the venture less appealing to generic drugmakers.

Eric Tichy, division chair of pharmacy supply solutions for the Mayo Clinic in Rochester, Minnesota, agreed, saying the barrier to entry to produce insulin is "pretty high."

"Insulin is a protein molecule, so it's a lot more complicated thansmall molecules," Tichy said. "So, there's only a couple of companies that make it and if more companies enter the market, then that would sort of drop the prices."

Eli Lilly, Novo Nordisk and Sanofi dominate the market for insulin in the U.S., but that still hasn't stopped other groups from trying to produce their own.

The nonprofit drugmaker Civica Rx announced in March that it planned to make and sell generic versions of insulin to consumers at no more than $30 per vial and no more than $55 for a box of five pen cartridges.

Most recently, California Gov. Gavin Newsom announced this month that he had approved a budget that would allocate $100 million to allow the state to begin making its own low-cost insulin.

Details of the state's plan to make insulin are still sparse, but Tichy compared it to tech entrepreneur Mark Cuban's Cost Plus Drug Company, which offers certain generic drugs at discounted prices, by selling medications at a fixed markup of 15% plus a $3 flat fee. The pharmacy offers medications for diabetes but does not sell insulin.

Meanwhile, state and federal lawmakers are pushing for legislation that would lower the out-of-pocket cost for patients on insulin.

There are at least 22 states that have passed laws that cap co-payments for insulin at $100 or less for a 30-day supply, according to the American Diabetes Association.

In March, the House passed legislation that would cap the monthly out-of-pocket cost of insulin at $35 for those with private health insurance, though the legislation has since been criticized by advocacy groups because the policy would not lower the list price of insulin.

While those policies are great, they don't really help people who are uninsured, Smith-Holt said.

She is pushing for more states to adopt the Alec Smith Insulin Affordability Act, which provides an emergency 30-day supply of insulin to patients for $35. The bill has already been signed into law in Minnesota, where Smith-Holt lives.

She also mentioned another proposal in the Senate that has not gone up for a vote yet that would seek to push drug companies to lower the list price of their medications, thus lowering the out-of-pocket for people who are uninsured.

No one should be "forced to make the decision between life or death," she said.

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Why is insulin still so expensive for diabetes patients in the U.S.?

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Nicole Smith-Holt's son, Alec, died in 2017 from diabetic ketoacidosis, a condition that occurs when the body doesn't have enough insulin. Alec had Type 1 diabetes. The 26-year-old had been recently removed from his parents' health insurance plan and was about $300 short of the $1,300 he needed to pay for his insulin medication, his mother said.