The Sentinel

Human Rights Action :: Humanitarian Response :: Health :: Education :: Heritage Stewardship ::
Sustainable Development
Week ending 23 March 2019

This weekly digest is intended to aggregate and distill key content from a broad spectrum of practice domains and organization types including key agencies/IGOs, NGOs, governments, academic and research institutions, consortia and collaborations, foundations, and commercial organizations. We also monitor a spectrum of peer-reviewed journals and general media channels. The Sentinel’s geographic scope is global/regional but selected country-level content is included. We recognize that this spectrum/scope yields an indicative and not an exhaustive product. Comments and suggestions should be directed to:

David R. Curry
GE2P2 Global Foundation – Governance, Evidence, Ethics, Policy, Practice

PDF: The Sentinel_ period ending 23 Mar 2019

:: Week in Review  [See selected posts just below]
:: Key Agency/IGO/Governments Watch – Selected Updates from 30+ entities   [see PDF]
:: INGO/Consortia/Joint Initiatives Watch – Media Releases, Major Initiatives, Research:: Foundation/Major Donor Watch -Selected Updates
:: Journal Watch – Key articles and abstracts from 100+ peer-reviewed journals  [see PDF]

World Leaders Adopt Outcome Document Urging Greater South-South Cooperation to Achieve Sustainable Development, as Buenos Aires Conference Concludes

South-South Cooperation

World Leaders Adopt Outcome Document Urging Greater South-South Cooperation to Achieve Sustainable Development, as Buenos Aires Conference Concludes
Enhanced Collaboration Crucial to Address Changing Geopolitical Landscape, Resource Constraints, Delegates Stress
United Nations Conference on South-South Cooperation, 5th Meeting (AM)

BUENOS AIRES, 22 March — Concluding a landmark conference on the crucial role of South-South cooperation in the planet’s sustainable development, representatives of 160 countries today adopted a sweeping outcome document calling for stepped-up collaboration against the backdrop of resource constraints and a shifting geopolitical landscape.

By the terms of the “Buenos Aires outcome document of the Second High-level United Nations Conference on South-South Cooperation”, heads of delegations and other officials — gathered on the third and final day of the Conference, also known as “BAPA+40” — cited significant changes in international politics and economic relations, which create conditions conducive to promoting South-South cooperation, pursuing sustained economic growth and building national and collective self-reliance. They noted that, while North-South cooperation remains the main modality for development cooperation, recent decades have seen South-South cooperation expand its scope, facilitate regional integration and provide innovative approaches for collective action.

Acknowledging that developing countries continue to face serious challenges, as well as new and emerging ones, participants recognized the need to enhance capacity-building in developing countries through enhanced resources and expertise, at those countries’ request. In that regard, they renewed their commitment to the implementation of the 2030 Agenda for Sustainable Development and the Addis Ababa Action Agenda, reaffirmed the General Assembly resolution endorsing the 1978 Buenos Aires Plan of Action for Promoting and Implementing Technical Cooperation among Developing Countries and welcomed other international agreements.

Noting with concern increases in debt levels around the world, participants called on borrowers and creditors to address challenges linked to debt sustainability as a matter of priority, in order to prevent a negative impact on long-term development and the achievement of the 2030 Agenda’s 17 Sustainable Development Goals. They also recognized that the shortage of resources continues to hinder the expansion of South-South and triangular cooperation, and underscored the need to further mobilize resources from all sources — public, private, domestic and international.

By other terms of the outcome document, participants recognized that South-South cooperation should not be seen as official development assistance (ODA) and stressed that it is not a substitute for, but rather a complement to, North-South cooperation. They further acknowledged the need to enhance the development effectiveness of South-South and triangular cooperation, while acknowledging its voluntary, participative and demand-driven nature.

Participants further called on both developed and developing countries, and all relevant stakeholders, to promote South-South and triangular cooperation policies and activities, and ensure a more holistic and coherent approach to sustainable development. They also called upon multilateral, regional and bilateral financial and development institutions to consider increasing financial resources and technical cooperation for those purposes, while stressing the need to reinvigorate the United Nations role within existing resources and with the approval of respective Governments…

US “threats” against International Criminal Court must stop, say UN experts

U.S. – International Criminal Court (ICC)

US “threats” against International Criminal Court must stop, say UN experts
GENEVA (22 March 2019) – Warnings by US Secretary of State Mike Pompeo and National Security Adviser John Bolton of measures against the International Criminal Court (ICC) must not be allowed to hinder the Court’s ability to fulfil its mandate, say UN human rights experts*.

“We are particularly concerned in light of recent reports of senior ICC staff resigning from their positions as a consequence of these threats,” said the UN experts.

In a speech on 10 September 2018, John Bolton warned that ICC judges, prosecutors and staff would face measures if they went ahead with investigating alleged war crimes by the US, Israel or other US allies.

He said the measures would include “all means necessary”, such as a ban on ICC judges and prosecutors entering the United States; freezing their funds in the US financial system; and ultimately, their prosecution in the US. He said the same would apply to companies or States assisting any ICC investigation of American citizens.

In March 2019, US Secretary of State, Mike Pompeo, said the US would revoke or deny visas to members of the ICC involved in investigations against US troops in Afghanistan or elsewhere, and threatened economic sanctions.

“These threats constitute improper interference with the independence of the ICC and could hinder the ability of ICC judges, prosecutors, and staff to carry out their professional duties,” said the UN experts.
“In order to guarantee effective and equal access to justice and a fair trial in accordance with international standards, the judicial system and individual judges must be independent and free from any improper interference.”

The UN experts expressed deep concern at the intimidation. “These threats may discourage human rights defenders, civil society organisations, victims’ representatives, companies or others from cooperating with the ICC in pursuit of truth and justice,” they said.

The experts are in contact with the US authorities on the issues.
(*) The UN experts: Mr. Michel Forst (France),Special Rapporteur on the situation of human rights defenders; and Mr. Diego García-Sayán (Peru), Special Rapporteur on the Independence of Judges and Lawyers.

Integrating Green and Gray : Creating Next Generation Infrastructure :: World Bank – World Resources Institute


Integrating Green and Gray : Creating Next Generation Infrastructure
World Bank – World Resources Institute
Author(s): Browder, Greg; Ozment, Suzanne; Rehberger Bescos, Irene; Gartner, Todd; Lange, Glenn-Marie
Published: 2019-03-21 :: 140 pages
English PDF (14.63MB)
A new generation of infrastructure projects that harness the power of nature can help achieve development goals, including water security and climate resilience. In this report from the World Bank and World Resources Institute, both organizations are calling for green infrastructure, such as mangroves and wetlands, to play a bigger role in traditional infrastructure planning. Integrating nature into mainstream infrastructure systems can produce lower cost and more resilient services. This report guides developing country service providers and their partners on how to seize this opportunity. It reviews approaches and examples of how to integrate green infrastructure into mainstream project appraisal processes and investments.

:: Traditional infrastructure systems worldwide rely on built solutions to support the smooth and safe
functioning of societies. In the face of multiplying environmental threats, this approach alone can no
longer provide the climate resiliency and level of services required in the 21st century.

:: Natural systems such as forests, floodplains, and soils can contribute to clean, reliable water supply
and protect against floods and drought. In many circumstances, combining this “green infrastructure”
with traditional “gray infrastructure,” such as dams, levees, reservoirs, treatment systems, and pipes, can provide next generation solutions that enhance system performance and better protect communities.

:: Service providers such as water utilities, flood management agencies, irrigation agencies, and
hydropower companies can deliver more cost-effective and resilient services by integrating green
infrastructure into their plans. However, to guide its appropriate use in mainstream infrastructure programs, green infrastructure must be as rigorously evaluated and carefully designed as gray projects.

:: This report offers service providers a framework to evaluate green infrastructure from a technical,
environmental, social, and economic perspective, and to assess key enabling conditions, with illustrative examples.

:: It also provides guidance for policymakers and development partners, who must set the incentives and enabling conditions to mainstream solutions that unite green and gray infrastructure.


Press Release : 21 March 2019
Green and Gray Infrastructure More Powerful When They Work Together, Says New Report
Integrating Green and Gray – Creating Next Generation Infrastructure shows how weaving the power of ‘green’ natural systems, including flood plains and forests, into ‘gray’ traditional infrastructure systems can lower cost and increase resilience.

“If we help nature then nature can help us – that’s the message of this report,” said Interim President of the World Bank Group Kristalina Georgieva. “Measures like replanting wetlands can shield cities from storms and flooding, and protecting forests improves watersheds. Infrastructure should make use of plants and nature to boost resilience and create a more livable environment.”

The report showcases World Bank projects where green infrastructure is already being deployed. For example, in Brazil, forests filter biological impurities to protect water sources and reduce the need for expensive water treatment plants upgrades. In Vietnam, mangroves are used as a first line of defense against typhoons and sea surges, helping to reduce investments in expensive man-made sea dikes. And in Somalia, natural river sediments are trapped behind dams, helping to recharge local aquifers, thus eliminating the need for deep and expensive groundwater pumps.

The report illustrates how emerging technology such as earth-based observations and advanced modelling make it cheaper and easier to design and assess the performance of green infrastructure. It also lays out a new framework for practitioners and service providers to integrate green infrastructure into gray, including technical, environmental, social, and economic dimensions.

The report finds that integrating green and gray infrastructure can help deliver a “triple-win” with benefits for the economy, communities, and the environment…

United States And Brazil To Partner In First-Ever Private-Sector-Driven Biodiversity-Focused Impact Investment Fund For The Brazilian Amazon


United States And Brazil To Partner In First-Ever Private-Sector-Driven Biodiversity-Focused Impact Investment Fund For The Brazilian Amazon
March 18, 2019
Today, United States Agency for International Development Administrator Mark Green and the Brazilian Secretary of the Office of International Relations within the Ministry of the Environment, Roberto Castelo Branco, signed a Letter of Intent to work toward the launch of the first-ever biodiversity-focused impact-investment fund for the Brazilian Amazon. The fund, to be financed largely by the private sector, is intended to leverage $100 million in investments in hard-to-reach, high-risk sectors to spur successful businesses that align with forest and biodiversity conservation.

Letter of Intent Between The United States Agency for International Development and The Ministry of Environment of the Federative Republic of Brazil
Washington D.C., March 18, 2019.
The Governments of the United States of America and the Federative Republic of Brazil have collaborated, over decades, to conserve the biodiversity and promote the sustainable development of the Brazilian Amazon. The two countries share the understanding that private-sector partnership and engagement are critical to the development of sustainable, market-oriented productive models in the Amazon. Further, access to credit and financing is one of the major impediments to strengthening entrepreneurism, value-chains, innovation, and start-ups in the region. Both countries believe that, with impact investing in Brazil rapidly expanding, a private-sector-led, financially viable, scalable approach must move forward financing for economic opportunities that conserve forests and biodiversity and also have positive impacts on local communities.

The risks and challenges of working in the Amazon have precluded most impact investors from expanding into the region. It is our mutual understanding that unlocking private finance for sustainable enterprises in the Amazon strengthens the autonomy and well-being of forest-dependent communities and entrepreneurs in the Amazon, and creates opportunities for the conservation of biodiversity, the restoration of land, and reduced deforestation, which can displace illegal and unsustainable practices with legal and sustainable options.

The two countries intend to work jointly toward the launch of a first-ever $100 million biodiversity-focused impact-investment fund for the Brazilian Amazon (“Fund”), largely financed with private-sector capital. The Fund aspires to offer investment opportunities in hard-to-reach, high-risk sectors with the potential to create successful and scalable impact businesses that align with the conservation of forests and biodiversity. The Fund intends to provide long-term capital for value-chains, businesses, and start-ups that foster sustainable use of forest and biodiversity resources and decrease deforestation, while improving well-being in local communities. By strengthening the Amazon’s financial and impact-investing ecosystem, and providing a blended-finance model for overcoming the inherent challenges, the Governments of Brazil and the United States are putting forward a new model of development that can be both scaled and replicated in the future, throughout the Amazon, other regions in Brazil, and the rest of the Western Hemisphere.

In addition, the two countries intend to deepen their collaboration to share best practices and technology, data, and tools, such as geospatial information, monitoring, and early-warning systems, to help Brazilian decision-makers address environmental challenges that include drought, fire, the degradation of land, deforestation, and desertification. These problems are increasingly prevalent across Brazil, and threaten vulnerable populations and ecosystems, and lessons learned in the Amazon can help protect other key biomes, such as the Caatinga in Northeastern Brazil and the Pantanal in Southwestern Brazil.

New Global Coalition Will Focus on Improving Value of Healthcare


New Global Coalition Will Focus on Improving Value of Healthcare
News 18 Mar 2019
:: A group of senior healthcare leaders, in cooperation with the World Economic Forum, is launching a Global Coalition for Value in Healthcare to address the rising costs of healthcare
:: Coalition will focus on payment-model reform, health informatics standardization and the dissemination of best practices to health systems around the world.
: A new report defines agenda for coalition, Value in Healthcare: Accelerating the Pace of Health System Transformation.

Geneva, Switzerland, 20 March 2019 – The healthcare sector faces major challenges in delivering value for healthcare. According to the OECD, spending on healthcare in 2016 – the most recent year that data is available – increased by 3.4%, the highest rate since 2009. In response, leaders in the $8 trillion global healthcare sector need to embrace value-based healthcare, an approach that defines the goal of healthcare as the achievement of improved health outcomes that matter to patients at the same or lower cost.

Achieving a value-based healthcare system faces numerous barriers. Optimizing its delivery requires high-quality health data, but industry estimates suggest that about 80% of healthcare data is unusable in its current format. Value-based healthcare also requires companies to make major changes to their business models, but such shifts can involve a high degree of risk, and there is often little incentive for the private sector to take on this challenge. From a regulatory perspective, changing the structure of the healthcare system requires strong political will and can generate backlash. The biggest obstacle to the spread of value-based healthcare is that misaligned incentives in current health systems make it difficult for industry stakeholders to act collectively.

As the final report of the Forum’s three-year Value in Healthcare project, Value in Healthcare: Accelerating the Pace of Health System Transformation, released by the World Economic Forum in collaboration with Boston Consulting Group (BCG), describes three major initiatives to address these challenges and accelerate the transition to value-based healthcare in health systems around the world:
:: A “user’s guide” to health system transformation: The report proposes best practices based on a review of pioneering efforts around the world and on the Forum’s experience with two pilot projects…

:: A “roadmap” for global health-informatics standardization: This effort lays the foundation for promoting value-based healthcare over the next four years by proposing a global vision and a “digital health bill of rights”, which will be developed in consultation with patient advocacy organizations around the world. This global vision and bill of rights will help governments, patient groups and the private sector ensure that their informatics work is patient-centred and will inform other efforts to harmonize informatics standards around the world.

:: The Global Coalition for Value in Healthcare: This public-private effort will provide a platform where stakeholders and medical practitioners can learn from one another, develop shared visions and goals, and exchange best practices. The coalition will provide technical assistance and facilitate local partnerships, develop global enablers of value-based healthcare, document and disseminate best practices, and build a global community of practice..

Read the full report here

Featured Journal Content :: The Lancet – Venezuela

Featured Journal Content

The Lancet
Mar 23, 2019 Volume 393Number 10177p1177-1260, e35
Venezuelans’ right to health crumbles amid political crisis
The Lancet
The rising prosperity of Venezuela during the 20th century helped to consolidate gains in health outcomes made over decades. Now, a country rich in natural resources is submerged in a complex humanitarian emergency due to the politico-economic crisis that started in 2008, progressively destroying the health-care system.

In this issue, Page and colleagues discuss the current situation in Venezuela and explain how the crisis has threatened the nation’s public health, resulting in increases in morbidity and mortality. The authors also report on the observations they made when visiting the Venezuelan borders with Colombia and Brazil, where the movement of Venezuelan migrants has already resulted in a strain on both countries’ health-care systems. Another worrying implication of the movement of migrants into neighbouring countries is the quick dissemination of infectious diseases, such as malaria and Chagas. A Review in The Lancet Infectious Diseases analysed the return of vector-borne diseases and the implications for spillover in the region. For example, the number of malaria cases increased by 359% between 2000 and 2015, and by a further 71% in 2017 (411 586 cases). Dengue incidence increased by more than four times between 1990 and 2016. These epidemics are exacerbated by the decline in public health programmes, such as childhood immunisation, insufficient potable water, and poor sanitation conditions.

In 2018, 82% of people in Venezuela (about 28·5 million people) and 75% of health centres around the country did not have a continuous supply of water, according to a report on the right to water published by five Venezuelan non-governmental organisations (NGOs). Running water is provided sporadically (in some areas this can be once every 20 days) and the water that does reach the population is of poor quality or not potable. To aggravate the situation, shortages of electricity have been recurrently reported over more than 3 months and have culminated in a widespread blackout between March 7 and March 11, leaving homes and hospitals in the dark. Failures in the electricity supply system were reported as causing the death of 79 patients between Nov 16, 2018, and Feb 9, 2019, in the 40 main hospitals of the country. These data are from a national survey, Encuesta Nacional de los Hospitales 2019 which also notes that 1557 patients died because of insufficient hospital supplies. The medical NGO that published these data explained that these are conservative estimates as many deaths are not reported.

In the meantime, hyperinflation (estimated by the International Monetary Fund to be at 10 million % in 2019) puts the cost of daily food out of reach for nine in ten Venezuelans, according to the ENCOVI (Living Conditions survey) 2017. The food crisis is further exacerbated by absence of food diversity and collapse of food infrastructure (production, distribution, and access to food). As a result, between 2016 and 2018, the proportion of the population that is undernourished increased from 5% to 12%, according to a report on the right to food published by three Venezuelan NGOs. Poor nutrition between conception and 2 years of age is threatening the physical, mental, and social development of new generations. Venezuela is the only country in Latin America showing a deterioration in child survival back to the levels of the 1990s. According to estimates in a recent study in The Lancet Global Health, the infant mortality rate reached 21·1 deaths per 1000 livebirths in 2016, almost 40% higher than in 2008.
Vowing to improve the situation, on March 1, the UN security council voted on two resolutions related to Venezuela but failed to pass either of them because the USA, Russia, and China clashed over the issue. The USA recognises Juan Guaido, leader of the National Assembly, as the country’s president, whereas China and Russia continue to recognise Nicolás Maduro as leader of the country. While the divisive debate regarding last year’s disputed presidential elections continues to rage, Venezuela is struggling with hunger and preventable diseases.

As we went to press, a UN team was visiting the country on an official human rights mission following a surprising invitation from Maduro, who has been reluctant to accept humanitarian aid. There is hope that Maduro will be transparent with the UN team and allow them to observe the true complexity of the situation. The UN human rights team is also scheduled to speak with members of Guaido’s party. Whatever the outcome of the UN’s mission, the urgent implementation of effective measures to facilitate the coordinated international response to the Venezuelans’ plight cannot come soon enough. The right to health and to food cannot be politicised and the international community is failing if these universal rights are not restored in Venezuela.


Venezuela’s public health crisis: a regional emergency
Kathleen R Page, Shannon Doocy, Feliciano Reyna Ganteaume, Julio S Castro, Paul Spiegel,
Chris Beyrer
The economic crisis in Venezuela has eroded the country’s health-care infrastructure and threatened the public health of its people. Shortages in medications, health supplies, interruptions of basic utilities at health-care facilities, and the emigration of health-care workers have led to a progressive decline in the operational capacity of health care. The effect of the crisis on public health has been difficult to quantify since the Venezuelan Ministry of Health stopped publishing crucial public health statistics in 2016. We prepared a synthesis of health information, beyond what is available from other sources, and scholarly discussion of engagement strategies for the international community. Data were identified through searches in MEDLINE, PubMed, and the grey literature, through references from relevant articles, and governmental and non-governmental reports, and publicly available databases. Articles published in English and Spanish until Dec 1, 2018, were included. Over the past decade, public health measures in Venezuela have substantially declined. From 2012 to 2016, infant deaths increased by 63% and maternal mortality more than doubled. Since 2016, outbreaks of the vaccine-preventable diseases measles and diphtheria have spread throughout the region. From 2016 to 2017, Venezuela had the largest rate of increase of malaria in the world, and in 2015, tuberculosis rates were the highest in the country in 40 years. Between 2017 and 2018, most patients who were infected with HIV interrupted therapy because of a lack of medications. The Venezuelan economic crisis has shattered the health-care system and resulted in rising morbidity and mortality. Outbreaks and expanding epidemics of infectious diseases associated with declines in basic public health services are threatening the health of the country and the region.