The Sentinel

Human Rights Action :: Humanitarian Response :: Health ::
Holistic Development :: Sustainable Resilience
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Week ending 27 September 2014

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, consortiums 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
Editor &
Founding Managing Director
GE2P2 – Center for Governance, Evidence, Ethics, Policy, Practice
david.r.curry@ge2p2center.net

pdf verion: The Sentinel_ week ending 27 September 2014

blog edition: comprised of the 35+ entries posted below on 28 September 2014

UN: High-Level Meeting on Response to Ebola Virus Disease Outbreak

UN: High-Level Meeting on Response to Ebola Virus Disease Outbreak
SG/2207
25 September 2014 – AM Meeting
‘Every Day, Every Minute, Counts,’ Warns World Health Organization Head at High-Level Meeting on Response to Ebola Virus Disease Outbreak
[Excerpt; Editor’s text bolding]

With the Ebola virus claiming the lives of 200 people each day, most of them women, world leaders at a high-level Headquarters meeting Thursday implored the international community to swiftly ramp up the response to the epidemic ravaging West Africa before it turned into a humanitarian catastrophe.

“Every day, every minute, counts,” said Margaret Chan, Director-General of the World Health Organization (WHO), insisting “We must try harder.” Overflowing treatment centres were turning away sick and dying patients. In some areas no treatment beds were available, she said, stressing the need for more centres, as well as community-based care facilities.

United States President Barack Obama agreed. “We are not moving fast enough. We are not doing enough. Right now, everybody has the best of intentions, but people are not putting in the kind of resources that are necessary to put a stop to this epidemic,” he said.

The worst ever outbreak of the virus already had caused a collapse of the public health systems in Liberia, Guinea and Sierra Leone — the three most affected countries. If left unchecked, the crisis could quickly become a global threat; stopping it was in everyone’s interest. Last week, the Security Council determined that the outbreak was a threat to international peace and security, adopting resolution 2177 (2014) to that effect.

Mr. Obama today called on international organizations to “cut through red tape and mobilize partners on the ground”, and on Governments to contribute more critical assets such as air transport, medical evacuation, health-care workers and equipment…

…United Nations Secretary-General Ban Ki-moon said advance teams had already deployed to the three most-affected countries and to the newly formed United Nations Mission for Ebola Emergency Response (UNMEER), based in Accra, Ghana, which would lead the Organization’s system-wide response. “We are focusing on stopping the outbreak, treating the infected, providing essential services, preserving stability, and preventing outbreaks in non-affected countries,” he said.

The crisis had highlighted the need to strengthen early identification systems and action, he said. The international community should consider forming a stand-by “white coats” corps of medical professionals, backed by WHO expertise and the United Nations logistical capacity.

“Now is the time for a robust and united effort to stop the outbreak. The world can and must stop Ebola — now,” he said, warning that while dozens of countries and organizations were making lifesaving contributions, they fell short of the 20-fold increase required….

…Liberian President Ellen Johnson-Sirleaf said “partners and friends, based on understandable fears, have ostracized us, shipping and airline services have sanctioned us and the world has taken some time to fully appreciate and adequately respond to the enormity of our tragedy”.

More than 1,700 Liberians had died already, among them 85 health-care workers, she said. Facing perhaps its greatest challenge ever, her nation was fighting back, building and staffing more treatment centres, and moving more aggressively to prevent the disease’s spread and to change the behaviour at the local level through community outreach.

“We cannot allow the projection of a worst-case scenario: that over 100,000 of our innocent citizens will die from an enemy disease they did not start and do not understand, that the resulting effect will reverse our gains in malaria control and child and maternal mortality,” she said.

Ernest Bai Koroma, President of Sierra Leone, said he had declared a state of emergency, shutting down the country for three days to get more than 27,000 health-care educators into every household in the country and reallocating millions of dollars from other vital services to combat Ebola….

…Alpha Condé, President of Guinea, said the outbreak was a threat to international peace and security. The response should be used to rebuild and strengthen the affected countries’ infrastructure so that once the crisis was over they could again foster economic growth and maintain stability….

White House FACT SHEET: Global Health Security Agenda: Getting Ahead of the Curve on Epidemic Threats

White House FACT SHEET: Global Health Security Agenda: Getting Ahead of the Curve on Epidemic Threats

The Ebola epidemic in West Africa highlights the urgency for immediate action to establish global capacity to prevent, detect and rapidly respond to biological threats like Ebola. Beginning in his 2011 speech at the United Nations General Assembly, the President has called upon all countries to work together to prevent, detect, and respond to outbreaks before they become epidemics.

The Global Health Security Agenda (GHSA) was launched on February 13, 2014 to advance a world safe and secure from infectious disease threats and to bring together nations from all over the world to make new, concrete commitments, and to elevate global health security as a national leaders-level priority. The G7 endorsed the GHSA in June 2014; and Finland and Indonesia hosted commitment development meetings to spur action in May and August.

On September 26, President Obama, National Security Advisor Rice, Assistant to the President for Homeland Security and Counterterrorism Monaco, and Secretaries Kerry, Hagel, and Burwell will meet with Ministers and senior officials from 44 countries and leading international organizations to make specific commitments to implement the GHSA and to work toward a commitment to assist West Africa with needed global health security capacity within 3 years.

Commitments to Action
In 2014, countries developed 11 lines of effort in support of the GHSA – known as Action Packages. The Action Packages are designed to outline tangible, measurable steps required to prevent outbreaks, detect threats in real time, and rapidly respond to infectious disease threats —whether naturally occurring, the result of laboratory accidents, or an act of bioterrorism. The Action Packages include specific targets and indicators that can be used as a basis to measure how national, regional, and global capacities are developed and maintained over the long-term. Since February, countries have made over 100 new commitments to implement the 11 Action Packages. For its part, the United States has committed to assist at least 30 countries over five years to achieve the objectives of the GHSA and has placed a priority for our actions on combating antibiotic resistant bacteria, to improve biosafety and biosecurity on a global basis, and preventing bioterrorism. http://www.cdc.gov/globalhealth/security

Next Steps: Governance and Tracking
Going forward, 10 countries have agreed to serve on the GHSA Steering Group, which will be chaired by Finland starting in 2015, with representation from countries around the world, including: Canada, Chile, Finland, India, Indonesia, Italy, Kenya, the Kingdom of Saudi Arabia, the Republic of Korea, and the United States. The Steering Group is charged with tracking progress, identifying challenges, and overseeing implementation for achieving the objectives of the GHSA in support of international standards set by the World Health Organization, the Food and Agriculture Organization of the United Nations, and the World Organization for Animal Health. This includes the implementation of internationally agreed standards for core capacities, such as the World Health Organization International Health Regulations, the World Organization for Animal Health Performance of Veterinary Services Pathway, and other global health security frameworks. To provide accountability and drive progress toward GHSA goals, an independent, objective and transparent assessment process will be needed. Independent evaluation conducted over the five-year course of the GHSA will help highlight gaps and needed course corrections to ensure that the GHSA targets are reached.

All nations share a responsibility to provide health security for our world and for accelerating action toward a world safe and secure from all infectious disease threats.
Participating Nations—Australia, Azerbaijan, Canada, Chile, China, Denmark, Ethiopia, Finland, France, Georgia, Germany, Guinea, India, Indonesia, Israel, Italy, Japan, Jordan, Kenya, Liberia, Malaysia, Mexico, Netherlands, Norway, Pakistan, Peru, Portugal, Republic of Korea, Saudi Arabia, Sierra Leone, Singapore, South Africa, Spain, Sweden, Switzerland, Thailand, Turkey, Uganda, Ukraine, United Arab Emirates, United Kingdom, United States, Vietnam, and Yemen.

MSF International President Addresses High-Level UN Meeting on Ebola

MSF International President Addresses High-Level UN Meeting on Ebola
September 25, 2014
Remarks by Joanne Liu, International President, Doctors Without Borders/Médecins Sans Frontières (MSF)
[Full text; Editor’s text bolding]

Excellencies, ladies and gentlemen.
Generous pledges of aid and unprecedented UN resolutions are very welcome. But they will mean little, unless they are translated into immediate action.

The reality on the ground today is this: the promised surge has not yet delivered.

The sick are desperate, their families and caregivers are angry, and aid workers are exhausted. Maintaining quality of care is an extreme challenge.

Fear and panic have set in, as infection rates double every three weeks. Mounting numbers are dying of other diseases, like malaria, because health systems have collapsed.

Without you, we fall further behind the epidemic’s deadly trajectory. Today, Ebola is winning.

Our 150-bed facility in Monrovia opens for just thirty minutes each morning. Only a few people are admitted—to fill beds made empty by those who died overnight.
The sick continue to be turned away, only to return home and spread the virus among loved ones and neighbors.

The isolation centers you have promised must be established NOW.

And other countries must not let a few states carry the load. Complacency is a worse enemy than the virus

The required response must be hands-on, rigorous and disciplined. And it must not be subcontracted. It is not enough for states to just build isolation centers. While NGOs can manage some, you will have to manage many.

Don’t cut corners. Massive, direct action is the only way.

But have no doubt about what you will face. This will be extremely challenging.

Scaling up the response will present huge organizational difficulties. The UN cannot fail in coordinating and leading this effort.

In parallel, an equally massive effort is needed to create a vaccine, an additional tool for cutting the chain of transmission.

But current models of vaccine development will not work. We need incentives for trials and production, along with collaborative research and open source data. A safe vaccine must be accessible, and rapidly delivered to the most affected populations.

There is today a political momentum the world has rarely—if ever—seen.

As world leaders, you will be judged by how you use it.

Thank you.

WHO responding to unprecedented scale of humanitarian emergencies

WHO responding to unprecedented scale of humanitarian emergencies
September 2014
WHO and health partners are responding to an unprecedented five “Grade 3” priority crises at the same time
[Excerpt]
For the first time ever, WHO is leading the health response to five major humanitarian crises at the same time. More than 60 million people, from West Africa to Iraq, urgently require a wide range of health-care services.
West Africa’s Ebola outbreak, and conflict-enflamed humanitarian crises in South Sudan, Central African Republic, Syria and Iraq, have stretched health services to the limit and caused many to collapse. This has required WHO and its health partners to fill increasingly widening gaps to ensure life-saving and routine care for millions of displaced persons and host communities.

“We are dealing with an unprecedented number of multiple humanitarian health crises concurrently. These are more complex and affecting more people than at any point since the end of the Second World War,” says Dr Bruce Aylward, Assistant Director-General of WHO’s Polio and Emergencies Cluster.

Five highest level crises

The 5 crises have, due to their scale and the emergency health response required, each been categorized as Grade 3 (G3) emergencies, the highest grading determined by WHO as part of its Emergency Response Framework. The ERF grades emergencies across three levels, with Grade 3 being the most serious.

The scale of the emergencies is stark, including:
:: West Africa Ebola outbreak – 22 million people living in the three worst-affected countries – Liberia, Sierra Leone and Guinea – are at risk.
:: Iraq – 20 million people affected, including 1.8 million who are internally displaced.
:: Syria – 10.8 million people inside Syria, including 6.5 million people displaced within the country. Another 3 million people have fled the conflict to regional neighbours Lebanon, Turkey, Jordan, Iraq and Egypt.
:: South Sudan – 5.8 million people need humanitarian assistance, including 1.3 million who have been displaced.
:: Central African Republic – 2.5 million people are in need, including 425 000 displaced.

“Just two years ago, WHO developed the Emergency Response Framework (ERF) to guide our response in all types of emergencies,” explains Dr Aylward. “The ERF ensures that the full resources of the organization are made available to support the response to the most severe crises.”

“We are dealing with an unprecedented number of multiple humanitarian health crises concurrently.”

“We felt comfortable that the ERF would help us manage two Grade 3 emergencies concurrently, and if we were running 3 responses, we expected to be exiting one before entering the next. But 2 years later, we are managing five Grade 3 emergencies based on their scale, complexity, urgency, and political, social or economic impact. This is unprecedented – not only for WHO, but for all humanitarian partners.”

“And these will be long-term, sustained crises, not just a time-limited surge period,” he adds….

Security Council Unanimously Adopts Resolution Condemning Violent Extremism, Underscoring Need to Prevent Travel, Support for Foreign Terrorist Fighters

Security Council Unanimously Adopts Resolution Condemning Violent Extremism, Underscoring Need to Prevent Travel, Support for Foreign Terrorist Fighters
UN Security Council
7272nd Meeting (PM) SC/11580
24 September 2014
[Excerpt from overview]
At a summit presided over by United States President Barack Obama, opened by United Nations Secretary-General Ban Ki-moon and addressed by scores of national leaders, the Security Council this afternoon called on all States to cooperate urgently on preventing the international flow of terrorist fighters to and from conflict zones.

Through resolution 2178 (2014), adopted unanimously during a meeting that heard from over 50 speakers, the Council condemned violent extremism and decided that Member States shall, consistent with international law, prevent the “recruiting, organizing, transporting or equipping of individuals who travel to a State other than their States of residence or nationality for the purpose of the perpetration, planning of, or participation in terrorist acts”.

Expressing concern over the establishment of international terrorist networks, the Council underscored the “particular and urgent need” to prevent the travel and support for foreign terrorist fighters associated with the Islamic State in Iraq and the Levant (ISIL), Al-Nusra Front (ANL) and other affiliates or splinter groups of Al-Qaida.

In that context, the Council, through the resolution, decided that all States shall ensure that their legal systems provide for the prosecution, as serious criminal offences, of travel for terrorism or related training, as well as the financing or facilitation of such activities.

Member States, it also decided, shall prevent entry or transit through their territories of any individual about whom that State had credible information of their terrorist-related intentions, without prejudice to transit necessary for the furtherance of judicial processes. It called on States to require airlines to provide passenger lists for that purpose….

UNHCR: Asylum Trends, First half 2014 – Levels and Trends in Industrialized Countries

UNHCR: Asylum Trends, First half 2014 – Levels and Trends in Industrialized Countries
September 2014 – 36 pages
[Editor’s abstract for media release and report content]
This report summarizes patterns and trends in the number of individual asylum claims submitted in Europe and selected non-European countries during the first six months of 2014. The data in this report are based on information available as of 3 September 2014, unless otherwise indicated.

These data cover the 38 European and six non-European States that currently provide monthly asylum statistics to UNHCR. Figures are mostly based on official asylum statistics, reflecting national laws and procedures.
UNHCR’s reports on asylum applications in industrialized countries are normally published twice annually.

War, armed conflict, and human rights concerns in a number of countries – notably the Syrian Arab Republic and Ukraine – are among the principal reasons for the upsurge in the number of  asylum-seekers in industrialized countries observed during the first half of 2014. An estimated 330,700 new asylum applications were recorded between January and June 2014, some 64,300 claims or 24 per cent more than during the corresponding period of 2013 (266,300 claims). This figure is almost identical to the figures recorded during the preceding six months of July through December 2013 (328,100).

“We are clearly into an era of growing conflict,” said UN High Commissioner for Refugees António Guterres. “The global humanitarian system is already in great difficulty. The international community needs to prepare their populations for the reality that, in the absence of solutions to conflict, more and more people are going to need refuge and care in the coming months and years. Unfortunately, it is not clear that the resources and the access to asylum will be available to help them.”

Despite the net overall increase in new claims shown in the report, more than two thirds of these were in just six countries – Germany, the United States, France, Sweden, Turkey and Italy.

The number of people applying for refugee status in the 44 industrialized countries covered by the report is just one element in the global picture of forced displacement from wars and conflict. Worldwide, 51.2 million were forcibly displaced as of the end of 2013. Most are either internally displaced within their own countries, or are hosted as refugees in states bordering onto war zones.

The full Asylum Trends report is available here.