The Sentinel

Human Rights Action :: Humanitarian Response :: Health ::
Holistic Development :: Sustainable Resilience
__________________________________________________
Week ending 20 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

pdf verion: The Sentinel_ week ending 20 September 2014

blog edition: comprised of the 35+ entries below posted on 21 September 2014

FACT SHEET: U.S. Response to the Ebola Epidemic in West Africa
The White House
September 16, 2014
Excerpt focused on opening language and commitment of military assets

As the President has stated, the Ebola epidemic in West Africa and the humanitarian crisis there is a top national security priority for the United States. In order to contain and combat it, we are partnering with the United Nations and other international partners to help the Governments of Guinea, Liberia, Sierra Leone, Nigeria, and Senegal respond just as we fortify our defenses at home. Every outbreak of Ebola over the past 40 years has been contained, and we are confident that this one can—and will be—as well.

Our strategy is predicated on four key goals:
:: Controlling the epidemic at its source in West Africa;
:: Mitigating second-order impacts, including blunting the economic, social, and political tolls in the region;
:: Engaging and coordinating with a broader global audience; and,
:: Fortifying global health security infrastructure in the region and beyond.

The United States has applied a whole-of-government response to the epidemic, which we launched shortly after the first cases were reported in March. As part of this, we have dedicated additional resources across the federal government to address the crisis, committing more than $175 million to date. We continue to work with Congress to provide additional resources through appropriations and reprogramming efforts in order to be responsive to evolving resource needs on the ground. Just as the outbreak has worsened, our response will be commensurate with the challenge.

New Resources to Confront a Growing Challenge
The United States will leverage the unique capabilities of the U.S. military and broader uniformed services to help bring the epidemic under control. These efforts will entail command and control, logistics expertise, training, and engineering support.
:: U.S. Africa Command will set up a Joint Force Command headquartered in Monrovia, Liberia, to provide regional command and control support to U.S. military activities and facilitate coordination with U.S. government and international relief efforts. A general from U.S. Army Africa, the Army component of U.S. Africa Command, will lead this effort, which will involve an estimated 3,000 U.S. forces.
:: U.S. Africa Command will establish a regional intermediate staging base (ISB) to facilitate and expedite the transportation of equipment, supplies and personnel. Of the U.S. forces taking part in this response, many will be stationed at the ISB.
:: Command engineers will build additional Ebola Treatment Units in affected areas, and the U.S. Government will help recruit and organize medical personnel to staff them.
:: Additionally, the Command will establish a site to train up to 500 health care providers per week, enabling healthcare workers to safely provide direct medical care to patients.
:: The United States Public Health Service Commissioned Corps is preparing to deploy 65 Commissioned Corps officers to Liberia to manage and staff a previously announced Department of Defense (DoD) hospital to care for healthcare workers who become ill. The deployment roster will consist of administrators, clinicians, and support staff…

Full text of fact sheet: http://www.whitehouse.gov/the-press-office/2014/09/16/fact-sheet-us-response-ebola-epidemic-west-africa

UN OCHA – EBOLA VIRUS DISEASE OUTBREAK – Overview of needs and requirements
Compiled by OCHA in collaboration with WHO, UN partner agencies and other key responders.
September 2014 :: 34 pages
SCOPE OF THE OVERVIEW
The overview of requirements covers primarily Guinea, Liberia and Sierra Leone, the three countries with intense transmission of the virus. The overview also provides information on countries with localized transmission of the virus, such as Senegal and Nigeria, or at risk of Ebola Virus Disease (EVD) transmission.

Building upon the WHO Ebola Roadmap and the activities and plans of all UN entities responding to the ebola crisis, this overview describes the collective requirements needed to defeat the ebola outbreak and to mitigate the immediate and longer term social, economic, development and security consequences in affected countries and the region.

These needs go beyond the sizeable medical requirements needed to treat, contain, and prevent the ebola outbreak, and include needs and requirements related to non-ebola medical service (i.e. reproductive healthcare and malaria and tuberculosis (TB) treatment); food availability; clean water; livelihoods, and logistics concerns related to travel and transport of goods and services within and outside the ebola affected areas.

The overview covers a period of six months, in line with the analysis that it will take 6-9 months overcome the outbreak according to the WHO Ebola Roadmap. As the outbreak is rapidly evolving, the needs and requirements contained in this overview will be updated and disseminated accordingly.

The Economic Impact of the 2014 Ebola Epidemic: Short and Medium Term Estimates for Guinea, Liberia, and Sierra Leone
The World Bank
Working Paper 90748 :: 29 pages
September 17, 2014
pdf: http://www-wds.worldbank.org/external/default/WDSContentServer/WDSP/IB/2014/09/17/000470435_20140917071539/Rendered/PDF/907480WP0Econo00201400901700PUBLIC0.pdf
A new World Bank report outlines the long-term toll the Ebola crisis could take on the three most heavily affected countries—Guinea, Liberia and Sierra Leone—if those countries and their partners don’t immediately ramp up efforts to contain the disease outbreak. At the low-end, according to the report The Economic Impact of the 2014 Ebola Outbreak, the loss to countries’ GDPs could be $4.8 billion if the epidemic is contained by December 2014. Worst case scenarios show a staggering loss of $49 billion by the end of 2015 if the disease spreads to neighboring countries.
Abstract
The 2014 outbreak of the Ebola Virus Disease in West Africa has taken a horrible human toll. Although the outbreak originated in rural Guinea, it has hit hardest in Liberia and Sierra Leone, in part because it has reached urban areas in these two countries, a factor that distinguishes this outbreak from previous episodes elsewhere. As of September 10, 2014, there had been 2,281 recorded deaths out of 4,614 suspected or confirmed cases of Ebola. Experts fear that the true numbers may be two to four times larger, due to underreporting. Misery and suffering have been intense, especially in Liberia where doctors have had to turning patients away for lack of space in Ebola treatment centers. Inevitably, before the outbreak is contained the human impacts will increase considerably over these numbers. Epidemiological estimates are acknowledged as highly uncertain and are not the subject of this note. What is certain is that limiting the human cost will require significant financial resources and a concerted partnership between international partners and the affected countries. Particularly in Liberia and Sierra Leone, government capacity is already overrun and the epidemic is impacting macroeconomic activity and budgetary resources. This note informs the response to the epidemic by estimating these macroeconomic and fiscal effects. Any such exercise is necessarily highly imprecise due to limited data and many uncertain factors, but it is still necessary in order to plan the economic assistance that must accompany the immediate humanitarian response. The goal is to help affected countries to recover and return to the robust economic growth they had experienced until the offset of this crisis.

JOINT STATEMENT: Ebola Crisis Could Set Progress in Liberia, Guinea, and Sierra Leone Back a Decade
Joint Statement: Catholic Relief Services; OXFAM. Plan International, Child Fund Alliance, Save the Children
As UNSC Convenes for Emergency Meeting in New York, International Community Must Do More to Prevent Health Catastrophe

FAIRFIELD, Conn. (Sept. 18, 2014) — As the UN Security Council meets today for only the second time in history to address a world health emergency, the Ebola crisis continues to devastate communities in Liberia, Guinea and Sierra Leone. Without concerted and immediate international action to tackle this crisis, the outbreak could see these countries’ hard-fought for progress set back years, bringing the healthcare system to its knees and, for Liberia and Sierra Leone, back to levels not seen since the end of their respective civil wars.

Current reports estimate that over 2,450 people have already lost their lives in West Africa and thousands more are fighting the highly-contagious virus. Recent forecasts put the number of potential infections at 20,000 if nothing is done soon. With no known cure, less than half of those infected are expected to survive.

While millions of children worldwide start their new school year this week, filled with excitement and hope, the classrooms in Ebola-affected countries remain eerily quiet, as communities are forced into quarantine for the foreseeable future. Many other countries in West Africa are currently on alert. Vacant farmland has not been ploughed in time for next year’s harvest, raising real concerns that families will not be able to provide for loved ones over the coming months. Over-crowded rural clinics are being forced to turn away pregnant mothers and young children suffering from malaria, tuberculosis and other life-threatening diseases.

With extremely limited or no medical facilities or trained doctors to help contain the outbreak, the governments of Liberia, Guinea and Sierra Leone are doing all they can to contain the epidemic. Even before the current crisis, Liberia had just 51 medical doctors to serve a population of 3.7 million people, and Sierra Leone also had one of the lowest number of health workers per capita in the world. All three affected countries are, to varying degrees, still recovering from protracted conflicts and facing challenges posed by widespread poverty. The sheer scale and impact of the Ebola crisis threatens the very progress they have fought so hard to achieve.

As international development organizations, we will continue to do all we can to support the people and governments of Liberia, Sierra Leone, and Guinea, namely by providing highly-trained personnel, medical equipment, and by supporting communities, but we do not yet have the means to respond effectively to an epidemic of this scale.

e welcome the leadership shown by certain governments so far in responding to the crisis. But a further and massive increase in financing, personnel, and expert capacity is urgently needed if we are serious about stopping the spread of Ebola. Without this, thousands more of this crisis will be felt for years to come.

We are calling on World leaders to:
:: Deploy disaster response and specialist medical teams with biohazard capacity to support containment and case management in Liberia, Sierra Leone and Guinea
:: Increase financial investment to ensure that the WHO Roadmap and UN Overview of Needs and Requirements are fully funded to ensure a scaled-up response
:: Commit to investing in and strengthening the healthcare sector, in order to build back stronger, more resilient healthcare systems and communities.

World hunger falls, but 805 million still chronically undernourished
MDG target to halve proportion of world’s hungry still within reach by end of 2015
16 September 2014, Rome – About 805 million people in the world, or one in nine, suffer from hunger, according to a new UN report released today.

The State of Food Insecurity in the World (SOFI 2014 confirmed a positive trend which has seen the number of hungry people decline globally by more than 100 million over the last decade and by more than 200 million since 1990-92. The report is published annually by the Food and Agriculture Organization (FAO), the International Fund for Agricultural Development (IFAD) and the World Food Programme (WFP).

The overall trend in hunger reduction in developing countries means that the Millennium Development Goal (MDG) of halving the proportion of undernourished people by 2015 is within reach, “if appropriate and immediate efforts are stepped up,” the report said. To date, 63 developing countries have reached the MDG target, and six more are on track to reach it by 2015.

“This is proof that we can win the war against hunger and should inspire countries to move forward, with the assistance of the international community as needed,” the heads of FAO, IFAD and WFP, José Graziano da Silva, Kanayo F. Nwanze and Ertharin Cousin, wrote in their foreword to the report.

They stressed that “accelerated, substantial and sustainable hunger reduction is possible with the requisite political commitment,” and that “this has to be well informed by sound understanding of national challenges, relevant policy options, broad participation and lessons from other experiences.”…

…Despite significant progress overall, several regions and sub-regions continue to lag behind. In Sub-Saharan Africa, more than one in four people remain chronically undernourished, while Asia, the world’s most populous region, is also home to the majority of the hungry – 526 million people…

…With the number of undernourished people remaining “unacceptably high”, the agency heads stressed the need to renew the political commitment to tackle hunger and to transform it into concrete actions. In this context, the heads of FAO, IFAD and WFP welcomed the pledge at the 2014 African Union summit in June to end hunger on the continent by 2025…

…This year’s report includes seven case studies – Bolivia, Brazil, Haiti, Indonesia, Madagascar, Malawi and Yemen – that highlight some of the ways that countries tackle hunger and how external events may influence their capacity to deliver on achieving food security and nutrition objectives. The countries were chosen because of their political, economic – particularly in the agricultural sector – diversities, and cultural differences…

UN: MDG Gap Task Force Report 2014 launched
18 September 2014
Persistent gaps between promises made and delivered by developed countries hold back greater progress on the Millennium Development Goals – MDG Gap Task Force Report 2014
[Overview excerpt]
Targets for the Millennium Development Goals related to the global partnership to improve people’s lives and end poverty show mixed results on providing the poorest developing countries with greater access to aid, trade, debt relief, essential medicines and technologies, according to a new report launched today by United Nations Secretary-General Ban Ki-moon.

The lives of millions of people worldwide have improved due to concerted efforts – at the global, regional, national and local levels – to achieve the eight Millennium Development Goals (MDGs). Recent statistics show that with many MDG targets already met – including reducing poverty, increasing access to clean drinking water, improving the lives of slum dwellers, and achieving gender parity in primary school – many more targets are within reach by the end of 2015. However, much unfinished business remains.

“Now more than ever, leaders and citizens across the globe must boldly step forward to join in essential collective actions to eradicate poverty, raise living standards and sustain the environment,” Mr. Ban said. “I call on all Governments and international institutions to continue strengthening the global partnership for development so that we can usher in a more sustainable future.”…

As Sixty-eighth Session Nears Conclusion, General Assembly Adopts Resolution Incorporating Sustainable Development Goals into Post-2015 Agenda
Delegates Also Pass Measures Addressing Malaria, Revitalizing Work of Assembly
United Nations
Sixty-eighth General Assembly GA/11544
Plenary
108th Meeting (PM)
10 September 2014

The General Assembly adopted three resolutions today, including one that would pave the way for the incorporation of sustainable development goals into the post-2015 development agenda.

In adopting the “Report of the Open Working Group on Sustainable Development Goals established pursuant to General Assembly resolution 66/288” (document A/68/L.61), as orally amended, the Assembly decided that the outcome document from the Open Working Group on Sustainable Development Goals would be the main basis for integrating the sustainable development goals into the future development agenda. The resolution went on to state that other inputs would also be considered during the intergovernmental negotiation process at the upcoming General Assembly session…

…In a final act, the Assembly adopted ”Consolidating gains and accelerating efforts to control and eliminate malaria in developing countries, particularly in Africa, by 2015” (document A/68/L.60), thereby calling for increased support for the implementation of international commitments and goals pertaining to the fight to eliminate malaria.

The resolution urged malaria-endemic countries to work towards financial sustainability to increase national resources allocated to controlling that disease, while also working with the private sector to improve access to quality medical services. Further, the resolution called upon Member States to establish or strengthen national policies, operational plans and research, with a view to achieving internationally agreed malaria targets for 2015…

…The General Assembly will reconvene on Thursday, 11 September, for a high-level stock-taking event on the Post-2015 Development Agenda.

IMF’s 2014 Financial Access Survey Helps to Map Global Financial Inclusion
Press Release No. 14/425
September 16, 2014
The International Monetary Fund (IMF) released today the results of the fifth annual Financial Access Survey (FAS), the most comprehensive global source of data on access to, and use of, basic consumer financial services by households and nonfinancial corporations. For the first time, the survey includes data on mobile money indicators. The 2014 FAS round was again conducted with financial support from the Ministry of Foreign Affairs of The Netherlands, while the Bill & Melinda Gates Foundation provided funding to capture data on the use of mobile money services.

The FAS provides geographic and demographic data worldwide, offering a strong quantitative underpinning to the theoretical literature linking financial inclusion and economic growth. The positive correlation between the increase in the use of commercial banks services (a measure of financial inclusion) and the increase in GDP per capita (a measure of economic growth) is especially noteworthy when comparing financial inclusion trends. Among African countries reporting data on commercial bank depositors, for instance, depositors per 1,000 adults experienced a five-fold increase from 2004 to 2013, while simultaneously achieving a 40-percent growth in real GDP per capita…

…The newly-expanded FAS is also capturing indicators on access to and use of mobile money services. Over the past decade, the emergence of ‘mobile money’–the practice of sending, receiving, and storing money using mobile phones–has improved the lives of populations that generally do not use commercial banks, even when access to more conventional banking models remained difficult.

The enhanced 2014 FAS provides a quantitative foundation to assess the transformational role of mobile money in financial inclusion. For example, the results of the 2014 FAS round for Kenya show a dramatic increase in the number of active mobile money accounts in recent years. In 2007, mobile money accounts represented just 30 percent of deposit accounts in commercial banks, but by 2009, they surpassed the number of commercial bank deposit accounts. At the same time, the number of mobile money transactions increased by more than 130 times, from close to 5.5 million in 2007 to more than 700 million in 2013.

IRCT [to 20 September 2014]

IRCT issues series of factsheets to tackle torture
15 September 2014

In collaboration with IRCT members across the globe, the IRCT is releasing a series of country factsheets to highlight how common torture is in the countries where IRCT torture rehabilitation centres operate.
The factsheets, released every two weeks throughout the year, summarise the situation of torture in the respective country, the accessibility to justice and rehabilitation and outline the numbers of torture victims. The factsheets also profile the main perpetrators and the ways in which each country can improve their own capacity to fight torture.

Currently the country factsheets cover essential torture information in Albania, Chile, Mexico, Moldova, Pakistan, Peru, Russia and Turkey. Over the coming months factsheets will be released covering Ethiopia, Guatemala, Kyrgyzstan, Lebanon, the Philippines, Sierra Leone and Sri Lanka.

MacArthur Foundation
http://www.macfound.org/

September 18, 2014 – Publication
Advancing the Use of Evidence in Social Policy
A brief from the Coalition for Evidence-Based Policy outlines an increasing demand for and uptake of evidence-based approaches to policymaking, especially in the federal government. The report points to several examples in which the Coalition successfully encouraged the use of evidence-based approaches by federal committees and agencies, including a competition launched by the Justice Department’s National Institute of Justice that seeks to encourage criminal justice agencies to use randomized control trials to enhance their daily operations.

Nepal in “historic introduction of IPV”
ReliefWeb/ Report from UN Country Team in Nepal
18 September 2014
Excerpt
KATHMANDU, 18 September 2014 – In a landmark step to accelerate the global eradication of polio and help prevent a resurgence of the disease, Nepal is today introducing the Inactivated Polio Vaccine (IPV) into its routine immunization programme. Nepal has the distinction of being the first country in South Asia region to launch IPV as part of the global roll-out of the vaccine.
Until now, oral polio vaccine (OPV) has been the primary tool in the global polio eradication effort, reducing incidence of the disease by more than 99 percent worldwide thanks to its unique ability to stop person-to-person spread of the virus. Nepal, along with Bangladesh, Bhutan, Democratic People´s Republic of Korea, India, Indonesia, Maldives, Myanmar, Sri Lanka, Thailand and Timor-Leste, was declared polio free last March. Endemic polio has been successfully eliminated from all but three countries worldwide.
Nepal has made tremendous progress in improving the health and survival of children in the last 25 years. The under-5 mortality rate has significantly reduced from 147 per thousand live births in 1990 to 54 per thousand in 2011. Also, the coverage of immunization against polio has doubled to 90 percent in 2011 from 44 percent in 1984. Thanks to the tireless efforts of community members and the Female Community Health Volunteers together with the Government and its partners WHO, UNICEF, Rotary and GAVI, Nepal has been able to achieve near universal immunization coverage.
Despite this progress, experts caution that polio-free countries remain at risk of re-infection until the disease has been eradicated everywhere. New evidence now demonstrates that adding one dose of IPV at 14 weeks of age to OPV is even more effective than OPV alone at stopping the virus and protecting children. IPV and OPV evoke different immune responses and when used together, maximize immunity to polio virus.
IPV is being introduced in Nepal in order to quickly maximize childhood immunity to polio and maintain the country’s polio-free status. IPV has been proven an extremely safe and effective vaccine and has been used successfully in many developed countries for several decades. It is important to note that IPV is recommended in addition to the oral vaccine and does not replace the oral vaccine…

Investing in Global Health Systems: Sustaining Gains, Transforming Lives
IOM
September 16, 2014
Key Findings (PDF)
Report pdf: http://www.nap.edu/catalog.php?record_id=18940
Health and life expectancy in poor countries have improved rapidly over a short time, contributing to a more prosperous, stable, and productive world. The United States has been a part of this success and therefore has an interest in protecting the health gains of the past few decades. In addition, the recent Ebola outbreak in West Africa has drawn attention to the consequences of neglecting health systems development, as a strong health system allows for prompt response to pandemic threats and draws on the same skills and infrastructure that support routine health care. Vulnerabilities in this system pose financial, political, and health risks to developing countries and, in a larger sense, to the world.
An IOM study looked at how health systems improvements can lead to better health, reduce poverty, and make donor investment in health sustainable. The resulting report stresses the importance of the health system in making transformative investments that support health in developing countries, and outlines a broad donor strategy that can make effective use of the United States’ comparative advantage in science and technology to improve health for the world’s most vulnerable people.

BMC Public Health
(Accessed 20 September 2014)
http://www.biomedcentral.com/bmcpublichealth/content

Research article
Factors influencing adolescent girls’ decision in initiation for human papillomavirus vaccination: a cross-sectional study in Hong Kong
Albert Lee, Mandy Ho, Calvin Ka Cheung, Vera Mei Keung BMC Public Health 2014, 14:925 (8 September 2014)
Abstract (provisional)
Background
Cervical cancer is one of the common cancers among women worldwide. Despite HPV vaccination being one of the effective preventive measures, it is not included in government vaccination programme in Hong Kong. This study aimed to assess the knowledge of and attitude towards cervical cancer prevention among Chinese adolescent girls in Hong Kong, and to identify factors influencing the initiation of HPV vaccination.
Methods
This was a cross-sectional study conducted in Hong Kong during the period of October 2010 to November 2010. A self-administered questionnaire was used, with 1,416 girls from 8 secondary schools completing the questionnaire. Knowledge scores were composited and initiation of HPV vaccination was staged based on stage of change. Analyses were conducted to identify the association of initiation of HPV vaccination with participant’s personal and family factors as well as their knowledge and attitude towards cervical cancer prevention.
Results
The uptake rate of HPV vaccination was low (7%) with 58% respondents in pre-contemplation and contemplation stage. The survey identified a significant gap in knowledge on cervical cancer prevention. The main channels of information were from media and very few from schools or parents. However, 70% expressed their wishes to have more information on cancer prevention, and 78% stated that they were willing to change their lifestyles if they knew the ways of prevention. Multivariate analysis identified three independent significant factors for initiation of vaccination (action and intention): perceived cancer as terrifying disease, school should provide more information on cancer prevention, and comments from relatives and friends having received the vaccine. The cost of vaccination and socio-economic background were not found to be significant.
Conclusions
Public education on cervical cancer needs to be well penetrated into the community for more sharing among friends and relatives. School as setting to provide source of information would facilitate uptake rate of HPV vaccine as students have expressed their wishes that school should provide more information on prevention of cancer. School and community education on cancer prevention would help adolescents to have better understanding of the seriousness of cancer.