New England Journal of Medicine
July 7, 2016 Vol. 375 No. 1
http://www.nejm.org/toc/nejm/medical-journal

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Perspective
Zika and the Risk of Microcephaly
M.A. Johansson, L. Mier-y-Teran-Romero, J. Reefhuis, S.M. Gilboa, and S.L. Hills

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Review Article
The Changing Face of Clinical Trials: Adaptive Designs for Clinical Trials
D.L. Bhatt and C. Mehta
Investigators use adaptive trial designs to alter basic features of an ongoing trial. This approach obtains the most information possible in an unbiased way while putting the fewest patients at risk. In this review, the authors discuss selected issues in adaptive design.

Pediatrics
July 2016, VOLUME 138 / ISSUE 1
http://pediatrics.aappublications.org/content/138/1?current-issue=y

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Review Articles
Interventions to Improve HPV Vaccine Uptake: A Systematic Review
Emily B. Walling, Nicole Benzoni, Jarrod Dornfeld, Rusha Bhandari, Bryan A. Sisk, Jane Garbutt, Graham Colditz
Pediatrics Jul 2016, 138 (1) e20153863; DOI: 10.1542/peds.2015-3863

PLOS Currents: Disasters
http://currents.plos.org/disasters/
[Accessed 9 July 2016]

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Research Article
Codified Hashtags for Weather Warning on Twitter: an Italian Case Study
July 5, 2016 ·
Introduction: During emergencies increasing numbers of messages are shared through social media platforms becoming a primary source of information for lay people and emergency managers. For Twitter codified hashtagging is emerging as a practical way to coordinate messages during emergencies and quickly identify relevant information. This paper considers a case study on the use of codified hashtags concerning weather warning in Italy in three different regions.
Methods: From November 3rd to December 2nd 2014, tweets identified by the 3 codified hashtags #allertameteoTOS, #allertameteoLIG and #allertameteoPIE were retrieved, collecting a total of 35,558 tweets published by 7361 unique tweets authors, with the aim to assess if codified hashtags could represent an effective way to align formal and informal sources of information during weather related emergencies. An auxiliary R-package was built to lead the analytics used in this study. Authors performed a manual coding of users, hashtags and content of messages of all Twitter data considered.
Results: Content analysis showed that tweets were overwhelmingly related to situational updates, with a high percentage containing geo-location information. Communication patterns of different user types were discussed for the three contexts. In accordance with previous studies, individuals showed an active participation primarily functioning as information hub during the emergency.
Discussion: In the proposed cases codified hashtags have proven to be an effective tool to convey useful information on Twitter by formal and informal sources. Where institutions supported the use of the predefined hashtag in communication activities, like in Tuscany, messages were very focused, with more than 90% of tweets being situational updates. In this perspective, use of codified hashtags may potentially improve the performance of systems for automatic information retrieval and processing during disasters.

PLoS Neglected Tropical Diseases
http://www.plosntds.org/
[Accessed 9 July 2016]

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Research Article
Mapping the Risk of Snakebite in Sri Lanka – A National Survey with Geospatial Analysis
Dileepa Senajith Ediriweera, Anuradhani Kasturiratne, Arunasalam Pathmeswaran, Nipul Kithsiri Gunawardena, Buddhika Asiri Wijayawickrama, Shaluka Francis Jayamanne, Geoffrey Kennedy Isbister, Andrew Dawson, Emanuele Giorgi, Peter John Diggle, David Griffith Lalloo, Hithanadura Janaka de Silva
| published 08 Jul 2016 | PLOS Neglected Tropical Diseases
http://dx.doi.org/10.1371/journal.pntd.0004813
Author Summary
Snakebite is a neglected tropical disease which mainly affects the rural poor in tropical countries. There is little reliable data on snakebite, which makes it difficult to estimate the true disease burden. Hospital statistics underestimate numbers of snakebites because a significant proportion of victims in tropical countries seek traditional treatments. On the other hand, time limited or localized surveys may be inaccurate as they may underestimate or overestimate numbers depending on when and where they are performed. To get a truer picture of the situation in Sri Lanka, where snakebites are an important cause of hospital admission, we undertook an island-wide community survey to determine the number of bites, envenomings and deaths due to snakebite in the previous 12 months. We found that there were more than 80,000 bites, 30,000 envenomings and 400 deaths due to snakebite, much more than claimed by official statistics. There was variation in numbers of bites and envenomings in different parts of the country and, using the data from our survey, we were able develop snakebite risk maps to identify snakebite hotspots and cold spots in the country. These maps would be useful for healthcare decision makers to allocate resources to manage snakebite in the country. We used free and open source software and replicable methods, which we believe can be adopted to other regions where snakebite is a public health problem.

PLoS Neglected Tropical Diseases
http://www.plosntds.org/
[Accessed 9 July 2016]

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Viewpoints
What Is Next for NTDs in the Era of the Sustainable Development Goals?
James Smith, Emma Michelle Taylor
| published 07 Jul 2016 | PLOS Neglected Tropical Diseases
http://dx.doi.org/10.1371/journal.pntd.0004719
…Conclusion: From Invisibility to Ubiquity
We are now firmly in the post-MDG era, but are still feeling our way into the Brave New World of the SDGs. The NTD lobby has been extraordinarily effective in building momentum and ultimately achieving recognition for NTDs within the new SDGs. This success is somewhat tempered by the sheer array of new goals, related targets, and uncertainty about how resources and commitments will map onto them.

The fight now is for traction within the emerging SDG Framework, and this requires a different focus. There is a need to shift from the limited number and international perspective of the MDGs to the much larger number of goals that need to be taken up and acted upon by a huge number of national governments. There is an opportunity here for NTDs to be leveraged throughout the SDGs; focusing on NTDs can assist nation states in grappling with the large array of new goals and targets. National governments must be—and can be—convinced of the crosscutting nature of NTD programmes and the benefits of mainstreaming NTD interventions, securing indicators and, thus, funding. There is a lot of hard work ahead, however.

There is a certain irony here that the previously “invisible” NTDs have gained prominence through their ubiquity within the SDGs, and this prominence is due in no small measure to the work of the NTD lobby thus far. Within the narrower rubric of the MDGs, the lower profile of NTDs was somewhat obscured until concerted efforts were made to underline how NTDs underpinned and interacted with the other goals and the very fabric of poverty itself. There is great value in NTDs being named in target 3.3, but there is still a challenge regarding relevance given the large number of other goals and targets, which may slice funding commitments rather more thinly than was the case with the MDGs. However, the ubiquity of NTDs in relation to the broader SDG agenda can come to the fore in relation to a greater number of goals and targets, especially those for which strong arguments can be made that NTDs may severely hamper progress: for example, goal 1 (end poverty) or goal 2 (end hunger), or where focusing on NTDs can drive progress towards specific targets, for example, 6.1 (achieve universal and equitable access to safe drinking water), 6.2 (achieve access to adequate and equitable sanitation and hygiene for all), and 3.8 (achieve UHC). From this perspective, an investment in NTDs becomes an investment in the broader sustainable development agenda [8,16].

Underlying and implicit in this is the ultimate aim of UHC. Here NTDs can act as both a focal point and a tracer indicator. Perhaps the newfound prominence and enduring ubiquity of NTDs is the mechanism to raise the prominence of the need for ubiquitous health coverage. If NTDs can become a mechanism to drive UHC, there may well be profound implications for the direction the NTD community choose to take next in their advocacy and action. There are a great many potential synergies to be built on, but also a great amount of coordination to be undertaken. Moreover, there is a risk to be managed as the NTD lobby looks to reconcile the WHO’s 2020 goals for the NTD Roadmap with the 2030 timeframe of the SDGs [18].

PLoS Pathogens
http://journals.plos.org/plospathogens/
(Accessed 9 July 2016)

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Research Article
Preventing Vaccine-Derived Poliovirus Emergence during the Polio Endgame
Margarita Pons-Salort, Cara C. Burns, Hil Lyons, Isobel M. Blake, Hamid Jafari, M. Steven Oberste, Olen M. Kew, Nicholas C. Grassly
| published 06 Jul 2016 | PLOS Pathogens
http://dx.doi.org/10.1371/journal.ppat.1005728
Abstract
Reversion and spread of vaccine-derived poliovirus (VDPV) to cause outbreaks of poliomyelitis is a rare outcome resulting from immunisation with the live-attenuated oral poliovirus vaccines (OPVs). Global withdrawal of all three OPV serotypes is therefore a key objective of the polio endgame strategic plan, starting with serotype 2 (OPV2) in April 2016. Supplementary immunisation activities (SIAs) with trivalent OPV (tOPV) in advance of this date could mitigate the risks of OPV2 withdrawal by increasing serotype-2 immunity, but may also create new serotype-2 VDPV (VDPV2). Here, we examine the risk factors for VDPV2 emergence and implications for the strategy of tOPV SIAs prior to OPV2 withdrawal. We first developed mathematical models of VDPV2 emergence and spread. We found that in settings with low routine immunisation coverage, the implementation of a single SIA increases the risk of VDPV2 emergence. If routine coverage is 20%, at least 3 SIAs are needed to bring that risk close to zero, and if SIA coverage is low or there are persistently “missed” groups, the risk remains high despite the implementation of multiple SIAs. We then analysed data from Nigeria on the 29 VDPV2 emergences that occurred during 2004−2014. Districts reporting the first case of poliomyelitis associated with a VDPV2 emergence were compared to districts with no VDPV2 emergence in the same 6-month period using conditional logistic regression. In agreement with the model results, the odds of VDPV2 emergence decreased with higher routine immunisation coverage (odds ratio 0.67 for a 10% absolute increase in coverage [95% confidence interval 0.55−0.82]). We also found that the probability of a VDPV2 emergence resulting in poliomyelitis in >1 child was significantly higher in districts with low serotype-2 population immunity. Our results support a strategy of focused tOPV SIAs before OPV2 withdrawal in areas at risk of VDPV2 emergence and in sufficient number to raise population immunity above the threshold permitting VDPV2 circulation. A failure to implement this risk-based approach could mean these SIAs actually increase the risk of VDPV2 emergence and spread.

Author Summary
Global, coordinated withdrawal of serotype-2 OPV (OPV2) is planned for April 2016 and will mark a major milestone for the Global Polio Eradication Initiative (GPEI). Because OPV2 withdrawal will leave cohorts of young children susceptible to serotype-2 poliovirus, minimising the risk of new serotype-2 vaccine-derived poliovirus (VDPV2) emergences before and after OPV2 withdrawal is crucial to avoid large outbreaks. Supplementary immunisation activities (SIAs) with trivalent OPV (tOPV) could raise serotype-2 immunity in advance of OPV2 withdrawal, but may also create new VDPV2. To guide the GPEI strategy we examined the risks and benefits of implementing tOPV SIAs using mathematical models and analysis of data on the 29 independent VDPV2 emergences in Nigeria during 2004–2014. We found that in settings with low routine immunisation coverage, the implementation of a small number of tOPV SIAs could in fact increase the probability of VDPV2 emergence. This probability is greater if SIA coverage is poor or if there are persistently unvaccinated groups within the population. A strategy of tOPV SIA in sufficient number and with high coverage to achieve high population immunity in geographically-focused, at-risk areas is needed to reduce the global risk of VDPV2 emergence after OPV2 withdrawal.

PNAS – Proceedings of the National Academy of Sciences of the United States of America
http://www.pnas.org/content/early/
(Accessed 9 July 2016)

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Biological Sciences – Ecology:
Large scale, synchronous variability of marine fish populations driven by commercial exploitation
Kenneth T. Frank, Brian Petrie, William C. Leggett,and Daniel G. Boyce
PNAS 2016 ; published ahead of print July 5, 2016, doi:10.1073/pnas.1602325113
Significance
Large-scale synchronous variation in the abundance of marine fish populations has generally been viewed as a response to coupled atmosphere–ocean forcing. The possibility that commercial exploitation could contribute significantly to these variations has been largely dismissed. We demonstrate, using data from 22 Atlantic cod stocks distributed across the North Atlantic, that fishing pressure can cause synchronous changes in stock abundance at spatial and temporal scales comparable to those attributed to climate forcing. We conclude that an understanding of the underlying causes of the large-scale, often synchronous variability of exploited marine fish populations and their underlying food chains will require greater acceptance of the potential importance of exploitation than has been evident to date.
Abstract
Synchronous variations in the abundance of geographically distinct marine fish populations are known to occur across spatial scales on the order of 1,000 km and greater. The prevailing assumption is that this large-scale coherent variability is a response to coupled atmosphere–ocean dynamics, commonly represented by climate indexes, such as the Atlantic Multidecadal Oscillation and North Atlantic Oscillation. On the other hand, it has been suggested that exploitation might contribute to this coherent variability. This possibility has been generally ignored or dismissed on the grounds that exploitation is unlikely to operate synchronously at such large spatial scales. Our analysis of adult fishing mortality and spawning stock biomass of 22 North Atlantic cod (Gadus morhua) stocks revealed that both the temporal and spatial scales in fishing mortality and spawning stock biomass were equivalent to those of the climate drivers. From these results, we conclude that greater consideration must be given to the potential of exploitation as a driving force behind broad, coherent variability of heavily exploited fish species.

Risk Management and Healthcare Policy
Volume 9, 2016
https://www.dovepress.com/risk-management-and-healthcare-policy-archive56
[Accessed 9 July 2016]

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Review
Multimorbidity in chronic disease: impact on health care resources and costs
McPhail SM
Risk Management and Healthcare Policy 2016, 9:143-156
Published Date: 5 July 2016
Abstract:
Effective and resource-efficient long-term management of multimorbidity is one of the greatest health-related challenges facing patients, health professionals, and society more broadly. The purpose of this review was to provide a synthesis of literature examining multimorbidity and resource utilization, including implications for cost-effectiveness estimates and resource allocation decision making. In summary, previous literature has reported substantially greater, near exponential, increases in health care costs and resource utilization when additional chronic comorbid conditions are present. Increased health care costs have been linked to elevated rates of primary care and specialist physician occasions of service, medication use, emergency department presentations, and hospital admissions (both frequency of admissions and bed days occupied). There is currently a paucity of cost-effectiveness information for chronic disease interventions originating from patient samples with multimorbidity. The scarcity of robust economic evaluations in the field represents a considerable challenge for resource allocation decision making intended to reduce the burden of multimorbidity in resource-constrained health care systems. Nonetheless, the few cost-effectiveness studies that are available provide valuable insight into the potential positive and cost-effective impact that interventions may have among patients with multiple comorbidities. These studies also highlight some of the pragmatic and methodological challenges underlying the conduct of economic evaluations among people who may have advanced age, frailty, and disadvantageous socioeconomic circumstances, and where long-term follow-up may be required to directly observe sustained and measurable health and quality of life benefits. Research in the field has indicated that the impact of multimorbidity on health care costs and resources will likely differ across health systems, regions, disease combinations, and person-specific factors (including social disadvantage and age), which represent important considerations for health service planning. Important priorities for research include economic evaluations of interventions, services, or health system approaches that can remediate the burden of multimorbidity in safe and cost-effective ways.

Science
08 July 2016 Vol 353, Issue 6295
http://www.sciencemag.org/current.dtl

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In Depth
Panel slams plan for human research rules
By David Malakoff
Science08 Jul 2016 : 106-107
National Academies report urges creation of new national commission on ethical studies.
Summary
In a development certain to fuel a long-running controversy, a prominent science advisory panel is calling on the U.S. government to abandon a nearly finished update to rules on protecting human research participants. It should wait until a new high-level commission, created by Congress and the president, to recommend improvements and then start over, the panel says. The recommendation, made 29 June by a committee of the National Academies of Sciences, Engineering, and Medicine that is examining ways to reduce the regulatory burden on academic scientists, is the political equivalent of stepping in front of a speeding car in a bid to prevent a disastrous wreck. It’s not clear, however, whether the panel will succeed in stopping the regulatory express—or just get run over. Both the Obama administration, which has been pushing to complete the new rules this year, and key lawmakers in Congress would need to back the halt—and so far they’ve been silent. Still, many researchers and university groups are thrilled with the panel’s recommendation, noting that they have repeatedly objected to some of the proposed rule changes as unworkable—with little apparent impact.

Stability: International Journal of Security & Development
http://www.stabilityjournal.org/articles
[accessed 9 July 2016]

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Research Article
Mass Claims in Land and Property Following the Arab Spring: Lessons from Yemen
08 Jul 2016
Jon Unruh
Abstract
The Arab Spring uprisings have released a flood of land and property conflicts, brought about by decades of autocratic rule. Expropriations, corruption, poor performance of the rule of law, patronage and sectarian discrimination built up a wide variety of land and property transgressions over approximately 30 years. The result has been the creation of longstanding, acute grievances among large components of national populations who now seek to act on them. If new, transitional or reforming governments and their international partners fail to effectively attend to such grievances, the populations concerned may act on them in ways that detract from stability. This article critiques the case of Yemen, whose transitional government, with international support, initiated a land and property mass claims process in the South in order to address a primary grievance of the southern population as part of the National Dialogue transition. A series of techniques are described that would greatly improve the mass claims process once it inevitably recommences after the Houthi conflict comes to an end. These improvements would attach more importance to socio-political realities and how to quickly attend to them, as opposed to an over-reliance on specific legalities. Such an approach could have wider utility among Arab Spring states seeking to address similar land and property grievances.

Tropical Medicine & International Health
July 2016 Volume 21, Issue 7 Pages 819–935
http://onlinelibrary.wiley.com/doi/10.1111/tmi.2016.21.issue-6/issuetoc

Reviews
HIV-free survival at 12–24 months in breastfed infants of HIV-infected women on antiretroviral treatment (pages 820–828)
Lana Clara Chikhungu, Stephanie Bispo, Nigel Rollins, Nandi Siegfried and Marie-Louise Newell
Version of Record online: 24 MAY 2016 | DOI: 10.1111/tmi.12710

Clinical outcomes of HIV-exposed, HIV-uninfected children in sub-Saharan Africa (pages 829–845)
Stanzi M. le Roux, Elaine J. Abrams, Kelly Nguyen and Landon Myer
Version of Record online: 20 MAY 2016 | DOI: 10.1111/tmi.12716

Parental migration and children’s timely measles vaccination in rural China: a cross-sectional study (pages 886–894)
Xianyan Tang, Alan Geater, Edward McNeil, Hongxia Zhou, Qiuyun Deng, Aihu Dong and Qiao Li
Version of Record online: 30 MAY 2016 | DOI: 10.1111/tmi.12719

World Heritage Review
n°80 – July 2016
http://whc.unesco.org/en/review/80/

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World Heritage in Turkey
The 40th session of the World Heritage Committee is taking place in Istanbul from 10 to 20 July 2016, and we are extremely grateful to Turkey for generously hosting this session.

UNICEF – Office of Research – Innocenti Working Paper
WP-2016-18 | June 2016 ::65 pages
What We Know about Ethical Research Involving Children in Humanitarian Settings: An overview of principles, the literature and case studies
Gabrielle Berman, Jason Hart, Dónal O’Mathúna, Erica Mattellone, Alina Potts, Claire O’Kane, Jeremy Shusterman and Thomas Tanner
Abstract:
This working paper identifies and explores the issues that should be considered when undertaking ethical research involving children in humanitarian settings. Both the universal (i.e. relevant to all research involving children) and specific ethical issues that may arise when involving children in research in humanitarian settings are examined. This is undertaken through a review of the literature, relevant case studies, and a reflection on the ethical issues highlighted in UNICEF’s Procedure for Ethical Standards in Research, Evaluation, Data Collection and Analysis (the Ethics Procedure). The key findings of this overview highlight that many of the ethical issues that are present in other settings remain relevant and applicable in the context of humanitarian settings. These include: an institution’s capacity to appropriately and respectfully engage children in research, understanding power relations, securing informed consent and assent, ascertaining harms and benefits, maintaining privacy and confidentiality, and ensuring appropriate communication of findings.
Downloads: https://www.unicef-irc.org/publications/pdf/IWP_2016_18.pdf

Journal of Operations Management
Available online 2 July 2016
Empirically grounded research in humanitarian operations management: The way forward
AJ Pedraza-Martinez, LN Van Wassenhove

Volume 44, Pages 1-68 (May 2016)
Original Research Articles
Fleet management policies for humanitarian organizations: Beyond the utilization–residual value trade-off
Pages 1-12
Mahyar Eftekhar, Luk N. Van Wassenhove
Abstract
Four-wheel drive vehicles play a pivotal role in securing the last-mile distribution of goods and services in humanitarian development programs. To optimize the use of their fleets, humanitarian organizations recommend policies aimed at enhancing the utilization of vehicles while preserving residual value. Although these decisions have a significant impact on cost, there is limited empirical evidence to show that the recommended policies are actually implemented and that they produce the expected benefits. This paper theoretically and empirically examines the complex and inter-related effects of vehicle-to-mission allocation decisions and of alternative vehicle usage patterns on vehicle utilization and residual value in humanitarian development programs. The results suggest that humanitarian organizations could break the utilization–residual value trade-off by adopting different policies than the ones currently in place. They also reveal that organizations need to realize that what seems logical from the headquarters’ perspective may be illogical or inconvenient for the field, and as a result, the field may do the opposite of what is recommended or even instructed. Therefore, they either need better data and analysis combined with audits or they need to improve mechanisms that incentivize field delegations to follow standards recommended by the headquarters.

MSF Field Research
Issue Date: Jul-2016
A Médecins Sans Frontières ethics framework for humanitarian innovation
Sheather, Julian; Jobanputra, Kiran; Schopper, Doris; Pringle, John; Venis, Sarah; Wong, Sidney; Vincent-Smith, Robin
Abstract:
A framework to be used to guide work that does not lie within the purview of formal research ethics oversight
URI: http://hdl.handle.net/10144/615490

Full text [framework only]

This framework is intended to be used to guide work that does not directly involve human participants and does not lie within the purview of formal research ethics oversight.

.1. Clearly identify the problem you are seeking to address, and what benefit you expect the innovation to have. This step may seem obvious, so what is its ethical significance? When identifying the problem, there should be consideration of up-stream solutions that may address the problem in a holistic and sustainable way. For instance, rather than focusing on technocratic fixes, what are the socio-political determinants of the problem and the wider possibilities for solutions? Who has stakes in finding a solution and who may have interests in perpetuating the problem? Is the problem a moving target? Collaboration and cross-fertilization with other disciplines should be considered in order to help to see the problem from various perspectives. In short, do not underestimate the importance of fully identifying the problem.

.2. Ensure that the innovation shows respect for human dignity. While this is a broad concept, it has practical implications. The focus of concern is respect for human beings, reminding us that the simplest or most direct solutions may not be ethically appropriate. Innovators must show due respect for the multiple and overlapping interests of those affected by the innovation. It extends beyond a concern for physical wellbeing to include psychological and cultural integrity. It also incorporates a concern for individual privacy and a respect for the confidentiality of individual, family, and community-based data.

.3. Clarify how you will involve the end user from the start of the process. Innovation should be driven by the requirements of the user. The innovation cycle should be participatory, using methods to involve relevant individuals and communities. Innovators must be sensitive to power dynamics between and within cultures and power imbalances between aid workers and beneficiaries.

.4. Identify and weigh harms and benefits. When considering innovations, a critical first step is the identification, as far as is reasonably possible, of potential harms along with the anticipated benefits. The next step involves weighing these harms and benefits.
.a. Where reasonably foreseeable harms outweigh the likely benefits, implementation will not be ethical. Potential harms include, but are not limited to, physical and psychological harms to individuals. There is also need to consider potential harm to communities.
.b. Where innovation involves a favourable balance of benefits and harms, all reasonable steps must be taken to minimise (mitigate) the harms as far as possible. Unnecessary harms must be eliminated. Where harms are unavoidable, those affected should be informed of the nature and severity of the risks involved.
.c. Conflicted partnerships or conflicts of interest may result in reputational harm to the organisation. If these are identified then oversight by an existing Ethics Review Board is recommended.

.5. Describe the distribution of harms and benefits, and ensure that the risk of harm is not borne by those who do not stand to benefit. Innovators need to give careful consideration to the distribution of benefits and harms associated with their projects. Do the risks or benefits fall unequally across groups? If so, is it appropriate to proceed, and how can these inequalities of distribution be addressed or mitigated? Equally, it is important that the innovation takes into account vulnerable groups; it may be ethically warranted to give particular attention to those who have particular needs. Just as we tend to give more health care to the unwell, so particular attention may need to be given to those who are vulnerable or who may not be able to protect their own interests. This is expressed in the humanitarian principle of impartiality. In addition, consider whether anyone is ‘wronged’ by the innovation. A ‘wrong’ is an infringement that is distinct from harm. For example, selecting one group for an innovation project over another may wrong the other group (as opposed to harming them).

.6. Plan (and carry out) an evaluation that delivers the information needed for subsequent decisions to implement or scale-up the innovation; and then ensure that the beneficiaries have access to the innovation. Innovation requires an acceptance of the risk of failure – not all innovation projects will achieve their desired outcome. But in all cases, we can learn and apply these lessons in the future. Given the time, energy, and resources that these projects require, rigorous evaluation and sharing of lessons is itself a moral obligation. Therefore, consideration should be given to dissemination of findings, since it may be important to avoid further exposure to potential harm by sharing findings, whether these are positive or negative. Likewise there should be a willingness and strategy for wider implementation of the innovation if found to be successful, and a commitment to ensure beneficiaries – at least in the communities where it was tested and ideally in similar communities affected by humanitarian crises – have access to the innovation subsequently.

The Sentinel

Human Rights Action :: Humanitarian Response :: Health :: Education :: Heritage Stewardship ::
Sustainable Development
__________________________________________________
Week ending 2 July 2016

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

pdf version: The Sentinel_ week ending 2 July 2016

Contents [click on link below to move to associated content]
:: Week in Review
:: Key Agency/IGO/Governments Watch – Selected Updates from 30+ entities
:: 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

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:: Week in Review
A highly selective capture of strategic developments, research, commentary, analysis and announcements spanning Human Rights Action, Humanitarian Response, Health, Education, Holistic Development, Heritage Stewardship, Sustainable Resilience. Achieving a balance across these broad themes is a challenge and we appreciate your observations and ideas in this regard. This is not intended to be a “news and events” digest.

Global Humanitarian Overview 2016
June Status Report – A Consolidated Appeal to Support People Affected by Disasters and Conflict
United Nations Office for the Coordination of Humanitarian Affairs (OCHA) :: Partnerships and Resource Mobilization Branch (PRMB),
June 2016 :: 15 pages
Report pdf: http://www.unocha.org/stateofaid/assets/2016GHO_MYR.pdf

FOREWORD [Editor’s text bolding]
The UN-coordinated appeals for 2016 require an unprecedented US$21.6 billion to meet the needs of over 95.4 million people across 40 countries. Since I launched the Global Humanitarian Overview in December, Cyclone Winston swept through Fiji and an earthquake brought widespread devastation in Ecuador. The harsh effects of El Niño this year led us to revise the joint Ethiopia Humanitarian Requirements Document and develop a response plan for Zimbabwe. Funding requirements for new appeals issued since December (Burundi, Fiji, Haiti, Ecuador and Zimbabwe) and for appeals which have been revised are outlined in the pull-out poster inside this Status Report. Requirements of the plan for Sudan, now under development, are also included.

Our global appeal is currently 25 per cent funded. The World Humanitarian Summit echoed the fact that humanitarian action is woefully under-resourced and requires an immediate, effective and collective response. Underfunding jeopardizes the lives of people affected by conflict and disaster. To take just a few examples: underfunding means that the UN and its partners cannot adequately meet the needs of 13.5 million people whose lives have been overturned by the Syria crisis. It means humanitarian assistance cannot be assured in the critical post-electoral phase in Central African Republic where some humanitarian partners are withdrawing their operations from the country. It means further deterioration in the lives of half the population of the Lake Chad Basin, the scene of one of the world’s most neglected crises. And it means that humanitarian partners in Myanmar will be unable to provide for the food security, health, protection and livelihood needs of 1 million people in 2016. As I write, I hear that medical facilities in Iraq are today closing down due to depletion of international funding, and renewals simply not coming through.

We are grateful to our donors for their commitment and support so far this year, and for recognizing that the UN-coordinated appeals ensure a coherent, strategic and well-planned response to crises. We stand ready and resolute to continue providing vital humanitarian assistance across the world wherever and whenever needs arise and to whoever is in need. Donor support in the first half of 2016 has enabled us to deliver critical, life-saving relief. It is now incumbent on us to do substantially more to invest in the lives of millions of people bearing the brunt of crises around the globe. Their needs cannot wait. With more funding, millions of displaced women, girls, boys, and men will eat nutritious food, drink clean water and reap the benefits of good health, shelter, an education and protection. Investing in the survival and dignity of millions in need is investing in our shared, common humanity.
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Stephen O’Brien
United Nations Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator

Human Rights Council
32nd regular session of the Human Rights Council (13 June to 1 July 2016)
http://www.ohchr.org/en/hrbodies/hrc/pages/hrcindex.aspx

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1 July 2016
Human Rights Council extends the mandates on internally displaced persons and on violence against women

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30 June 2016
Human Rights Council extends mandates of Special Rapporteur on the right to food and of Working Group on discrimination against women

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30 June 2016
Council establishes mandate on protection against violence and discrimination based on sexual orientation and gender identity
GENEVA (30 June 2016) – The Human Rights Council this afternoon decided to appoint, for a period of three years, an Independent Expert on protection against violence and discrimination based on sexual orientation and gender identity. It also adopted a resolution on youth and human rights.

Adopted by a vote of 23 in favour, 18 against and 6 abstentions, the resolution said the mandate of the Independent Expert would be to assess the implementation of existing international human rights instruments with regard to ways to overcome violence and discrimination against persons on the basis of their sexual orientation or gender identity, and to identify and address the root causes of violence and discrimination…

Action on Resolution on Protection against Violence and Discrimination Based on Sexual Orientation and Gender Identity
In a resolution (A/HRC/32/L.2/Rev.1) on protection against violence and discrimination based on sexual orientation and gender identity, adopted by a vote of 23 in favour, 18 against and 6 abstentions as amended, the Council decides to appoint, for a period of three years, an Independent Expert on protection against violence and discrimination based on sexual orientation and gender identity, with the mandate to assess the implementation of existing international human rights instruments with regard to ways to overcome violence and discrimination against persons on the basis of their sexual orientation or gender identity; raise awareness of violence and discrimination against persons on the basis of their sexual orientation or gender identity, and to identify and address the root causes of violence and discrimination; and engage in dialogue and to consult with States and other relevant stakeholders. The Council also requests the Independent Expert to report annually to the Human Rights Council, starting from its thirty-fifth session, and to the General Assembly, starting from its seventy-second session.

The result of the vote was as follows:
In favour (23): Albania, Belgium, Bolivia, Cuba, Ecuador, El Salvador, France, Georgia, Germany, Mexico, Mongolia, Netherlands, Nigeria, Panama, Portugal, Republic of Korea, Slovenia, Switzerland, The former Yugoslav Republic of Macedonia, United Kingdom of Great Britain and Northern Ireland, Venezuela, and Viet Nam.

Against (18): Algeria, Bangladesh, Burundi, China, Congo, Côte d’Ivoire, Ethiopia, Indonesia, Kenya, Kyrgyzstan, Maldives, Morocco, Namibia, Qatar, Russian Federation, Saudi Arabia, Togo, and United Arab Emirates.
Abstentions (6): Botswana, Ghana, India, Maldives, Philippines, and South Africa.

Migration / Refugees /Asylum / Humanitarian Response

Editor’s Note:
Again this week, we highlight a number of announcements and milestones associated with the global migration/refugee/asylum crises. We observe, unhappily, how many of these developments establish disappointing new precedents, often challenging and apparently compromising long-established principles and practices in IHL.

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REGULAR PRESS BRIEFING BY THE UN INFORMATION SERVICE – Geneva: 1 July 2016
[Excerpt; Editor’s text bolding]
…Greece
Mr. Spindler spoke about a large-scale exercise to pre-register asylum seekers on mainland Greece, launched on 8 June by the Greek Asylum Service with UNHCR’s support. So far, more than 15,500 people residing in open temporary accommodation structures had received asylum seeker cards, valid for one year, allowing them to reside legally in Greece and to have the right to access services, pending the full lodging of their asylum application. The exercise would help to identify those eligible for family reunification or relocation to another EU country. It would also identify persons with specific needs so that they may be referred to the appropriate organizations and receive assistance and support.

The pre-registration exercise aimed to address the need to access international protection by an estimated 49,000 people currently on mainland Greece. The process was open to those who had entered Greece between 1 January 2015 and 20 March 2016. The exercise was supported financially by the European Commission (DG Home) and implemented with the help of UNHCR and the European Asylum Support Office (EASO). In addition, IOM provided information to asylum seekers about its Assisted Voluntary Return programme.

UNHCR had supported the exercise with technical guidance on the design, planning and preparation, as well as the provision of material resources. UNHCR was also supporting the identification of people with specific needs and facilitated their access to assistance. Among the 15,500 people pre-registered to date, roughly a third of the target population, some 680 unaccompanied and separated children had been identified and referred to EKKA, the specialized government entity in charge of unaccompanied and separated children.

At the end of the exercise, those pre-registered would be given an appointment with the Asylum Service to lodge their asylum claim and access family reunification and relocation. Asylum-seekers would be notified of the date of their appointment by a text message. People with specific needs, including unaccompanied and separated children were being prioritized for appointments.

Following the pre-registration, expanded capacity would be needed to fully register, process asylum claims and follow up family reunification and relocation cases. UNHCR was ready to support the Greek authorities in this regard. Faster implementation and an increased number of places for relocation were needed as more people eligible for relocation were identified. As of 29 June, only 1,970 asylum seekers had been relocated from Greece out of an agreed target of 66,400. Resettlement for those who had family links outside the EU should be also explored.
The exercise was proceeding as planned, with processing capacity now increased to about 700 people per day. The pre-registration was expected to be completed by early-mid August. Pre-registration was ongoing in the Attica and Thessaloniki regions and would move to other parts of Greece in the following weeks.

In response to a question, Mr. Spindler said that that was a special procedure. Usually, people arriving in a country requested asylum in that country and were entered into the asylum system. But in this case, people were arriving in Greece in very large numbers since last summer. Those who arrived more recently were still on the islands and those provisions did not apply to them as they fell under the EU-Turkey agreement. But for those on the mainland, whose movements had been stopped by the closing of the borders, the pre-registration exercise would offer three possibilities: to apply for asylum in Greece, apply for family reunification if they had relatives in other EU countries, or the relocation programme. Voluntary return under the IOM scheme was also possible. UNHCR, together with the Greek asylum system and all partners were trying to find a solution for those people stuck in Greece.

The total of those having arrived in Greece who were still in the country at the moment was 57,000, out of which 49,000 people were on the mainland and the rest were on the islands. Regarding relocation, the agreed goal had been 160,000 thousand places in all countries, not just Greece. The agreement had included 66,400 people to be relocated out of Greece, and 39,600 out of Italy. As of 29 June, 24 countries had made 8,090 places available for asylum seekers to be relocated under the programme. Also as of 29 June, 2,759 asylum-seekers had actually been relocated, including 789 out of Italy and 1,970 out of Greece. The scheme needed to be speeded up. It was important for the EU to support Greece at this moment.

In response to other questions, Mr. Spindler said that it was crucial that more countries came forward with relocation places. The EU’s combined population was over 500 million; it should be possible to find places for those in need, also because not all 57,000 people would apply for asylum. So far, few countries had come forward and those who had, had not offered enough places for relocation. The relocation exercise was a way to share the responsibility of assessing asylum claims, so that Greece didn’t need to deal on its own with this situation, with which it was already overburdened. He also said that it was realistic for Europe to deal with those displaced people as it had dealt with hundreds of thousands or even millions of displaced people in the past.

The asylum seekers could not choose what country to go to but any links they had with a specific country would be taken into account. Most of the asylum seekers had mobile phones and that is why this system of notification about the appointment dates was chosen.

In response to further questions, Mr. Spindler said that the 57,000 he spoke of were the people remaining in Greece, out of over one million people who had arrived in Greece during the recent crisis and had relocated by themselves. UNHCR had been advocating for an orderly relocation programme which would avoid people having to risk their lives and use smugglers. It would have been much more effective for the receiving communities and local authorities to organize the reception of people rather than being overwhelmed by hundreds of thousands of arrivals. They would have been spread all over the EU and it would have been a more regular, predictable system. That is why UNHCR had been advocating for this from the very beginning…

Sarah Crowe, for the United Nations Children’s Fund (UNICEF), said that UNICEF’s ask was that family unity be preserved and that immigration law be broadened, particularly for unaccompanied and separated children, so that if they have family ties anywhere within Europe, not just the EU, this should be taken into consideration. Children were best off in the family unit and needed to be reunified with their families wherever they were and when in children’s best interests.

In response to a question, Mr. Spindler said that countries had been coming forward regularly to offer places, but the number of places was inadequate. Leonard Doyle, for the International Organization for Migration (IOM), said that there had been a large increase in voluntary returns, and according to the latest IOM report there had been 70,000 voluntary returns worldwide in 2015. Greece played a role in that and Mr. Doyle would get back to the press with precise numbers on returns from that country. There had been a relatively large number of assisted voluntary returns facilitated by IOM, from Greece to a variety of countries. There had been assisted voluntary returns to 156 countries of origin worldwide, from 97 different host countries…

Video:
Geneva Press Briefing: HRC, OCHA, IOM, UNHCR, UNICEF, IOM, ITC, WTO
1 Jul 2016 – Biweekly Geneva Press Briefing Chaired by Alessandra Vellucci, Director of the United Nations Information Service in Geneva

IOM Member States Endorse Move to Join United Nations
07/01/16
Switzerland – Member States of the International Organization for Migration (IOM), meeting at a Special Council in Geneva on 30th June, decided that IOM should join the United Nations system as a related organization.

IOM Director General William Swing will communicate the decision of IOM Member States to United Nations Secretary General Ban Ki-moon. It is expected to enter into force, upon signature of the agreement, on 19 September during a UN Summit on Migrants and Refugees, after being submitted to the UN General Assembly for approval.

“Today has been a watershed moment in the life of this Organization, which is celebrating its 65th year,” said IOM Director General William‎ Lacy Swing. “Member States approved the motion by which IOM will join the United Nations system.”

“We expect to soon have a seat and a voice at the UN table and the UN will soon have a dedicated migration agency,” he added.

The decision taken unanimously by IOM Member States also recognized IOM’s operational efficiency, flexibility and cost effectiveness.

Also at the Special Council, the People’s Republic of China joined IOM, becoming its 165th member state. Tuvalu and Solomon Islands also joined the Organization.
“We welcome China, Tuvalu and Solomon Islands membership of IOM at this crucial time,” said Director General Swing.
IOM, which assisted an estimated 20 million migrants last year, is an intergovernmental organization with over 9,500 employees and 450 offices worldwide.