Five-point plan to prevent and address all forms of harassment for greater accountability and transparency within UNAIDS
27 February 2018
The Executive Director of UNAIDS, Michel Sidibé, has announced a five-point plan to prevent and address harassment, including sexual harassment, and unethical behaviour within UNAIDS. The plan will ensure that inappropriate behaviour and abuse of authority are identified early on, that measures taken are properly documented and that action to be taken follows due process and is swift and effective.

“I am putting mechanisms in place to review all UNAIDS policies on sexual harassment, abuse of authority and unethical behaviour and ensuring a professional assessment of all actions taken to date to identify if there are any gaps in implementation,” said Mr Sidibé. “This will further enhance the transparency of our processes and allow us to continue moving forward.” The five-point plan will be led by the newly appointed UNAIDS Deputy Executive Director, Management and Governance, Gunilla Carlsson.

First, focal points will be appointed in each department, country office, liaison office and regional office, who will have structured reporting mechanisms in place, reporting back directly to Ms Carlsson.

Second, an open platform will be created for staff to report on harassment, abuse of authority or unethical behaviour within the organization. The open platform will also enable staff to propose innovative options for preventing harassment.

Third, training will be stepped up, with face-to-face training to help staff recognize inappropriate behaviour, improve their skills to prevent harassment and empower them to rapidly report any cases of abuse they may encounter or witness. The training will also include recognizing unconscious bias and encourage increased understanding and tolerance within the multicultural environment of the United Nations.

Fourth, UNAIDS will develop and conduct an annual comprehensive and independent, organization-wide survey on staff well-being that includes questions on harassment, sexual harassment and unethical behaviour.

Fifth, the recently introduced performance management system will be further enhanced. As well as being evaluated on work-based performance, targets met, management effectiveness and progress achieved, staff at all levels will also be evaluated on their ethical behaviour in the workplace. A 360-degree evaluation will be incorporated as part of the assessment process.

The new initiatives will be integrated with a number of progressive policies that UNAIDS has already in place to facilitate the reporting of cases of abuse, including an anonymous, free, 24-hour hotline accessible from anywhere around the world. Wellness and capacity-building teams with specialized staff will visit and work with field offices or departments to address management and operational concerns in order to ensure a constructive working environment in all UNAIDS offices worldwide.

This initiative is in line with the United Nations Secretary-General’s action plan on sexual harassment. UNAIDS has been a frontrunner of United Nations reform and is leading work to ensure gender equality in the workplace. In 2013, UNAIDS launched a Gender Action Plan, which had six targets to reach to ensure gender balance across the organization, including ensuring a 50/50 gender balance in the UNAIDS Secretariat and that 50% of UNAIDS country directors are women. By the end of 2017, 48% of UNAIDS country directors were women and the gender balance across the organization was 53/47, with slightly more women working for the organization than men.

“UNAIDS’ vision stands for zero: zero new HIV infections, zero discrimination and zero AIDS-related deaths,” said Mr Sidibé. “Zero tolerance for sexual harassment is part our mission and is central to our work,” he added.

UNAIDS is continuing to strive to ensure a safe and conducive working environment for its staff in order to continue leading global efforts towards ending the AIDS epidemic by 2030.

Featured Journal Content

The Lancet
Mar 03, 2018 Volume 391 Number 10123 p813-910
http://www.thelancet.com/journals/lancet/issue/current
Comment
Death and suffering in Eastern Ghouta, Syria: a call for action to protect civilians and health care
Samer Jabbour, Fouad M Fouad, Jennifer Leaning, Donna McKay, Rabie Nasser, Leonard S Rubenstein, Annie Sparrow, Paul Spiegel, Ahmad Tarakji, Ronald Waldman, Rola Hallam, Denis Mukwege, Ghanem Tayara

Since Feb 4, 2018, Syrian forces with Russian support have bombarded Eastern Ghouta, an enclave out of government control near Damascus. This military action has killed hundreds of civilians and injured more than 1550 people as of Feb 21, 2018,1 in an area where about 390 000 people, most of whom are civilians, have lived under siege since October, 2013. The recent escalation is reportedly part of a Syrian Government offensive supported by its Russian and Iranian allies to retake Ghouta. In just 1 day, on Feb 20, 2018, PAX, an international peace movement, documented 110 civilians killed and hundreds injured in 131 air strikes, 44 barrel bombs, 28 surface-to-surface “elephant” missiles, five cluster bombs, and countless other artillery and rocket fire.2 Amnesty International sees this as continuing “war crimes on an epic scale”.3

The Syrian American Medical Society, which has tracked attacks on health-care facilities during the offensive, now reports that 25 hospitals and health centres have been hit, some more than once in 4 days.4 Several health-care facilities are destroyed or put temporarily out of service, reducing capacity by 50% at a time when patients most need care. A doctor in Eastern Ghouta said, “Hospitals are overwhelmed. Floors are overflowing with injured and blood. Those patients we discharged a couple of days ago are now back with more serious injuries…The word ‘catastrophe’ can’t describe what’s happening.”4 The injured are running out of places to go. Retaliatory shelling by rebel groups on Damascus neighbourhoods has also killed and maimed scores of civilians and also deserves condemnation.

Physicians for Human Rights (PHR) found that “the unspeakable suffering…was deliberately planned and meticulously implemented over time”.5 The Syrian Government has not contested PHR’s finding but says it is attacking “terrorists”. This claim is not supported by patterns of attacks,6 which predominantly target civilian areas, and demonstrate a position that all civilians in opposition-held areas are legitimate targets.7

The people of Ghouta endured a deadly sarin chemical attack in August, 2013, in which 1466 people, including 426 children, died.8 This led to the US–Russia sponsored deal to remove the Syrian Government’s chemical weapons stockpile. However, killing and destruction continued by other means. Ghouta has been subjected to regular shelling and artillery strikes, including of hospitals and civilian areas. Compounding the impact of Syrian Government violations of international humanitarian law, many Ghouta civilians suffer violence by authoritarian rebel groups and are impoverished by a war economy in which corrupt Syrian Government and rebel intermediaries participate.9 The worsening situation for civilians under siege and bombardment has long been reported but has not led to an improvement for civilians or even a slight lessening of their suffering.9, 10 The Syrian Government has allowed only minimal and intermittent aid and regularly removes urgently needed medical supplies from the very occasional convoy it permits.9, 10 In December, 2017, Ghouta doctors sent a letter to WHO Director-General Tedros Adhanom Ghebreyesus, pleading for support: “Once, we were family doctors, pediatricians, specialists…now we are specialists in war trauma, chemical attacks and siege-induced starvation.”11 The Syrian American Medical Society estimates that more than 1000 critically ill patients now need medical evacuation. The Syrian Government has allowed only 37 as of Feb 17, 2018. Every day, patients die.

Inaction in the face of unrelenting attacks on civilians represents an epic failure of world leaders.12 The UN Security Council has utterly failed the people of Syria. The UN Secretariat seems to operate without an effective strategy for political negotiations or aid delivery.8, 13 These compounded failures are increasing frustrations with the UN as a legitimate interlocutor on human rights violations everywhere,14 and translate into deaths and suffering. We cannot allow this situation to continue. Political negotiations have not prioritised or reduced attacks against civilians. The Syrian Government’s continued ability to deny aid to populations it is besieging illustrates the failure of the current aid delivery process and the impotence of the UN. There are no mechanisms to ensure timely delivery of aid, delivery of sufficient aid for the entire population, or delivery of the most needed types of aid. From April to December, 2016, PHR documented that only three of the nine convoys to besieged areas in Eastern Ghouta provided aid sufficient for even half of the population living there. Of the remaining six convoys, three provided aid sufficient for less than a third of each area’s besieged population.15 Eastern Ghouta has received aid only once since November, 2017.

In the face of this desperate situation, health professionals and concerned citizens still have something to contribute; we have an obligation to do so, and there is a long history of mobilisation that makes a difference. The three most urgent priorities are to stop the targeting and besieging of civilians, to end attacks on health-care facilities and other civilian targets, and to allow unobstructed flow of aid, including medical supplies and evacuation of the wounded.

Three levels of action are possible. First, citizens and health professionals must press government officials, especially in countries directly involved in the war, to act today. The UN Security Council must end its paralysis, and Russia in particular must not block action to end the siege and attacks on civilians and hospitals. We will closely watch the expected vote on a Ghouta ceasefire at the UN Security Council. But the UN Security Council is not the only forum. Given the UN Security Council deadlock, in 2016, the UN General Assembly took the unusual step of establishing an international mechanism to investigate grave crimes committed in Syria.16 Justice for the unspeakable crimes we are witnessing is imperative for long-term stability in Syria, although it will not bring immediate relief to besieged Ghouta. While this can be a lengthy process, an initial step of imposing sanctions on parties to the crimes would have an impact.

Second, health professionals and concerned citizens must come together and mobilise. We call on health professionals and citizens around the world who are outraged about the situation in Ghouta and international inaction to join hands in advocacy, mobilisation, and public action and call for an end to the violence, attacks on health facilities, personnel, and patients, and for the protection of civilians in Syria.

Third, the UN Secretariat must change tactics and strategy to be more impactful. Protecting civilians, removing siege, and ensuring medical evacuations and flow of aid must be top of the agenda for any UN-mediated negotiation. The UN and its agencies, especially those operating in Damascus, should exert all pressure and use all leverage, including but not limited to flow of funds for aid, to ensure respect for international law and delivery of aid to people who need it the most. The lesson from the 2013 polio outbreak among children in non-government-controlled areas who did not receive vaccines is valuable. Under pressure, WHO and UN agencies used a whole-of-Syria approach to tell the Syrian Government that everyone across the conflict lines must get vaccinated in one programme. 3 million children were vaccinated across Syria, half of them in non-government controlled areas.17 Donor countries can press for reforming WHO–Syria operations to ensure this model extends to all health aid.

Collectively, these actions can contribute to protecting the people in Syria who are suffering so desperately.
We declare no competing interests.

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Journal of the American Academy of Child & Adolescent Psychiatry’s (JAACAP)
March 2018 Volume 57, Issue 3
http://www.jaacap.com/issue/S0890-8567(17)X0005-1
Letter to the Editor
Mental Health in Syrian Refugee Children Resettling in the United States: War Trauma, Migration, and the Role of Parental Stress
Arash Javanbakht, David Rosenberg, Luay Haddad, Cynthia L. Arfken
Abstract
Syrian children have been exposed to war trauma, limited access to clean water, sanitation, and good nutrition, and for many, stresses of forced migration.1 Despite these exposures by the children and their families, information on the mental health of Syrian refugees is limited. Recent studies have reported the high prevalence of posttraumatic stress disorder (PTSD), depression, and anxiety in adult Syrian refugees resettling in Middle East and the United States (US), where we found a high prevalence of possible depression (32.2%), anxiety (40.3%), and PTSD (47.7%) in adult Syrian refugees soon after arrival (A. Javanbakht et al.)

Emergencies

POLIO
Public Health Emergency of International Concern (PHEIC)
Polio this week as of 28 February 2018 [GPEI]
:: 23 February marked 64 years since the first large-scale trial of inactivated polio vaccine (IPV). Developed by Joseph Salk, IPV was found to be safe and effective, and is now part of routine vaccination programmes worldwide. Each year, it confers lifelong protection against polio to millions of young children.
:: Learn more about IPV by watching our brand new animation on the two polio vaccines, available in English, French, and Arabic.
:: Summary of newly-reported viruses this week:
Afghanistan: Three new wild poliovirus type 1 (WPV1) positive environmental samples have been reported in Nangarhar province.
Pakistan: Four new WPV1 positive environmental samples have been reported, two collected in Sindh province, one in Khyber Pakhtunkhwa province, and one in Balochistan province.

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Syria cVDPV2 outbreak situation report 36, 27 February 2018
Situation update 27 February 2018
[Editor’ text bolding]
:: No new cases of cVDPV2 were reported this week. The total number of cVDPV2 cases remains 74. The most recent case (by date of onset of paralysis) is 21 September 2017 from Boukamal district, Deir Ez-Zor governorate.
:: An inactivated polio vaccine (IPV) immunization round continues in accessible areas of Aleppo utilizing mobile and fixed teams. To date the round has reached a total of 233,518 children aged 2-23 months, representing 71% of the estimated target, in Damascus, Hasakah, parts of Aleppo governorates, and Jurmana district of rural Damascus.
:: All empty vials of monovalent Oral Polio Vaccine type 2 (mOPV2) have been collected and destroyed in Damascus.
:: Preparations are ongoing for a nationwide immunization round utilizing bivalent OPV (bOPV), which is planned for March. The campaign will target all children aged less than 5 years.
:: An independent external surveillance review has concluded in Iraq. The Ministry of Health Iraq has accepted a key recommendation to revitalize the AFP surveillance system in conflict affected northern governorates bordering Syria.
:: The Global Certification Commission for Polio Eradication in its 17th meeting in Geneva acknowledged the dedication of frontline health workers and their efforts to help control the cVDPV2 outbreak in Syria, noting innovative operational strategies used to overcome challenges in the field to reach all children and to ensure adequate specimen transportation.