The Sentinel

Human Rights Action :: Humanitarian Response :: Health :: Education :: Heritage Stewardship ::
Sustainable Development
Week ending 26 October 2019

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

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

PDF: The Sentinel_ period ending 26 Oct 2019

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

UN Independent International Fact-Finding Mission on Myanmar calls on UN Member States to remain vigilant in the face of the continued threat of genocide

Myanmar – Rohingya

UN Independent International Fact-Finding Mission on Myanmar calls on UN Member States to remain vigilant in the face of the continued threat of genocide
23 October 2019
NEW YORK (23 October 2019) – The head of the UN Independent International Fact-Finding Mission on Myanmar, Marzuki Darusman, told the General Assembly on Wednesday that Myanmar is failing in its obligations under the Genocide Convention to prevent, to investigate and to enact effective legislation criminalising and punishing genocide.

Mr. Darusman spoke to the General Assembly at the request of the Human Rights Council. He said the Mission’s findings are based on the fact that the policies, laws, individuals and institutions that laid the groundwork for the brutal “clearance operations” in 2016 and 2017 remain in place and strong.

Mr. Darusman said the Mission found that crimes under international law, which were reported on last year, continue to be committed by Myanmar’s military, called the Tatmadaw, throughout the country, impacting Myanmar’s ethnic communities.

Serious violations of human rights and humanitarian law have been committed in both northern Myanmar and in the context of the continuing conflict between the Tatmadaw and the Arakan Army in Rakhine State. “This confirms our previous conclusion that the cycle of impunity enables, and indeed fuels, this reprehensible conduct on the part of the security forces,” Mr Darusman said.

The harsh persecution of the Rohingya community in Myanmar continues unabated in defiance of the international community. The treatment of some 600,000 Rohingya remaining in Rakhine State is largely unchanged. Their situation has worsened, as they endure another year subjected to discrimination, segregation, movement restrictions and insecurity, without adequate access to livelihoods, land, basic services, including education and health care, or justice for past crimes committed against them by the Tatmadaw.

This makes the return to Rakhine State of close to one million Rohingya refugees in Bangladesh simply impossible, Mr. Darusman said…

Joint Statement by the Special Rapporteur on the Human Rights of IDPs, IOM, OCHA and UNHCR to mark the 10th Anniversary of the Adoption of the Kampala Convention


Joint Statement by the Special Rapporteur on the Human Rights of IDPs, IOM, OCHA and UNHCR to mark the 10th Anniversary of the Adoption of the Kampala Convention
2019-10-23 13:05
New York – Africa is marking today the 10th anniversary of the adoption of the African Union Convention for the Protection and Assistance of Internally Displaced Persons in Africa. Also known as the Kampala Convention, this ground-breaking treaty has so far been ratified by 28 countries on the continent.

As the world’s first and only continent-wide legally binding instrument for the protection and assistance of internally displaced persons (IDPs), the Kampala Convention is a testament to the determination of African States to address the multiple challenges of IDPs. The treaty incorporates the basic elements of the 1998 UN Guiding Principles on Internal Displacement and outlines the responsibilities of States and other actors.

Internal displacement remains a significant problem in countries across Africa, with more than 17.8 million people being displaced by conflict and violence. Women and children constitute the vast majority of those affected.

We fully recognize the role and contribution that the Convention has made in preventing displacement across Africa, providing effective responses to displacement crises and supporting solutions for displacement situations, whether triggered by armed conflicts, violence or the effects of climate change and disasters.

We also welcome and support the decision of the Assembly of the African Union to declare 2019 as the ‘Year of Refugees, Returnees and Internally Displaced Persons: Towards Durable Solutions to Forced Displacement in Africa’. This commemorative decision is an important opportunity to take stock of progress in implementing the Convention and identify outstanding challenges.

Now is the time to fully translate the Kampala Convention into practice. We applaud all countries that have ratified the Convention and taken concrete steps to realize the spirit and letter of the treaty, including through developing relevant national laws and policies. We welcome the latest accession by the Republic of South Sudan to the Convention and call on all those that have not ratified and domesticated the Convention to do so without delay.

We also welcome the announcement earlier today of the United Nations Secretary-General to establish a High-level Panel on Internal Displacement to increase global attention on displaced persons and develop concrete recommendations to improve the response.

We furthermore call on member States of the African Union, international organizations and other partners to support the full and effective participation of both displaced and host communities in the implementation of the Convention. We also call on the international community to do more to strengthen its assistance and solidarity with countries and communities coping with internal displacement, including through a more collaborative and strategic approach and innovative financing mechanisms.

Opinion _ A Win for the Uighurs :: Wall Street Journal

Human Rights – Uighurs / Sakharov Prize

Wall Street Journal
Review & Outlook
A Win for the Uighurs
Europe bestows its Sakharov prize on an imprisoned economist.
By The Editorial Board
Oct. 25, 2019 7:03 pm ET
This week a human-rights activist languishing in the Chinese gulag was awarded Europe’s Sakharov Prize for Freedom of Thought, named after the famous Soviet nuclear physicist-turned-dissident. China’s response tells you why the man deserved it. A Chinese Foreign Ministry spokesman accused the European Parliament of intervening in China’s internal affairs and celebrating “a terrorist.”

The man’s name is Ilham Tohti. By profession he is an economist. Today he is one of the more than a million Uighurs—an ethnic Muslim minority in Xinjiang Province—who have been rounded up and detained in China’s internment camps.

In 2014 Mr. Tohti was arrested and charged with “separatism.” In a statement he gave to Radio Free Asia to be released upon his arrest, he said the only things he ever asked for are “human rights, legal rights, autonomous regional rights, and equality.” The Uighur people, he said, also have a right to be treated with dignity, and not have their culture erased.

It can be tempting to dismiss these awards as empty symbolic gestures, but China doesn’t make that mistake. When the Nobel Committee in 2010 awarded its peace prize to imprisoned democracy activist Liu Xiaobo, it went bananas and took its displeasure out on trade with Norway.

President Xi Jinping and his fellow Communists appreciate that with this prize Europe is directing the world’s attention to China’s larger assault on the Uighur people. Secretary of State Mike Pompeo has called this assault “reminiscent of the 1930s.” The U.S. government has begun to take a stronger line on behalf of the Uighurs, imposing sanctions on the Chinese officials who are responsible. Good to see Europe join in.

Seven Mining, Metals Companies Partner on Responsible Sourcing with World Economic Forum


Seven Mining, Metals Companies Partner on Responsible Sourcing with World Economic Forum
News 25 Oct 2019
:: Leading mining and metals companies have joined forces to accelerate responsible sourcing of raw materials with the World Economic Forum.
:: The Mining and Metals Blockchain Initiative will explore the building of a blockchain platform to address transparency issues, the track and tracing of materials, the reporting of carbon emissions or to increase efficiency.
:: Antofagasta Minerals, Eurasian Resources Group Sàrl, Glencore, Klöckner & Co, Minsur SA, Tata Steel Limited, Anglo American/De Beers (Tracr), are founding members.

Geneva, Switzerland, 25 October 2019 – Seven leading mining and metals companies have partnered with the World Economic Forum to experiment, design and deploy blockchain solutions that will accelerate responsible sourcing and sustainability practices.

The Mining and Metals Blockchain Initiative will pool resources and cost, increase speed-to-market and improve industry-wide trust that cannot be achieved by acting individually. It aims to be a neutral enabler for the industry, addressing the lack of standardization and improving efficiency. The intention is to send out a signal of inclusivity and collaboration across the industry. The group will look to develop joint proof-of-concepts for an inclusive blockchain platform. Over time, this could help the industry collectively increase transparency, efficiency or improve reporting of carbon emissions.

In many cases, blockchain projects to support responsible sourcing have been bilateral. The result has been a fractured system that leaves behind parts of the ecosystem and lacks interoperability. This new initiative is owned and driven by the industry, for the industry. Members will examine issues related to governance, develop case studies and establish a working group.

Key areas of collaboration and development could include carbon emissions tracking and supply chain transparency. They will work to use blockchain technology to increase trust between upstream and downstream partners, to address the lack of industry standardization and to track provenance, chain of custody and production methods.

“Material value chains are undergoing profound change and disruption”, said Jörgen Sandström, Head of the Mining and Metals Industry, World Economic Forum. “The industry needs to respond to the increasing demands of minerals and materials while responding to increasing demands by consumers, shareholders and regulators for a higher degree of sustainability and traceability of the products.”

The World Economic Forum has offered its platform and expertise to help industry leaders better understand the impact and potential of blockchain technology. It will provide guidance on governance issues related to the delivery of a neutral industry platform and the expansion of members.

New $90 Million Fund to Address Global Climate Change through Catalytic Capital [Terra Silva]

Heritage Stewardship – Forests

New $90 Million Fund to Address Global Climate Change through Catalytic Capital
October 23, 2019
Terra Silva to accelerate climate-smart practices in tropical forests worldwide
The David and Lucile Packard Foundation and the John D. and Catherine T. MacArthur Foundation today announced the launch of Terra Silva, a $90 million impact investing collaborative designed to respond to the challenges of global climate change. Terra Silva will make investments focused on the conservation, restoration, and sustainable management of critical tropical forests worldwide.

“Forests currently provide the only proven carbon-negative solution at scale,” said Susan Phinney Silver, Mission Investing Director at the Packard Foundation. “Given the urgency of climate change, we are committed to using mission investments in new ways to amplify and accelerate efforts like Terra Silva to reduce greenhouse gases as fast as possible.”

Terra Silva is launching at a pivotal time for sustainable forestry and related agriculture practices in the market. It will focus on three targets: accelerating reforestation, conservation, and afforestation in tropical forest regions; creating more environmentally and socially sustainable forest management practices at scale within critical tropical forests; and improving the sustainability of emerging climate-smart forestry and agriculture practices. In these ways, Terra Silva will mobilize private financing to conserve and restore tropical forests, promote biodiversity, and support thriving communities in and around critical tropical forests worldwide.

The ultimate goal of Terra Silva is to significantly expand opportunities for commercial investment in sustainable forestry and agriculture by pioneering new investment models, accelerating their adoption, and helping build market infrastructure for climate-smart forestry. More information can be found here.

Terra Silva will incorporate catalytic capital – investment capital that is patient, risk-tolerant, concessionary, and flexible in order to unlock impact and additional investment that would not otherwise be possible – in the form of an investment vehicle financed by the Packard Foundation, the MacArthur Foundation, and another mission-driven investor…

The Sveriges Riksbank Prize in Economic Sciences in Memory of Alfred Nobel 2019

Development Research

The Sveriges Riksbank Prize in Economic Sciences in Memory of Alfred Nobel 2019
14 October 2019
The Royal Swedish Academy of Sciences has decided to award the Sveriges Riksbank Prize in Economic Sciences in Memory of Alfred Nobel 2019 to
:: Abhijit Banerjee, Massachusetts Institute of Technology, Cambridge, USA
:: Esther Duflo, Massachusetts Institute of Technology, Cambridge, USA
:: Michael Kremer, Harvard University, Cambridge, USA
“for their experimental approach to alleviating global poverty”

Their research is helping us fight poverty
The research conducted by this year’s Laureates has considerably improved our ability to fight global poverty. In just two decades, their new experiment-based approach has transformed development economics, which is now a flourishing field of research.

Despite recent dramatic improvements, one of humanity’s most urgent issues is the reduction of global poverty, in all its forms. More than 700 million people still subsist on extremely low incomes. Every year, around five million children under the age of five still die of diseases that could often have been prevented or cured with inexpensive treatments. Half of the world’s children still leave school without basic literacy and numeracy skills.

This year’s Laureates have introduced a new approach to obtaining reliable answers about the best ways to fight global poverty. In brief, it involves dividing this issue into smaller, more manageable, questions – for example, the most effective interventions for improving educational outcomes or child health. They have shown that these smaller, more precise, questions are often best answered via carefully designed experiments among the people who are most affected.

In the mid-1990s, Michael Kremer and his colleagues demonstrated how powerful this approach can be, using field experiments to test a range of interventions that could improve school results in western Kenya.

Abhijit Banerjee and Esther Duflo, often with Michael Kremer, soon performed similar studies of other issues and in other countries. Their experimental research methods now entirely dominate development economics.

The Laureates’ research findings – and those of the researchers following in their footsteps – have dramatically improved our ability to fight poverty in practice. As a direct result of one of their studies, more than five million Indian children have benefitted from effective programmes of remedial tutoring in schools. Another example is the heavy subsidies for preventive healthcare that have been introduced in many countries.

These are just two examples of how this new research has already helped to alleviate global poverty. It also has great potential to further improve the lives of the worst-off people around the world.


The Lancet
October 26, 2019
Where next for randomised controlled trials in global health?
The 2019 Nobel Memorial Prize in Economic Sciences was awarded to three economists—Esther Duflo, Abhijit Bannerjee, and Michael Kremer—for their experiment-based research to mitigate global poverty. The award was notable for several reasons. Esther Duflo was only the second woman to win the prize since it began in 1969, and the youngest ever winner. Previous prizes were awarded largely for contributions to theory—for example, by observing and interpreting the behaviour of markets. But this year, the Sveriges Riksbank committee’s recognition of the randomised controlled trial (RCT) elevates a method long used in medicine, but much less so in human development.

Although based in the USA, the three laureates have worked with some of the poorest people to understand their lives and the constraints that keep them poor. They made important discoveries. Those living in poverty often spend their meagre disposable income on activities to relieve tedium or bring small pleasures. In India, they found that people spent their budgets on religious festivals. In Nicaragua, it was owning a radio or television. The laureates concluded that simply providing money to the poor to alleviate poverty was not enough because there are too many competing expenditures. They decided to break down the problems into smaller manageable questions and use empirical data to examine which interventions work and which do not, and what motivates people to make the choices they make. They used RCTs to assess the causal effects of an intervention.

Together, their work has made important contributions to health care, education, agriculture, and gender issues. Understanding how demand for de-worming medicines to treat parasitic infections in Kenya is affected by price provided the case for why governments should subsidise health care. In India, vaccination uptake increased by improving service quality and providing families with small incentives. The laureates have used their findings to develop new anti-poverty programmes and influence policy. Despite their success in producing evidence for social change, many notable economists and social scientists have criticised RCTs on philosophical, epistemological, political, and methodological grounds. Of course, other study designs and approaches, such as more qualitative analyses, aid our understanding of health and development too, but the RCT remains the best means of discovering whether any proposed intervention may work.

While development economics has drawn lessons from medicine, what can medicine learn from this experimentalist turn in economics? The laureates have shown that RCTs can be done in some of the most challenging human circumstances. Importantly, the design of interventions must be based on a detailed understanding of context. Too often, a policy shown to work in one setting is transplanted to another, with scant regard for whether the situation is at all similar. This scenario is especially true for health policy, in which a community of highly paid international consultants travel business class from country to country peddling their favourite idea.

A good example of where these lessons have been learnt is the HOPE-4 trial, published last month in The Lancet. This cluster RCT of hypertension management in Malaysia and Colombia achieved impressive results. The intervention had multiple components—task shifting, peer support, free medicines, and simplified guidelines. But what was particularly important was that the intervention in each country was designed following a detailed study of the lived experience of patients and after interrogation of policy makers. This knowledge was integrated with systematic reviews of experiences elsewhere. Why would someone be expected to take a tablet for high blood pressure for life when they feel perfectly well? Only by answering this question and others might interventions be successful.

RCTs in global health must evolve to become more meaningful. Too often, trials are severely restricted, with little ability to plan for changes across the study (adaptive) and being ready for unforeseen decision making (simulation modelling) at a huge cost and effort. An upcoming Lancet Global Health Series on improving efficiency in global health clinical trials aimed both at researchers and funding bodies will focus on innovative designs and avoiding research waste.

The lesson from this year’s Nobel Prizes is that one size does not fit all. In conceiving and doing rigorous experiments to find out what really works, we need to listen to the voices of the poor and design interventions that respond to their beliefs, needs, and expectations.

Global Health Progress launched to drive cross-sectoral collaborations in support of the Sustainable Development Goals

Global Health – SDGs/Agenda 2030

Global Health Progress launched to drive cross-sectoral collaborations in support of the Sustainable Development Goals
25 October 2019
Geneva, 25th October 2019 – To drive new and existing collaborations to support the SDGs, with a particular focus on SDG 17: Partnership for The Goals, the International Federation of Pharmaceutical Manufacturers & Associations (IFPMA) has launched Global Health Progress. This knowledge hub collates industry efforts – from individual company programs to initiatives between multiple IFPMA member companies – to highlight contributions to the SDGs, visualize efforts, and enhance opportunities for further collaboration. Global Health Progress also shares information and best practices to support continual learning, drawing on complementary expertise to expand the reach and impact of programs.

2020 marks the 10-year countdown until the SDG deadline. The global goals were launched five years ago as the blueprint for dignity, peace and prosperity for people and our planet. Since their launch, countries have made progress towards achieving the goals. However, complex health and wellbeing issues remain – from poverty and inequality to conflict and climate change. Further, many countries are now faced with a double burden of disease – as they continue to tackle infectious disease challenges, they also battle with an increasing prevalence of non-communicable diseases (NCDs) – which present new issues in implementing effective and sustainable solutions for health. The innovative biopharmaceutical industry recognizes the need for new approaches to reach the 2030 deadline.

Global Health Progress highlights over 200 collaborations which use innovative approaches to tackle global health challenges. The collaborations are helping to bring different actors together – governments, academia, multilateral organizations, other private sector companies, local NGOs and more – to catalyze cross-sector initiatives to tackle health related challenges, as well as address gender equality and education issues. A range of program strategies are being used – including capacity building, community awareness and health service delivery – to address systemic health issues and lay foundations to sustain program gains. In consultation with local actors, IFPMA member companies are fostering local ownership and designing programs according to specific health needs and existing health system infrastructure. The collaborations are transforming traditional partnership approaches by working with a growing number of other business sectors to develop integrated solutions, including partnerships with generic manufacturers, telecommunication and insurance companies, and financial institutions.

IFPMA’s Director General, Thomas Cueni, discussed the value of innovative approaches to collaboration to address global health challenges “If we are to overcome today’s most pressing global health challenges, we need some fresh, out-of-the-box thinking and innovative alliances that bring diverse sectors together to unlock greater value for organizations involved and greater impact for the beneficiaries on the ground. Our industry is committed to sharing knowledge and Global Health Progress is one way in which we are helping to drive new collaborations to strengthen healthcare systems. Effective partnerships will help our innovations to grow, reaching more patients worldwide.”…

UNICEF: Lack of funding leaves millions of children in conflict and disaster zones at risk

Humanitarian Response – Fiscal Resources

Press release
Lack of funding leaves millions of children in conflict and disaster zones at risk
$4 billion humanitarian appeal nearly 50 per cent unfunded heading into final quarter of 2019
NEW YORK, 22 October 2019 – Millions of children living in areas affected by conflict and disaster are at risk because of substantial shortages in funding for lifesaving humanitarian programmes, UNICEF said today.

To date, UNICEF has only received 54 per cent of the US$4.16 billion needed to meet the basic health, education, nutrition and protection needs of 41 million children in 59 countries this year. Heading into the final quarter of 2019, the funding gap stands at 46 per cent.

“Millions of vulnerable children around the world are suffering the grievous consequences of increasingly complex humanitarian crises,” said UNICEF Executive Director Henrietta Fore. “Without additional resources, these children will not go to school, be vaccinated, receive adequate nutrition, or be protected from violence and abuse. While we continue to appeal for an end to conflicts and better readiness to emergencies, we need additional donor support to help us meet children’s most basic needs.”

Emergencies with the largest funding gaps include Pakistan (83 per cent), Cameroon (80 per cent), Burkina Faso (76 per cent) and Venezuela (73 per cent). Large-scale emergencies in Syria and neighboring countries, Yemen, Democratic Republic of the Congo and Bangladesh also remain significantly underfunded.

If these funding gaps persist through the end of the year, the consequences for children will be dire:
:: In the Democratic Republic of the Congo, US$ 61 million is urgently required to provide essential services for communities in areas that have long suffered from humanitarian and security crises, and at the same time to create an environment conducive to an effective Ebola response.

:: In Ethiopia, UNICEF needs more than US$43 million to provide children and families affected by drought and displacement with access to safe water, hygiene and sanitation.

:: In Haiti, UNICEF requires nearly US$ 2 million to provide nutritional support to over 19,000 children in need of urgent nutrition assistance and US$ 2 million to support family reunification and care services for unaccompanied and separated children.

:: In Libya, without US$ 540,000 in urgent funding, UNICEF will be unable to provide mine risk education for 50,000 children.

:: In northeast Nigeria, nearly US$ 7 million in funding is urgently needed to sustain lifesaving nutrition programmes, including US$ 3.5 million to prevent a break in the supply pipeline of ready-to-use-therapeutic food for the treatment of severe acute malnutrition in children.

:: In South Sudan, UNICEF child protection programmes are only 20 per cent funded while water, sanitation and hygiene programmes are 26 per cent funded.

:: In Sudan, UNICEF needs US$ 12 million to continue lifesaving treatment for more than 61,000 children under five suffering from severe acute malnutrition.

:: In Syria, where the funding gap is at US$ 30 million, 2.1 million children could miss out on critical formal and non-formal education activities.

:: In Syria’s neighbouring countries (Turkey, Lebanon, Jordan, Iraq, Egypt), home to 2.5 million Syrian refugees, a funding gap of US$ 249 million means that 460,000 children could also miss out on education activities.

:: In Venezuela, UNICEF requires at least US$ 6 million to help 60,000 children enroll and stay in school, through the provision of school feeding programmes. UNICEF also needs at least US$ 3 million to help vaccinate nearly 400,000 children against preventable diseases over the next three months.

:: In West and Central Africa, UNICEF humanitarian assistance to support education for children in countries affected by emergencies are 72 per cent unfunded.

“During my time on the ground in countries under crisis – countries like DRC, Mozambique, South Sudan, Syria and Yemen – I’ve seen firsthand the power of humanitarian funding to change the lives of vulnerable children for the better,” said Fore. “With increased support, together we can reach even more of the children who need us most.”



Ebola – DRC+
Public Health Emergency of International Concern (PHEIC)

Ebola Outbreak in DRC 64: 22 October 2019
1. Situation update
In the past week, from 14 to 20 October, 21 new confirmed Ebola virus disease (EVD) cases were reported from five health zones in two affected provinces in the Democratic Republic of the Congo. The incidence of new confirmed EVD cases remains substantial in parts of North Kivu and Ituri provinces – in particular in the Biakato Mine Health Area, Mandima Health, with the majority (76%) of newly confirmed cases linked to this health area.

The deployment of additional support to the Biakato Mine Health Area has led to improvements in response efforts. The proportion of confirmed cases listed as contacts has increased in the past week from 13% to 57%. This increase was similarly witnessed in confirmed cases with a known epidemiological link to a case which augmented from 47% to 90% in the past week. While this is encouraging, there remain notable challenges in accessing and mounting the full range of public health activities in some areas.

In the 21 days from 30 September to 20 October, the number of affected health areas has decreased, with 20 health areas and nine health zones reporting new cases (Table 1, Figure 2). During this period, a total of 50 confirmed cases were reported, with the majority coming from the health zones of Mandima (54%; n=27 cases) and Mambasa (10%; n=5 cases). While many cases detected outside of these zones have travelled from these hotspots, onward local transmission has been observed in Kalunguta and Mabalako health zones, highlighting the high risk of resurgence and redispersion of cases.

As of 20 October 2019, a total of 3243 EVD cases were reported, including 3127 confirmed and 116 probable cases, of which 2171 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases, 56% (1821) were female, 28% (923) were children aged less than 18 years, and 5% (163) were healthcare workers…

Implementation of ring vaccination protocol
As of 20 October 2019, 240,824 people at risk have consented to and received the rVSV-ZEBOV-GP Ebola vaccine.
The Democratic Republic of the Congo health authorities have endorsed the use of a second investigational Ebola vaccine, manufactured by Johnson & Johnson. This vaccine, which is administered as a two-dose course, 56 days apart, will be circulated in at-risk populations in areas that do not have active EVD transmission. Regular vaccination activities in EVD-affected areas will continue. The Merck/MSD vaccine will continue to be provided to all people at high risk of Ebola infection including those who have been in contact with a person confirmed to have Ebola, all contacts of contacts, and others determined to be at high risk of contracting Ebola…


Public Health Emergency of International Concern (PHEIC)

Polio this week as of 23 October 2019
:: Wild poliovirus type 3 (WPV3) has been declared as globally eradicated. At an event held on World Polio Day 2019, Professor David Salisbury, chair of the independent Global Commission for the Certification of Poliomyelitis Eradication (GCC), presented the official certificate of WPV3 eradication to WHO Director General Dr Adhanom Ghebreyesus. Read more about this landmark declaration.
[See Milestones above for detail]
:: Polio eradication efforts do not only involve providing vaccines. For one Abdullahi Mahamed Noor, basketball is his way of bringing people together to raise awareness about the devastating disease. Read about his journey on using the sport to combat polio in Somalia.

Summary of new viruses this week:
:: Afghanistan— two WPV1 cases and six positive environmental samples;
:: Pakistan— four WPV1 cases and six WPV1-positive environmental samples;
:: Nigeria— two cVDPV2 positive environmental samples.
:: Chad— one cVDPV2 case;
:: Benin— one cVDPV2 case;
:: the Democratic Republic of the Congo— one cVDPV2 case;
:: Ghana— one cVDPV2 case and three cVDPV2 positive environmental samples;
:: Ethiopia— one cVDPV2 case:
:: Togo— one cVDPV2 case:
:: Zambia— one cVDPV2 case.


Philippines: Red Cross triples polio vaccination target
25 October 2019 IFRC
The Philippine Red Cross is more than tripling the number of children it aims to vaccinate in a door-to-door polio vaccination campaign, the Red Cross and the International Federation of Red Cross and Red Crescent Societies (IFRC) said today.

On 1 October 2019, the Red Cross announced support for a Department of Health campaign by activating volunteers in parts of Mindanao and Metro Manila to vaccinate 30,000 children in the hardest-to-reach communities. In fact, the Philippine Red Cross has reached nearly 60,000 children. Today, the target was increased to 100,000.

Announcing the increase, Philippine Red Cross Chairman Richard Gordon said:
“We’re particularly worried about children under five in urban slums, rural areas, migrant families and indigenous communities who have missed out on life-saving vaccinations. It’s simply not right that these children are at risk of death or lifelong disability in the 21st century. The tripling of our target reflects the commitment of Red Cross volunteers and staff, who are literally climbing mountains and crossing rivers to ensure no child is left behind. What’s more, they will do this again in a month when children need a booster, and a month after that too.”

Apart from low immunization rates, factors that contribute to the spread of polio, dengue and measles include low health literacy, unsafe water, poor sanitation, poor living conditions, high rates of chronic childhood malnutrition and poor access to healthcare. The Red Cross is also planning to reach 1 million people with life-saving health, hygiene and sanitation information…


The Sentinel

Human Rights Action :: Humanitarian Response :: Health :: Education :: Heritage Stewardship ::
Sustainable Development
Week ending 19 October 2019

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

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

PDF: The Sentinel_ period ending 19 Oct 2019

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

WHO gravely concerned about humanitarian situation in northeast Syria


WHO gravely concerned about humanitarian situation in northeast Syria
13 October, Cairo, Egypt —
WHO is gravely concerned about the humanitarian health situation in northeast Syria, where up to 200,000 people have been displaced as a result of increased military operations since 9 October, and almost 1.5 million people are in need of health aid. Many of those affected by the recent hostilities have already experienced immense physical and mental stress as a result of years of conflict and repeated displacement.

People in need of essential health care services face challenges related to insecurity and limited access to health care. Already weakened health services in northeast Syria have been severely impacted by the latest security developments. The national hospital in Ras Al-Ain is currently out of service, and the national hospital and two health centers in Tel Abyad are also currently non-functional. The three field hospitals in Al-Hol camp have limited their services since 12 October as a result of the escalation of hostilities which has impeded access of health staff to the camp. All health facilities in camps hosting displaced people in Ain Issa and Ras al Ain have also been evacuated, with additional facilities under threat as the conflict rapidly escalates.

A number of health partners have already suspended services due to insecurity, further disrupting access to essential health care services. On 12 October, a trauma stabilization point located south of Ras Al Ain was evacuated after being reportedly attacked, resulting in two health staff injured and two ambulances destroyed. On the same day, the hospital in Ras Al-Ain was also reportedly attacked. There were no casualties as the facility had already been evacuated.

Across northeast Syria, shortages of health workers is widespread as they too have been among those displaced by the ongoing insecurity, aggravating an already critical situation and further depriving underserved populations of access to medical care.

Damages to the pumping station in Ras Al Ain, the main water source for most of Al Hassakeh governorate, has increased the risk of outbreaks of infectious diseases. Even before the current escalation in conflict, acute diarreah and typhoid were two of the most reported diseases among people in northeast Syria in August 2019. Ongoing displacements, overcrowded living conditions, and limited access to safe water and sanitation services, will likely lead to an increase in the number of people affected by water-borne diseases.

Amid this chaotic and fast-moving situation, WHO and health partners are working hard to respond to urgent health needs. Almost 314,000 medical treatments, vaccines, in addition to trauma medicines for 500 trauma patients have already been prepositioned in Qamishly hub. An additional shipment of more than 100,000 treatments and medicines for 640 trauma patients will be airlifted to Qamishly in the coming week. Medicines for diarrheal diseases, have also been prepositioned for delivery to health facilities as needed. Despite the challenges, many health NGOs continue to operate or shift to new locations. Some casualty cases requiring hospitalization are referred to a WHO-supported facility in Al-Hassakeh, and WHO is in the process of contracting two additional hospitals in Al-Hassakeh and Al-Raqqa to support referral services.

As the situation evolves, WHO and partners will continue to assess health needs and scale up their response as needed.

WHO calls on all parties to the conflict to preserve the right to health for hundreds of thousands of innocent civilians in northeast Syria, and comply with International Humanitarian Law to protect all civilians, including health care workers and patients, as well as health facilities.

Organization of American States – Statement on Democracy, Destabilization

Organization of American States – Democracy, Destabilization

Statement of the OAS General Secretariat
October 16, 2019
The recent currents of destabilization of the political systems of the hemisphere have their origins in the strategy of the Bolivarian and Cuban dictatorships, which seek to reposition themselves once again, not through a process of re-institutionalization and re-democratization, but through their old methodology of exporting polarization and bad practices, to essentially finance, support and promote political and social conflict.

The “Bolivarian breezes” to which the president of the illegitimate Bolivarian constituent national assembly has referred, have brought destabilization, violence, drug trafficking, death and corruption. The Venezuelan people themselves have paid the highest cost, but the other countries of the hemisphere are also now paying a high price for the crisis caused by the Venezuelan dictatorship.

“Bolivarian breezes” are not welcome in this hemisphere. We strongly condemn the threat of exporting bad practices and destabilization to Colombia made by that person in the Bolivarian dictatorship.

The strategy of destabilization of democracy through the financing of political and social movements has distorted political dynamics in the Americas. For years, the Venezuelan dictatorship, with the support of the Cuban dictatorship, institutionalized sophisticated co-optation, repression, destabilization and media propaganda structures in the region. For example, the financing of the Venezuelan dictatorship to political campaigns has been one of the effective ways to increase capacities to generate conflict.

The crisis in Ecuador is an expression of the distortions that the Venezuelan and Cuban dictatorships have installed in the political systems of the hemisphere. However, what recent events have also shown is that the intentional and systematic strategy of the two dictatorships to destabilize democracies is no longer as effective as in the past.

The OAS General Secretariat reaffirms its obligation to protect democratic principles and human rights, and to defend them where they are threatened. It also remains available to member states in their efforts to address the destabilization factors organized by the Venezuelan and Cuban dictatorship.

The State of the World’s Children 2019 :: Children, food and nutrition: Growing well in a changing world :: UNICEF

Children – Rights, Health, Welfare

The State of the World’s Children 2019 :: Children, food and nutrition: Growing well in a changing world
UNICEF :: Flagship Report – October 2019 258 pages
For the first time in 20 years, UNICEF’s flagship report examines the issue of children, food and nutrition, providing a fresh perspective on a rapidly evolving challenge. This 2019 edition of The State of the World’s Children (SOWC) examines the issue of children, food and nutrition, providing a fresh perspective on a rapidly evolving challenge. Despite progress in the past two decades, one third of children under age 5 are malnourished – stunted, wasted or overweight – while two thirds are at risk of malnutrition and hidden hunger because of the poor quality of their diets. At the center of this challenge is a broken food system that fails to provide children with the diets they need to grow healthy. This report also provides new data and analyses of malnutrition in the 21st century and outlines recommendations to put children’s rights at the heart of food systems.

Key Messages
At least 1 in 3 children under 5 is undernourished or overweight and 1 in 2 suffers from hidden hunger, undermining the capacity of millions of children to grow and develop to their full potential.
:: Globally, at least 1 in 3 children under 5 is not growing well due to malnutrition in its more visible forms: stunting, wasting and overweight.
:: Globally, at least 1 in 2 children under 5 suffers from hidden hunger due to deficiencies in vitamins and other essential nutrients.
:: Undernutrition continues to exert a heavy toll. In 2018, almost 200 million children under 5 suffered from stunting or wasting while at least 340 million suffered from hidden hunger.
:: Overweight and obesity continue to rise. From 2000–2016, the proportion of overweight children (5 to 19 years old) rose from 1 in 10 to almost 1 in 5.
:: The number of stunted children has declined in all continents, except in Africa while the number of overweight children has increased in all continents, including in Africa.

The triple burden of malnutrition – undernutrition, hidden hunger and overweight – threatens the survival, growth and development of children, young people, economies and nations.
:: Stunting – a clear sign that children in a country are not developing well – is both a symptom of past deprivation and a predictor of future poverty.
:: Wasting can be lethal for children, particularly in its most severe forms. Contrary to common belief, most wasted children around the world live in Asia and not in emergency settings.
:: Hidden hunger harms children and women. Iron deficiency reduces children’s ability to learn and iron deficiency anaemia increases women’s risk of death during or shortly after childbirth.
:: Child overweight can lead to early onset of type-2 diabetes, stigmatization and depression, and is a strong predictor of adult obesity, with serious health and economic consequences.
:: The greatest burden of all forms of malnutrition is shouldered by children and young people from
the poorest and most marginalized communities, perpetuating poverty across generations.

The triple burden of malnutrition is driven by the poor quality of children’s diets: 2 in 3 children are not fed the minimum recommended diverse diet for healthy growth and development.
:: Only 2 in 5 infants under six months of age are exclusively breastfed, as recommended. Breastfeeding could save the lives of 820,000 children annually worldwide.
:: Use of breastmilk substitutes is of concern. Sales of milk-based formula grew by 41 per cent globally and by 72 per cent in upper middle-income countries such as Brazil, China and Turkey from 2008-2013.
:: Poor diets drive malnutrition in early childhood: 44 per cent of children aged 6 to 23 months are not fed fruits or vegetables and 59 per cent are not fed eggs, dairy, fish or meat.
:: Only 1 in 5 children aged 6 to 23 months from the poorest households and rural areas is fed the minimum recommended diverse diet for healthy growth and brain development.
:: Many school-going adolescents consume highly processed foods: 42 per cent drink carbonated soft drinks at least once a day and 46 per cent eat fast food at least once a week.

Globalization, urbanization, inequities, humanitarian crises and climate shocks are driving Unprecedented negative changes in the nutrition situation of children around the world.
:: Globalization is shaping food options and choices: 77 per cent of processed food sales worldwide are controlled by just 100 large firms.
:: In cities, many poor children live in “food deserts”, facing an absence of healthy food options, or in “Food swamps”, confronted with an abundance of high-calorie, low-nutrient, processed foods.
:: Poor families tend to select low-quality food that costs less. Because of poverty and exclusion, the most disadvantaged children face the greatest risk of all forms of malnutrition.
:: Climate shocks, loss of biodiversity, and damage to water, air and soil are worsening the nutritional prospects of millions of children and young people, especially among the poor.
:: UNICEF and its partners treated more than 3.4 million children with severe malnutrition in humanitarian settings in 2018, from Afghanistan and Yemen to Nigeria and South Sudan.

Improving children’s nutrition requires food systems to deliver nutritious, safe, affordable and sustainable diets for all children.
:: Millions of children are eating too little of what they need, and millions are eating too much of what they don’t need: poor diets are now the main risk factor for the global burden of disease.
:: National food systems must put children’s nutrition at the heart of their work because their nutritional needs are unique and meeting them is critical for sustainable development.
:: Financial incentives should be used to reward actors who increase the availability of healthy and affordable foods in markets and other points of sale especially in low-income communities.
:: Financial disincentives on unhealthy foods can improve children’s diets. For example, taxes on sugary foods and beverages can reduce their consumption by children and adolescents.
:: Fortification of complementary foods and staple foods with micronutrients can be a cost-effective intervention to combat hidden hunger in children, young people and women.

Food environments are crucial. When healthy options are affordable, convenient and desirable, children and families make better food choices.
:: Children, adolescents, young people, parents and families need support to demand nutritious foods, but food environments need to promote and support healthy diets.
:: Innovative, fun, memorable and engaging communication strategies to promote healthy eating can leverage the cultural and social aspirations of children, adolescents and families.
:: Legislation plays a key role in promoting good diets for children, such as by regulating the marketing of breastmilk substitutes to mothers and families, and of unhealthy food to children.
:: The marketing of unhealthy foods and sugarsweetened beverages is directly linked to growing overweight and obesity in children.
:: Front of package labelling – visible, accurate and easy to understand – helps children, young people and families make healthier food choices and incentivizes suppliers to deliver healthy food.
:: Governments need to promote healthy food environments in schools, including healthy meals and limiting the sale and advertising of ‘junk food’ in proximity to schools and playgrounds.
:: The health, water and sanitation, education and social protection systems also have crucial roles to play in promoting and supporting good nutrition for children, adolescents and women.

Investing in nutrition for children and young people is a cornerstone investment if the world is to achieve the Sustainable Development Goals by 2030.
:: Investing in child nutrition is key to human capital formation because nutrition is central to children’s growth, cognitive development, school performance and future productivity.
:: A large and young labour force – with a great creativity and productivity potential – is emerging in Africa and Asia. However, malnutrition risks limiting this demographic dividend.
:: Returns from investment in nutrition are high. For example, every dollar invested in reducing Stunting generates an economic return equivalent to about US$18 in high-burden countries.

One word must be at the heart of our response to children’s malnutrition – action. We need action that reflects the core role of food systems, that strengthens the supply of – and demand for – better food, that improves children’s food environments, and leverages the role of key supportive systems.

With action comes another imperative: accountability. Progress must be measured, shared, acted on and celebrated. Sound nutrition is fundamental to children’s well-being and the achievement of the Sustainable Development Goals. It needs to be put at the heart of government policy and supported by key stakeholders, including civil society and the private sector.

The State of the World’s Children 2019 report concludes with the following Agenda to Put Children’s Nutrition Rights First:
1 Empower families, children and young people to demand nutritious food.
2 Drive food suppliers to do the right thing for children.
3 Build healthy food environments for all children.
4 Mobilize supportive systems – health, water and sanitation, education and social protection – to scale up nutrition results for all children.
5 Collect, analyse and use good-quality data and evidence regularly to guide action and track progress.

World stumbling zombie-like into a digital welfare dystopia – UN Special Rapporteur on extreme poverty and human rights

Digital Technology – Social Welfare Systems – Human Rights

World stumbling zombie-like into a digital welfare dystopia, warns UN human rights expert
NEW YORK (17 October 2019) – A UN human rights expert has expressed concerns about the emergence of the “digital welfare state”, saying that all too often the real motives behind such programs are to slash welfare spending, set up intrusive government surveillance systems and generate profits for private corporate interests.

“As humankind moves, perhaps inexorably, towards the digital welfare future it needs to alter course significantly and rapidly to avoid stumbling zombie-like into a digital welfare dystopia,” the Special Rapporteur on extreme poverty and human rights, Philip Alston, says in a report to be presented to the General Assembly on Friday.

The digital welfare state is commonly presented as an altruistic and noble enterprise designed to ensure that citizens benefit from new technologies, experience more efficient government, and enjoy higher levels of well-being. But, Alston said, the digitization of welfare systems has very often been used to promote deep reductions in the overall welfare budget, a narrowing of the beneficiary pool, the elimination of some services, the introduction of demanding and intrusive forms of conditionality, the pursuit of behavioural modification goals, the imposition of stronger sanctions regimes, and a complete reversal of the traditional notion that the state should be accountable to the individual.

“Digital welfare states thereby risk becoming Trojan Horses for neoliberal hostility towards social protection and regulation,” said the UN Special Rapporteur. “Moreover, empowering governments in countries with significant rule of law deficits by endowing them with the level of control and the potential for abuse provided by these biometric ID systems should send shudders down the spine of anyone even vaguely concerned to ensure that the digital age will be a human rights friendly one”.

Alston said governments justified the introduction of expensive and complex biometric digital identity card systems on the grounds that they would improve welfare services and reduce fraud.

“The process is commonly referred to as ‘digital transformation’ by governments and the tech consultancies that advise them, but this somewhat neutral term should not be permitted to conceal the revolutionary, politically-driven, character of many such innovations,” Alston said. “Systems of social protection and assistance are increasingly driven by digital data and technologies that are used for diverse purposes, including to automate, predict, identify, surveil, detect, target and punish.”

The dominant role of the private sector in designing, constructing and even operating significant parts of the digital welfare state is a major reason for concern, according to Alston. “Most Governments have stopped short of requiring Big Tech companies to abide by human rights standards, and because the companies themselves have steadfastly resisted any such efforts, the companies often operate in a virtually human rights free-zone,” said Alston…

Connecting Africa to Broadband: A Roadmap for Inclusive Growth

Development – Africa/Broadband

Connecting Africa to Broadband: A Roadmap for Inclusive Growth
:: A new report says around $100 billion will be needed to achieve universal access to broadband connectivity in Africa by 2030
:: The report calls for urgent action to close the internet access gap while providing a roadmap and action plan for reaching this objective
:: This report, one of the first to quantify the cost of bridging the broadband gap in North and Sub-Saharan Africa, is the first deliverable of the Broadband Commission Broadband for All Working Group

WASHINGTON, October 17, 2019— What will it take for Africa to connect an additional 1.1 billion people online by 2030 and bridge the connectivity gap? A new report launched today at the World Bank/IMF Annual Meetings estimates the cost of closing the digital divide at around $100 billion or close to US$9 billion a year. The challenge shouldn’t be underestimated. In Sub-Saharan Africa, about a third of the population remains out of reach of 3G networks compared to about 2 percent in North Africa.

Achieving this target is a significant undertaking which will require the deployment of nearly 250,000 new 4G base stations and at least 250,000 kilometers of fiber across the region, the report says. Connecting the unconnected would also require rolling out innovative and alternative solutions (Wi-Fi, satellites, etc.) to reach the nearly 100 million people that live in remote, rural areas currently out of reach of traditional mobile networks…

Download the full report:

Counting the hidden $12-trillion cost of a broken food system :: Nature Editorial

Featured Journal Content

Volume 574 Issue 7778, 17 October 2019
Editorial | 16 October 2019
Counting the hidden $12-trillion cost of a broken food system
The world’s food system costs trillions in poor health and ecological damage. On World Food Day, governments and researchers must commit to more-regular audits of these unseen expenses.

There’s an unfolding tragedy at the heart of the world’s food system and its cause lies mainly at the door of governments, food manufacturers and agribusinesses.

The situation is urgent. One-third of all food goes to waste, and yet governments and other players in the food system are unable to prevent 820 million people from regularly going hungry. The food industry, especially, bears responsibility for the fact that 680 million people are obese, but it is largely governments and their citizens who have to pick up the costs of treatment.

When industrial-scale farms draw copious quantities of water to irrigate crops, again it is taxpayers who foot the bill for the water scarcity that can follow. It’s the same for agrochemicals and their effects on the health of people and ecosystems. Governments find themselves shouldering the costs of biodiversity loss, and mopping up agriculture’s contribution to greenhouse-gas emissions.

These hidden costs — or externalities — must be met, and last month a landmark report estimated them to be somewhere in the region of US$12 trillion a year, rising to $16 trillion by 2050. That is a staggering figure — equivalent to the gross domestic product of China.

What is equally alarming is that these costs are not being regularly counted, and the food and agriculture industries seem to assume that the bill will be paid. That isn’t right and has to change.

The report, which is the work of an organization called the Food and Land Use Coalition — which includes business groups and research institutions as well as the United Nations — also calculated the costs that governments and businesses would need to pay to transition to a more sustainable food system. That estimate comes to somewhere between $300 billion and $350 billion annually. In addition — and after taking account of hidden costs — a more sustainable food system could yield a further $5.7 trillion a year by 2030 in new economic opportunities, offsetting the $350-billion price tag by many multiples.

For example, a transition to plant-based diets containing less salt, sugar and processed foods is estimated to cost $30 billion. But the resulting economic benefits are predicted to be around $1.28 trillion. Cutting food waste is similarly estimated to cost $30 billion, with an estimated $455 billion expected to flow in commercial opportunities from waste reduction.

So if there’s money to be made, it is reasonable to ask what is holding companies back. Why aren’t they queueing up for a slice of the pie? Some undoubtedly are, but more could be persuaded, or compelled, to act.

Governments have several levers when it comes to getting companies to change behaviour. One is taxation, a function of which is to fund public services, including clean-up efforts. Another lever is regulation — although in recent years, the fashion among some governments, in developed countries at least, has been to avoid imposing strong regulations. Instead, there is a move towards using softer methods to change practices in industry, drawing on the work of researchers in the behavioural sciences, for example.

A third lever is financial incentives — such as promoting the idea that companies can make profits from sustainability. Such an approach has had a measure of success following the influential 2006 publication of The Economics of Climate Change: The Stern Review, from development economist Nicholas Stern of the London School of Economics and Political Science. Among other things, this report and others that followed paved the way for several climate-change funding initiatives.

Whichever lever is used — and the most effective route is likely to involve a combination of all three, and more — there must be more-regular accounting and publishing of these hidden costs. That could be a task for national ministries of finance, or national statistics offices, working closely with researchers.

The Food and Land Use Coalition has performed an important service, but its calculations cannot be a one-off exercise, and governments, in turn, need to use these data to compel industry to act.

Growing Better: Ten Critical Transitions to Transform Food and Land Use

Development, Governance, Food & Land Use

Growing Better: Ten Critical Transitions to Transform Food and Land Use
The Global Consultation Report of the Food and Land Use Coalition September 2019
For people, nature and climate
September 2019 :: 237 pages
Executive Summary [excerpt]
The world faces a remarkable opportunity to transform food and land use systems over the next ten years. This report lays out the scientific evidence and economic case that demonstrate that, by 2030, food and land use systems can help bring climate change under control, safeguard biological diversity, ensure healthier diets for all, drastically improve food security and create more inclusive rural economies. And they can do that while reaping a societal return that is more than 15 times the related investment cost (estimated at less than 0.5 percent of global GDP) and creating new business opportunities worth up to $4.5 trillion a year by 2030.1 Delivering such a transformation will be
challenging but will ensure that food and land use systems play their part in delivering the Sustainable Development Goals (SDGs) and the Paris Agreement targets on climate change.

Leaving these systems to continue on current trends, by contrast, means sleepwalking into a scenario wherein climate change, sea-level rise and extreme-weather events increasingly threaten human life, biodiversity and natural resources are depleted, people increasingly suffer life-threatening, diet-induced diseases, food security is compromised, and socioeconomic development is seriously impaired. Such a pathway would place the SDGs and the Paris Agreement targets out of reach and within a few decades threaten our collective security.

Transformation of food and land use systems thus needs to become an urgent priority globally – for leaders in the public and private sectors, and for civil society, multilateral institutions, the research community, consumers and citizens.

To support such leadership, this report from the Food and Land Use Coalition (FOLU) proposes a reform agenda. This agenda is centred around ten critical transitions that would enable food and land use systems to provide food security and healthy diets for a global population of over nine billion by 2050, while also tackling our core climate, biodiversity, health and poverty challenges (Exhibit 1). The specifics of the reform programme will inevitably vary from one country to the next, and from one community to the next. But all countries and communities could benefit from taking a holistic approach to the transformation of food and land use systems, combining the massive opportunities that are becoming available in respect of “nutritious food”, “nature-based solutions”, ”wider choice and supply” and “opportunity for all” agendas…



Ebola – DRC+
Public Health Emergency of International Concern (PHEIC)

Statement on the meeting of the International Health Regulations (2005) Emergency Committee for Ebola virus disease in the Democratic Republic of the Congo on 18 October 2019
…The WHO Secretariat provided details on the latest risk assessment. Risk remains very high at national and regional levels but still low at global level. In recent weeks, the incidence of EVD cases has consistently declined, with 15 new confirmed cases, reported in North Kivu and Ituri provinces during the last epidemiological week of 7–13 October, in comparison with 128 confirmed cases per week reported at the peak of the outbreak in April 2019. There is a shift in hot spots from urban settings to more rural, hard-to-reach communities, across a more concentrated geographical area. At present, 10 health zones are affected. These areas pose major security challenges. When response activities are suspended, the likelihood of underreporting and the potential for the disease to spread to new areas increases. In addition, continued transmission in remote areas where access is difficult creates the possibility of transmission chains going undetected.

The ring vaccination strategy is proving efficient and successful. Issues related to vaccine supply were reviewed. Given the uncertainty of the evolution of the epidemic, current supplies should be managed carefully.  The Secretariat also welcomed the commencement of Johnson and Johnson vaccine studies in Uganda and the imminent commencement of similar studies in the Democratic Republic of the Congo, in addition to continuing to track progress with other vaccine candidates.

The United Nations Ebola Emergency Response Coordinator gave an update on the situation and efforts to maintain an enabling environment to improve access and acceptance of Ebola response in communities. He re-emphasized the need for stronger community engagement and access in all areas, increased multisectoral collaboration, and more financial and human resources. Insecurity remains the greatest concern. Efforts to increase security are underway. There is a need to focus both on intervention gaps and the quality of interventions. Identifying areas where the virus might migrate and securing these areas constitutes a major priority.

The Committee was also appraised by the WHO Secretariat on progress on preparedness efforts in the nine neighbouring countries (priority 1: Burundi, Rwanda, South Sudan, and Uganda, and priority 2: Angola, Republic of the Congo, Central African Republic, Tanzania, and Zambia).  Bilateral roadmaps for cross-border coordination between DRC and the priority 1 countries are being implemented. On 21 October 2019, a high-level ministerial meeting will be held in Goma, DRC, to further strengthen alignment and coordination of cross-border surveillance across all nine high-risk neighbouring countries. A major challenge is the lack of funding for preparedness, particularly in the priority 2 countries. Of the US$ 66.6 million required for all the 9 countries, only US$ 4.5 million has been pledged. Compliance with IHR requirements for notification and verification of alerts was highlighted, in particular with regards to transparency and timely sharing of public health information.

Context and Discussion
The Committee commended the response to date, under the leadership of the Democratic Republic of the Congo Ministry of Health, and appreciated the progress made under the multisectoral coordination commission established in July 2019. Support provided by WHO, UN agencies, NGOs and other partners has also contributed to limiting the spread and impact of this virus in a difficult context in many areas in the Democratic Republic of the Congo. The courage and commitment of all frontline workers were specifically praised by the Committee.

While the Committee commended the efforts made by the neighbouring countries to strengthen preparedness, it remained deeply concerned by the lack of sustained financial support for these activities.

The committee noticed with appreciation that the general compliance of all states with the WHO recommendations to keep borders open and air travel meant operations could continue and economies in the area were not harmed by border closures.

However, the Committee is concerned that a year into the outbreak, the access and security situations on the ground could hinder final efforts to eliminate the virus from rural communities.

Conclusions and Advice
It was the view of the Committee that this event still constitutes a public health emergency of international concern (PHEIC) under the IHR (2005).

…Based on this advice, the reports made by the affected State Party, and the currently available information, the Director-General accepted the Committee’s assessment and on 18 October 2019 maintained the Ebola outbreak in the Democratic Republic of the Congo as a Public Health Emergency of International Concern (PHEIC).

The Director-General endorsed the Committee’s advice and issued them as Temporary Recommendations under IHR (2005) to reduce the international spread of Ebola, effective 18 October 2019.


Major milestone for WHO-supported Ebola vaccine
18 October 2019 News release Geneva
The World Health Organization (WHO) welcomes the European Medicines Agency (EMA) announcement recommending a conditional marketing authorization for the rVSV-ZEBOV-GP vaccine, which has been shown to be effective in protecting people from the Ebola virus.

Today’s announcement by EMA, the European agency responsible for the scientific evaluation of medicines developed by pharmaceutical companies, is a key step before the European Commission decision on licensing. In parallel, WHO will move towards prequalification of the vaccine.

“The conditional authorization of the world’s first Ebola vaccine is a triumph for public health, and a testimony to the unprecedented collaboration between scores of experts worldwide,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “My deepest gratitude is to the studies’ volunteers, researchers, health workers in Guinea, other countries and the Democratic Republic of the Congo who have put themselves at risk to ensure people are protected with this vaccine.”

In the past five years, WHO has convened experts to review the evidence on various Ebola vaccine candidates, informed policy recommendations, and mobilized a multilateral coalition to accelerate clinical evaluations. The EMA review was unique in that WHO and African regulators actively participated through an innovative cooperative arrangement put in place by WHO, which will help accelerate registration for the countries most at risk.

A randomized trial for the vaccine began during the West Africa Ebola outbreak in 2015. When no other organization was positioned to run a trial in Guinea during the complex emergency, the government of Guinea and WHO took the unusual step to lead the trial.

A global coalition of funders and researchers provided the critical support required. Funders included the Canadian Government (through the Public Health Agency of Canada, Canadian Institutes of Health Research, International Development Research Centre, Global Affairs Canada); the Norwegian Ministry of Foreign Affairs (through the Research Council of Norway’s GLOBVAC programme); the Wellcome Trust; the UK government through the Department for International Development; and Médecins Sans Frontières.

The trial was successfully run using an innovative ring vaccination design. In the 1970s, this ring strategy helped to eradicate smallpox, but this was the first time that an experimental vaccine was evaluated this way…

Merck Receives EU CHMP Positive Opinion for Investigational V920 Ebola Zaire Vaccine for Protection Against Ebola Virus Disease
October 18, 2019
[See Industry Watch below for detail]


Ebola Outbreak in DRC 63: 15 October 2019
Situation Update
In the past week, from 7 to 13 October, 15 new confirmed Ebola virus disease (EVD) cases were reported from five health zones in two affected provinces in the Democratic Republic of the Congo. While it is encouraging to see another week of relatively low numbers of newly confirmed cases (Figure 1), these are occurring in a concentrated area where limited access and insecurity pose challenges for the response. In such environments, risks of resurgence remain very high, as do the risks of re-dispersion of cases. For example, this past week, several people who were eventually confirmed as positive for EVD sought healthcare in health zones which are no longer experiencing ongoing transmission, such as Beni…


Public Health Emergency of International Concern (PHEIC)

Polio this week as of 16 October 2019
:: Preparations for World Polio Day taking place next week on 24 October are in full swing. On that day, the Global Commission for the Certification of Poliomyelitis Eradication (GCC) is expected to declare poliovirus type 3 (WPV3) as globally eradicated. The event will be broadcast on the internet. Viewers are welcome to follow the proceedings through a WebEx broadcast that will be available here.

:: The Polio Oversight board (POB) met on 6 September 2019 for its third meeting of the year to discuss the current status of work within the programme. The meeting summary is now available.

Summary of new viruses this week:
:: Pakistan — two WPV1-positive environmental samples;
:: Philippines — two cVDPV1-positive environmental samples.


Meeting of the Polio Oversight Board (POB)—Teleconference
6 September 2019 | 16h00-18h00 GVA time
The Polio Oversight Board held its third meeting of the year by teleconference to discuss the status of polio eradication efforts and preparations for the upcoming GPEI pledging moment in Abu Dhabi on November 19th, 2019.

[Excerpt below; full report available at title link above]
1. Key Challenges/Risks to Polio Programme
Michel Zaffran gave POB members an update on the status of global polio eradication, which is of great concern.
:: In Afghanistan, the lack of access due to the Taliban’s ban on house to house vaccination and more recently on all WHO/ICRC activities is leading to a large, vulnerable cohort of unvaccinated children. Even in the areas where vaccination activities are ongoing, the inability of the programme to have outside experts participate, in both training and supervision, as well as conducing post campaign monitoring, is leading to declines in campaign quality. The upcoming leadership transitions at all levels—from national elections to turnover in WHO and UNICEF staff—is both a potential risk and opportunity.

:: In Pakistan, the program is on, what the recent Technical Advisory Group meeting called a “failing trajectory”. Issues such as community resentment and mistrust, combined with sub-optimal SIA quality in certain areas is resulting in sizeable pockets of unimmunized children. This is leading to ongoing widespread virus circulation and a substantial increase in the number of polio cases (58 as of August 31st, compared to 12 reported in all of 2018). The program needs to be transformed, with national unity and all-party consensus at all levels to be effective. On an encouraging note, high levels of national commitment are now seen in Pakistan—what remains to be seen is if this commitment will translate to all levels and action.

:: Nigeria has made remarkable strides against the wild poliovirus, with the last case seen over three years ago—meaning that the entire continent has likely been Wild Poliovirus (WPV) type 3 free since September 2016. However, the Circulating Vaccine Derived Polio Virus (cVDPV) situation is extremely worrying. There appears to be a lack of political support and slow and poor-quality responses, exacerbated by a reluctance, in some countries, to declare an emergency and limited availability/access of trained experts to deploy rapidly. The budget reduction in the country is a real risk, given the increase in outbreaks and lack of ability to rapidly control them. The announcement of the certification of WPV3 eradication will need to be carefully communicated taking into account cVDPV outbreaks .

:: The world is facing more cVDPV2s than our modeling predicted at the time of the switch. Three years after the global withdrawal of Oral Poliovirus type 2 from National immunization programmes, the population mucosal immunity against type 2 poliovirus has waned dramatically. While monovalent OPV type 2 (mOPV2) is the only tool currently available to stop these outbreaks, the programme is now facing two challenges: i) the stockpile is being depleted and ii) the use of mOPV2 is seeding new VDPV2 outbreaks. A new vaccine that is less likely to revert to neurovirulence and cause outbreaks, the novel OPV (nOPV), is showing great promise in clinical trials and its use will be expedited under WHO’s Emergency Use License (EUL), but time will be needed to scale up production to phase out the use of mOPV2 altogether. Financing is a big challenge, as funds are not available currently. With the number of outbreaks higher than expected, funds are being pulled from preventative SIAs, which of course raises other risks. (GPEI lacks flexible funding). To ensure the responses being conducted are as effective as possible, new guidelines are being put into action to ensure rapid access to technical expertise as well as local financing…

[Excerpt from POB Discussion]
Seth Berkley (POB member, CEO, Gavi) asked GPEI to provide further details on plan B if nOPV doesn’t work or is delayed. We all know that scaling up vaccine production is a challenge and not without risks of delays. He agreed with Dr Elias that WHO needs to ensure EUL is ready to be rolled out without any problems. He expressed his concern that he felt the POB needed to really discuss, as a Board, what needs to be done to turn things around and get eradication back on track. He also noted his concern that the current investment case is based on a strategy that assumed the last case of WPV would be in 2020, which is now no longer a feasible assumption. He expressed that he thought donors would be expecting GPEI to be rethinking its approach in light of this and coming up with new ideas, and that the POB, as highest-level body, should ensure that happens. This means rethinking strategies, not just towing the line that getting access will solve all our problems. Dr Berkley requested that the management report done by McKinsey be circulated to the POB as a critical input to this rethink and prior to any POB visits to the field.


Editor’s Note:
WHO has posted a refreshed emergencies page which presents an updated listing of Grade 3,2,1 emergencies as below.

WHO Grade 3 Emergencies [to 19 Oct 2019]

Democratic Republic of the Congo
:: Statement on the meeting of the International Health Regulations (2005) Emergency Committee for Ebola virus disease in the Democratic Republic of the Congo on 18 October 2019
:: Ebola Outbreak in DRC 63: 15 October 2019
[See Ebola above for detail]

Syrian Arab Republic
:: WHO gravely concerned about humanitarian situation in northeast Syria 13 October 2019
[See Milestones above for detail]

Mozambique floods – No new digest announcements identified
Nigeria – No new digest announcements identified
Somalia – No new digest announcements identified
South Sudan – No new digest announcements identified
Yemen – No new digest announcements identified


WHO Grade 2 Emergencies [to 19 Oct 2019]

Iran floods 2019 – No new digest announcements identified
Libya – No new digest announcements identified

:: Middle East respiratory syndrome coronavirus (MERS-CoV) – The Kingdom of Saudi Arabia
18 October 2019
From 1 through 30 September 2019, the National IHR Focal Point of Saudi Arabia reported 4 additional laboratory-confirmed cases of Middle East respiratory syndrome (MERS-CoV) infection and one associated death…

:: Bi‐weekly Situation Report 20 – 10 October 2019
There are an estimated 911,566 Rohingya refugees in Cox’s Bazar, according to the latest ISCG situation report (August 2019). This includes 34,172 refugees from Myanmar who registered before 31st August 2017. All refugees, including new arrivals, face compounding vulnerabilities, including in health. WHO has been responding to this crisis since September 2017…
A comprehensive review of the work of WHO Health field monitors has taken place, and activities were subsequently revised with the aim of increasing catch up for drop-out and left-out children (through child registration validation) and improvements of reporting/feedback mechanisms…
A campaign strategy for the upcoming Measles-Rubella Supplementary Immunization Activity (MR SIA) in 2020 is under development, as well as implementation plans for major recommendations of the quarterly review meeting which took place in collaboration with the national programme.

occupied Palestinian territory
:: WHO Report – Right to health 2018 Regional Office for the Eastern Mediterranean
…This report analyses some of the major barriers to realization of the right to health for
Palestinians in the occupied Palestinian territory. It focuses on four main topics: provision and
availability of healthcare; access to healthcare; underlying determinants of health; and health
attacks. The West Bank and Gaza Strip have been under Israeli military occupation for over 50 years…

:: Vaccination campaign against cholera kicks off in Sudan
Attributable to the Federal Ministry of Health in Sudan, WHO and UNICEF
KHARTOUM, 11 October 2019 – “Sudan has launched an oral cholera vaccination campaign in response to the ongoing outbreak of cholera. More than 1.6 million people aged one year and above in the Blue Nile and Sinnar states will be vaccinated over the coming five days.
“The announcement of the Federal Ministry of Health in Sudan on the cholera outbreak last month allowed national and state authorities, and health partners, to act quickly and respond to the outbreak…

Afghanistan – No new digest announcements identified
Angola – No new digest announcements identified
Burkina Faso [in French] – No new digest announcements identified
Burundi – No new digest announcements identified
Cameroon – No new digest announcements identified
Central African Republic – No new digest announcements identified
Ethiopia – No new digest announcements identified
HIV in Pakistan – No new digest announcements identified
Iraq – No new digest announcements identified
Malawi floods – No new digest announcements identified
Measles in Europe – No new digest announcements identified
Niger No new digest announcements identified
Ukraine – No new digest announcements identified
Zimbabwe – No new digest announcements identified


WHO Grade 1 Emergencies [to 19 Oct 2019]

:: Kenya takes vital step against cervical cancer and introduces HPV vaccine into routi…
18 October 2019
With President Uhuru Kenyatta leading the way, Kenya today joins an increasing number of African countries taking a vital step against a common cause of death among women – in the country and the region – by introducing the human papilloma virus (HPV) vaccine against cervical cancer into its routine immunization schedule…

Chad – No new digest announcements identified
Djibouti – No new digest announcements identified
Mali – No new digest announcements identified
Namibia – viral hepatitis – No new digest announcements identified
Tanzania – No new digest announcements identified


UN OCHA – L3 Emergencies
The UN and its humanitarian partners are currently responding to three ‘L3’ emergencies. This is the global humanitarian system’s classification for the response to the most severe, large-scale humanitarian crises. 
Syrian Arab Republic
:: Syria ǀ Flash Update #7, Humanitarian impact of the military operation in north-eastern Syria, 16 – 18 October 2019

Yemen – No new digest announcements identified


UN OCHA – Corporate Emergencies
When the USG/ERC declares a Corporate Emergency Response, all OCHA offices, branches and sections provide their full support to response activities both at HQ and in the field.
Editor’s Note:
Ebola in the DRC has bene added as a OCHA “Corporate Emergency” this week:
CYCLONE IDAI and Kenneth – No new digest announcements identified
EBOLA OUTBREAK IN THE DRC – No new digest announcements identified

The Sentinel

Human Rights Action :: Humanitarian Response :: Health :: Education :: Heritage Stewardship ::
Sustainable Development
Week ending 12 October 2019

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

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

PDF: The Sentinel_ period ending 12 Oct 2019

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