Ebola

Ebola virus disease – Democratic Republic of the Congo
25 April 2019
This past week witnessed a notable escalation of security incidents surrounding the Ebola virus disease (EVD) response efforts. On 19 April, an attack on a hospital in Katwa by armed militia resulted in the tragic death of Dr Richard Mouzoko Kiboung, a WHO epidemiologist, and the injury of two other healthcare workers. To ensure the safety of all outbreak responders, Ebola response activities have been temporarily halted in some high-risk health areas until security measures can be reinforced.

WHO, the UN, and the government of the Democratic Republic of the Congo are actively collaborating to review current strategic and operational security measures to ensure the protection of healthcare workers in the field, and improve effective coordination and information sharing amongst all security elements covering the response. Existing operational security measures continue to be implemented and strengthened as well, including the establishment of security perimeters around the residences of EVD response personnel, increasing security at fixed locations, enhancing the joint quick response team (QRT) capacities of local police and UN security forces, and ensuring staff compliance with tracking procedures and adherence to curfew. These measures and other security risk management processes will be continually updated to reflect the needs of the evolving security situation on the ground.

In addition to revising security measures, efforts in community outreach through direct dialogue with various community leaders are also being intensified. Since January, there has been a notable increase in community resistance incidents, primarily around Katwa and Butembo. Incidents in April are anticipated to reach or go beyond March levels. As gaining community understanding and acceptance is integral to our ability to mount an effective outbreak response, community engagement efforts remain a significant element of our response to alleviate future security risks to healthcare workers, develop and increase local community capacity to ensure continuity of response operations, and improve the overall security situation in EVD hotspot areas…

Emergencies

POLIO
Public Health Emergency of International Concern (PHEIC)
Polio this week as of 24 April 2019
:: Starting 24 April to 30 April 2019, World Immunization Week is celebrated across the world. This year’s theme is Protected Together: Vaccines Work!, which aims to spotlight the important role parents, communities, health workers, innovators and everyday vaccine heroes play in ensuring everybody benefits from the lifesaving vaccines.

Summary of new viruses this week:
:: Afghanistan—three wild poliovirus type 1 (WPV1) cases and three WPV1-positive environmental samples;
:: Pakistan—advance notification of two wild poliovirus type 1 (WPV1) cases and 13 WPV1-positive environmental samples;
:: Nigeria—two circulating vaccine-derived type 2 (cVDPV2) cases and six cVDPV2-positive environmental samples;
:: Democratic Republic of Congo — one cVDPV2 case and two cVDPV2 community isolates; :: Somalia—one cVDPV2 case and one cVDPV2 contact isolate.

::::::

New York Times
http://www.nytimes.com/
Accessed 27 Apr 2019
Asia Pacific
Polio Vaccinator Is Shot and Killed in Pakistan
April 25
The woman was part of a vaccination campaign. Another worker in her team was injured. A total of three polio workers have been killed this week as unfounded rumors against vaccines spread.
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 27 Apr 2019]

Democratic Republic of the Congo
:: Zero Palu: Each household, each community, accelerate the commitment in the fight against malaria in the Democratic Republic of the Congo
25 April 2019 Kinshasa — The Democratic Republic of Congo has joined forces with the entire international community to commemorate World Malaria Day, under the theme: ‘Zero palu! I’m in !’. Read the story in French
:: 38: Situation report on the Ebola outbreak in North Kivu 24 April 2019
:: DONs – Ebola virus disease – Democratic Republic of the Congo 25 April 2019

Syrian Arab Republic
:: WHO-supported vaccination campaign to immunize 2.8 million children against vaccine-preventable diseases
22 April 2019, Damascus, Syria ‒ Over the next 6 days, the World Health Organization (WHO), in cooperation with the Syrian Ministry of Health and UNICEF, will conduct a series of national immunization days to immunize children under the age of 5 against vaccine-preventable diseases, including tuberculosis, pertussis, diphtheria, polio, tetanus, hepatitis B, haemophilus influenza, measles, mumps and rubella.
WHO aims to vaccinate approximately 2.8 million children under the age of 5 in 13 governorates in Syria. The campaign will focus on reaching almost 250 000 children who were not vaccinated during previous campaigns. Over 6800 vaccinators and 2487 mobile medical teams will be deployed to 900 public health centres and 1268 temporary vaccination posts. WHO is providing technical support to the Ministry of Health and covering the operational costs of the campaign…

Yemen
:: Government of Japan support to WHO response in Yemen 24 April 2019
…n 2019, donations from Japan will continue to allow WHO to scale up its capacity-building actives for national health care personnel. These activities will target thousands of health professionals across the country, building on their capacity to deliver pre-hospital care…

Bangladesh – Rohingya crisis – No new digest announcements identified
Cyclone Idai – No new digest announcements identified
Myanmar – No new digest announcements identified
Nigeria – No new digest announcements identified
Somalia – No new digest announcements identified
South Sudan – No new digest announcements identified

::::::

WHO Grade 2 Emergencies [to 27 Apr 2019]

Brazil (in Portugese)
:: Últimas notícias OPAS lança iniciativa que prioriza combate à malária em municípios onde se concentram maioria dos casos 
26 de abril de 2019 – Uma nova iniciativa da Organização Pan-Americana da Saúde (OPAS) tem como objetivo abordar a carga da malária na região das Américas, onde o número de casos é mais concentrado. Chamado de “Municípios eliminando a malária”, o projeto se centrará em reunir atores chaves com o fim de apoiar os esforços locais para adotar medidas efetivas contra a doença.

Cameroon – No new digest announcements identified
Central African Republic – No new digest announcements identified
Ethiopia – No new digest announcements identified
Iraq – No new digest announcements identified
Libya – No new digest announcements identified
MERS-CoV – No new digest announcements identified
Niger – No new digest announcements identified
occupied Palestinian territory – No new digest announcements identified
Sudan – No new digest announcements identified
Ukraine – No new digest announcements identified
Zimbabwe – No new digest announcements identified

::::::

WHO Grade 1 Emergencies [to 27 Apr 2019]
Afghanistan – No new digest announcements identified
Chad – No new digest announcements identified
Indonesia – Sulawesi earthquake 2018 – No new digest announcements identified
Kenya – No new digest announcements identified
Lao People’s Democratic Republic – No new digest announcements identified
Mali – No new digest announcements identified
Namibia – viral hepatitis – No new digest announcements identified
Peru – No new digest announcements identified
Philippines – Tyhpoon Mangkhut – 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 – No new digest announcements identified
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.
CYCLONE IDAI
:: 26 April 2019 Southern Africa: Tropical Cyclone Kenneth Flash Update No. 3 …

The Sentinel

Human Rights Action :: Humanitarian Response :: Health :: Education :: Heritage Stewardship ::
Sustainable Development
__________________________________________________
Week ending 20 April 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
Editor
GE2P2 Global Foundation – Governance, Evidence, Ethics, Policy, Practice
david.r.curry@ge2p2center.net

PDF: The Sentinel_ period ending 20 Apr 2019

Contents
:: 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]

Heritage Stewardship – Notre-Dame de Paris

UNESCO solemnly expresses the support of the international community to the President of the French Republic following the fire at Notre-Dame
19 April 2019
Paris, Elysée, 19 April 2019- Audrey Azoulay, Director-General of UNESCO, H.E Lee Byong-hyun, President of the executive Board and H.E Zohour Alaoui, president of the general Conference, accompanied by a delegation of ambassadors representing UNESCO’s Member States, bestowed this morning to the President of the Republic of France, Emmanuel Macron, a solemn declaration from the Organization’s Executive Board.

Through this unprecedented approach, UNESCO wishes to express the solidarity of the international community in the face of the tragic fire at Notre-Dame de Paris Cathedral, which is part of the “Paris, Rives de la Seine” site, inscribed as a UNESCO World Heritage Site since 1991…

UNESCO protects heritage worldwide, including endangered heritage. Since 2015, emergency missions have been deployed by UNESCO in more than 50 countries around the world to safeguard and rehabilitate heritage following disasters:

.

Statement by the Executive Board of UNESCO following the fire at Notre-Dame Cathedral in Paris, France
16 April 2019
We, the Member States of UNESCO, meeting today in the Executive Board at UNESCO Headquarters in Paris, wish to solemnly express our deep emotion at the fire that affected Notre-Dame Cathedral in Paris yesterday.

This tragedy reminds us that through the world heritage, it is the bond that unites humanity that is at stake. UNESCO stands always alongside the heritage, as an expression of the values we all share.

Notre-Dame Cathedral, in the heart of Paris, is a powerful symbol not only of France, but of humanity as a whole because of its exceptional architecture, its spiritual function, its place in history and its literary and artistic legacy. This is the outstanding universal value recognized and honoured by UNESCO in 1991, when it included the Cathedral in the World Heritage List.

This episode, like all the other episodes of inestimable loss and destruction that have unfortunately marked our history, reminds us that the heritage is vulnerable and that, accordingly, the commitment of the international community remains crucial for its protection and safeguarding. This is an opportunity to reaffirm our unwavering attachment to the protection of the heritage, an objective that the United Nations has set itself through UNESCO.

We, the Member States, express our full solidarity and determination to act. We share the grief of all those who have lost a majestic figure in the collective imagination of peoples around the world as a result of the destruction, which was fortunately stopped by the heroic efforts of the emergency
services.

We stand resolutely with the French authorities to support the work to restore Notre-Dame Cathedral, and to share UNESCO’s expertise in this task, in line with its mandate for the protection of the world heritage. For us and for future generations, it is our responsibility to ensure a future for our past.

Access to Medicines

At WHO Forum on Medicines, countries and civil society push for greater transparency and fairer prices
13 April 2019 News release
At a global forum on fair pricing and access to medicines, delegates from governments and civil society organizations called for greater transparency around the cost of research and development as well as production of medicines, to allow buyers to negotiate more affordable prices.

The forum, co-hosted by the World Health Organization (WHO) and the Government of South Africa, aimed to provide a global platform for frank discussion among all stakeholders – including governments, civil society organizations and the pharmaceutical industry – in order to identify strategies to reduce medicine prices and expand access for all.

The affordability of medicines has long been a concern for developing countries, but today it is also a global one. Each year, 100 million people fall into poverty because they have to pay for medicines out-of-pocket. High-income countries’ health authorities are increasingly having to ration medicines for cancer, hepatitis C and rare diseases. The problem extends to older medicines whose patents have expired, such as insulin for diabetes.

“Medical innovation has little social value if most people cannot access its benefits,” said Dr Mariângela Simão, WHO Assistant Director General for Medicines and Health Products. “This is a global human rights issue – everyone has a right to access quality healthcare.”

A report commissioned by WHO in 2017 showed that the cost of production of most medicines on WHO’s Essential Medicines List was a small fraction of the final price paid by governments, patients or insurance schemes. Some delegates at the forum noted that a lack of transparency around prices paid by governments means that many low- and middle-income countries pay higher prices for certain medicines than wealthier countries do.

There was consensus that countries can take an initial step towards fostering greater transparency by sharing price information. Countries from the so-called Beneluxa network have already joined forces to share such information, and the results have been promising. The data highlights discrepancies in what different countries are paying and can serve as a powerful tool to negotiate reduced prices. WHO’s database on vaccine markets and shortages – MI4A – was also highlighted at the forum as a useful tool to achieve competitive vaccine prices.

The event highlighted other successful examples of countries’ collaboration around achieving more affordable medicine prices; these include pooled procurement and voluntary sharing of policies. If several countries in the same region purchase medicines as a block, they can negotiate reduced prices due to the larger volume of medicines purchased. And European countries led by Austria have been sharing different policies to expand access to medicines through the WHO-supported PPRI (Pharmaceutical Pricing and Reimbursement Policies).

Industry bodies at the forum expressed support for the goal of access to medicines for all, and expressed their commitment to the Sustainable Development Agenda, which calls for partnership with the private sector to address global challenges such as access to medicines.

WHO will launch a public online consultation in the coming weeks to collect views and suggestions for a definition of what actually constitutes a ‘fair price’ from relevant stakeholders.

“Global Fragility Landscape” – World Bank

WORLD BANK GROUP – STRATEGY FOR FRAGILITY, CONFLICT AND VIOLENCE 2020–2025
Concept Note – April 2019 :: 14 pages
OVERVIEW
Fragility, conflict, and violence (FCV) has become the new development frontier. By 2030, at least half of the world’s poor people will be living in fragile and conflict-affected settings.1 The impact of FCV is particularly profound on the most vulnerable people and communities, whose livelihoods and economic opportunities are threatened. The global fragility landscape has worsened significantly, with more violent conflicts than at any time in the past 30 years; the largest forced displacement crisis since World War II; high levels of interpersonal and gang violence; and conflicts driving 80 percent of all humanitarian needs.

Today, conflict and violence impact more civilians than at any point over the last two decades. FCV
situations have a clear impact on poverty and, strikingly, the extreme poverty rate is rising only in fragile countries.2 In many contexts, this is due to large-scale violence, a collapse in basic services delivery, and the weakening of core state functions—dynamics that characterize most FCV situations and represent both a humanitarian and development challenge that calls for comprehensive and coordinated international responses. It will prove impossible to achieve the World Bank Group’s twin goals of ending extreme poverty and boosting shared prosperity unless fragility, conflict, and violence are tackled.

For these reasons, addressing FCV has become the core business of the World Bank Group (WBG)…

Building on the progress made over the past years, notably under IDA18 as well as in a number of MICs, the WBG’s FCV Strategy aims to identify a conceptual and operating framework and a set of priority actions over the next five years, with the ultimate goal of developing a more systematic
approach to strengthen the WBG’s support to client countries and vulnerable populations.

Recognizing the suffering of those affected by FCV, and lost opportunities that can span generations, this comprehensive Strategy will more clearly identify both what to do and how the institution can adapt to deliver to those in greatest need. It will discuss how to scale-up development efforts to address the underlying drivers of FCV and enhance the WBG’s impact in FCV settings.

This Concept Note outlines proposed areas of focus for the FCV Strategy. It outlines the global and institutional FCV context; explains the rationale for, and objectives of, the Strategy; presents key
focus areas; introduces preliminary options to address operational challenges; and lays out the Strategy development process…

Press Release
World Bank Group Launches Worldwide Consultations on Future Strategy for Fragility, Conflict and Violence
WASHINGTON, April 16, 2019 — The World Bank Group today announced the launch of global consultations to inform the development of its first formal strategy for Fragility, Conflict and Violence (FCV). Consultations will be held in more than 30 countries, covering all World Bank Group regions, between April and June 2019, with a final strategy expected in November.

The consultations will focus on gathering perspectives in countries faced with diverse FCV challenges, as well as in countries that support World Bank Group programs in FCV settings. They will aim to capture lessons learned and best practices for reducing fragility, conflict and violence and promoting peace and prosperity. Inputs gathered from representatives of government, civil society organizations, international partners, the private sector and others, will be integrated into a comprehensive operational strategy focused on addressing the drivers of fragility and maximizing the World Bank Group’s support for affected people and communities.

The development of a World Bank Group FCV strategy comes at a pivotal time: By 2030, at least half of the world’s poor will live in fragile and conflict-affected settings. The strategy will therefore support the World Bank Group’s goals of ending extreme poverty and promoting shared prosperity. The strategy is being developed jointly by the International Finance Corporation (IFC), the Multilateral Investment Guarantee Agency (MIGA) and the World Bank. It will cover the period from 2020 to 2025.

“To achieve our goal of ending extreme poverty, we must focus on people living in countries that suffer from conflict and fragility,” said World Bank CEO Kristalina Georgieva. “Our new strategy aims to address the underlying causes of fragility and invest in the long-term development that helps create the conditions for peace and prosperity”.

The consultations will be conducted in two phases: From April to June 2019, stakeholders will be asked to provide feedback on the FCV strategy concept through face-to-face meetings and by completing an online questionnaire. From August to September 2019, a draft of the proposed FCV strategy will be shared online for feedback. Throughout the process, the public is invited to share questions and comments by email and via social media channels, using the hashtag #fragility2stability…

Featured Journal Content

The Lancet
Apr 20, 2019 Volume 393 Number 10181 p1569-1668, e38
https://www.thelancet.com/journals/lancet/issue/current
Articles
The relationships between democratic experience, adult health, and cause-specific mortality in 170 countries between 1980 and 2016: an observational analysis
Thomas J Bollyky, Tara Templin, Matthew Cohen, Diana Schoder, Joseph L Dieleman, Simon Wigley
Open Access
Summary
Background
Previous analyses of democracy and population health have focused on broad measures, such as life expectancy at birth and child and infant mortality, and have shown some contradictory results. We used a panel of data spanning 170 countries to assess the association between democracy and cause-specific mortality and explore the pathways connecting democratic rule to health gains.

Methods
We extracted cause-specific mortality and HIV-free life expectancy estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 and information on regime type from the Varieties of Democracy project. These data cover 170 countries and 46 years. From the Financing Global Health database, we extracted gross domestic product (GDP) per capita, also covering 46 years, and Development Assistance for Health estimates starting from 1990 and domestic health spending estimates starting from 1995. We used a diverse set of empirical methods—synthetic control, within-country variance decomposition, structural equation models, and fixed-effects regression—which together provide a robust analysis of the association between democratisation and population health.

Findings
HIV-free life expectancy at age 15 years improved significantly during the study period (1970–2015) in countries after they transitioned to democracy, on average by 3% after 10 years. Democratic experience explains 22·27% of the variance in mortality within a country from cardiovascular diseases, 16·53% for tuberculosis, and 17·78% for transport injuries, and a smaller percentage for other diseases included in the study. For cardiovascular diseases, transport injuries, cancers, cirrhosis, and other non-communicable diseases, democratic experience explains more of the variation in mortality than GDP. Over the past 20 years, the average country’s increase in democratic experience had direct and indirect effects on reducing mortality from cardiovascular disease (−9·64%, 95% CI −6·38 to −12·90), other non-communicable diseases (−9·14%, −4·26 to −14·02), and tuberculosis (−8·93%, −2·08 to −15·77). Increases in a country’s democratic experience were not correlated with GDP per capita between 1995 and 2015 (ρ=–0·1036; p=0·1826), but were correlated with declines in mortality from cardiovascular disease (ρ=–0·3873; p<0·0001) and increases in government health spending (ρ=0·4002; p<0·0001). Removal of free and fair elections from the democratic experience variable resulted in loss of association with age-standardised mortality from non-communicable diseases and injuries.

Interpretation
When enforced by free and fair elections, democracies are more likely than autocracies to lead to health gains for causes of mortality (eg, cardiovascular diseases and transport injuries) that have not been heavily targeted by foreign aid and require health-care delivery infrastructure. International health agencies and donors might increasingly need to consider the implications of regime type in their efforts to maximise health gains, particularly in the context of ageing populations and the growing burden of non-communicable diseases.

Funding
Bloomberg Philanthropies and the Bill & Melinda Gates Foundation.

Education

Islamic Development Bank and Global Partnership for Education Launch Alliance to Address Global Education Crisis
The expanding support among world leaders for providing quality education to children in the world’s poorest countries received a major boost today as the Global Partnership for Education (GPE) and the Islamic Development Bank (IsDB) agreed to a multi-pronged collaboration that will broaden and deepen GPE’s engagement with new partners.
15 April 2019
The expanding support among world leaders for providing quality education to children in the world’s poorest countries received a major boost today as the Global Partnership for Education (GPE) and the Islamic Development Bank (IsDB) agreed to a multi-pronged collaboration that will broaden and deepen GPE’s engagement with new partners.

Dr. Mohamed Nouri Jouini, IsDB’s Vice President of Partnership Development, Julia Gillard, GPE Board Chair and Alice Albright, GPE’s Chief Executive Officer, today signed a letter of intent outlining the new collaboration, which aims to bolster developing countries’ access to critical financing to strengthen education systems, reduce the number of out-of-school children and enable more children to learn and thrive.

“This exciting new alliance comes at an urgent moment when hundreds of millions of children around the world are not in school and many more are in school, but not learning,” said Julia Gillard, GPE’s Board Chair and former Prime Minister of Australia. “It is a strategic step forward in the campaign to end the global education crisis. The Islamic Development Bank will provide vital political, technical and financial leadership in the education sector and is a privileged partner for GPE. Together we can achieve impressive progress.”

…As part of the collaboration, IsDB will help leverage new funding through the GPE Multiplier, an innovative funding mechanism that provides low- and lower middle-income countries one dollar from GPE for every three dollars they raise from other sources. IsDB will also work with GPE to strengthen coordination and policy dialogue among education groups in developing countries and become an alternate member of the GPE Board of Directors.

The two organizations also agreed to jointly promote greater political commitment for education through global, regional and country-level advocacy and communications efforts, and raise the political profile of education.

“Developing countries understand that education is a pre-requisite to nation building, a game-changer for their economic prosperity, social progress and political stability,” said Alice Albright, GPE’s Chief Executive Officer. “This new partnership between GPE and IsDB will help mobilize more resources, particularly through the GPE Multiplier, so we can extend learning to all children, especially those from vulnerable and marginalized communities.”

In addition to today’s letter of intent, GPE and IsDB each endorsed an agreement last week with several other partners to form a Global Education Coalition, whose goal is to enroll and retain 28 million out-of-school children in member countries of the Organization of Islamic Cooperation (OIC) by 2030. The coalition’s goal is to meet the Sustainable Development Goal for universal and equitable education by 2030.

Featured Journal Content

PLoS Neglected Tropical Diseases
http://www.plosntds.org/
(Accessed 20 Apr 2019)
Policy Platform
Combating infectious disease epidemics through China’s Belt and Road Initiative
Jin Chen, Robert Bergquist, Xiao-Nong Zhou, Jing-Bo Xue, Men-Bao Qian
| published 18 Apr 2019 PLOS Neglected Tropical Diseases
https://doi.org/10.1371/journal.pntd.0007107
Introduction
On March 17, 2017, the United Nations (UN) Security Council, backed by the consensus of its 193 member states, adopted Resolution 2344, which calls for strengthening regional economic cooperation through China’s Belt and Road (also called Silk Road) Initiative (BRI) [1]. Based on the cornerstones of peace and cooperation, openness and inclusiveness, and mutual learning and sharing benefit, this initiative was proposed by the Chinese government and is participated in by various parties. Its goal is to provide fundamental solutions to boost global economic development through enhancing policy coordination, facility connection, unimpeded trade, financial integration, and people-to-people bonds. The UN Secretary-General, Mr. António Guterres, acknowledged that the BRI tallies with, and complements, the Sustainable Development Goals (SDGs) in terms of promoting inclusive development, strengthening exchange between countries, and benefiting people within the initiative’s scope [2]. The BRI currently involves 69 countries (mainly those named in the initial Belt and Road outreach and those having signed cooperation agreements), 70% of the world population in total, 30% of the global gross domestic product, and 75% of the world’s energy reserves [2–4].

Although the BRI is primarily economic, it also includes important health dimensions. The Healthy China 2030 plan, promulgated in 2016, considers health as one of the national policy priorities, and the Memorandum of Understanding with the World Health Organization (WHO), signed in 2017, which promotes global health security and development along the terms of the initiative [5, 6]. Based on these agreements, the building of a Health Silk Road has become a core task leading to an extensive engagement in global health development [7, 8]…

The world is currently witnessing increasingly complex epidemics as well as natural disasters with a rising impact on both human health and the economy [1]. Growing commercial trade and more frequent personal exchange following the implementation of the BRI may amplify infectious disease transmission or inadvertently introduce emerging infectious diseases, leading to an increased burden for local medical systems. Moreover, infectious diseases resulting from poverty disproportionately affect poor and marginalised communities, which remains a more serious hurdle to achieving the SDGs and UHC [9, 10]. This is the reason why the initiative has made the need to combat infectious diseases a priority for social and economic development. The implementation of the BRI is expected to facilitate progress in eliminating infectious diseases such as the acquired immunodeficiency syndrome (AIDS) caused by the human immunodeficiency virus (HIV), tuberculosis (TB), malaria, and 17 neglected tropical diseases (NTDs), which make up SDG…

The purpose of this paper is to analyse the existing spectrum of the main infectious diseases in epidemics (based on the Global Burden of Diseases [GBD] study of 2016 [14, 15]), the potential negative effect on the economy, and the challenges to elimination. The paper also aims to explore opportunities and a feasible approach of global disease control with specific consideration of the BRI…

…Challenges regarding infectious diseases in Belt and Road countries
The spectrum of local infectious diseases
The thrust of the BRI has two main directions: the Silk Road, which connects China by land with European countries via central and western Asia and the Middle East, and the 21st Century Maritime connection across the South China Sea, the Indian Ocean, and the Mediterranean to reach sub-Saharan Africa, following the lead of the great Chinese Ming dynasty admiral and explorer Zheng He. These two land and maritime directions from China follow five routes [1].

The Health Silk Road, a core task of the BRI, encourages health development and security along the Road. The 2030 Agenda for SDGs also calls for halting HIV/AIDS, TB, and malaria as well as the termination of the ravages caused by the 17 NTDs by 2030 [13]. Altogether, according to the 2016 GBD study, the cost expressed in disability-adjusted life years (DALYs) amounts to an estimated 63.31 million (with substantial regional variations in the 69 countries), which currently accounts for 36.7% of the total toll of these diseases throughout the world [2, 14, 15].

The DALYs resulting from the ‘big three’ (HIV/AIDS, TB, and malaria) plus those due to the 17 NTDs along the route from China towards Southeast Asia and South Asia (excluding China) amounts to 34.81 million DALYs and are mainly due to HIV/AIDS, TB, and malaria in addition to dengue and intestinal nematode infections. The infectious disease epidemics in countries along the 21st Century Maritime Silk Road are mainly the same set of diseases plus schistosomiasis, which together generate 20.46 million DALYs. The China–central Asia–Russia–Europe route, involving countries in central Asia and eastern Europe, includes many of the same diseases as well as some additional ones—i.e., intestinal nematode infections, cystic echinococcosis, foodborne trematodiases, and cysticercosis—which together cause 2.39 million DALYs. A total of 0.50 million DALYs in the countries along the China–central Asia–west Asia axis are due to TB, leishmaniasis, malaria, HIV/AIDS, intestinal nematode infections, and cystic echinococcosis (Fig 1). Such high endemicity of infectious diseases in the region is a serious hurdle for the global elimination agenda. The DALYs due to these diseases vary across the regions, and so do the collaborative priorities and their expected potential impacts. For example, cooperative actions could lead to regional elimination of lymphatic filariasis (LF) along the Maritime Silk Road while simultaneously having a significant impact on malaria, dengue, intestinal helminth infections, schistosomiasis, and TB [16, 17].

…Conclusion and implication
A major part of the BRI focuses on support and communication to build a new mechanism for global health, prioritising the prevention and control of infectious diseases, preventing outbreaks becoming epidemics, and providing UHC, thus overcoming the vicious circle of poverty and ill health. China will strengthen cooperation with particular regard to the control of TB, echinococcosis, and dengue within the 69 countries and deliver enhanced communication and research leading to the elimination of LF, malaria, and schistosomiasis. Based on opportunities the BRI provides and the cooperative experience gained, the framework shown in Fig 3 should become available and applicable to the response to these challenges by sharing information, joint control, and technical know-how.

UHC and response to the challenges posed by infectious disease epidemics are vital for the new era, with health considerations at the core of the BRI. Despite the serious threats of the infectious disease epidemics, the emphasis on health through the BRI puts us in an excellent position to achieve the health-related aspects of the SDGs by implementing the Health Silk Road concept of improved life through health-related communication. Based on technical experience in this field, mature collaborating mechanisms, and the provision of financial support, the strategies in the context of the BRI reinforce the various countries’ extensive engagement in combating infectious disease epidemics.

Emergencies

POLIO
Public Health Emergency of International Concern (PHEIC)
Polio this week as of 17 April 2019
:: Co-chairs of Immunization Management Group (IMG) announced that the global goal set out in 2013 of 126-OPV using countries to introduce 1 dose of IPV in their immunization programme has been achieved.
:: Eminent Islamic religious scholars from Afghanistan and Pakistan came together in Muscat, Oman for the first ever joint Ulama Conference, under the aegis of the Islamic Advisory Group (IAG). for polio eradication The IAG convened religious scholars in a bid to appreciate their value as community leaders and secure bilateral support for polio eradication efforts across the joint poliovirus transmission corridors. At the end of the two-day conference, the scholars issued a joint declaration in support of the polio efforts. Watch the Opening Session here. Read the declaration here.
:: In keeping with the recommendations of the Emergency Committee under the International Health Regulations (IHR), Afghanistan and Pakistan have introduced an all-age polio vaccination for travelers crossing international borders to increase general population immunity the common wild poliovirus transmission corridor. Read more.

Summary of new viruses this week:
:: Afghanistan—three wild poliovirus type 1 (WPV1)-positive environmental samples;
:: Pakistan—three WPV1-positive environmental samples;
:: Nigeria—one circulating vaccine-derived type 2 (cVDPV2) case and seven cVDPV2-positive environmental samples.

::::::

Joining hands across the border
All travellers crossing the border between Pakistan and Afghanistan are vaccinated against polio, regardless of age
GPEI  16/04/2019
On both sides of the historical 2640-kilometre-long border between Pakistan and Afghanistan, communities maintain close familial ties with each other. The constant year-round cross border movement makes for easy wild poliovirus transmission in the common epidemiological block.

As a new tactic in their joint efforts to defeat poliovirus circulation, Afghanistan and Pakistan have introduced all-age polio vaccination for travellers crossing the international borders in efforts to increase general population immunity against polio and to help stop the cross-border transmission of poliovirus. The official inauguration of the all-age vaccination effort took place on 25 March 2019 at the border crossings in Friendship Gate (Chaman-Spin Boldak) in the south, and in Torkham in the north…

…It is estimated that the Friendship Gate border alone receives a daily foot traffic of 30 000. Travellers include women and men of all ages, from children to the elderly.

Pakistan and Afghanistan first increased the age for polio vaccination at the border in January 2016, from children under five years to those up to 10 years old. The decision was in line with the recommendations of the Emergency Committee under the International Health Regulations (IHR) which declared the global spread of polio a “public health emergency of international concern”,

The all-age vaccination against polio at the border crossings serves a practical implementation of another recommendation of the IHR Committee: that Pakistan and Afghanistan should “further intensify cross­border efforts by significantly improving coordination at the national, regional and local levels to substantially increase vaccination coverage of travelers crossing the border and of high risk cross­border populations.

…As part of the newly introduced all-age vaccination, all people above 10 years of age who are given OPV at the border are issued a special card as proof of vaccination. The card remains valid for one year and exempts regular crossers from receiving the vaccination again. Children under 10 years of age will be vaccinated each time they cross the border.

Before all-age vaccination began at Friendship Gate and Torkham, public officials held extensive communication outreach both sides of the border to publicize the expansion of vaccination activities from children under 10 to all ages. Radio messages were played in regional languages, and community engagement sessions sensitized people who regularly travel across the border. Banners and posters were displayed at prominent locations….

::::::
::::::

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 20 Apr 2019]
Bangladesh – Rohingya crisis
:: Bi‐weekly Situation Report 7 – 11 April 2019

HIGHLIGHTS
:: Ten new diphtheria cases were reported in week 14, (1 confirmed, 9 suspected), bringing the total number of reported case-patients to 8 545.
:: To gain an understanding of how women and men perceive immunization in camps, WHO organized two focus group discussions.
:: Water Quality Surveillance round 10 has been started in all refugee areas.

Varicella Update
A total of 2161 varicella cases were reported this week via weekly report form (2783 cases in week 13).
Risk Communication
WHO organized, two separate focus group discussions (FGDs), one for only women of all ages, and another of only men of all ages, held at the Camp 14 in Ukhiya of the Cox’s Bazar district. This was to gain an understanding of how women and men perceive immunization in the camps. The questions were kept open-ended to understand perception and attitude related to importance of Immunization, importance of Immunization schedule and compliance, gaps in communication with respect to immunization. Observations from these FGDs revealed that everyone in both the groups had heard about necessity of immunization but did not have clear reasons to believe or act. People opted for it because it is a free service and they trust health workers. Absence of knowledge about relevance of complying with the immunization schedule and dangers of missing out on any vaccine was identified.

Cyclone Idai
:: Cyclone-affected communities in Zimbabwe being vaccinated against cholera
Campaign targets nearly 500,000 people in Chimanimani and Chipinge
HARARE, Zimbabwe, 16 April 2019 – An oral cholera vaccine (OCV) campaign targeting some 487,825 people began Tuesday in Zimbabwe in the two districts most affected by cyclone Idai.
During the campaign all residents of Chimanimani and Chipinge districts aged 12 months and older will receive the vaccine to protect them against cholera.
While there have been no reported cases of cholera in the cyclone-affected areas in Zimbabwe, the Zimbabwe Ministry of Health and Child Care is launching the campaign, with support from UNICEF and the World Health Organization (WHO), as a proactive, preventative measure.
Funded by Gavi, the Vaccine Alliance, more than 975 000 OCV doses will be administered in two rounds for full immunity. The second dose will be given approximately two weeks after the first…

Democratic Republic of the Congo
:: 37: Situation report on the Ebola outbreak in North Kivu  16 April 2019
:: Disease Outbreak News (DONs) – Ebola virus disease – Democratic Republic of the Congo
11 April 2019
[See Ebola above for detail]

Myanmar  – No new digest announcements identified
Nigeria – No new digest announcements identified
Somalia – No new digest announcements identified
South Sudan – No new digest announcements identified
Syrian Arab Republic – No new digest announcements identified
Yemen  – No new digest announcements identified

::::::
 
WHO Grade 2 Emergencies  [to 20 Apr 2019]
Brazil (in Portugese)
:: Últimas notícias – Cerca de 70 milhões de pessoas serão vacinadas durante a Semana de Vacinação nas Américas  18 de abril de 2019

Cameroon  – No new digest announcements identified
Iraq – No new digest announcements identified
Libya – No new digest announcements identified
occupied Palestinian territory  – No new digest announcements identified
Sudan – No new digest announcements identified
Central African Republic  – No new digest announcements identified
Ethiopia – No new digest announcements identified
MERS-CoV – 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 20 Apr 2019]
Afghanistan – No new digest announcements identified
Chad  – No new digest announcements identified
Indonesia – Sulawesi earthquake 2018  – No new digest announcements identified
Kenya   – No new digest announcements identified
Lao People’s Democratic Republic  – No new digest announcements identified
Mali  – No new digest announcements identified
Namibia – viral hepatitis  – No new digest announcements identified
Peru  – No new digest announcements identified
Philippines – Tyhpoon Mangkhut  – 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: Humanitarian Response in Al Hol camp, Situation report No. 2
 
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.
CYCLONE IDAI
:: 20 April 2019   Mozambique: Cyclone Idai & Floods Situation Report No. 16 (A …
:: 18 April 2019   Zimbabwe: Floods Situation Report No. 3, As of 17 April 2019

The Sentinel

Human Rights Action :: Humanitarian Response :: Health :: Education :: Heritage Stewardship ::
Sustainable Development
__________________________________________________
Week ending 13 April 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
Editor
GE2P2 Global Foundation – Governance, Evidence, Ethics, Policy, Practice
david.r.curry@ge2p2center.net

PDF: The Sentinel_ period ending 13 Apr 2019

Contents
:: 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]

Secretary-General, at Annual Youth Forum, Says Young People Must Be Partners in Decision-Making, Development to Do What Is Right for Humankind, Planet
SG/SM/19540-ECOSOC/6969
9 April 2019
Following are UN Secretary-General António Guterres’ remarks at the eighth annual Economic and Social Council Youth Forum, in New York today:
[Excerpts]
Good afternoon to all of you. I am delighted to see so many participants at this eighth annual Economic and Social Council Youth Forum — all committed to ensuring that the youth of today and tomorrow are empowered, included and equal….

Right now, our world is faced with a myriad of tests: a climate crisis; protracted conflicts; unsustainable levels of youth unemployment; growing disparities between rich and poor; a clampdown on dissent; and strong opposition to our march for gender equality. Unless we face our social, economic and environmental challenges head on, we will not achieve the Sustainable Development Goals and the world will not be better. Many lives will be lost and the once in a generation opportunity we have to end poverty and bring lasting prosperity for all on a healthy planet will have been squandered.

Each of these challenges has one common denominator — the need for those in power to live up to their responsibilities; to do what is right for people and planet alike. That is why I am so pleased to see so many committed young people with us here today. I know you are not a homogenous group and young people are not immune to engaging in the negative trends in our societies. But more often than not, young people in our world today are a lightning rod for change.

You show the courage and persistence that is often lacking among older generations. And you can imagine that I know a little bit about older generations. Because it is your future, your livelihoods, your freedom, your security, your environment, you do not and you must not take no for an answer. In the United Nations, you have a partner that will accompany you on this journey towards a more peaceful, just and prosperous world.

Last September, we launched the United Nations Youth Strategy — and through my Youth Envoy, that is here on my right hand side, with young people and with partners across the United Nations system, we are working hard to translate that Strategy’s promise into tangible change. With this strategy, we aim to ensure the Organization responds better to the needs of young people but especially that we include your contributions to making the Sustainable Development Goals a reality for all. We also aim to increase action to address the needs, build the agency and advance the rights of youth around the world in all its diversity…

Today, young people face high unemployment rates and a prevalent sense of disenfranchisement. Sixty four million young people are unemployed. Some 145 million young workers live in poverty. And some 617 million youth worldwide lack basic mathematics and literacy skills. Young women in particular are too often discriminated against, from health to education, from access to the labour force and access to financing. In some regions, for example, female youth unemployment is almost double that of men.

If we are to achieve the Sustainable Development Goals, governments, civil society and international partners must scale up their investment in young people — ensuring they are educated, empowered and employed. And we must respond quickly to the challenges that the Fourth Industrial Revolution is presenting — the loss of jobs for many; the demand for new and relevant skills; and the potential weakening of the social contract.

To make sure our work is relevant and effective, we need your ideas, your energy and your creativity. Around the world, young people are striving for peace, justice, inclusion, gender equality and human rights. Last month we saw hundreds of thousands of young people marching for climate action. I count on you to keep up the pressure as we move towards my Climate Action Summit this year and the crucial climate talks next year.

You are also critical to efforts to address hate speech and promote intercultural and interfaith understanding and tolerance. Last week, I was in Tunisia, where I met with students and youth representatives. Two thirds of the Arab world’s people are under the age of 30. Harnessing the dynamism of young people, like the students I met in Tunis, is key to that region’s future. Engaging youth globally is essential for the well being of the entire world. We need your insights and partnership as we work for a better future for all.

This September, world leaders will meet in New York for a series of meetings aimed at catalysing greater ambition, leadership and action to achieve the goals of the Paris Agreement and the 2030 Agenda. The key messages and outcomes of your discussions this week will be shared with decision makers and policymakers in those meetings.

But that is not enough. We need you to mobilize. We need you to activate your networks. We need you to engage in the youth focused events leading up to September, including Youth Day before the Climate Action Summit. I also recommend your contribution to the 2019 World Conference of Ministers Responsible for Youth, in Lisbon, in June.

Above all, we need you to both be the change we need and to push world leaders — in governments, in cities, in the private sector — to step up their ambition and to meet their responsibilities; to do what is right for people and planet alike.

Afghanistan

ICC judges reject opening of an investigation regarding Afghanistan situation
Press Release : 12 April 2019
Today, 12 April 2019, Pre-Trial Chamber II of the International Criminal Court (ICC) rejected unanimously the request of the Prosecutor to proceed with an investigation for alleged crimes against humanity and war crimes, on the territory of in the Islamic Republic of Afghanistan. The judges decided that an investigation into the situation in Afghanistan at this stage would not serve the interests of justice. The Chamber is composed of Judge Antoine Kesia-Mbe Mindua, who will be appending a concurring separate opinion, Judge Tomoko Akane and Judge Rosario Salvatore Aitala…

.

Statement of the Office of the Prosecutor following the decision of Pre-Trial Chamber II concerning the Situation in Afghanistan
Statement : 12 April 2019
The Prosecutor and her Office have carefully studied the decision of Pre-Trial Chamber II delivered earlier today rejecting the request to authorise an investigation into the situation in the Islamic Republic of Afghanistan.

The Office of the Prosecutor notes that the Judges of Pre-Trial Chamber II are satisfied that there is a reasonable basis to believe that crimes under the jurisdiction of the International Criminal Court have been committed in Afghanistan, and that the requirements of gravity and complementarity have been met. The Pre-Trial Chamber then refused to authorise an investigation on its assessment of the interests of justice. The Office will further analyse the decision and its implications, and consider all available legal remedies…

State of World Population 2019
UNFINISHED BUSINESS the pursuit of rights and choices FOR ALL
UNFPA, 2019 :: 180 pages
PDF: https://www.unfpa.org/publications/state-world-population-2019

Press Release
World must work harder to secure sexual and reproductive rights for all, says new UNFPA report
UNITED NATIONS, New York, 10 April 2019—The global reproductive rights movement that began in the 1960s transformed the lives of hundreds of millions of women, empowering them to govern their own bodies and shape their own futures. But despite the gains made over the past 50 years, since the establishment of UNFPA, the United Nations sexual and reproductive health agency, the world still has a long way to go before rights and choices are claimed by all, according to the State of World Population 2019, released by UNFPA today.

On the journey towards rights and choices, women and girls have faced social and economic barriers every step of the way. A coalition of civil society, activists, and organizations such as UNFPA have been helping tear down those barriers.

The efforts of the reproductive rights movements have dramatically reduced the number of unintended pregnancies and maternal deaths, and have cleared the way for healthier, more productive lives for untold millions, the new UNFPA report says.

The report traces advances in reproductive health on the anniversaries of two important milestones. It has been 50 years since UNFPA began operations in 1969 as the first United Nations agency to address population growth and reproductive health needs. It is also the 25th anniversary of the 1994 International Conference on Population and Development (ICPD), where 179 governments called for all people to have access to comprehensive reproductive health care, including voluntary family planning, and safe pregnancy and childbirth services.

Much has been achieved since 1969, says the report. The average number of births per woman was 4.8 then, compared to 2.9 in 1994 and 2.5 today; fertility rate in the least developed countries dropped from 6.8 in 1969, to 5.6 in 1994 and 3.9 in 2019; and the number of women who died from pregnancy-related causes has decreased from 369 per 100,000 live births in 1994, to 216 in 2015. In addition, 24 per cent of women used modern contraceptives in 1969, compared to 52 per cent in 1994 and 58 per cent in 2019.

However, reproductive rights are still out of reach for too many women, including the more than 200 million women who want to prevent a pregnancy but cannot access modern contraceptive information and services.

“Despite the increasing availability of contraceptives over the years, hundreds of millions of women today still have no access to them, and to the reproductive choices that come with them,” said UNFPA Executive Director Dr. Natalia Kanem. “Without access, they lack the power to make decisions about their own bodies, including whether or when to become pregnant.”

“The lack of this power—which influences so many other facets of life, from education to income to safety—leaves women unable to shape their own futures,” added Dr. Kanem.

The report includes, for the first time, data on women’s ability to make decisions over three key areas: sexual intercourse with their partner, contraception use and health care. Across the 51 countries where this information is available, only 57 per cent of women who are married or in a relationship are able to make their own choices over all three of these areas.

“I call on world leaders to re-commit to the promises made in Cairo 25 years ago to ensure sexual and reproductive health and rights for all,” said Dr. Kanem. “The world will have a historic opportunity to complete the unfinished business of the ICPD at the Nairobi Summit on ICPD25 to be held in Kenya in November, where governments, activists and stakeholders will rally to protect the gains made so far, and fulfill the promise of the ICPD agenda, so that no one is left behind.”…

Facts and figures from the report:
:: Number of deaths of women from pregnancy-related causes per 100,000 live births, worldwide: 369 in 1994; 216 in 2015.
:: Global modern contraceptive prevalence rate: 24 in 1969; 52 in 1994; 58 in 2019.
:: Global fertility rate, or average number of births per woman: 4.8 in 1969; 2.9 in 1994; 2.5 in 2019.
:: The highest unmet needs for sexual and reproductive health services are among marginalized groups, including minority ethnic groups; young people; unmarried people; lesbian, gay, bisexual, transgender and intersex people; people with disabilities; and the rural and urban poor.
:: An estimated 800 million women alive today were married when they were children.
:: Every day, more than 500 women and girls in countries with emergency settings die during pregnancy and childbirth

SDGs – Development Finance

Drive to mobilise ‘trillions’ through private finance for development ‘completely unrealistic’ – new ODI research
Press release | 10 April 2019
New report on blended finance finds policy makers have unrealistic expectations about how much private money can be mobilized.

The drive to use aid and other public funds to mobilise trillions of dollars of private investment in developing countries is well off target, new research from the Overseas Development Institute (ODI) has found.

A major new report on the use of blended finance, the term used when public-sector development funds are used to encourage private investments in poorer countries, has found policy makers have unrealistic expectations about how much private money can be mobilised. It also reveals private investment is heavily concentrated in middle-income countries (MICs), with very little going to low-income countries (LICs).

The report, ‘Blended finance in the poorest countries: the need for a better approach’, finds that for every $1 of public money invested in this way mobilises just $0.37 of private finance in LICs and just $0.75 in all developing countries.

The report finds only 1% of the total private finance mobilised by the UK government, including through the CDC Group, the UK government’s DFI, was mobilised in the poorest countries during the period 2012 to 2015.

Lead author Samantha Attridge, Senior Research Fellow at ODI, said: ‘Our research shows that an urgent reality check on blended finance is needed. The current approach is not leveraging significant amounts of private investment overall and very little for low-income countries. The “billions to trillions” mantra is completely unrealistic without significant changes to the system.

‘Donors and development finance institutions (DFIs) need to make urgent changes to their business models and risk appetites to get anywhere near the amounts required to achieve the Sustainable Development Goals.

‘They also need to focus more on supporting developing country governments to build a more conducive investment climate for investable companies and projects. Until they do that, aid spent on blended finance risks diverting much needed resources away from the poorest countries.’’…

.

Research reports and studies
Blended finance in the poorest countries: the need for a better approach
| April 2019 | Samantha Attridge and Lars Engen
The need to mobilise private finance is at the heart of international discussions on how to finance the Sustainable Development Goals (SDGs) and move the needle from ‘billions’ of dollars in development aid to ‘trillions’ of dollars in investment.
With an estimated SDG financing gap of $2.5 trillion a year in developing countries alone, the international development community is placing an increasing emphasis on blended finance. This report aims to provide hard evidence to inform the discussion on the role of blended finance in plugging the SDG financing gap in developing countries.

We found that:
:: Expectations that blended finance can bridge the SDG financing gap are unrealistic: ‘billions-to-billions’ is more plausible than ‘billions to trillions’.
:: The big push on blended finance risks undermining the poverty eradication agenda in the poorest countries.
:: Policy-makers need a better understanding of the poverty and development impact of blended finance, as well as its true costs, to ensure value for money and effective policy-making and allocation of aid.
:: Multilateral development banks and development finance institutions need to collectively adopt a more distinct and tailored approach to blended finance in low-income countries.

Featured Journal Content

Forced Migration Review (FMR)
FMR 60 March 2019
https://www.fmreview.org/GuidingPrinciples20/contents
Special Issue Theme: Education: needs, rights and access in displacement
Education is one of the most important aspects of our lives – vital to our development, our understanding and our personal and professional fulfilment throughout life. In times of crisis, however, millions of displaced young people miss out on months or years of education, and this is damaging to them and their families, as well as to their societies, both in the short and long term. This issue of FMR includes 29 articles on Education, and two ‘general’ articles.

Foreword: Education – a humanitarian and development imperative
Manuel Bessler
For far too long, donors and the international community have neglected education in humanitarian response. Switzerland was no exception. Food, water, health and shelter were the usual priorities during emergencies, while education was considered more of a long-term objective to be tackled by national governments and development agencies once a crisis was over.

However, we were wrong. We simply ignored the families’ tendencies to see their children’s education – often interrupted or absent – as a priority need in displacement. We were not sufficiently aware of education’s life-sustaining and protective role during conflict and crisis. We underestimated the impact education can have on peaceful coexistence and misjudged the social and economic consequences of the lack of education during displacement for both host and home countries…

This edition of Forced Migration Review is timely and necessary. In a time of unprecedented displacement, rising hostilities and an increase in protracted conflicts, it is important to recall what is at stake if displaced girls and boys are prevented from going to school. Education is the most powerful means of breaking cycles of vulnerability and poverty, and without education there can be no sustainable development. The young displaced generation has enormous potential for contributing to society. However, greater international commitment is needed to support countries dealing with rising population movements. Eighty-five per cent of refugees live in developing countries that already struggle with over-stretched education systems. We need to provide assistance to countries to ensure that displaced children can access local schools. We need to provide support to national education ministries, teachers and parents so that both displaced and host-community children can learn and grow up in safe, child-friendly environments. We need to find creative solutions to enable children and youth who have missed out on learning to catch up. All this requires the joint action of the humanitarian and development communities, NGOs, multi- and bilateral agencies and the private sector. Switzerland calls on others to follow suit by prioritising education in policy making, funding and action on the ground. The provision of education for displaced children and youth is both an immediate emergency response and an effective way to work towards durable solutions during protracted displacement.

[29 articles on this theme included in this issue]

Knowledge Platforms

UNESCO – Launch of the Global Alliance of Open Access Scholarly Communication Platforms to democratize knowledge
12 April 2019
A new momentum is emerging in the dissemination of scientific knowledge worldwide.

In Inclusive Knowledge Societies, people have ready access to information and communications resources, in languages and formats that suit them, and possess the skills to interpret and make use of them. Within this framework, promoting access to scientific scholarship (in the broadest sense) has remained a central challenge to most Member States. UNESCO, with its partners, continues to pursue this objective through its programmes on Open Science and Open Access as well as in partnership with other key actors .

At a session organized by UNESCO on 8th April at the WSIS Forum 2019 in Geneva, coordinators of six platforms – AmeliCA, AJOL, Érudi, J-STAGE, OpenEdition, and SciELO Network agreed to join forces to democratize scientific knowledge following a multicultural, multi-thematic and multi-lingual approach. The Global Alliance of Open Access Scholarly Communication Platforms (GLOALL) was launched with a recognition of the principle that scientific and scholarly knowledge is a global public good essential for the achievement of the UN Sustainable Development Goals. The session directly addressed WSIS action line C3 on Access to Information and Knowledge and action line C7 on E-Science.

In addition to fostering democratization of knowledge generated in ALL places, subjects and languages, the GLOALL carries a vision to promote the development of multilingual scholarly communication standards, products and services. The alliance seeks to enhance operational and subject interoperability in order to strengthen engagement with research worldwide…

In the shorter term, GLOALL will generate a unified vision for the alliance based on mutual trust; share experience, technology and know-how that can enhance and foster the development of tools, contents and practices for inclusive Open Access. It will work to improve interoperability among platforms and address language barriers for the knowledge uptake. It will also work together to curate content that addresses SDGs.

Humanitarian Response – Vaccines

Humanitarian mechanism for vaccines used for first time in Europe to counter high prices –
:: A new humanitarian mechanism for vaccines has been used for the first time in Europe, allowing MSF to vaccinate refugee children in Greece at an affordable price.
:: Children were vaccinated with the pnemococcal conjugate vaccine, which is usually prohibitively expensive in Europe.
:: We urge for more vaccines to be included in the humanitarian mechanism, allowing children to be protected against more diseases.

Press Release 12 April 2019 Athens — Médecins Sans Frontières (MSF) has started vaccinating refugee children on the Greek islands of Chios, Samos and Lesvos using a programme set up to allow children in humanitarian emergencies to access the pneumococcal conjugate vaccine (PCV) at an affordable price.
This marks the first time the ‘Humanitarian Mechanism’ is used in a high-income country—the programme offers the vaccine at a special reduced price of about US$9 per child (for the three doses needed for full immunisation) for humanitarian use by civil society organisations and UN agencies. Pneumonia remains the single largest killer of children under five worldwide, and children living in precarious conditions—including those in refugee camps—are at particularly high risk.

Emergencies

POLIO
Public Health Emergency of International Concern (PHEIC)
Polio this week as of 10 April 2019
:: The report by the Director-General World Health Organization on the eradication of poliomyelitis is online, ahead of the 72nd World Health Assembly scheduled for May 2019. The report summarizes the remaining challenges to a polio-free world and presents the main elements of the new GPEI Polio Endgame Strategy 2019-2023.
:: An Independent Outbreak Response Assessment (OBRA) took place in Kinshasa, Democratic Republic of Congo on 5 April 2019. The OBRA was carried out to evaluate the quality of the response to the VDPV2 epidemic in the DRC and make the necessary recommendations to interrupt the transmission as soon as possible.
:: The Inaugural WHO Partners Forum convened in Stockholm, Sweden between 8-11 April 2019 with an aim to start a series of conversations with partners to help WHO meet the strategic goals as committed in the Thirteenth General Programme of Work (GPW13) for 2019-2023. The two-day meeting highlighted WHO’s impact on global health, encouraged support from WHO partners to enhance the quality and quantity of resources, and take stock of the innovations and lessons learned to strengthen partnerships and financing activities.  Read more here.

Summary of new viruses this week:
:: Pakistan – four WPV1-positive environmental samples

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 13 Apr 2019]

Bangladesh – Rohingya crisis
:: Bi‐weekly Situation Report 6 – 2 April 2019 pdf, 734kb

Cyclone Idai
:: Fast rollout of cholera vaccines for people in need in Mozambique 10 April 2019, Maputo
[See Milestones above for detail]

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 12th April 2019
12 April 2019 Statement Geneva
:: 36: Situation report on the Ebola outbreak in North Kivu 9 April 2019
:: DONs – Ebola virus disease – Democratic Republic of the Congo 11 April 2019
[See Ebola above for detail]

South Sudan
:: The Ministry of Health with support from WHO and partners investigates a cluster of unexplained deaths in Jie payam, Kapoeta East 8 April 2019

Myanmar – No new digest announcements identified
Nigeria – No new digest announcements identified
Somalia – No new digest announcements identified
Syrian Arab Republic – No new digest announcements identified
Yemen – No new digest announcements identified

::::::

WHO Grade 2 Emergencies [to 13 Apr 2019]

Brazil (in Portugese)
:: Brasil lança campanha de vacinação contra a influenza 10 de abril de 2019

Cameroon 
:: As internally displaced persons reach nearly 1 million in Ethiopia, WHO reinforces medical supplies 8 April 2019

Iraq
:: WHO sends shipment of kits and medical supplies to Missan governorate Baghdad 8 April 2019 – Responding to the needs of the Directorate of Health in Missan following the recent floods that hit the area, WHO, with the generous support of donors, sent a large consignment of emergency kits and medical supplies on 4 April to support the Directorate, 304 kilometres south east of Baghdad…

Libya
:: Amid Tripoli clashes, WHO rushes medical aid to the wounded in Libya Tripoli, 11 April – As clashes around Tripoli continued and the number of wounded rose to the hundreds, WHO reacted swiftly to provide field hospitals and ambulances with critically-needed life saving supplies.

occupied Palestinian territory 
:: Mobile clinic brings mammography services to remote communities in the West Bank
April 2019

Sudan
:: Sudan prepares to vaccinate over 11 million children against measles and polio 8 April 2019

Central African Republic – No new digest announcements identified
Ethiopia – No new digest announcements identified
MERS-CoV – 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 13 Apr 2019]
Afghanistan – No new digest announcements identified
Chad – No new digest announcements identified
Indonesia – Sulawesi earthquake 2018 – No new digest announcements identified
Kenya – No new digest announcements identified
Lao People’s Democratic Republic – No new digest announcements identified
Mali – No new digest announcements identified
Namibia – viral hepatitis – No new digest announcements identified
Peru – No new digest announcements identified
Philippines – Tyhpoon Mangkhut – No new digest announcements identified
Tanzania – No new digest announcements identified

::::::

WHO AFRO – Outbreaks and Emergencies Bulletin
Week 14: 01-07 April 2019
The WHO Health Emergencies Programme is currently monitoring 65 events in the region. This week’s edition covers key new and ongoing events, including:
:: Ebola virus disease outbreak in the Democratic Republic of the Congo
:: Cyclone Idai in Southern Africa (Mozambique, Zimbabwe and Malawi)
:: Humanitarian crisis in Cameroon
:: Humanitarian crisis in Ethiopia.

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 – No new digest announcements identified
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.
CYCLONE IDAI
:: 12 April 2019  Mozambique: Cyclone Idai & Floods Situation Report No. 10
:: 12 April 2019  Zimbabwe: Floods Situation Report No. 2, As of 10 April 2019
:: 10 April 2019  Southern Africa: Cyclone Idai Snapshot (as of 9 April 2019)

The Sentinel

Human Rights Action :: Humanitarian Response :: Health :: Education :: Heritage Stewardship ::
Sustainable Development
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Week ending 6 April 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
Editor
GE2P2 Global Foundation – Governance, Evidence, Ethics, Policy, Practice
david.r.curry@ge2p2center.net

PDF: The Sentinel_ period ending 6 Apr 2019

Contents
:: 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]