Global Health – Operational Reform

WHO unveils sweeping reforms in drive towards “triple billion” targets
6 March 2019 News Release Geneva
WHO today announced the most wide-ranging reforms in the Organization’s history to modernize and strengthen the institution to play its role more effectively and efficiently as the world’s leading authority on public health.

The changes are designed to support countries in achieving the ambitious “triple billion” targets that are at the heart of WHO’s strategic plan for the next five years: one billion more people benefitting from universal health coverage (UHC); one billion more people better protected from health emergencies; and one billion more people enjoying better health and well-being.

These changes include:
:: Aligning WHO’s processes and structures with the “triple billion” targets and the Sustainable Development Goals by adopting a new structure and operating model to align the work of headquarters, regional offices and country offices, and eliminate duplication and fragmentation.

:: Reinforcing WHO’s normative, standard-setting work, supported by a new Division of the Chief Scientist and improved career opportunities for scientists.

:: Harnessing the power of digital health and innovation by supporting countries to assess, integrate, regulate and maximize the opportunities of digital technologies and artificial intelligence, supported by a new Department of Digital Health.

:: Making WHO relevant in all countries by overhauling the Organization’s capabilities to engage in strategic policy dialogue. This work will be supported by a new Division of Data, Analytics and Delivery to significantly enhance the collection, storage, analysis and usage of data to drive policy change in countries. This division will also track and strengthen the delivery of WHO’s work by monitoring progress towards the “triple billion targets” and identifying roadblocks and solutions.

:: Investing in a dynamic and diverse workforce through new initiatives including the WHO Academy, a proposed state-of-the-art school to provide new learning opportunities for staff and public health professionals globally. Other measures include a streamlined recruitment process to cut hiring time in half, management trainings, new opportunities for national professional officers, and previously-announced improvements in conditions for interns.

:: Strengthening WHO’s work to support countries in preventing and mitigating the impact of outbreaks and other health crises by creating a new Division of Emergency Preparedness, as a complement to WHO’s existing work on emergency response.

:: Reinforcing a corporate approach to resource mobilization aligned with strategic objectives and driving new fundraising initiatives to diversify WHO’s funding base, reduce its reliance on a small number of large donors and strengthen its long-term financial stability.

“The changes we are announcing today are about so much more than new structures, they’re about changing the DNA of the organization to deliver a measurable impact in the lives of the people we serve,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Our vision remains the same as it was when we were founded in 1948: the highest attainable standard of health for all people. But the world has changed, which is why we have articulated a new mission statement for what the world needs us to do now: to promote health, keep the world safe and serve the vulnerable.”

The new measures were developed following an extensive period of consultation with staff, and were developed jointly by WHO’s Global Policy Group, which consists of the Director-General and each of the organization’s six regional directors: Dr Matshidiso Moeti (Regional Director for Africa), Dr Carissa Etienne (Regional Director for the Americas), Dr Poonam Khetrapal Singh (Regional Director for South-East Asia), Dr Zsuzsanna Jakab (Regional Director for Europe), Dr Ahmed Al-Mandhari (Regional Director for the Eastern Mediterranean) and Dr Takeshi Kasai (Regional Director for the Western Pacific).

WHO’s new corporate structure is based on four pillars which will be mirrored throughout the organization.

The Programmes pillar will support WHO’s work on universal health coverage and healthier populations. The Emergencies pillar will be responsible for WHO’s critical health security responsibilities, both in responding to health crises and helping countries prepare for them. The External Relations and Governance pillar will centralize and harmonize WHO’s work on resource mobilization, communications. The Business Operations pillar will likewise ensure more professionalized delivery of key corporate functions such as budgeting, finance, human resources and supply chain.

The four pillars will be supplemented by the Division of the Chief Scientist at WHO Headquarters in Geneva to strengthen WHO’s core scientific work and ensure the quality and consistency of WHO’s norms and standards.

Underpinning the new structure, 11 business processes have been redesigned, including planning, resource mobilization, external and internal communications, recruitment, supply chain, performance management, norms and standards, research, data and technical cooperation.

The Global Policy Group stressed the role of working with partners. Dr Tedros said WHO must develop a new mindset to seek out and build partnerships that harness the combined strength of the global health community – both in the public and private sectors. One example of this is a new Global Action Plan for Healthy Lives and Well-Being for All, under which 12 partner organizations are working together to achieve health-related Sustainable Development Goals.

Access to Information

UNESCO pilots global data collection on access to information
05 March 2019
UNESCO has kicked off global data collection on the implementation of access-to-information (ATI) laws in 43 countries, putting its monitoring and reporting instruments for SDG indicator 16.10.2 to the test.

As the custodian agency for indicator 16.10.2 on access to information, UNESCO is mandated to monitor and report on the “number of countries that adopt and implement constitutional, statutory and/or policy guarantees for public access to information”.

The data collected through the global exercise will be significant for UNESCO in mapping global progress towards ATI commitments.

For Member States, who are the primary duty-bearers with an obligation to monitor and report progress towards SDGs, the findings can help enrich their own national and global reporting, such as to national stakeholders and at the 2019 and subsequent United Nations High-level Political Forum (UN HLPF) on Sustainable Development Goals.

The 43 pilot countries selected for this global data collection are developing and least developed countries that will submit their Voluntary National Reviews (VNRs) to the UN HLPF in July this year, in which Goal 16 will be under review.

These countries are Algeria, Azerbaijan, Bosnia and Herzegovina, Brazil, Burkina Faso, Cambodia, Cameroon, Central African Republic, Chad, Chile, Congo (Republic of the), Côte d’Ivoire, El Salvador, Eritrea, Eswatini (Swaziland), Fiji, Ghana, Guatemala, Guyana, Indonesia, Iraq, Kazakhstan, Kenya, Lesotho, Mauritania, Mauritius, Nauru, Oman, Pakistan, Palau, Philippines, Rwanda, Saint Lucia, Serbia, Sierra Leone, South Africa, Timor-Leste, Tonga, Tunisia, Turkey, Turkmenistan, and United Republic of Tanzania.

Funded by the Swedish International Development Cooperation Agency (Sida), the global data exercise is being carried out in collaboration with UNESCO Institute for Statistics (UIS) and the Centre for Law and Democracy (CLD) using UNESCO’s set of reporting and monitoring instruments for indicator 16.10.2. UNESCO developed the instruments in close consultations with experts, CSOs, concerned organizations and other UN agencies

Liberty-Privacy

Facebook – A Privacy-Focused Vision for Social Networking
March 6, 2019
Today, Mark Zuckerberg outlined Facebook’s vision and principles around building a privacy-focused messaging and social networking platform:

:: Private interactions. People should have simple, intimate places where they have clear control over who can communicate with them and confidence that no one else can access what they share.
:: Encryption. People’s private communications should be secure. End-to-end encryption prevents anyone — including us — from seeing what people share on our services./li>
:: Reducing Permanence. People should be comfortable being themselves, and should not have to worry about what they share coming back to hurt them later. So we won’t keep messages or stories around for longer than necessary to deliver the service or longer than people want them.
:: Safety. People should expect that we will do everything we can to keep them safe on our services within the limits of what’s possible in an encrypted service.
:: Interoperability. People should be able to use any of our apps to reach their friends, and they should be able to communicate across networks easily and securely.
:: Secure data storage. People should expect that we won’t store sensitive data in countries with weak records on human rights like privacy and freedom of expression in order to protect data from being improperly accessed.

We’re committed to working openly and consulting with experts across society as we develop this. You can read Mark’s full note

DR Congo – Ebola

Ebola response failing to gain the upper hand on the epidemic – MSF
Democratic Republic of Congo
Press Release 7 Mar 2019
:: Despite a rapid and large outbreak response with new vaccines and treatments, the signs are that Ebola is not under control
:: Since the beginning of the year, more than 40 per cent of new Ebola cases are people who died of Ebola in the communities
:: Patients and communities must be treated as partners in the response; we must listen to their needs not preach to or coerce them

Seven months into the largest-ever Ebola outbreak in the Democratic Republic of the Congo (DRC), the Ebola response is failing to bring the epidemic under control in a climate of deepening community mistrust, Médecins Sans Frontières (MSF) said at a press conference in Geneva today.

Since the beginning of the year, more than 40 per cent of new cases are people who died of Ebola in the communities. At the epicentre of the epidemic, in Katwa and Butembo in North Kivu province, 43 per cent of patients in the last three weeks were still being infected without known links to other cases.

“We have a striking contradiction: on the one hand a rapid and large outbreak response with new medical tools such as vaccines and treatments that show promising outcomes when people come early – and on the other hand, people with Ebola are dying in their communities, and do not trust the Ebola response enough to come forward,” said International President of MSF, Dr Joanne Liu.

Last week, MSF suspended our Ebola activities in Katwa and Butembo, in North Kivu province, after successive attacks on the two treatment centres. While MSF does not know the motives or identities of the attackers, these incidents follow an escalation of tensions around the Ebola response. Dozens of security incidents occurred against the response as a whole in the month of February alone. While the causes of these acts are not all the same, it is clear that various political, social and economic grievances are increasingly crystallising around the response.

A range of issues have led to these tensions: from the massive deployment of financial resources focusing only on Ebola, in a neglected region suffering from conflict, violence and long-standing health needs; to elections being officially postponed due to the Ebola outbreak, exacerbating suspicions that Ebola is a political ploy.

The use of police and armed forces to compel people to comply with health measures against Ebola is leading to further alienation of the community and is counterproductive to controlling the epidemic. Using coercion for activities such as safe burials, tracking of contacts and admission into treatment centres discourages people from coming forward and pushes them into hiding.

The Ebola response must take a new turn. Choices must be given back to patients and their families on how to manage the disease. Vaccination for Ebola must reach more people, and more vaccines are needed for this. Other dire health needs of communities should be addressed. And coercion must not be used as a tactic to track and treat patients, enforce safe burials or decontaminate homes.

“Ebola is a brutal disease, bringing fear, and isolation to patients, families and health care providers,” said Dr Joanne Liu. “The Ebola response needs to become patient and community centred. Patients must be treated as patients, and not as some kind of biothreat.”

Seven months since the beginning of the current Ebola outbreak in the provinces of North Kivu and Ituri, there have been 907 cases of Ebola cases (841 confirmed and 66 probable) and 569 people have died. [source: World Health Organization (WHO) report week 9]

Further to the suspension of its activities in Katwa and Butembo, MSF has maintained its Ebola-related activities in the North Kivu towns of Kayna and Lubéru, as well as its management of two Ebola transit facilities in Ituri province, in the towns of Bwanasura and Bunia. In the city of Goma, MSF has been supporting emergency preparedness by reinforcing the surveillance system and ensuring there is adequate capacity to manage suspected cases.

It has almost been six years, since 11 July 2013, that three MSF staff remain missing after being abducted in Kamango, Nord Kivu, where they were carrying out a health assessment. MSF continues to search for them.

Emergencies
 
POLIO
Public Health Emergency of International Concern (PHEIC)
Polio this week as of 6 March 2019
:: On 26-27 February 2019, the Global Commission for Certification of the Eradication met at the World Health Organization in Geneva to continue its work on global certification criteria for wild poliovirus eradication and containment.  The GCC reviewed all the latest global epidemiology and examined remaining challenges in the interruption of wild polio virus. Read more here.
:: Featured on polioeradication.org: Coffee with Polio Experts— Dr Nicksy Gumede-Moeletsi, senior virologist at WHO’s Regional Office for Africa, talks about how genetic analysis of isolated polioviruses is helping strategically drive eradication efforts in Africa.
 
Summary of new viruses this week:
:: Pakistan – two WPV1-positive environmental samples;
:: Nigeria — one circulating vaccine-derived poliovirus type 2 (cVDPV2) case.
 
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GCC intensifies work on global certification criteria
Global Commission for Certification of Poliomyelitis Eradication (GCC) meet in Geneva to intensify its work on global certification criteria
On 26-27 February 2019, the Global Commission for Certification of Poliomyelitis Eradication (GCC) met at the World Health Organization (WHO) headquarters in Geneva, Switzerland, to continue its intensified work on global certification criteria for poliomyelitis eradication and poliovirus containment.  The work of the GCC is critical to verifying the achievement of a world free of all polioviruses
 
 
The GCC reviewed the latest global epidemiology of all poliovirus transmission, examined remaining challenges such as subnational surveillance and immunity gaps, and evaluated current containment status.

The GCC expressed its concerns over the lack of progress in the interruption of transmission of wild poliovirus type 1 (WPV1) in Pakistan and Afghanistan and the spread of vaccine-derived polioviruses (VDPVs). As expressed in a recently-published letter from the four Chairs of the GPEI’s main global advisory bodies, it is essential that improvement is achieved in both routine immunization services and supplementary immunization activity (SIA) quality. Nevertheless, the GCC is continuing to accelerate its work, including taking into consideration circulating vaccine-derived polioviruses (cVDPVs), which continue to take on added significance as the time extends since the discontinuation of type 2 poliovirus in oral polio vaccine (OPV) with consequent loss of type 2 polio immunity. The GCC is also occupied with the urgent and increasing need for effective containment of polioviruses in laboratories and vaccine manufacturing facilities.

Noting that wild poliovirus type 3 (WPV3) has not been isolated anywhere since November 2012, the GCC re-affirmed its decision to undertake sequential certification of WPV eradication, meaning that WPV3 will be certified as eradicated prior to WPV1.  The GCC has requested that the Director-General of WHO ask the Regional Directors of Africa and the Eastern Mediterranean respectively to confirm from their Member States that the last WPV3s in both Regions were identified more than six years ago. The GCC will review these data in conjunction with the final reports from the four Regions that have already been certified. This will permit the GCC to certify the eradication of WPV3.

The GCC noted progress in identifying the interruption of WPV1 transmission in the African Region, which will be eligible for regional certification when the African Regional Certification Commission is convinced of the evidence of absence of wild polioviruses that meets surveillance standards.

The outcomes and recommendations of the GCC will be presented to the WHO Director-General, and if accepted, incorporated into the Global Polio Eradication Initiative Strategic Plan 2019-2023.  The full report from the GCC’s meeting will be made available at www.polioeradication.org.

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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 9 Mar 2019]
Democratic Republic of the Congo
:: 31: Situation report on the Ebola outbreak in North Kivu  3 March 2019
:: DONS – Ebola virus disease – Democratic Republic of the Congo   7 March 2019

Syrian Arab Republic
:: Unexploded mines pose daily risk for people in northern Syria   6 March 2019

Bangladesh – Rohingya crisis
:: Bi‐weekly Situation Report 4 – 04 March 2019

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  
Yemen – No new digest announcements identified  

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WHO Grade 2 Emergencies  [to 9 Mar 2019]
Libya
:: WHO responds to critical health needs in southern Libya
6 March 2019 – In response to increasing violence in Sabha City, southern Libya, the World Health Organization (WHO) has delivered trauma medicines sufficient for more than 400 patients requiring trauma care to Sabha Medical Centre, Murzuq General hospital and Ghodwa field hospital. WHO has also delivered 6 incubators and 2 ventilators to the neonatal intensive care unit of Sabha Medical Centre, and pre-positioned additional trauma medicines at the Medical Supply Office in Sabha to be delivered to health facilities as needed.

Clashes between armed groups in Sabha and Murzuq in February resulted in increasing numbers of injured patients, overwhelming health facilities already facing shortages of specialists and medical supplies. The total number of casualties is 250, which includes 44 dead and 206 wounded…

Brazil (in Portugese) – 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
Hurricane Irma and Maria in the Caribbean – No new digest announcements identified
Iraq – 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  
Sao Tome and Principe Necrotizing Cellulitis (2017) – No new digest announcements identified
Sudan – No new digest announcements identified
Ukraine – No new digest announcements identified
Zimbabwe – No new digest announcements identified

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WHO Grade 1 Emergencies  [to 9 Mar 2019]
Afghanistan
Chad
Indonesia – Sulawesi earthquake 2018
Kenya
Lao People’s Democratic Republic
Mali
Namibia – viral hepatitis
Peru
Philippines – Tyhpoon Mangkhut
Tanzania

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WHO AFRO – Outbreaks and Emergencies Bulletin – Week 09/2019
Week 09: 25 February – 03 March 2019
The WHO Health Emergencies Programme is currently monitoring 59 events in the region. This week’s edition covers key new and ongoing events, including:
:: Ebola virus disease in the Democratic Republic of the Congo
:: Measles in Madagascar
:: Lassa fever in Nigeria
:: Humanitarian crisis in Nigeria
:: Humanitarian crisis in South Sudan 

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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

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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.
Ethiopia 
:: Ethiopia Humanitarian Bulletin Issue #4 | 17 February – 03 March 2019

HIGHLIGHTS
The Government of Ethiopia and humanitarian partners will formally launch the 2019 Ethiopia Humanitarian Response Plan (HRP) on 7 March.
Some 90,000 displaced people in Amhara region need urgent assistance.
Improved security along the OromiaSomali border is enabling humanitarian partners to move relief commodities to Dawa zone after more than a year.

Somalia 
:: Humanitarian Bulletin Somalia, 1 February – 5 March 2019

Highlights
– Dry conditions worsen across Somalia.
– Protecting livestock to save livelihoods.
– Access constraints continue.
– Redoubling efforts to End Polio Outbreaks.
– Sustained response through pooled funds.

The Sentinel

Human Rights Action :: Humanitarian Response :: Health :: Education :: Heritage Stewardship ::
Sustainable Development
__________________________________________________
Week ending 2 March 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 2 Mar 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]

Venezuela

Competing United States, Russian Federation Draft Resolutions on Political, Humanitarian Situation in Venezuela Blocked in Security Council
28 February 2019
SC/13725
The Security Council failed today to adopt two competing draft resolutions — one from the Russian Federation, the other from the United States — responding to the political and humanitarian situation in Venezuela.

By the terms of the draft put forward by the United States, which was vetoed by China and the Russian Federation, the Council would have expressed its deep concern that the presidential elections of 20 May 2018 were neither free nor fair, and call for the start of a peaceful political process leading to free, fair, and credible presidential elections, with international electoral observation, in conformity with Venezuela’s Constitution.

It would have supported the peaceful restoration of democracy and rule of law in Venezuela and encouraged subsequent peaceful, inclusive, and credible initiatives to address the crisis. It would also have stressed the importance of ensuring the security of all members of the National Assembly, and members of the political opposition, as well as the need to prevent further deterioration of the humanitarian situation in Venezuela and to facilitate unhindered access and delivery of assistance to all in need throughout the country in line with humanitarian principles.

The draft resolution from the Russian Federation, which lacked the minimum number of affirmative votes for passage, would have had the Council urge the settlement of the situation in Venezuela through peaceful means, within the framework of its Constitution, and in full respect of its sovereignty, territorial integrity and the right to self-determination of the Venezuelan people, as well as welcome the Secretary-General’s calls in that regard.

It would have supported all initiatives aimed at reaching a political solution amongst Venezuelans to the situation, including the Montevideo Mechanism, through a genuine and inclusive process of national dialogue; reaffirm the Government’s primary role in the initiation, organization, coordination and implementation of international assistance efforts and initiatives within its national territory; and recall that such assistance should be provided with the consent of, and on the basis of an appeal by, the Government.

Speaking after the vote on his delegation’s text, Elliot Abrams, Special Representative for Venezuela of the United States, said the situation in Venezuela requires immediate Council action. “The time for a peaceful transition to democracy is now,” he said. Asserting that some Council members are choosing to shield President Nicolás Maduro and his cronies, he said the United States will remain steadfast in its support for interim President Juan Guaidó and the National Assembly.

The representative of the Russian Federation, who took the floor twice, said his delegation was forced to exercise its veto because the United States draft was not geared towards resolving the problem in Venezuela. Emphasizing that his delegation’s text was aimed at helping Venezuelans solve their own problems, he said a decision to hold elections or not is theirs alone to take. “Do not decide for them,” he said, adding that today’s vote was a glaring example of the need for the veto in the Council.

Expressing regret over the lack of Council unity, Peru’s representative said the failure to adopt the United States draft — for which his delegation voted in favour — is incomprehensible, given that it was a minimal text with no references to human rights violations, the terrible humanitarian situation, the breakdown of the economic order and the exodus of more than 3 million Venezuelans.

South Africa’s delegate, who voted in favour of the Russian Federation’s text and against its United States counterpart, said it was unfortunate that two divergent drafts were submitted. Division in the Council undermined its credibility, he said, describing the United States draft as unbalanced and prescriptive.

The representative of Indonesia said his delegation refused to accept either draft resolution because they were both incomplete and overly politicized — nor, he added, would they help Venezuelans. “In all honesty, I have to admit that my delegation is starting to believe that dialogue and negotiations are a luxury here in the Council,” he said.

Venezuela’s representative, speaking at the end of the meeting, said his country rejects the fact that its Constitution is being used to justify a colonial intervention and to support a fictious entity. Economic war is being waged against Venezuela, violating the rights of its people and turning them into hostages, he said, adding that in the past two weeks, the United States and the United Kingdom had stolen more than $30 billion from the Venezuelan people…

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Featured Journal Content

Lancet Global Health
Mar 2019 Volume 7Number 3e281-e384
http://www.thelancet.com/journals/langlo/issue/current
Articles
Trends in infant mortality in Venezuela between 1985 and 2016: a systematic analysis of demographic data
Jenny García, Gerardo Correa, Brenda Rousset
Summary
Background
Between the 1950s and 2000, Venezuela showed one of the most substantial improvements in infant mortality rates in Latin America. However, the recent economic crisis alongside an increase in infectious and parasitic diseases might be reversing previous patterns. Because no official updated mortality statistics have been published since 2013, the effect of these recent events has been difficult to assess accurately. We therefore aimed to estimate infant mortality rate trends and report the effect of the crisis.
Methods
We estimated infant mortality rates using direct methods (ie, death counts from Venezuelan Ministry of Health via yearbooks and notifiable diseases bulletins, and birth records published by the UN Economic Commission for Latin America and the Caribbean and the Venezuelan National Institute of Statistics) and indirect methods (using census data and a Living Conditions Survey ENCOVI 2016). We shaped yearly estimations using a semiparametric regression model, specifically a P-Spline model with a cubic thin plate base. The primary objective was to estimate infant mortality rate trends from 1985 to 2016.
Findings
Around 2009, the long-term decline in infant mortality rate stopped, and a new pattern of increase was observed. The infant mortality rate reached 21·1 deaths per 1000 livebirths (90% CI −17·8 to 24·3) in 2016, almost 1·4 times the rate of 2008 (15·0, −14·0 to 16·1). This increase represents a huge setback on previous achievements in reducing infant mortality.
Interpretation
Our conservative estimation indicates that Venezuela is in the throes of a humanitarian crisis. The increase in infant mortality rate in 2016 compared with 2008 takes the country back to the level observed at the end of the 1990s, wiping out 18 years of expected progress, and leaves the Venezuelan Government far from achieving the target of nine deaths per 1000 livebirths stated in the UN Millennium Development Goals.
Funding
None.

Children in Armed Conflict

Open Letter to UN Secretary-General António Guterres
February 25, 2019
Dear Secretary-General Guterres,
As organizations working to protect the rights of children in armed conflict, we urge you to include the Saudi and Emirati-led Coalition (SELC) for all relevant violations in list A of the annexes of your 2019 annual report to the United Nations Security Council on children and armed conflict.

Changing the way the coalition is listed, from the ‘coalition to restore legitimacy in Yemen’ to the ‘SELC,’ would accurately reflect Saudi Arabia and the United Arab Emirate’s (UAE) leadership in the coalition, and in financing and directly engaging in hostilities via airstrikes and UAE ground forces deployed throughout the country. Including the SELC in list A of the annexes of your 2019 annual report for all relevant violations, including attacks on schools and hospitals, is critical to ensuring a credible, accurate listing of perpetrators, and providing the UN with the foundation to enter into dialogue with the SELC to actually drive change for children through the signing and implementation of a time-bound action plan. While the coalition was included in list B in your 2018 annual report as a party that has implemented positive measures aimed at improving the protection of children, the record shows that coalition violations against children have continued to occur.

For example, your 2018 annual report on children and armed conflict attributed to the coalition 19 of 20 attacks on schools and five attacks on hospitals carried out in 2017.1 Yet, the coalition was delisted in the 2018 report for attacks on schools and hospitals; the Houthis, to whom the report attributed five attacks on hospitals in 2017, remained listed for the same grave violation.2 Measures that the SELC might have taken in 2017 or 2018 have failed to end attacks and other abuse against children. The August 9, 2018 coalition airstrike on a school bus in Saada that killed at least 26 children is just one horrific example of many.

We have included in this letter documentation of three of the five ‘trigger’ violations— killing and maiming, attacks on schools and hospitals, and recruitment and use—carried out in Yemen in 2018 by the SELC. The incidents were gathered through a systematic desk review of publically available sources, including UN and international nongovernmental organization (INGO) reports and reputable media reports; they are representative, rather than exhaustive, of attacks against children during the reporting period.

We note that the Houthi armed group and other parties to the conflict have recruited and used children, killed and maimed children, or attacked schools and hospitals, and consequently been listed in list A of your annex. Given continued grave violations carried out by these parties, we urge you to maintain these listings.

The stakes have never been higher. More than 24 million people in Yemen, half of them children, need humanitarian assistance.3 And child protection needs have continued to increase; verified reports of grave violations of children’s rights, including killing and maiming and recruitment and use, increased by nearly 25 per cent in 2018.4

The leadership you have shown these past months in helping secure the Stockholm Agreement and support its implementation have already had a significant impact on the conflict. However, the desire to fulfill and preserve this and other agreements should not prevent the international community from reflecting painful realities in its assessments of the SELC, the Houthi armed group, or any other party to the conflict. We hope you continue to seek an agreement that would safeguard the rights of children, and help to ensure accountability for all parties responsible for grave violations and other violations of international law in Yemen.

Sincerely,
Action Against Hunger
Childfund Alliance
Global Centre for the Responsibility to Protect
Human Rights Watch
Mwatana
Physicians for Human Rights
Save the Children
War Child
Watchlist on Children and Armed Conflict

PDF includes listing of violations: https://childfundalliance.org/component/zdocs/document/viewDocument/2712

Philanthropy

New Competition for a $100 Million Grant: Round Two of 100&Change – MacArthur Foundation
February 27, 2019 Press Release
MacArthur today announced it will launch a new round of its 100&Change competition for a single $100 million grant to help solve one of the world’s most critical social challenges. 100&Change remains open to organizations and collaborations working in any field, anywhere in the world. Proposals must identify a problem and offer a solution that promises significant and durable change; they will be accepted online only from April 30 to August 6, 2019.

In the inaugural round of 100&Change, from 1,904 proposals submitted, Sesame Workshop and International Rescue Committee were awarded $100 million to educate young children displaced by conflict and persecution in the Syrian response region and to challenge the global system of humanitarian aid to focus more on building a foundation for future success for millions of young children. Other funders and philanthropists have committed an additional $254 million to date to support bold solutions by 100&Change applicants, including a $100 million LEGO Foundation grant to Sesame Workshop and $9 million in funding from USAID and GHR Foundation to Catholic Relief Services. Many 100&Change applicants found that the competition challenged them to be more ambitious in their thinking, facilitated collaboration among groups to tackle an issue at a broader scale, and enabled them to create proposals they could use to pursue other funding.

Building on the success of 100&Change, MacArthur is creating Lever for Change, a new nonprofit committed to unlocking philanthropic capital and helping donors put their resources to work to accelerate social change.

“We set out to do something bold three years ago when we launched 100&Change—address problems and support solutions that are radically different in scale, scope, and complexity,” said MacArthur President Julia Stasch. “We learned there is no shortage of compelling ideas with the potential for tremendous social impact. The success of 100&Change led us to create Lever for Change, which seeks to connect donors with organizations and collaborations with the potential to deliver the impactful and inspirational change they both dream of helping to bring about.”…

Democracy

Global leaders launch campaign to defend democracy and a rules-based order
Former leaders from democratic nations call for renewed effort to defend shared values and push back against authoritarianism and anti-democratic trends
February 15, 2019
WASHINGTON, DC – Amidst the rising tide of authoritarianism and anti-democratic trends around the world, a prestigious group of bipartisan former leaders from democratic nations today issued a Declaration of Principles [below] aimed at reaffirming shared values and a rules-based order.

Among those leading this effort are former Secretary of State Madeleine Albright and former National Security Advisor Stephen Hadley, former Swedish Prime Minister Carl Bidlt, and former Japanese foreign minister Yoriko Kawaguchi, co-chairs of a global bipartisan task force organized under the auspices of the Atlantic Council and Canada’s Centre for International Governance Innovation (CIGI).

“For the past seven decades, free nations have drawn upon the shared values to advance freedom, increase prosperity, and secure peace,” said Albright. “It’s time for citizens around the world who care about these values to stand up and make their voices heard. We need to make clear what we stand for and what kind of world we want to live in.”

“The goal is to reaffirm support for the principles that have been at the foundation of the international order since the end of World War II: democracy; free, fair, and open markets; and the rule of law,” said Bildt. “We cannot sit idly by while autocrats and demagogues undermine these core principles.”

The declaration [was] released at the Munich Security Conference…Task force members David Miliband, Anders Fogh Rasmussen, Tzipi Livni, Toomas Hendrik Ilves, Wolfgang Ischinger, Ana Palacio, and Radek Sikorski will also be in Munich for the launch of the Declaration. The task force represents leading democracies around the world, including Australia, Brazil, Canada, Denmark, France, Germany, India, Indonesia, Israel, Japan, Mexico, Poland, South Korea, Spain, Sweden, Tunisia, the United Kingdom, and the United States.

The release of the declaration marks the beginning of an organized effort led by the Atlantic Council and CIGI to revitalize a rules-based order and rebuild public support in favor of democracy, open markets, and alliances. A key priority will be to engage influential members of Congress and parliamentarians in leading democracies an encourage concrete actions to secure and defend a rules-based order. At the same time, the Council will seek to establish a dialogue among a broader group of world powers to identify areas of agreement in support of a stable global order…

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Declaration of Principles for Freedom, Prosperity, and Peace
February 2018
We, citizens, former officials, and representatives of governments and private entities, united by common values, have agreed as follows:

THE PRESENT CHALLENGE
For seven decades, free nations have drawn upon common principles to advance freedom, increase prosperity, and secure peace. The resulting order, built on the foundation of democratic values and human dignity, has brought better lives for our citizens and billions of people around the world.

But the international system must rise to meet new challenges. New technologies are transforming societies. In many of our nations, stagnant wages, income disparities, and uneven benefits from global trade are leading many to question free market economics and the value of engagement in the world. Increased migration is fueling concerns about job security and national identity.

Around the world, politicians are exploiting these challenges, denigrating the rule of law, and undermining faith in democracy. Autocrats and extremists are attacking these principles, oppressing their own people, threatening security, and contending that might makes right.

Yet, free peoples have met greater challenges in the past, and we can master those in our time.

Innovations in communications, energy, health, and more yet to come are opening possibilities unimaginable before. Entrepreneurship based on freedom and new ideas can drive prosperity. Empowered men and women can address social problems from the bottom up. Governments that answer to their citizens and respect the rule of law can best address inequity, correct injustice, and serve the good of all.

Free nations must adapt and change. Yet our principles remain sound because they reflect the common aspirations of the human spirit. Societies that respect these principles are better placed to produce security and prosperity. Nations that uphold them are more likely to work together in peace. And authoritarians who stifle enterprise, dispense arbitrary justice, and abuse their people ultimately will fail.

Inspired by the inalienable rights derived from our ethics, traditions, and faiths, we commit ourselves to seek a better future for our citizens and our nations. We will defend our values, overcome past failures with new ideas, answer lies with truth, confront aggression with strength, and go forward with the confidence that our principles will prevail.

We call on all who are willing to join us in this common cause.

SEVEN STATEMENTS
1. Freedom and Justice
We affirm the right of all people to live in free and just societies, where fundamental rights are protected under the rule of law.
Governments, as well as private entities and individuals where they are able, have a responsibility to:
:: respect and protect the freedoms of speech, conscience, religion, the press, expression, association, and assembly
:: allow for the free flow of information and ideas, while protecting personal information and individual privacy
:: ensure equal protection and non-discrimination with regard to race, religion, ethnicity, tribe, culture, nationality, language, gender, disability, and sexual identity
:: combat corruption, hold public officials accountable, and uphold the rule of law

2. Democracy and Self-Determination
We affirm the right of all people to make decisions about their own affairs through elected governments that reflect their consent, free from foreign interference.
Governments, as well as private entities and individuals where they are able, have a responsibility to:
:: respect and protect the right of all people to choose their own leaders through a free, fair, and competitive democratic process
:: refrain from threats, coercion, intimidation, violence, election meddling, or other undue interference in the internal or external affairs of free nations
:: respect the right of peaceful self-determination and seek the settlement of disputes over political status without threats, violence, or oppression

3. Peace and Security
We affirm the right of all people to live in peace, free from threats of aggression, terrorism, oppression, crimes against humanity, and the proliferation of weapons of mass destruction.
Governments, as well as private entities and individuals where they are able, have a responsibility to:
:: refrain from engaging in or providing support for such actions
:: seek to prevent such violence and cut off material or financial support or safe haven to governments, groups, or individuals engaged in such actions
:: support the peaceful settlement of disputes, including civil conflicts, and refrain from the use of force, except as just and necessary to advance these principles

4. Free Markets and Equal Opportunity
We affirm the right of all people to engage in economic activity based on free market principles, with equal opportunity to contribute to and the ability to share in the benefits of national prosperity.
Governments, as well as private entities and individuals where they are able, have a responsibility to:
:: protect the right of people to own property, purchase goods and services, and invest in free and open markets
:: promote the free and fair flow of trade and investment; protect intellectual property; respect agreements; and support an open global economy
:: protect the rights of workers, including the right to seek gainful employment; seek to mitigate the adverse impacts of global trade; and encourage inclusive, equitable, and well-regulated economies
:: seek to mitigate poverty, eradicate disease, and facilitate access to food, water, shelter, medical services, and education for their own citizens and others in need

5. An Open and Healthy Planet
We affirm the right of all people to enjoy free and open access to the global commons and a safe and healthy planet.
Governments, as well as private entities and individuals where they are able, have a responsibility to:
:: reduce the risk of damage to the global climate or environment caused by nature or human activity
:: refrain from undue interference with freedom of navigation in the air, seas, and outer space, or with access to cyberspace
:: while harnessing their benefits, seek to mitigate potentially dangerous or unethical applications of advanced technology
:: while protecting their national identity and controlling migration over their borders, provide refuge for those fleeing from persecution or violence, and respect the rights of all people living and working in their nations

6. The Right of Assistance
We affirm the right of national sovereignty, while recognizing that sovereignty obligates governments to uphold these principles.
Governments, as well as private entities and individuals where they are able, have a responsibility to:
:: allow their citizens to receive assistance from others to advance these principles, including, in non-free societies, support to non-violent groups, political parties, and individuals aiming to foster democracy or human rights
:: assist those adversely impacted by violations of these principles, and where governments or other actors are unwilling or unable to cease or remedy flagrant or systematic violations, take such actions just and necessary to prevent them

7. Collective Action
We affirm the right of all people to cooperate in support of these principles and to work together to advance them.
Governments, private entities, and individuals should seek to advance these principles by supporting:
:: partnerships, coalitions, and alliances that bring together likeminded governments, including a potential new alliance of free nations
:: public-private partnerships and coalitions that bring together governments, private entities, and other stakeholders
:: international institutions and agencies, including the United Nations, that aim to foster dialogue, cooperation, and shared responsibility between nations

THE TASKS AHEAD
Principles are not self-executing. Working with all who are ready to join us, we will develop a plan of action to implement these principles and advance our common goals.

We call on individuals, institutions, corporations, and governments in our own nations and around the world to advance these principles and create a more effective and responsive set of global rules. Our responsibilities rise commensurate with our influence.

We will advocate for these principles within our own nations, reaching out as broadly as possible to build public support.

We will seek to revise and strengthen the international system to reflect these principles and advance them on the basis of international law.

We will reach out to all nations to seek common ground, enlisting all those willing to help build an adapted international order based on these principles.

We will forge creative solutions to address the just claims of nations underrepresented in the current system, the needs of those left behind in our societies, and the impact of revolutionary technology so that it becomes an agent of sustainable development and positive, rather than destructive, change.

We will establish a standing mechanism to track compliance with these principles and call out those that are seeking to undermine them. We will urge our governments to act when these principles are violated.

We will stand firm behind our principles and work together to advance freedom, prosperity, justice, security and peace for all nations.

SIGNATORIES
Co-Chairs
Madeleine Albright, former secretary of state, United States
Carl Bildt, former prime minister, Sweden
Stephen Hadley, former national security advisor, United States
Yoriko Kawaguchi, former minister of foreign affairs, Japan
[Other signatories at title link]

Legal Rights – Employment

Women, Business and the Law 2019: A Decade of Reform
World Bank, 2019 :: 36 pages
PDF: https://openknowledge.worldbank.org/bitstream/handle/10986/31327/WBL2019.pdf
Overview
Much improvement has occurred over the past decade, especially in Sub-Saharan Africa where the pace of reform is increasing, but persistent gaps remain. However, in the Middle East and North Africa, the pace of reform is occurring so slowly that the legal gender gap is only increasing as other regions reform at a faster pace.
This study develops new insight into how women’s employment and entrepreneurship are affected by legal gender discrimination, and in turn how this affects economic outcomes such as women’s participation in the labor market. The ten-year timeseries shines a light on the size of the legal gender gap, how quickly it is closing and where there are regional patterns of reform.
By laying a roadmap for progress over time and identifying potential areas for reform, this study both celebrates the progress that has been achieved and emphasizes the work that remains. To build on this work, the timeseries developed here will be extended in order to further research on the interaction between inequality of opportunity for women and labor market dynamics.

.

Press Release
Despite Gains, Women Face Setbacks in Legal Rights Affecting Work
Reforms have improved women’s economic inclusion but gaps remain, ten-year study shows
WASHINGTON, February 27, 2019— Globally, women are accorded only three-quarters of the legal rights that men enjoy according to a new index released by the World Bank today, constraining their ability to get jobs or start businesses and make economic decisions that are best for them and their families.

“If women have equal opportunities to reach their full potential, the world would not only be fairer, it would be more prosperous as well,” said World Bank Group Interim President Kristalina Georgieva. “Change is happening, but not fast enough, and 2.7 billion women are still legally barred from having the same choice of jobs as men. It is paramount that we remove the barriers that hold women back, and with this report we aim to demonstrate that reforms are possible, and to accelerate change.”

The index, introduced in the study Women, Business and the Law 2019: A Decade of Reform, looks at milestones in a woman’s working life, from starting a job through to getting a pension, and legal protections associated with each of these stages. The data spans a ten-year period where 187 countries are scored according to eight indicators.

Achieving gender equality is not a short-term process, requiring strong political will and a concerted effort by governments, civil society, international organizations among others, but legal and regulatory reforms can play a foundational role as an important first step.

Progress over the last ten years in the areas measured by the index has been significant. During this time, the global average has risen from 70 to 75. 131 economies have made 274 reforms to laws and regulations that improve women’s economic inclusion. 35 countries implemented legal protections against sexual harassment at work, protecting nearly two billion more women than a decade ago. 22 economies removed restrictions on women’s work, reducing the likelihood that women are kept out of working in certain sectors of the economy. And 13 economies introduced laws mandating equal remuneration for work of equal value.

Six economies – Belgium, Denmark, France, Latvia, Luxembourg, and Sweden – now hold perfect scores of 100, meaning they give women and men equal legal rights in the measured areas. A decade ago, no economy could make that claim. Under this index, economies that conducted reforms experienced bigger increases in the percentage of women working overall, leading to women’s economic empowerment.

Despite these efforts, women in many parts of the world still face discriminatory laws and regulations at every point in their working life. Fifty-six countries – spanning all regions and income levels – enacted no reforms at all to improve women’s equality of opportunity over the ten-year period. The pace of reform was the slowest in the category of managing assets – examining gender differences in property rights.

The study develops new insight into how women’s employment and entrepreneurship are affected by legal discrimination, and in turn how this affects economic outcomes such as women’s participation in the labor market. The new index aims to lay a roadmap for progress over time and identify potential areas where more work is needed, to inspire reforms that benefit gender equality…

Emergencies

POLIO
Public Health Emergency of International Concern (PHEIC)
Polio this week as of 27 February 2019
:: The Global Commission for Certification of the Eradication is convening this week in Geneva. The outcomes of the previous meeting are available are available here. The GCC oversees the certification process for polio eradication and most recently met in Amman, Jordan in October 2018.
:: A delegation of Korea International Cooperation Agency (KOICA) visiting the WHO Regional Office for Africa in Brazzaville received a first-hand demonstration of the “real-time” surveillance system for polio monitoring in Africa. Strong and timely disease surveillance is the key for rapid outbreak response. The Republic of Korea is a key partner in strengthening eradication efforts. Read more here.

Summary of new viruses this week:
::  Afghanistan— one wild poliovirus type 1 (WPV1)-positive environmental sample;
:: Pakistan – five WPV1-positive environmental samples;
:: Mozambique— one circulating vaccine-derived poliovirus type 2 (cVDPV2) from a contact;
:: Nigeria— two cVDPV2-positive environmental samples and 8 cVDPV2 isolates from healthy contacts

::::::
Statement of the Twentieth IHR Emergency Committee
1 March 2019
[Excerpt]
Conclusion
The Committee unanimously agreed that the risk of international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC) and recommended the extension of Temporary Recommendations for a further three months. The Committee considered the following factors in reaching this conclusion:
:: Rising number of WPV1 cases:  Although the declaration of the PHEIC and issuance of Temporary Recommendations has reduced the risk of international spread of WPV, progress is fragile, and should international spread now occur, the impact on WPV eradication would be even more grave in terms of delaying certification and prolonging requirements for dedicated human and financial resources in support of the eradication effort.  The increasing cases in Afghanistan and Pakistan with associated cross border spread of WPV1 continuing between the two countries as well as the widespread geographic detection through environmental sampling of the virus in Pakistan heighten concerns, especially as cases have increased during the current low season
:: Complacency: There is a risk of global complacency as the numbers of WPV cases remains low and eradication becomes a tangible reality, and a concern that removal of the PHEIC now could contribute to greater complacency.
:: Rising number of cVDPV outbreaks: Many countries remain vulnerable to WPV importation.  Gaps in population immunity in several key high-risk areas is evidenced by the current number of cVDPV outbreaks of all serotypes, which only emerge and circulate when polio population immunity is low as a result of deficient routine immunization programs.  Currently four WHO Regions are managing polio outbreaks.
:: International spread of cVDPV: The international spread of cVDPV2 affecting Somalia and Kenya, and Nigeria and Niger, are other examples of the current heightened risk of international spread of polioviruses.  Waning population immunity to type 2 polioviruses in the face of the limited IPV supply and weak routine immunization in many countries means that significant numbers of countries neighboring these outbreaks may be at high risk of importation of cVDPV2.
:: Weak routine immunization: Many countries have weak immunization systems that can be further impacted by various humanitarian emergencies, and the number of countries in which immunization systems have been weakened or disrupted by conflict and complex emergencies poses a growing risk, leaving populations in these fragile states vulnerable to outbreaks of polio.
:: Surveillance gaps: The appearance of highly diverged VDPVs in Somalia and Indonesia are examples of inadequate polio surveillance, heightening concerns that transmission could be missed in various countries.  Similar gaps exist in Lake Chad countries and around the Horn of Africa.
:: Protracted outbreaks: The difficulty in rapidly controlling VDPV outbreaks in Nigeria and DR Congo was another risk.
:: Lack of access: Inaccessibility continues to be a major risk, particularly in several countries currently infected with WPV or cVDPV, i.e. Afghanistan, Nigeria, Niger and Somalia, which all have sizable populations that have been unreached with polio vaccine for prolonged periods.
:: Population movement: The risk is amplified by population movement, whether for family, social, economic or cultural reasons, or in the context of populations displaced by insecurity and returning refugees. There is a need for international coordination to address these risks.  A regional approach and strong cross­border cooperation is required to respond to these risks, as much international spread of polio occurs over land borders…

…Additional considerations

The world is at a critical point in polio eradication. Failure to boost population immunity through strengthening routine immunization, and failure to prevent outbreaks through implementation of high quality SIAs in areas of known high risk, could jeopardize or severely delay polio eradication.  The current situation calls for unabated efforts and use of every tool available, to achieve the goal in these most challenging countries.  Particularly in the three remaining endemic countries, further engagement with senior levels of government and other key stakeholders is needed to advocate for polio eradication, and ensure all levels of government maintain a strong commitment until the job is done.

Noting the spread of polioviruses in several areas close to international borders, the committee strongly urges that surveillance, population immunity assessments and outbreak preparedness activities intensify in all neighboring countries, particularly in Benin, Malawi, Ethiopia, South Sudan, Djibouti, Lake Chad basin countries and the Central African Republic.  There needs to be a renewed urgency to addressing these gaps wherever they exist.

Countries using mOPV2 should take great care in accounting for all vials of the vaccine, to avoid unauthorized and inappropriate use outside a globally agreed SIA campaign.
Based on the current situation regarding WPV1 and cVDPV, and the reports provided by Afghanistan, Indonesia, Mozambique, Nigeria, Niger, Pakistan and Papua New Guinea, the Director-General accepted the Committee’s assessment and on 28 February 2019 determined that the situation relating to poliovirus continues to constitute a PHEIC, with respect to WPV1 and cVDPV…

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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 2 Mar 2019]
Democratic Republic of the Congo
:: 30: Situation report on the Ebola outbreak in North Kivu  26 February 2019
:: DONS – Ebola virus disease – Democratic Republic of the Congo  28 February 2019

Syrian Arab Republic
:: WHO concerned over critical health situation in Al-Hol camp, Al-Hasakeh  26 February 2019,
Damascus, Syria – WHO-supported medical teams working round the clock at Al-Hol camp to provide health care services to new arrivals from rural Deir–ez-Zor.

Yemen
:: Remarks at the Yemen High-Level Pledging Conference – WHO  Geneva, Switzerland
26 February 2019  Dr Mike Ryan, ADG, Emergency Preparedness and Response, WHO

Bangladesh – Rohingya crisis – 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  

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WHO Grade 2 Emergencies  [to 2 Mar 2019]
Iraq
:: WHO condemns violence against health workers in Iraq
Baghdad, 26 February 2019 – The World Health Organization (WHO) strongly condemns the recent attack on a medical practitioner who was physically assaulted while providing medical care to a critically ill 70-year old female in Azadi Teaching Hospital in the Kirkuk governorate on 18 February 2019.
“WHO calls on the authorities in Iraq to ensure the safety of health workers, health facilities, and the sanctity of health care,” said Dr Adham Rashad Ismail, acting WHO Representative in Iraq. “Such attacks constitute a serious violation of international humanitarian law and deprive the most vulnerable population of children, women and the elderly of their right to essential health services,” he added…

occupied Palestinian territory 

:: WHO Regional Director for the Eastern Mediterranean calls for respecting the right to health of all Palestinians and protection for health care
27 February 2019, oPt – Concluding a three-day visit to the occupied Palestinian territory (oPt), Dr Ahmed Al-Mandhari, WHO Regional Director for the Eastern Mediterranean, called for ensuring regular and reliable access to health for all Palestinians and respect for the sanctity of health care.
During his visit, the Regional Director met with Prime Minister Dr Rami Hamdallah for a discussion on the importance of achieving universal health coverage, and reiterated WHO’s support to ongoing efforts to improve the health and well-being of all Palestinians.
In his meeting with Minister of Health Dr Jawad Awad, the Regional Director commended the progress made to improve health services that best meet people’s needs, noting that WHO will continue to work closely with the Ministry of Health to strengthen the Palestinian health system and respond to humanitarian health needs.
   The Regional Director underlined that the recently enforced restrictions on vaccine imports to the oPt might, if not resolved, jeopardize sustainability of the highly successful immunization programme and pose a serious health security threat, not only to the West Bank and Gaza, but also to neighbouring countries…

Brazil (in Portugese) – 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
Hurricane Irma and Maria in the Caribbean – No new digest announcements identified
Libya – No new digest announcements identified
MERS-CoV – No new digest announcements identified
Niger – No new digest announcements identified
Sao Tome and Principe Necrotizing Cellulitis (2017) – No new digest announcements identified
Sudan – No new digest announcements identified
Ukraine – No new digest announcements identified
Zimbabwe – No new digest announcements identified

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WHO Grade 1 Emergencies  [to 2 Mar 2019]
Afghanistan
Chad
Indonesia – Sulawesi earthquake 2018
Kenya
Lao People’s Democratic Republic
Mali
Namibia – viral hepatitis
Peru
Philippines – Tyhpoon Mangkhut
Tanzania

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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

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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.
Ethiopia  – No new digest announcements identified
Somalia  – No new digest announcements identified

The Sentinel

Human Rights Action :: Humanitarian Response :: Health :: Education :: Heritage Stewardship ::
Sustainable Development
__________________________________________________
Week ending 23 February 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 23 Feb 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]

Venezuela – Exodus

Venezuelan Outflow Continues Unabated, Population Abroad Now Stands at 3.4 Million
Joint Announcement Posted: 02/22/19
Geneva – The number of refugees and migrants from Venezuela worldwide now stands at 3.4 million, UNHCR, the UN Refugee Agency, and IOM, the International Organization for Migration, announced today.

According to data from national immigration authorities and other sources, countries in Latin America and the Caribbean are hosting an estimated 2.7 million Venezuelans, while other regions account for the rest.

On average, during 2018, an estimated 5,000 people left Venezuela every day in search of protection or a better life.

Colombia hosts the highest number of refugees and migrants from Venezuela, with over 1.1 million. It is followed by Peru, with 506,000; Chile, 288,000; Ecuador, 221,000; Argentina, 130,000; and Brazil, 96,000. Mexico and countries in Central America and the Caribbean are also hosting significant numbers of refugees and migrants from Venezuela.

“The countries of the region have shown tremendous solidarity with refugees and migrants from Venezuela, and implemented resourceful solutions to help them. But these figures underscore the strain on host communities and the continued need for support from the international community, at a time when the world’s attention is on political developments inside Venezuela,” said Eduardo Stein, joint UNHCR-IOM Special Representative for Venezuelan refugees and migrants.

Latin American countries have granted some 1.3 million residence permits and other forms of regular status to Venezuelans and reinforced their asylum systems in order to process an unprecedented number of asylum applications. Since 2014, over 390,000 asylum claims have been lodged by Venezuelans, over 232,000 in 2018 alone.

With rising numbers, the needs of refugees and migrants from Venezuela and the communities hosting them continue to increase. Governments in the region have strengthened their national response and are cooperating – through the Quito process – to enhance the assistance and protection of Venezuelan nationals and facilitate their legal, social and economic inclusion. The next regional meeting of this process will take place in Quito in the first week of April.

To complement these efforts, a humanitarian Regional Refugee and Migrant Response Plan (RMRP) for refugees and migrants from Venezuela was launched last December, targeting 2.2 million Venezuelans and 500,000 people in host communities in 16 countries.

Yemen

Nationwide measles and rubella immunization campaign reaches 11.6 million children in Yemen
21 February 2019 – In collaboration with local health authorities, WHO and UNICEF have concluded a nationwide measles and rubella vaccination campaign in Yemen reaching more than 11.6 million (90%) children aged 6 months–16 years across the country.

WHO, with the support of Saudi Arabia, United Arab Emirates, Kuwait and Gavi, the Vaccine Alliance, contributed to the campaign through the provision of vaccines, fuel, training, deployment of health workers and supervisors, as well as raising awareness among communities about ways to protect themselves against these diseases.

Dhamar, Mareb and Sana’a governorates have reported over 100% coverage due to a large number of internally displaced persons coming from other governorates. The campaign continued for an additional 3 days in districts where low coverage was reported.

Despite the challenging conditions, WHO teams and health workers were able to reach high-risk areas, IDP camps and marginalized communities with awareness-raising activities and vaccination.

Development :: World Youth Report

WORLD YOUTH REPORT: YOUTH AND THE 2030 AGENDA FOR SUSTAINABLE DEVELOPMENT
UNITED NATIONS DEPARTMENT OF ECONOMIC AND SOCIAL AFFAIRS
2018 :: 252 pages ISBN: 978-92-1-130349-0 eISBN: 978-92-1-363256-7

THE ROLE OF YOUTH IN ADAPTING THE 2030 AGENDA FOR SUSTAINABLE DEVELOPMENT TO NATIONAL AND LOCAL CONTEXTS
Institutional and structural synergies and integration at the local and national levels are essential for meeting the objectives embodied in the 2030 Agenda. Achievement of the Sustainable Development Goals will require working not only horizontally across policy sectors and 4 The priority areas are education, employment, hunger and poverty, health, environment, substance abuse, juvenile justice,
leisure-time activities, girls and young women, full and effective participation of youth in the life of society and in decision-making, globalization, information and communication technologies, HIV/AIDS, armed conflict, and intergenerational issues…

STRUCTURE OF THE REPORT
The Report comprises six substantive chapters:

Chapter I provides an overview of global youth population trends and their implications, the role of youth in relation to the 2030 Agenda, and how youth are referenced in the 2030 Agenda and the Addis Ababa Action Agenda.

Chapter II explores the area of youth education, outlining opportunities and challenges for young people and policymakers. The chapter details aspects of the Sustainable Development Goals that pertain to education—with particular emphasis on Goal 4 (quality education)—and examines related targets. This chapter also explores the multidimensional issues surrounding education and how they impact youth, with special attention given to disparities in education; the rights-based approach to education; education challenges for young women, youth with disabilities, migrant youth and youth
affected by conflict; entrepreneurship education; and financing education.

Chapter III explores the area of youth employment, highlighting development challenges and opportunities for young people and policymakers. The chapter focuses on aspects of the Sustainable Development Goals pertaining to employment, looking specifically at Goal 8 (decent work and economic growth), and examines the relevant targets. This chapter also explores global and regional
trends and priorities such as underemployment, formal versus informal work, entrepreneurship, and disguised employment; it further considers employment challenges specific to youth living in poverty, youth with disabilities, young women, youth in conflict and post-conflict settings, and young migrants.

Chapter IV explores the nexus between the youth education and employment issues addressed in chapters II and III. It specifically examines those areas in the context of the transition from school to work, providing a set of case studies on skills development targeting marginalized and vulnerable youth. It also explores the human development approach to youth education and employment.

Chapter V examines the key elements of youth policies and their role in advancing youth development objectives in the context of the 2030 Agenda. Special emphasis is given to the importance of accurate, timely and high-quality age-disaggregated data for the development of evidence-based youth policymaking. The chapter considers how enhanced efforts to ensure the collection of such data, including data on marginalized and vulnerable youth, can be undertaken through statistical and data system capacity-building, public-private partnerships, and support for youth-led data collection and use. It also addresses issues related to defining and interpreting indicators, and provides an in-depth analysis of indicators associated with both the Sustainable Development Goals and the World Programme of Action for Youth.

Chapter VI moves to the concrete aspects of implementing the 2030 Agenda, analysing the role young people have and can play at the local and national levels. It sets out a series of principles to help guide such engagement, while highlighting, including through case studies, the many ways young people are contributing to the implementation and monitoring of the 2030 Agenda through engagement in awareness-raising, policymaking and data collection, as well as through participation in national and international review processes.

A concluding chapter summarizes and synthesizes the key messages put forward in the Report. A statistical annex presents the most recent data available on the 90 youth-related indicators for the Sustainable Development Goals and the 34 core indicators for the World Programme of Action for Youth.

.

Press Release
World Youth Report: Addressing the complex challenges facing young people today
20 February 2019, New York
Today, there are 1.2 billion young people aged 15 to 24 years, accounting for 16 per cent of the global population. The active engagement of youth in sustainable development efforts is central to achieving sustainable, inclusive and stable societies by the target date, and to averting the worst threats and challenges to sustainable development, including the impacts of climate change, unemployment, poverty, gender inequality, conflict, and migration…

In education, 142 million youth of upper secondary age are out of school. In employment, 71 million young people are unemployed; and millions more are in precarious or informal work. Disparities within and between countries in education and employment among youth are stark, with gender, poverty, rurality, disability, and migrant/refugee status all being major elements of disadvantage. For instance, about 156 million youth in low- and middle-income countries are working poor (ILO), while almost 30 per cent of the poorest 12- to 14-year old have never attended school…

Health :: Labor :: Environment

US$180m programme launched on mining sector
New $180-million Global Environment Facility programme will improve health conditions for artisanal miners across eight countries, while slashing mercury emissions harmful to the environment

The artisanal and small-scale gold mining (ASGM) sector accounts for 20 per cent of the world’s annual gold production;

As many as 15 million people work in the ASGM sector globally – including 4.5 million women and over 600,000 children;

The ASGM sector is the single largest source of man-made mercury emissions, responsible for the release of as much as 1,000 tonnes of mercury to the atmosphere annually, which represents nearly 40% of the total emissions.

London, 18 Feb 2019 – Urgent action is needed to protect millions of men, women and children exposed to toxic levels of mercury through gold production every year, according to the supporters of a new $180-million programme to reform the artisanal and small-scale mining (ASGM) sector.
Launched today at London’s Goldsmiths’ Centre, the Global Environment Facility (GEF) supported Global Opportunities for the Long-term Development of the ASGM Sector (GEF GOLD) programme aims to reduce the use of mercury in artisanal gold mining and introduce and facilitate access to mercury-free extraction methods, while also working with governments to formalize the sector, promote miners’ rights, safety and their access to markets.

Spanning eight countries the five-year programme is a partnership between the Global Environment Facility, the United Nations Development Programme, the United Nations Environment Programme, the United Nations Industrial Development Organization, Conservation International and the governments of Burkina Faso, Colombia, Guyana, Indonesia, Kenya, Mongolia, the Philippines and Peru.

“From smartphones to wedding rings, gold passes through all of our hands every day. But for most of us the source of that gold, and its real cost, remains a mystery,” said Gustavo Fonseca, GEF Director of Programs. “Introducing safe, mercury-free technologies into the ASGM sector will help provide a safe transition to job formality and dignified work for millions, while putting an end to the environmental impacts that can pave way to sustainably produced gold.”

Every year, more than 2,700 tonnes of gold is mined around the world. Twenty percent of that – over 500 tonnes annually is produced by artisanal and small-scale miners. These miners and processors— majority of them in developing countries often work in harsh conditions, without the protection of industry regulations on pay, health or safety, in order to sate the global hunger for gold—investment in jewellery and consumer products.

While ASGM represents a development opportunity for rural populations, who often have few livelihood alternatives, miners operate on the edges of legality in many countries, with ASGM either banned outright or limited by legislation and licensing procedures designed primarily for large-scale operations.

By supporting the regulatory and policy reforms needed to formalize the work of artisanal and small-scale miners across the eight programme countries, GEF GOLD aims to secure miners’ livelihoods, through opening up the access to markets and finance needed to increase incomes and enable the uptake of mercury-free technology. By phasing out mercury use, the programme aims to achieve eventual mercury emission reductions of 369 tonnes, supporting countries’ commitments under the Minamata Convention on Mercury to reduce and, where feasible, eliminate mercury use in the sector…

Heritage Stewardship

Sites in Iran, Morocco and Spain recognized as important for the world’s agricultural heritage
21 December 2018, Rome – A traditional saffron cultivation system in Iran, an argan-based agro-pastoral system in Morocco, and an ancient olive trees system in Spain today won recognition from FAO as Globally Important Agricultural Heritage Systems (GIAHS).

All the sites feature unique ways to produce nutritious foods and/or spices using traditional knowledge and skills while improving local people’s livelihoods and preserving biodiversity.

The sites were designated by the GIAHS Scientific Advisory Group based on selection criteria, including: global importance, their value as a public good in terms of supporting food and livelihood security, agro-biodiversity, knowledge systems, adapted technologies, cultures, and outstanding landscapes.

…FAO’s global agricultural heritage network now consists of 57 remarkable landscapes in 21 countries around the globe.

Saffron Farming System based on Qanat irrigation in Gonabad, Iran
The Saffron Farming System is located in Iran’s central plateau that has an arid and semi-arid climate. Severe water shortages in the area pose major threats to food security and livelihoods of local communities.

However, proper use of water resources supplied by the Qanat (or aquaduct) irrigation system and production of high value added products, especially saffron, have created a unique opportunity for farmers and residents of the region to improve their livelihoods.

Saffron does not require large quantities of water compared to cereals, which has resulted in allocation of more areas for the cultivation of this invaluable crop making it a major source of income for many farmer households. Today it plays a key role in creating job opportunities, reducing migration, providing sustainable livelihoods, improving efficiency in water use and productivity as well as developing eco-tourism in the area.

Ancient Olive Trees Agricultural System “Territorio Sénia”, Spain
“Territorio Sénia” is located at the meeting point between the areas of the Valencian Community, Catalonia and Aragon. This territory includes 27 municipalities which are linked by their geography, their history, their language and their culture and also have the highest concentration of ancient olive trees in the world.

The existence of 5,000 ancient olive trees is what makes this territory a unique place offering local communities numerous opportunities for rural development, including the recovery of abandoned ancient olive trees and utilizing these for production, a bigger cooperation between economic sectors, production of olive oil, oleotourism and many others. Average annual output of olive oil in the area is estimated at more than 12,000 tonnes. These income generating activities have significantly helped to improve the living conditions of local people. In addition, there are different varieties of olives on each farm, to improve the pollination of flowers and future varieties of olives, contributing to biodiversity.

Argan-based agro-pastoral system in Ait Souab-Ait Mansour Region, Morocco
The agro-forestry-pastoral system in Ait Souab-Ait Mansour is a unique region where argan trees have been cultivated for centuries. This system is based on agroforestry practices in dry stone terraces being highly resilient to arid environment, water scarcity and poor soils. It uses only locally adapted species and pastoralism activities and relies on a traditional water management provided by the Matifiya – a rain water reservoir carved into rock.

The Amazigh indigenous communities as well as communities of Arab origin have developed a specific culture and identity sharing their traditional knowledge and skills. Although farmers earn the majority of their income from the cultivation of argan trees, the integrated system also provides them with other food and material such as staple crops, cereals, fire wood, meat and wool.

Featured Journal Content

Child Care, Health and Development
Volume 45, Issue 2 Pages: 147-311 March 2019
https://onlinelibrary.wiley.com/toc/13652214/current
REVIEW ARTICLES
Prevention of psychological distress and promotion of resilience amongst unaccompanied refugee minors in resettlement countries
Ritu Mitra, Matthew Hodes
Pages: 198-215
First Published: 20 January 2019
Abstract
Aim
As increasing numbers of unaccompanied refugee minors (URMs) are arriving in Europe, there is a need to investigate which factors promote psychological resilience and improve their mental health. This review aims to identify preventive post settlement influences, including living arrangements, access to mental health services, and effective treatments that may improve mental health outcomes.
Methods
A systematic literature review was conducted of published papers in any language for children (<18 years) entering a host country, unaccompanied and seeking asylum. Specific studies were eligible if they examined any treatment or nontreatment influences on mental health or psychological resilience for the URM. Thirteen published quantitative studies were identified.
Results
URMs in more supportive living arrangements including foster care had lower risk of PTSD and lower depressive symptoms compared with those in semi‐independent care arrangements. URMs living in reception settings that restricted freedom had more anxiety symptoms. Regarding help seeking, one study found only 30% of URMs had foster parents or guardians who could detect a mental health need. Two papers found the URMs had low levels of contact with mental health services despite the high prevalence of psychiatric symptoms. URMs were less likely than accompanied children to receive trauma‐focused interventions, cognitive therapy, or even practical assistance with basic social needs.
With regard to treatment evaluation, only case series were identified. Three studies found cognitive behavioural therapy improved PTSD symptoms and mental health outcomes. A less structured approach (mental health counselling alone) did not improve functional health outcomes.
Conclusion
Higher support living arrangements with low restrictions are associated with lower psychological distress. Most URMs are not receiving psychological interventions, and there is a dearth of studies evaluating treatment effectiveness for this group. There is an urgent need for more research to investigate pathways to mental health services and treatment efficacy in this vulnerable group.

Featured Journal Content

Science
22 February 2019 Vol 363, Issue 6429
http://www.sciencemag.org/current.dtl
Policy Forum
Regulation of predictive analytics in medicine
By Ravi B. Parikh, Ziad Obermeyer, Amol S. Navathe
Science22 Feb 2019 : 810-812 Restricted Access
Algorithms must meet regulatory standards of clinical benefit
Summary
Artificial intelligence (AI) and increased computing power have long held the promise of improving prediction and prognostication in health care (1). Now, use of predictive analytics and AI in medicine, though with fits and starts, is transitioning from hype to reality: Several commercial algorithms have received regulatory approval for broad clinical use. But the barrier for entry of new advanced algorithms has been low. To unlock the potential of advanced analytics while protecting patient safety, regulatory and professional bodies should ensure that advanced algorithms meet accepted standards of clinical benefit, just as they do for clinical therapeutics and predictive biomarkers. External validation and prospective testing of advanced algorithms are clearly needed (2), but recent regulatory clearances raise concerns over the rigor of this process. Given these concerns, we propose five standards to guide regulation of devices based on predictive analytics and AI. Although well-established research standards, such as the TRIPOD Checklist, exist for developing and validating multivariable prediction models in medicine (3), our standards provide regulatory guidance for such algorithms prior to implementation in clinical settings.